Good Conversation Means Good Listening

As a psychologist who treats socially anxious patients with CBT, one of the behavioral skills I put in the treatment plan is meeting new people.  Or, getting closer to someone we kind of know but don't know well enough to invite for an outing.  How do we go from meeting someone new at a BBQ or from a conversation at the copy machine or from chatting on Google hangouts to the point where we can call that person a friend?

In a word: conversation.  Or more accurately, listening, according to Celeste Headlee in her TED Talk: 10 ways to have a better conversation.

Don't have the time to watch her 12 minute talk?  You can read her full transcript, here.

Or, in an even bigger hurry?  I've listed her ten rules of thumb for better conversation below:

1. Attend.  Give your full attention.  Don't multitask.  Look in their eyes, not at your watch or that cute boy who walked by.  And absolutely, do not glance at your cell phone.  If your text notification goes off?  Unless it's from your mother's surgeon, ignore.  Better yet, say excuse me while I mute this.  I want to hear what you're saying.   

2. Set yourself aside, in the words of Road Less Traveled author Dr. Scott Peck. Don't pontificate. Don't lecture. Refrain from sharing your opinion (no matter how well researched it is).  Assume you have something to learn. In Celeste's words, Everyone is an expert in something.

3. Use open-ended questions, like journalists do.  Start your questions with Who, What, When, Where, Why or How. (Here I will violate Rule #2 and interject my well researched opinion:  skip the Why questions:  They tend to sound accusing or judgmental.)  Try asking your new acquaintance, "What was that like?" "How did that feel?" "So what did you think at that point?"  "How did you know to do that?"

4. Go with the flow. When an opinion or reply comes into your mind, ignore and listen for a little bit longer. Stay focused on their story.

5. If you don't know, say that you don't know. We all like to be the expert on something.  And so does the person you are trying to friend.

6. Assume their story is unique.  Because it is.  How they felt when their favorite sports team won the tournament is not the same as how you felt when your team won. In Celeste's words,  Don't equate your experience with theirs.

7. Try not to repeat yourself. Don't be boring. Resist the impulse to say, for the third time, that witty remark you made to your cubicle neighbor.

8. Keep to the basic plot of your story.  Stay out of the weeds. You don't need to remember the specific dates, names, street names of that excellent Taco house you like to visit.  Your listener cares about you and how you felt.

9.  Listen. As Epictetus said, “We have two ears and one mouth." Use them accordingly. Who is Epictetus?  It doesn't matter. (Refer to Rule #8).

10. Be brief.

And with that?  I will briefly end this post.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas  

Say No To Drugs - What Helps for Depression

It is more and more common for clients to tell me they want to work on their mental health symptoms without the use of medications, especially in light of recent findings questioning the efficacy of several commonly prescribed antidepressants.  I like to support the goal of avoiding psychotropic medications in some situations.  While it is true that some disorders typically require medication (bipolar disorder, schizophrenia), especially those where the symptoms have reached severe levels (persistent suicidal thoughts, planning or intent), it is often a welcome sign that a person is interested in doing all they can, on their own, to feel better. 

So when I read this review on PsychCentral, written by Therese Borchard, I wanted to share a summary here for those of you who want to know what are some of the most effective ways to manage your depression without medication.  Although, I want to add, these are excellent suggestions for people taking medications as well.

Six Steps for Beating Depression

From 
“The Depression Cure: 6-Step Program to Beat Depression without Drugs,”

by Stephen Ilardi

1. Omega-3 Fatty Acids   Seafood, oils (flaxseed oil -unheated; canola or soybean oil for cooking), beans (kidney, pinto, mungo), nuts, seeds, spinach, winter squash, broccoli, cauliflower, dietary supplements (fish oil, flaxseed oil).



2. Engaged Activity  keeps us from ruminating, and ruminating causes depression.
Socializing, reading, hobbies, creating art, exercise of all kinds.


3. Physical Exercise    Research suggests 30 minutes  of brisk walking three times a week can be as effective as some medications AND exercisers are less likely to become depressed again later.    

Activities such as walking, biking, jogging, and weight lifting.  Exercise changes the brain. It increases the activity level of important brain chemicals such as dopamine and serotonin and a key growth hormone called BDNF. Because levels of this hormone plummet in depression, some parts of the brain start to shrink over time, and learning and memory are impaired. But exercise reverses this trend, protecting the brain in a way nothing else can.


4. Sunlight Exposure Important for keeping the body’s internal clock working properly. Without light exposure, the body clock gets out of sync, throwing off important circadian rhythms that regulate energy, sleep, appetite, and hormone levels. On average – a half hour of sunlight is enough to reset your body clock, even on gray, cloudy days.


5. Social Support   Relationships matter. The more satisfying the connections, the better. Think about ways to increase the number of people in your social network especially those you can confide in.


6. Sleep    Disrupted sleep is one of the most potent triggers of depression, and there’s evidence that most episodes of mood disorder are preceded by at least several weeks of subpar slumber.   Keep a sleep log.  Each morning write the estimated number of hours you slept the night before to include approximately how many times you woke up throughout the night and couldn’t get back to sleep for more than ~ten minutes.  

Must Love Dogs or At Least Want to Walk One

In previous posts I have talked about the challenge of finding friends and how to make small talk once you meet new people. Cultivating healthy friendships and getting social support are often such an integral part of therapy.

Not long ago I read a blog post on the topic, 13 Ways to Make Friends. You can read the full post, here.

There are a few additions in the 13 Ways that I hadn't talked about in my posts so I thought I would mention three of them here.

Volunteering: Not only will you come into contact with other caring, proactive fellow volunteers, but receptive and appreciative individuals at the receiving end of your efforts as well. Research has shown that engaging in meaningful work and activities helps alleviate depression, for example.

In short, good feelings can come from helping others.

I should know.

In my city of Austin, Texas, checking out the Get Involved section on the KUT public radio website is a great way to explore volunteer opportunities.

You might check out the websites of your local radio stations, newspapers, churches, or simply ask around. In addition to finding worthwhile volunteer work, asking someone to share their volunteer experiences is a great way to get someone to open up to you.

Get Cyber-Social: Though not as beneficial as face-to-face interactions, joining internet support groups and social networking sites have been shown to help lift a person's spirits and decrease feelings of loneliness. Sometimes that sense of "not being alone" via online discussion forums and emails can add to one's positive wellbeing. Feeling validated in one's thoughts, opinions, and experiences is described as helpful by many.

Whether you explore medical conditions, mental health issues, books, art, music, energy conservation, the list is virtually endless these days, there's a good chance you can find like-minded individuals who are willing to connect online.

Social networking sites, the ones where you can search and reconnect with old friends scattered far and wide, are seemingly the new wave of staying in touch.

But remember, spending time close up and personal, such as having lunch together, taking a walk, meeting face to face, tends to yield more benefits that limiting your interactions to the electronic screen. And second, when moving from an internet-only relationship to meeting in person, please take precautions and observe safety rules.

Get a Dog: Having completed my doctoral dissertation in the area of the health value of pet ownership, I learned there are many benefits, including lowering blood pressure. Increasing social opportunities is another. For example, I worked with someone who met his girlfriend at a dog park.

Studies have shown that people walking a dog tend to be viewed as more approachable and friendly. It's similar to the baby stroller effect. People are drawn to babies and pets, especially dogs.

I cannot say for sure that walking an iguana, say, would have the same effect, but maybe.

Man Pauses While Walking His Iguana

by Matthew Eastmond

I mean, an iguana is a curiosity and there are those that think iguanas are the cat's meow. But there are others who would run in the opposite direction if they saw a small, horny-backed creature scurrying their way. So factor in the social likeability factor when choosing a pet to parade in public.

Puppies probably rate highest but that doesn't mean you should run out and buy a new puppy when you've already got a dog. The expense and effort of too many pets could backfire.

I recently finished a cute book, Must Love Dogs, where the heroine borrows her brother's dog to meet a man from the personal ads and he, too, shows up with a borrowed dog.

The book was made into a really funny movie of the same title, starring Diane Lane and John Cusack, if you'd rather watch it on your home screen. Laughter is the best medicine, right?

Better yet, watch it with a friend. The two-footed or four-footed variety.

Small Talk, Big Skill

Very often in therapy, building friendships becomes a behavioral goal. Two of my earlier posts talk about finding oneself with too few friends and some general strategies for finding friends. This post will give some suggestions on what to actually talk about once you have found people worth getting to know.

Putting yourself in a situation where you can meet people is an important step in the friend-building process. A next, big step and helpful skill is the art of initiating a conversation. A step many people find very anxiety producing. A step many believe they are no good at. A step many people are too afraid to try. A step the leaves people avoiding social situations altogether.

It may be a comfort to know that many people experience social anxiety and many people report having trouble coming up conversation starters. So it never hurts to remind yourself that you're not the only person who struggles to break the ice and make small talk.

But when two people are standing next to each other, and the idea is to socialize, somebody's got to do it, right? And it may as well be you. Especially if you're motivated because (a) you want more connections in your life and (b) someone has caught your eye.

And you never know, the person you're eyeing could be more shy than you. Could be hoping you talk first. Could welcome an end to the awkwardness. This is when you can take a deep breath and tell yourself that your attempt at small talk might just be appreciated.

There are three main types of small talk that I will cover: (1) Ice Breakers (2) Introductions, and (3) Follow Ups. Today's post will concern itself with Ice Breakers. In a later post, or two, we'll talk about Introductions and Follow Ups.

With Ice Breakers, here are some suggestions to keep in mind:

(1) You're not trying to make a deep connection the first time you meet. You don't need to dazzle or impress. You're just trying to get some conversation, any conversation, started. So keep your opener short and simple.

(2) The less you know the person, the less personal your comment or question. Keep your comments neutral and general. Focus on something around you, not about you.

(3) Likewise, the more conventional your location, the more conventional you will want to keep the conversation topics. Conventional means neutral, common, general, maybe even boring. Don't ruffle feathers. Don't try to be profound. Keep it light and upbeat.

If you are in an edgy nightclub, at a rock concert, or watching performance art, taking risks might work. But in general, it's safer to keep your comments bland. You don't know this person yet, or very well, so you don't want to startle, pry or challenge. You want to keep it comfortable. And the less you know about a person, keeping it bland is the safest bet.

(4) Look for something you have in common with the person you're trying to talk to. You may be wondering, what if I don't know this person very well? How you can I possibly know what we have in common. Well, here's the answer. At a minimum, what you have in common is your location.

So look around you. Whether you're in the same room or standing on the same sidewalk, at a minimum you've got your physical surroundings in common. And always? There's the weather.

Here are some general topics along these lines:

4The weather (again, it works).

4Traffic (everybody hates it).

4The building.

4The club, organization or group that is holding the function.

4The sports team that's on the television above the bar (but only if he is paying attention).

4The music that's playing.

4The people you both know.

4The class you're both taking.

4The store in which you're standing in line.

Here are a few examples of Ice Breakers:

At a house party: "Who do you know here?" Or, "How do you know Jon and Cara?" "Do you know this neighborhood very well?"

At a wedding: "Are you here with the bride or the groom?" "How long have you known her?" "Their vows were so unusual. Do you know if they wrote them?" "I know the bride but not much about the groom. Do you know how they met?"

At a neighborhood barbeque: "Do you live in this neighborhood?" "I can't believe how overcast it is today. I hope it doesn't rain." "I see Donna has put in some new landscaping over there. She's really keeping her yard nice." "It's been ages since I've had barbeque. I definately brought my appetite with me today. How about you? Are you much for beef brisket?"

At a restaurant or nightclub: "Have you eaten here before?" "Did you have to wait long for your glass of wine?" "What do you suggest on the menu?" "Have you tried the sushi here? Is it any good?" "Where do people park in this town? It took me forever to find a place."

If you look back at the Ice Breakers I suggested, they mostly tend to focus the topic of conversation away from the personal, away from the individuals involved. Instead they direct the questions to people and things around them.

When someone doesn't know you very well, they may not be interested in discussing anything very revealing about themselves. So wait a good while before asking questions of a personal nature.

Sometimes the person you approach will respond to your ice breaker in a talkative way. But there's also the chance of a lengthy pause, an awkward silence. So a future post will talk about the next step, conversational Follow-Uppers.

Meanwhile, picture yourself in a recent situation where you wish you had tried to start a conversation. Or you did make an attempt but didn't get very far. And now refer back to my suggestions and see if you can come up with a few Ice Breakers of your own. Practicing in your head, or covert rehearsal in CBT language, is a good way to up your chances of success the next time around.

A few links you might find helpful:

Tips for Starting Conversation with People you Don't know by Laurie Pawlik-Kienlen

The Shy Person's Guide to Conversation by Susie Cortright

Small Talk on the Job

And there are books on the topic:

The Fine Art of Small Talk by Debra Fine

Small Talk: The Art of Socializing by Kathy Schmidt, Louise Jordan, and Marisha Rogers

The Art of Mingling by Jeanne Martinet

Conversationally Speaking by Alan Garner

Painting: The Conversation by Shelley Grund

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist in Austin, Texas

finding friends

In my last post, I talked about being new in a city and the struggle to find friends.

Years ago, I read a research study dealing with social support. It found that the variable most predictive of a friendship developing between any two people was, simply, time spent together. Not common interests, like I guessed. Not same background or religion. Not age. Not level of education.

Greater length of time spent in each other's company was the factor most associated with friendship bonding. Either long periods of time in one space (think weekend workshop or jury duty) or repetitive intervals across time (weekly art class). Time that allows for talking and getting to know each well enough to break down the barriers and move to a point where calling each other for a get together feels acceptable. Safe. And eventually easy.

I wish it were faster. I wish we could attend a party, walk up to someone new and say, "Hi. I overheard your conversation and you seem like someone I could be friends with." But this rarely happens. It might have been this easy in kindergarten. The older we get, though, the longer it usually takes. We grown ups are a leery lot.

Place of employment is a common venue for making friends. We can see the "time spent together" factor at work here. Many of my clients in this friendless predicament report the social scenerio at their jobs is lacking They might have made slight inroads or none. "Everyone is married." Or, "They're all older than me." Or, "They all do the bar hopping scene. I don't like bars." When friends don't arise in the work place, it can lead to looking around and wondering, "Now what?"

Well, here's one idea for the now what. Remember this one goal: Put yourself into situations where you are likely to see the same people again and again.

Visiting a museum one afternoon is not going to cut it. Signing up for a book club where the same people will be meeting week after week might.

What kind of situations? Start with an interest. A hobby. A creative outlet. An athletic pursuit.

What do I like to do? What am I interested in doing that I've never done before? What have I long wanted to try but haven't made the time to do so? Gardening? Creative writing? Volley ball? Woodworking?

Thumb through the newspaper in the local/metro or life section. Check out informal classes or adult education available at nearby colleges. Read over the available class schedules as a way of getting ideas or jogging your memory: photography, landscaping, stained glass, salsa or country western dance, yoga, walking tours, home improvement, bridge, dominoes.

Look for events that meet repeatedly, once/week or every other, where it seems likely you'll see the same faces on a repeat basis. A one-time seminar on a Saturday is better than sitting home and meeting no one. But a class or support group that meets regularly is a better bet for getting in the time needed to develop a friendship.

Some venues encourage interacting, such as team sports, creative writing classes, support groups, walking clubs. Others are more of a solitary pursuit. Avoid the latter. We want to optimize our recreation and volunteer time. Go where the opportunity for getting to know others is made easy.

The beauty of my plan is this: Even if your pursuit doesn't result in friends, let's say you're not interested in anyone who shows up, you are spending time doing something entertaining, challenging, and fun. You might be learning something.

Another benefit? You become more interesting this way. So when you do meet someone who has friendship potential, you're more likely to have something to offer. To be found friendship worthy.

So starting with something you're interested in is one friendship finding avenue. I'll have more to offer in a later post or two.

Feeling Friendless

Lonely Walk Home

by Michael Pickett

Living in a large, popular city, I see quite a few people coping with transition. One of the common requests for an initial appointment will go something like, "I'm new in town," or "I've lived here about a year now," followed by their complaint, typically something to do with depression or anxiety.

Many clients, particularly those beyond their mid-20's, are shocked, at a loss, or somewhat ashamed when they realize they are struggling in the friendship department.

Maybe they were used to making friends easily. Or they remember that reaching out to make friends never was easy but they somehow stumbled into a group of chums.

And now they find themselves feeling friendless. They start to feel the panic rise. How do I do this? Where do I start? What's wrong with me that I haven't found friends yet?

At some point in therapy, it becomes apparent to me that they are struggling to establish friends. It might take us awhile to reach the stage where we decide the client needs to target socializing. It's seldom a problem area people feel comfortable bringing up. People feel awkward admitting their lack of affiliation. The worry about the stigma of appearing friendless. The fear of being judged as a social dud.  

In therapy we explore the client's friendship history. How did they make friends in the past? Did it feel easy or was it a struggle? What types of friendships did they enjoy? Close confidantes or more distant acquaintances? Feel a part of a close knit group or often like an outsider looking in?

We often talk about the ease of making friends in high school and college, in particular. Life surrounded by hundreds or thousands of same-age, similarly situated peers. Mostly single, working part-time jobs, flexible schedules, with a variety of clubs and avenues available to study, exercise and socialize. To make friends. Dorm life is a friendship building tool at the ready. Close to campus apartment living is another. Potential friends all around, within arms reach, even.

Sometimes friends come in a bundle. A sports team. A choir group. A work team. Or we start to date someone and they have a big group of friends. Gradually they become our friends, too. Though not always easily. This wriggling into and feeling accepted by a pre-existing set of friends can feel awkward for many. Especially when those friendships go back to their days in the nursery. It's a situation ripe for feeling odd-person-out.

Which brings me to relationship break-ups and divorce. These are transitions where friendships are often lost. Partners exit and take their friends with them. You see this in a large group of couples. After the break up, maintaining friendships with those remaining in the couples club is a logistical nightmare. Seeing and hearing about The Ex can be too painful. Too close a reminder of what is lost. Learning about their new dating interests. Ouch.

Sometimes the friends appear to take sides. Or they don't know what to do and in their uncertainty, fail to reach out. This can really hurt the person left behind. Loss on top of loss can leave someone with profound self doubt, feeling sad and lonely.

It is well documented in the research literature that socializing on a regular basis is associated with positive physical health and emotional wellbeing. Feeling connected and cared about, laughing and going places together, keeping busy, exercising together, having someone to confide in: These are all benefits of friendships. It is no wonder, then, that finding oneself in a suddenly-friendless situation is associated with the onset or exacerbation of depression, anxiety, or a number of psychological conditions.

So how does one go about finding friends, exactly? Stay tuned. In my next post we'll talk about the goal of meeting new people and making friends.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas