A Case For Doing Less This Holiday Season

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I’m declaring “holiday stress” a national mental health crisis. I just read one of those 5 tips to reduce holiday stress articles, and one suggestion for letting off steam was to go to a private place to scream out all your pent-up rage. Really, Cosmo? This is solid advice for a med student about to take their board exams…but the holidays should never reach this level of stress!

The pressure we put on ourselves to make the holidays magical is massive. For many of us, it comes from a place of caring; let’s make it special for the kids, create memories, carry on a sense of tradition and obligation, impress others, and strive for perfection. The holidays are a people-pleaser’s dream come true and a perfectionist’s worst nightmare.

Manage expectations

I want you to try something. I want you to visualize how you hope your holiday dinner with the family will go. Do you have it? Good. Do you feel all warm and safe, picturing joy and peace, the kids caroling in the snow and the smell of gingerbread wafting through the house? Good news, you’re an optimist.

Or on the other hand, does the thought of the holidays fill you with a sense of dread, worrying about getting it all done in time, how to handle Uncle Bill’s political rants, or the kids throwing tantrums in front of the guests? Well, I guess you’re more of a realist.  

Ada, one of our therapists here at People Bloom once had a client who talked about Thanksgiving going “exactly as planned.” The turkey came out just right, everyone had a great time and no one argued. He was retirement age and that was the first time it has ever happened. Ada’s advice to him was, “You need to mark that on the calendar because that’s not going to be a common occurrence!”

At any rate, regardless of how you visualized your holiday this year, now I want you to erase it! Yes, you heard me; erase the expectation. Things never go quite as we imagine they will. Going into holiday festivities with no expectation, and with no anticipation of the worst will clear your mind of the worries. All you can do is face the next few weeks with an open heart. Have a plan, but be willing to hold onto the plan loosely and do your best. This brings us to the next question: how do you do your best without burning yourself out? 

Managing emotional labor

When it’s time to plan for the holidays, you know that if you don’t do it, it won’t get done. So you take it on yourself to do it all, and do it right.  I know there’s a part of you that enjoys the adrenaline rush, and the thrill of bringing joy and delight to your family. But there’s another part too: the tired part, the part that doesn’t always feel appreciated for going above and beyond, the disappointed part when things often do not turn out as planned.

If you’re running the household, things are busy enough. The holidays take busy to the next level, which can leave you feeling stretched too thin and wondering if it’s worth the effort you tirelessly put in.

Questioning traditions

If the holiday hustle and bustle leaves you tired and worn out, ask yourself…

Who am I doing all this for?
Do these people matter? If it’s distant relatives and acquaintances you only see once a year, can you imagine taking some pressure off yourself to impress?

Why am doing this?
Focus on what makes the holidays meaningful to you. When you really delve deep, it’s not about anything external. The holidays are about faith for some, as well as family time, gratitude and a sense of community. All the consumerism and chaos that go beyond this is societal, self-imposed and likely unnecessary/slightly awful.

What will happen if I DON’T do everything on the list?
So, there will be two pies instead of three, there won’t be a handcrafted wreath on the door, Aunt Gloria won’t get a Christmas card, and the kids won’t get 28 presents each. And everyone will survive. I promise the world won’t end.

Drop unnecessary rituals. I know you always made 17 varieties of toffee brittle to give to every member of the extended family. They treasure it when they receive it, but nothing in the world order is changed if they don’t get their sugar fix. Ask yourself why you feel compelled to do so much for others. Is it because you have boundless energy and it brings you joy? Or is it a sense of obligation? If it’s the latter, you know what to do. Or not to do, in this case.

A relaxed host is a happy host

 If you’re hosting the big dinner, take on what you can and let the rest fall by the wayside. You could tear your hair out making sure every traditional dish makes it to the table, but your guests will be more impressed by a simple meal with a relaxed and happy you than a decadent six-course meal with a stressed out, frantic and exhausted you.

If your holiday dinner is not already a potluck, consider making it a potluck. No, really. And don’t worry if a dish doesn’t get made or there is an uneven and ungodly amount of candied yams. Food is food! For too long we’ve worried ourselves silly balancing out the meal with obsessive precision! Even if things have been that way for years past, who’s to say it has to stay that way for this holiday onward?

No one expects perfection but you. Few people notice the lengths you went to for that perfect cornucopia centerpiece. Being known as the Martha Stewart of the clan just makes people take your attention to detail for granted. If they do notice that you’ve stopped doing something, that is an opportunity for you to explain new traditions and to focus on the things that matter more: relationships.

If you do less, the truth is, the holidays won’t look like they usually do, but the person who notices this most is you, and others will be forgiving - a lack of décor or mismatched silverware is the last thing on their minds.  Who knows, if your holiday guests notice that you are too tired to go the extra mile this year, there’s a good chance they’ll pick up the slack. And even if they don’t - the key is to know that’s ok too.

Asking for help

As the hostess with the mostess, you make it look easy, but gathering everyone together can be overwhelming, even for you. Make your life easier by asking for help.  It doesn’t make you helpless - on the contrary, it’s empowering to assert yourself and request a favor here and there.

You don’t have to do it all. Delegate tasks that others can do. People at family gatherings often feel like lumps on a log - restless and eager to help. Keep them busy with tasks that don’t need you - let them take drink orders, add festive music to the playlist, greet guests at the door and take coats.

Feeling present

When you do less, you notice more. I noticed how much more centered I feel when I can just…be among people who I cherish, without planning, controlling and feeling responsible for their fun. Gathering as a family is hard enough in itself - you already checked the box. You celebrated the holidays. Whatever happens, happens.

So take a little off your plate this year. No, don’t literally take food off your plate. Go ahead and eat that third helping of turkey. And if no one stepped up to cook a turkey - a store bought rotisserie isn’t the worst thing that can happen to your family. You’ll see things turn out just fine even when you let it go.

This holiday season, make this your new mantra: simplicity is key, and good enough is good enough.

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 Karen Lenz is the Executive Assistant at People Bloom Counseling. She’s the office admin whiz - not a therapist. She writes blog posts as a human navigating this world, a client sitting across from a therapist, much like you. She is thankful to get to share her experiences with you, and she’s starting to realize that when things go all wrong at Thanksgiving, that’s part of the fun because it makes a great story to re-tell at every family dinner for generations to come.

Caregivers: Two Factors to Keep in Mind when Caring for a Cancer Patient

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Caring for a loved one going through cancer is taxing. You’re used to seeing this person as strong, independent and capable. For perhaps the first time, they’re physically weak, emotionally shut down and have a hard time pulling themselves up. They’re cranky when they used to be the most patient person in the world. They’re tired, they sleep a lot, they’ve lost weight, gained weight, they don’t want to eat their favorite foods, they can’t do what they used to...

And, worst of all, you can’t make things much better for them.

You try to be there, to help out in whatever way you can, to remind them of how great they’re doing, how much you care… But none of these change the fact that they’re still suffering. You can’t take their exhaustion, their nausea, their discomfort away. You perk up when you catch glimpses of their old self before fatigue takes over and they have to climb back into bed. Seeing cancer suck the life out of them makes you angry and it breaks your heart.

Because the word cancer is often equated with death, aka the ultimate out-of-control experience, there is a tendency to want to take back control. For caregivers, this can come in the form of doing too much or sometimes not enough. As a Medical Family Therapist, I learned that there are two important elements to keep in mind as the caregiver of someone going through a medical crisis like cancer.

Agency

The first is agency, defined as the ability for the patient to make independent and empowering choices about their life. If you’re feeling out-of-control as the caregiver, just imagine how your loved one must be feeling in their body. The last thing you’d want is for them to feel even more powerless over their situation. Provided they’re of sound mind to do so, decisions should be made by them, with them and along side them, rather than for them.

Choose your battles. Both of you are already battling cancer and that’s tiring enough. If they have a preference that’s irritating but nothing more, let them have their way. If they have a strong opinion about how they receive care, express your concerns but respect their wishes. Their life is still theirs even though it’s hard to watch because you want something better for them. They have their reasons for certain choices, even though you might not understand or agree.

Communion 

Aside from agency, a desire for communion, that is, a sense of belonging and being with their community, is also very important. Just because they disagree with you about what supplements to take does not mean you step away from their care all together. They might still need someone to fend for them at the next oncology visit, or you still make great company even though you’re doing nothing more than watching a show together.

Cancer patients often feel very alone, like they’re the only one going through cancer. While they may find that sense of camaraderie at support groups, you’re the one who has been there before cancer and now during cancer. You know they’re more than their cancer and you want to see them through. You’re the one who will love them through all of their changes and still find them beautiful.

Seattle resources

Caring for a cancer patient can be very isolating. It is important for you to pay attention to what you might be needing to sustain care. If you’re a caregiver needing support for yourself, Cancer Lifeline and Cancer Pathways are two wonderful organizations in the Seattle area with support groups for caregivers. There you’ll likely find others who also share your exhaustion, frustration, sadness, pain and guilt around caregiving. There you might also discover your need for communion during this trying time.

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. You can find her at ada@peoplebloomcounseling.com.

Speaking up for Yourself as a Breast Cancer Patient

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October is breast cancer awareness month. While there’s often a lot of noise around screening and prevention, I want to talk about finding your voice when you’re at your oncology appointments. I work with a lot of breast cancer patients who wished they had requested this or asked that question during a medical visit, but it didn’t occur to them until after the fact or they may have felt unsure of themselves. And it’s difficult to broach that topic now that the appointment is over. 

Healthcare is changing

Gone are the days where doctors have all the authority and knowledge and patients come in and are told what’s wrong with them and how to fix it. Granted, I’m not saying don’t trust your medical team; they still have a lot to offer during a time of medical uncertainty. But, with the blessing and curse of search engines, you can easily look up symptoms, possible diagnosis, treatment and side effects, and seek medical consultation to confirm or deny your findings. While this might lead to misdiagnosis or unnecessary anxiety, now more than ever, patients are more likely to present at their doctor’s office looking more like this: “You recommended six rounds of chemo, but a recent study published in the New England Journal of Medicine found that women like me with early-stage breast cancer may not need chemo after all. What’s that about?”

Collaborative healthcare

The field of medicine has been calling it “collaborative healthcare.” As the name suggests, every time you go into your doctor’s office, it is really meant to be a collaboration, a partnership to a healthier you. You’re the one who has been living in your body for the past however many years; you’re the one who knows your medical history or have the means to find out whether there has been a history of cancer on either side of your family.

As a patient, you have something to offer too.

The thing is, when you feel heard, understood and your questions answered, you’re more invested in your treatment, and you’re more likely to follow recommendations that make sense to you. While you might not be thrilled about treatment itself, you can look forward to seeing your medical team because you know they care about you and have your best interest at heart.

Current reality

The reality is that there’s still a power differential between the provider and the patient. Your oncologist did go to med school and further specialized in cancer. Your degree was in business; not oncology. There is a firehose of information shared during appointments and on handouts, not to mention the emotional turmoil of needing to go through treatment. As a cancer patient, you are at a more vulnerable place. Rather than being told you need to jump and how high, this is a crucial time to find your voice and feel empowered about your own care. It is after all your body.

A push for self-advocacy

Because you’re such an important part of the treatment process, I strongly encourage you to advocate for yourself. If you’re not in a place to do so, bring a friend or a family member with you who could. The following are examples of ways to help you find your voice as you interact with your oncology team:

1. Do a little research, if that could help you – Emphasis on “a little”. Google does not replace medical school and decades of experience, but credible websites can help to learn a little about what might be going on with you. I say this with the caveat: for some people, knowledge is power. For others, knowledge is anxiety. Still for the rest, knowledge is power up to a certain extent, then it turns into anxiety. So, do what helps you.

2. Know your rights as a patient – This is the two page handout I call snooze reading. You can pick one up at any healthcare provider’s office and it shows you your rights as a patient seeking medical care. To name a few, you have the right, according to your local health department, to say yes to treatment, to say no to treatment, to change providers, to have access to records, to file a complaint, etc. You have more rights than you know. While you might fear ramifications for some of these actions, the stress of not being in charge of your own care could be worse.

3. Read your reports – It’s a lot of medical terminology, I know. Unless you’re also in the medical field, it can read like french. That’s the beauty of Google, you can search for terms, struggle to know what it really means, then proceed to 3) and 4). I know an oncologist who thanks his patients for reading their reports, because many people don’t.

4. Come with questions – You do have questions, even if you’re afraid of the answers. Your $135 visit with your surgeon is the best time to ask them. I know of a patient who goes to her appointments with her list of 20 questions. And, she brings her partner to catch the answers that goes over her head. Better to ask a silly question than to wish you had asked it after the fact.

5. Ask follow-up questions – Even for the over-prepared, there’s bound to be questions that are left unanswered. Secure message your doctor’s office in between appointments; you don’t have to wait until your next visit, unless your appointment is soon and you’d prefer a face-to-face.

6. Ask yourself, “What do I need or want?” – Being diagnosed and treated for cancer is a very uneasy time. Your world has just been overhauled. It’s okay to ask for what would put you at greater ease. Could a warm robe bring comfort during your next check up? A blanket during your four-hour chemo? Do you want to bring your special stuffed animal to every radiation treatment? Request a certain radio station during your MRI?

7. Ask for what you need or want – As you come upon your preferences along the way, share them. Make it happen. I know someone who asked for a surgical pen so she could go home and mark on her husband. Cancer is hard enough; let’s bring some lightheartedness into the mix.

Cancer has a way of prompting us to re-evaluate life, which could include finding your voice. You’ll never have as much medical attention given you than when you’re in active treatment. While it’s not necessarily the attention you’d like, let it be a time when you can focus on you.

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. She’s a big proponent of standing up to your medical provider, even if it’s uncomfortable in the moment. After all, when you’re already diagnosed and treated for cancer, what do you have to lose? Please take care of you.

Friend, this is how to Support me During a Break-up

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Yes, it sucks and it hurts

First of all, if you’re going through a break-up, my heart aches with you. This absolutely sucks and it can feel like the pain never ends. If you haven’t already, I want you to watch this video. Psychologist Guy Winch talks about what it takes a to mend a broken heart:

I might add that while it’s important for your friends to show you compassion and patience, it’s even more important to be compassionate and patient towards yourself as you recover. The time it takes for you to heal might not be proportional to the length of the relationship. 

Close to home 

As a relative, a friend, a therapist, I’ve witnessed many heartbreaks. Take Tammy, for example, my playmate. We go way back. We have so many inside jokes and recall the silliest stories. We share embarrassing selfies and we’ve seen each other at our best and at our worst. And worse it was when she went through a tumultuous divorce a few years ago. Is her ex coming back? Is he gone for good? There was so much back and forth and “fun” is not the word I’d use to describe this rollercoaster ride.

The thing is, there’s never a good time to break up. Even if it’s for the better, it always sucks. Sometimes it’s easier for the relationship to keep dragging on than it is to be honest about parting ways. Regardless of how your relationship ended, when your friends don’t know what to say, they can say the most insensitive things. Have you ever stopped opening up to a friend because of something they’ve said? You probably didn’t bother correcting them because you’re just trying to stop hemorrhaging.

So what shouldn’t your friends do? Let’s see if this resonates with you. 

What not to do when helping me get through my break-up 

1.    Bad mouth my ex – When I call my ex every name in the book, you want to support me and jump on the bandwagon. I know you mean well because you don’t like seeing me this way. But when I hear those colorful words flying out of your mouth, I’m silently wishing that you’d tone it down. Not only am I managing my own emotional response; I’m also cued into yours. I don’t have the bandwidth for that.

2.    Argue with me when I defend my ex – So there’s a reason why we got together. However long or short it has been, there was something there. If they’re all that terrible, what does that say about me that I chose to be in a relationship with them? This back and forth is a part of the process. Please let me be.

3.    Remind me why we should’ve never gotten together in the first place – This stings. I might already realize this and have mustered up all the courage to break up with that person, let alone tell you. The last thing I’d need to hear is, “Remember when I told you...”

4.    Tell me I’ll find someone better – I’m not saying that’s not true, but not now. I’m still aching over this relationship and I’m not ready for another one. Please; I really can’t think about someone else right now.

5.    Hurry me along – I don’t know why but I feel like I’m never going to get over this person. Every playlist, place, car ride remind me of them. I don’t know how long this is going to take. The last thing I need is for you to get irritated at me because it has been five months and I’m still down and out. Please let me be me when I’m with you.

So, let’s take a break here. Rather than simply telling your friends what they shouldn’t do during your break up, what would you rather they do instead? Would the following help?

What to do when helping me get through my break-up

1.    Listen – I know I’m rambling. I just want to pour my heart out and get things off my chest. You don’t have to agree with me. You don’t even have to side with me. Just give me your best ear and don’t judge me.

2.    Offer a place to stay – Sometimes I just want to get out of my element and have a change of scenery. I wouldn’t mind crashing on your couch for a few nights. Just offer.

3.    Take a break from talking about my ex – That’s all I think about. Perhaps it seems like that’s all I want to talk about. But really, help set some limits around that. Let me go on for an hour and then let’s move onto something else. I need a break from this too.

4.    Keep inviting me out – I still want a life. Whether I’m in a relationship or not doesn’t change that. Yes, it might be hard to see people in pairs but I’m still human. Being in good company helps me heal.

5.    Give me space – I know I sound like I’m contradicting myself, but I’m really not. Sometimes, I don’t want to go out and I just need space to think and process what the hell just happened. If I’m not in the mood, you can probe a little but then check back later if I insist on being alone.

I’m sure this is not an exhaustive list but I really hope this can be a conversation starter. Share this post and add your own pointers. You’re uniquely you and your friends who have never seen you this way simply don’t know how best to support you.

For your recovery, for their understanding, for your friendship, given them somethin’. 

Finally, let us know if the counselors at People Bloom can support you in more ways than 10. We’re not your friends and we can’t thank you enough for them, but as therapists, we have other tools to help you get back on your feet. You know where to find us.

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 Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples and families living with cancer. Her clinician Bob Russell specializes in teens and young professionals. Whatever your challenges, let us know if we can help you!

You Are Not Your Diagnosis

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In my many years of practicing therapy, I have had some clients who feel that what they consider to be their traits, temperament, and preferences - i.e. their personality - is reduced to a diagnosis. Perhaps you identify with and have nurtured these qualities over time, and you take pride in that. Your way of being has helped you navigate the world and has gotten you where you are today. Thus, in addressing these qualities in therapy, you might be concerned that the work we do could radically change you as a person or invalidate your life experiences.

Here’s my short answer: You are not your diagnosis, or even the symptoms of your diagnosis.

My initial meeting with you helps me understand where you’ve been and what you’re struggling with. While a diagnosis is necessary for billing insurance and can be helpful to guide treatment, I see the qualities that you bring into sessions as a condition, and sometimes, as a timestamp of where you’re at, rather than a disorder. There is nothing wrong with you. Some things are just not working as well as you’d like, and you can use some help figuring it all out.

Here’s an analogy:  I once knew a young man who was well over six feet tall. He liked being tall, but he had had a problem hitting his head on low overhanging things like street signs and door frames. Not that I saw him in the office about being tall -- I saw him for something entirely different. He doesn't necessarily have to change being the way he is, as much as hopefully growing to be someone who is more versatile, like learning to duck at times.

My point is: Therapy is often about adjusting to situations, as a practical matter. You don’t have to stop being you; but we can help you do you with more flexibility.

Let me know if I can help!

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Bob Russell is a therapist at People Bloom Counseling, a Redmond psychotherapy practice in WA. He helps teens and their families thrive through the adolescent years. He also helps twenty somethings figure out their place in life. In his 40+ years working in mental health, he’s developed a knack for helping people peel the layers of the onion that make up their identity. Bob can be found at PeopleBloomCounseling.com.

Lone Rangers Need Friends Too: Finding Community in an Increasingly Isolated World

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Making light of loneliness

The only thing I can bring myself to watch lately is comedy shows. My latest fixation is on the Netflix special Getting Coffee in Cars with Comedians, in which Jerry Seinfeld takes comedians out to coffee. When two comedians get together, they commiserate about the state of the world and their fears and insecurities, but always find a way to make it funny.  Comedy shows remind me of the human condition which is this: We all struggle, and we all feel desperately lonely sometimes. This is even when, and perhaps especially when, we have all the fame and money in the world.

I know this sounds depressing, but it’s meant to be reassuring. We are all in this tough world together, so we might as well laugh as a way to cope.

If famous comedians with millions of adoring fans feel this lonely, where does that leave us regular folks?

We have all been there

In her last post, Ada made an appeal for social inclusion, urging readers to reach out to those who may feel excluded. It inspired me to pay attention to people who may not be in my inner circle, but it also reminded me of all the times I have felt excluded.
I was that painfully shy kid in school, so it’s a sensitive topic. It’s been 20 years since junior high but still feels #toosoon. And even as an adult, I have felt abandoned by flaky friends, like a loner on many a Friday night, or terrified of rejection when I initiate hangouts.

So, I wanted to talk about what this young adult does when she feels like the “other.” 

The loneliness epidemic

So many people live in solitude and wish they had more connection. We all know that feeling lonely is emotionally distressing, but science also confirms that it can lead to a whole slew of health problems. And conversely, people who are well connected live longer and happier lives.

We Americans pride ourselves on our individualism and place a lot of value on independence - that cowboyin’ lone ranger mentality. But we are social creatures, and even lone rangers need friends. Friendships came so naturally when we were kids surrounded by peers, but once we’re no longer in proximity of a social group, making new friends gets difficult. As we get older, many of us are worse at maintaining friendships. The fact that we're highly mobile and can move half way across the world also doesn't help. But, as we get older, our need for friendships doesn’t diminish.

You can try to counteract this disconnect with social media “friends,” but unless you’re using Facebook to decide where to meet the gang in real life, the social media experience can leave us feeling empty. We all crave acceptance, closeness, and meaningful connections.

Do you get lonely sometimes?

If you answered yes to this question, you're normal. Admitting that you feel lonely takes courage, because we humans have our egos to protect. It means confronting our social insecurities and realizing our relationships are not where we'd like them to be. We tend to blame ourselves for feeling this way, as if it shows that we're weak for needing others. So this is how it goes down: we feel lonely, we beat ourselves up for feeling this way, and we cope by trying to convince ourselves we don't need community.

It just doesn't work.

Welcome to the party

You are one of many lonely people. The irony is that our feelings of loneliness unite us all. Everyone feels this way sometimes, even people who seem to have it all. If you have a tendency to get lonely, studies show that it’s not your fault. The feeling of loneliness begins a vicious cycle: We crave companionship, and if we sense the slightest rejection, we perceive people’s reactions to us negatively and we feel more sensitive than usual. This further perpetuates our feelings of loneliness. Psychologist John Cacioppo explains this perceived rejection here.

The problem with the simple solution

Well-meaning acquaintances probably tell you to “just get out there and meet people,” enthusiastically suggesting that you get on a dating app or join a knitting circle. But it’s not that simple. Social interaction doesn’t necessarily make us feel any less alone. Sometimes the more people we are surrounded by, the lonelier we get.

Even people in relationships get lonely; in fact, a strained relationship in which you feel distance between you and your partner can make you feel more solitary than actually being alone. There are also the happily married couples who found companionship, but got so caught up with their relationship and family life that their social outlets dwindled over time.  

Want to combat loneliness?

It turns out, one thing that helps to combat loneliness is learning how to interact better. If you identify as someone who perceives slights that might not actually be there, a trained therapist can help you read social cues so you can interact with the world in healthier ways. You’ll see with practice that what we may view as rejection may not be so, and over time you’ll build up the courage to approach others, make plans, and interact with less fear.

Opening up

Knowing how common the feeling of loneliness is might help you be more open about it.  Try telling a confidant that you’re dealing with this, and they might just share their struggles of feeling isolated as well. Much like the comedians confiding in each other about their anxieties, we can find fellow lonely souls who may share our concerns. This sense of comradery is good for our souls.

You’d be amazed at the kindness you might encounter when you open up and show vulnerability. Here's a better cycle: Vulnerability can beget vulnerability.

Put yourself first

It may seem counterintuitive to focus your attention inward when you’re already feeling so self-aware. But try it. Take your attention off the external world “out there” and do things for yourself that make you feel worthwhile. Imagine a lovely guest from out of town is coming to stay with you. How would you treat your friend? Would you cook special meals, make their bed and keep the house tidy? Well…the twist is, that guest is you! Pamper yourself, respect yourself, tend to your needs. This diverts attention from your expectations of others and things that are outside your control.

Ease into the world at your own pace

As a lonely person, I used to try combat my own solitude by inviting everyone I know to hang out at once. These bashes rarely went well, and usually had two outcomes: 1) people would show up, I’d feel all this pressure to make it fun. I wasn’t in my comfort zone and I’d get overwhelmed and vow to never do that again… or 2) almost no one would show up. As a sensitive gal, I’d internalize this as meaning I’m unlovable as a friend and the rejection cycle ensues.

I learned over time that it'd be in my best interest to embrace my introversion.  I started small and continue to take small steps. I run with my strengths, not my weaknesses. I do better with an intimate crowd of one or two and I'm happy with that. 

Be true to you

When you’re ready to go out in the world, find what works for you. Do what makes you feel comfortable so that you can be excited about it. Your interests and hobbies make you who you are. Go find your people. There is a crowd for every interest these days and sharing your likes with others can be a gateway to making connections. Sites like Meetup.com allow you to find activities based on shared interests. Find art classes, lectures, or musical events that provide a structured activity so there is less pressure to interact. If you’re religious, try joining community events at your congregation.

There is no pressure to keep attending social events if they don’t feel right. But, putting yourself out there is a form of therapy called “exposure therapy.” The theory is, the more you expose yourself to an uncomfortable situation, the less white knuckling you'll be doing and more at ease you will feel with time.

The key to being around others? Enjoy the activity as your first priority, and if connections happen, that's the cherry on top.

You got this!

Meeting new people can be intimidating. Go easy on yourself and treat yourself with compassion as you navigate this strange new world. Having a professional around to help you through this process can make a big difference. Talk to a therapist for guidance if you’re not sure where to start. You know where to find us.

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Karen Lenz is the Executive Assistant at People Bloom Counseling. She’s the office admin whiz - not a therapist. She writes blog posts as a human navigating this world, a client sitting across from a therapist, much like you. She is thankful to get to share her experiences with you, and hopes that her messy journey might resonate with you and make you feel less alone.

A Case for Social Inclusion

Photo by James Baldwin on Unsplash

Don’t go through life alone 

In previous posts, I’ve talked about the importance of friendships. When we’re going through a hard time, we fare better with a friend’s support because we have access to a larger pool of physical and psychological resources. Just knowing that someone cares for you, thinks about you, and is willing to do tangible things to help you can make you feel ten feet tall. Someone has your back; you don’t have to fight the fight alone.

This is not just with friends.

Being seen and standing with

Given the political climate, there has been more seeing and standing with each other against the “isms” of society. We may personally know someone who is oppressed or the sheer knowledge that injustice is happening to another human being is enough to make us take a stand. This is not okay. We may be standing with strangers but that doesn’t matter. It is our way of saying they matter, and they are one of us and we’re one of them.

Social inclusion is key to our sense of well-being. Let me tell you how.

A ball experiment

In a social experiment involving sets of three subjects, they were initially asked to take a life satisfaction survey. Questions included items such as, “How would you rate your quality of life? How satisfied are you with your current relationships? How do you like your job? How hopeful are you about your future?” and the like.

They were then taken into separate rooms and two of the subjects were given the same instructions: pass the ball equally back and forth to each other and then eventually at the exclusion of an identified third. This third subject, however, was told that the ball would be equally passed between the three of them.

They did as told.

At first, it was pretty uneventful. It was an equal ball opportunity; no hard feelings. Over time, it became apparent that for one reason or another, the third person was being left out. This person signaled, reached up but was only passed the ball occasionally. At the end of the back and forth passing which lasted no more than a few minutes, they were told to re-take the same life satisfaction questionnaire. Can you guess how their answers differed?

Experiment results

The two people who felt included and were simply following instructions rated similar results as before. If they felt that life was good; life was still good. If life sucked; the experiment didn’t change their perspective much. The third person, however, had a more pessimistic view of looking at the world compared to just moments before: their quality of life decreased, they felt like their dreams weren’t going to come true, they were less satisfied with their jobs, etc.

All this from passing a ball back and forth with complete strangers. Do these results surprise you?

Social exclusion in your life

When was the last time you found yourself in a situation where you felt “other?” What was that like? What thoughts went through your mind? How did that impact your mood? What did you do afterwards? I can imagine this all depends on how important the social gathering, the relevance of those people in your life, how frequently this has been happening, and how you interpreted their cold shoulders. We’ve all been there; it’s hard to not be picked, seen and included.

You can pretend that it didn’t bother you, but it did. You can hide that it hurts, but it still hurts.

Extending the invitation

Knowing how that feels, what if you can make your community a little more inviting? Who’s in your circle and how are you including them? How can you extend your circle to bring in others? These do not have to be over the top gestures. Small things matter.

For example, when was the last time you were in a conversation in a group and you noticed someone on the outskirts and you simply left them there? You were not intentionally being rude but you also didn’t make any effort to include them. What if you locked eyes with that person from time to time? What if you asked them a question and brought them into the conversation? What if a smile made the other’s world a less lonely place?

In case you feel “other”

If you feel “other” and you’re having a hard time integrating into your community, we’re here for you. Here at People Bloom, we’re all about helping you grow your tribe: the people who will be there for you when we’re no longer in your life. I help couples connect and cancer patients heal. Bob helps teens and young adults find their way through their home, school, work and social life. We hope to meet you!

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. She’s guilty as charged when it comes to remembering how she has left someone on the outskirts. She’s going to change that in the next two weeks.

A Life Worth Living: What to Do When Faced with Thoughts of Suicide

Photo by Larisa Birta on Unsplash

Death by suicide

Social media blew up two weeks ago when fashion icon Kate Spade and culinary expert Anthony Bourdain died by suicide days of each other. After all, who doesn’t know the brand Kate Spade, hasn’t walked past one of her stores, or perhaps own one of her purses? Foodie or not, who hasn’t heard of Anthony Bourdain and his culinary storytelling that sparks interest and delight in food and cultures all around the world?

News like this often get the immediacy of the press and then slowly fade away. However, if you are familiar with the feelings of suicide or have lost family, friends and role models to suicide, you do not just recover and move on. These thoughts, feelings and images still consume your mind even when the news has moved to national crises like the horror of separating immigrant children from their families.

Suicide unfortunately happens amongst everyday folks, and this rarely makes the news or causes a social media uproar. While Spade and Bourdain may have been inspiring role models, their deaths didn’t spur this strong reaction because they matter more than the rest of us. It is because high profile celebrity suicides affect our collective consciousness and bring awareness to a problem people face in their small communities. We want to open the discussion about suicide and what we can do to prevent it.

Soapbox about suicide language

As a healthcare professional in the state of Washington, I am required to take a suicide prevention training every six years. One of the most significant takeaways from the last training was changing the way we talk about suicide. We often talk about someone having “committed suicide.” If we really stop to think about it, the closest association of someone having “committed” something is a crime.

While we would never say that someone “committed cancer” or “committed heart disease,” let’s start by saying that it was death by suicide. I understand that suicide implies a choice whereas medical illnesses does not, but it doesn’t help for us to talk about our struggles if we’re loading on the stigma.

Thoughts about ending the pain: a common experience

Recently, I took another suicide and self-harm training. This time, it was with Jack Klott, a suicide prevention consultant. There, I learned that the thoughts of suicide is actually a common experience. Difficult or sometimes chronic life circumstances can create a felt sense of unbearable pain. This then challenges our capacity to cope, and thinking about death is an effort to get rid of this intolerable pain.

The thing is, as a society, we freak out when someone talks about thoughts of suicide. We are quick to talk them off the ledge, which in imminent situations, we need to. But in cases where it took a lot of courage to even admit to having these thoughts, it doesn’t help to be told to not think or feel this way. Rather, we need a be willing to learn about each others’ pain and to encourage the person with suicidal thoughts to get help.

Additional factors to protect against suicide

Indeed, having a support network is a protective factor in preventing suicide. Jack Klott also mentioned the importance of the following factors:

• Resilience. This is about the process of adapting and recovering from significant stress or hardships. In a separate training, I learned and shared about stress-resilience habits.
  

• Hope. Remind yourself how you got through difficult circumstances in the past, because you have. When it’s hard to hold hope, allow and trust others to hold that with you and for you.
  

• Tolerate stress and distress. In moments of despair, it’s about surviving that moment without making matters worse. Dialectical Behavior Therapy (DBT) is a pioneer in teaching you how to tolerate, rather than avoid, distress. Here’s an overview on distress tolerance.
  

• Regulate emotions. In the face of unbearable pain, emotions are strong and overwhelming. This often prevents your pre-frontal cortex from thinking rationally. Learning DBT skills can help you label and regulate your emotions, so you don’t feel so crazy inside.
  

• Social support. I mentioned it above, but I see it’s such a necessity to mention it again. Suicidal thoughts are a common experience. The only way we can feel less alone about it is if we give it a collective voice. Much like the #metoo movement, don’t suffer in silence. Reach out if you’re having a hard time. Reach in if you know someone is struggling. We are each others’ safety net.
  

• A reason for living. Did you know that a lot of amazing things needed to occur for you to be born? The odds of you being born to the parents you were born to required a lot of “coincidences” in the history that preceded them. And I’m not even talking about how babies are made. That math is 1 in 400,000,000,000. You’re uniquely you. While you might not be a Kate Spade or an Anthony Bourdain, this world is not the same without you. You are changing the world by being in it and doing you.

Life is hard; get help

If you’re struggling with thoughts about suicide, share these thoughts with a trusted friend or healthcare professional. Text CONNECT to 741741 in the United States. Call the National Suicide Prevention Hotline at (800) 273-TALK (8255). Visit Now Matters Now to learn helpful ways to deal with your suicidal thoughts.

For people living outside of the US, International Association for Suicide Prevention has a list of resources to help you.

You don’t have to go about this alone. Get help.

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

The Origins of Depression and What to Do with your Bad Feelings

Photo by Teddy Kelley on Unsplash

Depression stats 

Did you know that according to the Anxiety and Depression Association of America, Major Depressive Disorder affects as many as 16.1 million adults in our country? That’s 6.7% of our adult population. In fact, it is such a prevalent problem that the World Health Organization made a video about depression, giving it a personality as the Black Dog:

If it’s likely that someone at work, the mom at the soccer game, or the checker at the grocery store struggles with depression, then what do we know about its origin? Perhaps you’re wrestling with the black dog yourself and you want to learn how to live with this uninvited pet.

The thing is, depression didn’t come out of thin air; it isn’t our natural state. Depression has been linked to genetics, chemical imbalances, and environmental causes, making it hard to determine the exact cause of the condition in each person. The good news is that there are things you can do to manage it.

Depression and its origin 

Depression from genes 

Depression can be hereditary. A lot of research has gone into identifying biological factors that seem to coincide with this disorder. Anecdotal evidence also supports this: depressed people often seem to come from depressed families, in a way that can go back generations. This shows there must be some genetic component.

Depression from chemical imbalances 

Depression has also been linked to chemical imbalances. The idea of a "chemical imbalance" is a rather vague one. An imbalance between what and what? No one seems to know for sure. But many of us have heard about the role that too little of the neurotransmitter Serotonin is linked to depressive symptoms. Hence, various anti-depressants are used for alleviating depression, as most of these drugs raise serotonin levels in the brain.

Depression from environmental causes 

Depression can creep in due to difficult life circumstances. A history of abuse, family conflict, bullying, oppression, social isolation, etc. can weigh on anybody. A wise supervisor once said, “Every issue in counseling can be traced to some sense of grief and loss.” Indeed, when life doesn’t happen as expected, you’re wrestling with the gap between the life you want and the life you’re living.

We all want to feel good 

It’s a no-brainer that people like to feel good. We can all agree that feeling bad is something we want to avoid. Some people are better at the game of maximizing "good" over "bad" feelings, in a way that works for them their whole lives. They’re good at “feeling good” and “looking on the bright side,” at “letting problems wash over them like water over a duck’s back”. Maybe they hang around like-minded people. But regardless of how they do it, some people make it look easy.

It’s not easy for everyone.

Advances in the field 

Science and technology constantly make improvements upon our everyday lives, but these advances are limited when trying to help us understand how people can be good at the art of managing feelings. Sure, we can identify triggers to feelings, how it shows up in our bodies, and what urges we have to say or do in response to these feelings. However, there is much more to understanding an emotion than measuring how strong or frequent it is.

The intangibility of feelings 

What is the basic nature of feelings? You can't quantify them very well. You can't show me five pounds' worth. You can talk about how it feels to have a feeling, but you can’t objectively say what one is. It doesn't do it justice to use another word like "sensation" to describe it - that just replaces one vague word with another. Feelings are very real things, but they are also intangible.

Make depression go away! 

Modern culture dodges such a question, because feelings are such poor candidates for objective discussion, especially in scientific circles. Feelings are not "rational”. It seems easier to attribute the bad feelings of depression to something that runs in families that can be treated with the right medication. Indeed, many people who suffer from depression, at best, can only guess at where it came from. They just know that they have "it". You either have "it", or you don't. The most important thing is to make it go away.

Depression is like the black dog. A constant companion, depression is made up of a collection of feeling-loaded problems that, at a certain point, qualify you for the diagnosis. These symptoms include poor mood, lack of motivation, negative thinking, pessimism, inability to enjoy the things you once did, or low self-esteem. Like all other emotions, these bad feelings come from somewhere. For each person struggling with depression, there is a story of how the black dog got there and why he’s staying.

Get to know the black dog 

In order to treat depression on an individual level, we need to delve into the feelings - messy as they may be - and set aside our need to explain our behavior with science and research for a moment. Getting to know the black dog: that part is indeed subjective and hard to define. But those feelings that make up the black dog are a huge part of who you are, a huge part of your life story. If you want to grow as a person and make the most out of life, it would be important to bring the black dog into our therapy room.

Delve into messy feelings

Depression is problematic feelings that begin to take over your life. When you learn about these feelings and how they have fit in to your life story, it makes you more aware of who you are and how you are. As the stories about these feelings get unraveled, you will be equipped with "data" as to how to better handle them. You can end up becoming more and more like those people who are "good at" knowing and managing their feelings.

Emotional life is that way; you can't put numbers to it or objectively explain it. Yet, with practice, you can learn to acknowledge your feelings, get to know them better, understand why you feel the way you do, and what you can do about them. The black dog doesn’t take up as much space in your life; you can have him on a leash, rather than the other way around.

I want to help you with this process. When you're ready, I’ll be in my office.

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Bob Russell recently joined People Bloom Counseling, a Redmond psychotherapy practice in WA. He helps teens and their families thrive through the adolescent years. He also helps twenty somethings figure out their place in life. Having been through rough patches during his teen and young adult years, he knows what it’s like to delve into messy feelings and come out stronger on the other side.

5 Tips for Surviving the Overwhelm

Photo by nikko macaspac on Unsplash

A COMMON EXPERIENCE

In an earlier post, I wrote about helping my playmate Tammy and her son Trevor move. Well, last month, Trevor got sick at school and he was sent home for much of the week. Tammy, a single mom, could not afford to miss so much work. It so happened that Tammy’s family was out-of-town and she also started part-time school. Tammy was at her wits end, and as her good friend, I did not respond well.

Say, just because I’m a therapist doesn’t mean I'm always patient and stoic. Even I don't have my sh*t together all the time. But, that’s probably content for a different post.

As I debriefed the incident with Tammy, it reminded me that this is a common experience. The work project is due on the same week the in-laws are coming in, and the hot water tank failed while little Joey developed chicken pox. Some of the events were foreseeable; others were sprung on us and converged into the perfect storm. When all is said and done, one can probably laugh about it. But in the midst of the chaos, what are we to do to survive these moments?

5 Tips for the Overwhelmed

1. Ask for help yesterday

Okay, I don’t mean to sound facetious, but I am suggesting for you to ask for help before things are in dire straits. We live in a culture where people are prized for doing it all by themselves. To ask for help is to show that you don’t have it all together, that you’re not making the cut. But the thing is, we all lean on each other to get through life and others might not know that you’re drowning or might not understand the kind of help you need until you ask. Even if the ask is simply, “I don’t know what I need, but I can’t pull this off by myself!” That’s cuing the other person to problem solve with you when you don’t have the bandwidth to do so alone.

I want to emphasize asking for help early on because by the time you’re feeling desperate, any sign of rejection is taken as a slap in the face and you’re more likely to shut down and not reach out. That will often make things worse. When things haven’t hit rock bottom but you’re feeling the strain of the situation, you still have it in you to communicate about your needs and give the other person time to plan ahead. If that person is not available, others might still be.

You don’t have to wait until you’re at the end of your rope to say you need a little help along the way. Sometimes having people remove just a thing or two from your plate is enough to give you clarity about your next steps, rather than feeling stuck in the overwhelm.

2. Don’t think about the other person when asking for help

This is important enough to put in its own category. There’s a tendency to consider whether another person can give the help before we even ask. Oh, it’s the weekday, people have their lives. It’s the weekend, people are busy. I can’t ask; that person lives so far away. I know for sure they have soccer practice on Wednesday nights so I wouldn’t want to interrupt their schedule. Chances are you’re right. We’re all busy, or often times we look it because that’s another thing our society values. But, can you puh-lease let the other person decide whether they can help you, rather than deciding for them?

What if they want to help you and can bring over take-out, rather than cooking at home? What if Garret can step in to take the kids to soccer, freeing your friend up for laundry service? You don’t know what other people might decide to do when you present them with the need. By not asking or by asking during a crisis, it closes off the possibilities that are available to all of you.

3. Drop the ball on other things

I get it. I know you have a lifestyle to maintain; you still want to pack lunches, eat nutritious meals and do your exercises. You’re pissed off that expected and unexpected things are disrupting your routine. Listen: You can’t have it all. Not right now. There’s too much going on. Some things have got to give. I wouldn’t say this to you when you’re just going about your everyday predictable life. When things are not going as planned, it’s important to pivot and see what you can get off your plate, including the things that are already there before sh*t hit the fan.

This is not about giving up or giving in; it’s about being adaptable to your circumstances. If you eat frozen dinners, miss yoga and run a just good enough meeting, no one is going to die. When you’re no longer putting out fires and you have more in you, you can go back to doing you.

4. Take it a moment at a time*

So you have lots to do and you want everything to be fixed two days ago. You can’t possibly imagine how you’re going to get through the week because the more you anticipate what’s ahead, the more overwhelmed you feel. If you’re not already aware, your ability to make sound decisions goes out the window when there’s too much going on. Now is simply not the time to think about your final exam in two weeks, your kid’s birthday party in a month or your performance review coming up. There is enough on your plate you don’t need to pile on more. Now is only about how you can get through this moment without making things worse.

What do you need to do right here, right now to resolve the most pressing thing? What do you need to do the next hour to chip away at this other problem? What needs to happen tonight to plan for tomorrow morning? During periods of overwhelm, just focus on the immediate, putting one foot in front of the other. When you’re past this storm, you can look up again to see how you’ve pulled it off, hopefully with some help.

5. Do the opposite of what you want to do*

There’s a tendency to want to self-sabotage when we’re going through a hard time. Thoughts like What’s the point? No one cares. I can’t do this anymore! This is too hard. Why me? will frequent your mind at the most opportune time. Why this happens is a topic for a different post, but what’s more important is that you don’t entertain these thoughts or act on them. Instead, when you want to give up, lean in. When you don’t want to call a friend, call your friend. When you don’t want to get out of bed, get out of bed and start on whatever you know would help the situation.

Do the opposite of what you want to do so that by doing so, you might, though not guaranteed, bring on feelings of hope, relief and comfort, which is the opposite of despair, misery, and distress. Be active by acting the way you want to feel because if you wait until you feel better before you do something, that day may never come. Especially not during times of overwhelm.

EXPECT IT

All this to say, while we're still living and breathing, we'll go through rough patches. This is life. But, it doesn't mean we're helpless to our circumstances. Rather, in light of life's difficulties, how will we get through them and hopefully grow some wisdom along the way...

If you’re feeling the strain and need help, reach out. If you’re in the thick of it, now is a good time too. I specialize in couples and cancer patients and Bob works with teens and millennials. We’re here for you and we can help you get through this overwhelm.

*Borrowed from the traditions of Dialectical Behavior Therapy (DBT)

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. During times of overwhelm, she finds it most helpful to reach out to her husband, eat sushi, and ask for prayers from her favorite people. She’s about getting through that day, because the next day, will be a new day. It always is.