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Pay attention, your body is trying to talk to you

8/19/2013

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A major part of therapy is increasing your awareness, not just of your surroundings and other people, but also of yourself. Self-awareness is a process centered on gaining insight into how your thoughts and feelings impact you, others, and relationships. In this post I want to take a tangible turn and focus on listening to your body, literally.

The idea of becoming more aware of your physical experience and signals is grounded in the mindfulness process. I’ll write more about that at a later time but if you are interested, just do a quick search of mindfulness.

It’s my belief that the majority of mental health issues come down to a combination of feeling depressed, anxious, or both and struggling with how to cope with these feelings. This is a gross simplification, but in the end most conditions have an anxious or depressed underpinning. I often ask patients how you know you are depressed, anxious, or both. How do you know? Most describe an event (or many) that explains a change in their emotions and behaviors. This is an appropriate response, but it usually doesn't include a description of how their body is reacting during times of duress.

About those body signals. I start with fairly easy, straightforward questions. How do you know you are hungry or thirsty? How do you know you are hot? The answers are obvious: stomach growls, throat is dry, you sweat or feel warm. The same rationale applies to depression and anxiety or any emotion for that matter. Your body almost always tells you when you are happy, sad, angry, etc.

Even when feeling depressed your body sends you signals. Common symptoms include but are not limited to lack of energy, somatic complaints (aches and pains), decreased appetite, and tears from eyes (also known as crying). As for cognitive issues, symptoms include poor concentration, negativistic thinking, and memory problems.

For anxiety, common cognitive symptoms include but are not limited to excessive worrying, difficulty concentrating, and attention issues. Physical symptoms include sweating, tremors and shakes, chest pain, fatigue, and nausea.

Increase your body awareness when in an emotional state. Specifically, ask yourself what is physically happening when you are happy, sad, etc. Making connections between bodily cues and emotions will lead to an improved quality of life. For example, if you know you have trouble paying attention when anxious, by identifying the anxiety you can then intervene with relaxation techniques before the anxiety impacts your thinking. If you have unhealthy conversations when feeling hurt, recognizing your emotions will assist you in coping with your hurt feelings until you are in a psychological state where you can have a healthy conversation.

A good exercise is to reflect on the lowest and highest moments of your day (or any memorable experience), how you felt, and what if anything was happening with your body. As you do this more often, you will become efficient in identifying the body-emotion connections. Soon you’ll be able to recognize how you feel during that emotional experience instead of afterwards. I’ll write much more about how to become more mindful of your body and experience in the coming weeks.

As usual, feel free to share via facebook, twitter, etc. Comments are welcomed!

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Q&A Series: How to have that difficult conversation with someone you love

8/16/2013

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In a relationship, how do you tell your partner hard things they don't want
to hear? 

-- Anonymous August 2013

So this question not only comes up in most therapy experiences, but also on a daily basis for most people. If someone is complaining or expressing frustration about a relationship, there is probably a conversation that hasn't been had, that needs to be had.

Relationships are work. Relationships are fun when things are going well. Maybe that’s why it’s difficult to have a conversation that may lead to a disagreement, argument, or even a breakup. At some level, there is fear and anxiety about what might happen if avoided issues are brought to attention. When a relationship seems to be going well, it takes a lot of courage to discuss an issue that may lead to conflict.

So how do you have a difficult conversation with a loved one? Here are a few things to consider.

Imagine your partner’s emotional reaction. Recognize why you feel the conversation will be difficult. Try to imagine how your partner might react. If you think they will respond with anger and defensiveness, then try to start the conversation by saying you are not trying to cause hurt or anger (or any negative emotion). If your partner expresses hurt or anger, then apologize and repeat that your intent is not to hurt but to better a situation.

Emphasize care and concern. Clarify that you are bringing this issue to attention because you care about the other person, and how certain actions impact your partner and you. Reiterate that you are initiating this conversation out of care and love, and that the conversation is needed for change; change that would benefit your partner and the relationship.

Find a moment of empathy. Recognize how you feel. Then find an experience where your partner felt the same way. Make a connection between the two. Let’s say you are frustrated by your partner’s pattern of starting but not finishing a task. With that, let’s say your kids have a tendency to not put their toys away after playing and it’s very frustrating for your partner. Then you could say, “You know how you feel when the kids leave a mess of toys, that’s how I feel when you start something and then don’t finish it.” Connecting an emotion with your message increases the impact of your message.

Context and comfort. Understand your partner. If your partner prefers to talk privately, then have a private conversation. If they are more comfortable knowing ahead of time that a serious conversation is needed, then give them a heads up. Providing a familiar environment is a great way to give your partner a sense of control and to show that you are attune to their feelings.

I usually do not recommend this, but if they are more comfortable communicating via email, then try initiating the conversation via email. Again, I don’t recommend having an email conversation instead of a face-to-face conversation, but for some it’s an easier, more comfortable way to express thoughts and absorb information. You have a better chance of a productive conversation if both people are in a relaxed mindset.

Praise. Lastly, appreciate your partner for being open to a difficult conversation. Even if an issue isn't resolved, praising your partner's effort of being attentive and listening to your feelings will make future conversations smoother and hopefully productive. A simple “thanks for listening” can go a long way.

Although scary, these are the type of conversations that can strengthen your relationship. Openness about one’s feelings in a relationship sets clear and healthy boundaries for you and your partner. You can read more about boundaries here.

As usual, feel free to share via facebook, twitter, etc. Comments are welcomed!

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Clinical Commentary: 10 Things Therapists Won't Tell You

8/9/2013

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I recently read an article that purportedly exposed therapists' secrets. You can read the entire article HERE. In this post, I am going to list the 10 things from the article and respond to each. From my perspective, the author's approach was to describe a worst-case scenario, and then generalize it to the entire field of psychotherapy. Let's get started:

1) “Your childhood was bad? Wait till you see your bill."

Most psychologists have a set hourly fee and this is almost always discussed during the initial phone consultation or certainly during the first session. On top of that, if you have insurance, you usually pay a fraction of the hourly rate.


2) “I may not have any training."

Does not apply to psychologists for the most part. All licensed psychologists are required to display their education and license in their office. All are required to earn continued education credits as well. A great question to ask a therapist is the type and length of their training.

3) “Will you ever stop talking?”

This one is somewhat funny as the article mentioned a therapist falling asleep during a session. I have honestly never asked myself "Will you ever stop talking?" However, I have thought, "This person is talking alot about non-issues, are they avoiding real issues?"

4) “I need you more than you need me.” 

The author suggests some therapist may drag therapy along for financial gain. Maybe this happens (saddens me to say that), but you always have the final say in your therapy. A therapist can't force you to continue therapy. Have goals for therapy and regularly review those goals with your therapist. If you aren't making progress, maybe it's time for change.


5) “Your secret is (sort of) safe with me.”“Maybe I’m the one who needs therapy.”

There was a saying in graduate school, "Research is MEsearch." I'm sure many folks chose the field of psychology because of their own background. I actually am a believer that all therapists should seek therapy for two reasons: 1) It's important to know what it's like to sit in the patient chair 2) It's important to know your own psychological makeup. 


6) “A morning run might work just as well.”

I actually agree with this idea and regularly encourage patients to find the relationship between their emotional and physical health. I know for me personally, exercising is directly associated with my emotional state, energy level, and self-esteem.

7) “I don’t have to practice what I preach.”

The author is referencing the idea that therapists should have to undergo therapy. I addressed this in #5.

8) “Your secret is (sort of) safe with me.”

One of the many things discussed during the first session is confidentiality. Whatever is discussed in session is confidential with a few exceptions: If there is an imminent threat to yourself or other(s), alleged child or elderly abuse, or in some legal situations. I am mandated by law to ensure the safety of the patient and citizens. If I ever share confidential information (which is rare), I always notify the patient ahead of time.

9) “I’ll be there for you, but your insurance might not.”

Unfortunately this is somewhat true. Things are improving, especially with the Mental Health Parity and Addiction Equity Act. However at the end of the day, insurance companies play a large role in treatment. Sad state of affairs, in my opinion. I'll say more about insurance companies in a later post.

10) “Time’s up. Here’s a pill.”

This refers to psychiatrist and not psychologists, as the latter do not have prescribing privileges. My personal opinion is medication is a very last resort, after at least a year of therapy. The exception is if there is some sort of immediate issue where medication can stabilize the individual.

As usual feel free to share via facebook, twitter, etc. Comments are appreciated.
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Why do people cheat?

7/30/2013

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Unfortunately it happens all the time: infidelity in relationships. No one enters a relationship with the intention to be unfaithful. So why do people cheat?

There is plenty of evidence that we are hardwired to stray, that the human species like most others is not naturally monogamous. With that said, let’s shelf the biology and focus on the psychology. In working with couples who have experienced infidelity, there usually is a process of deterioration in the relationship that culminates in cheating by one or both partners. Let’s take a closer look at that process:

Emotional dishonesty.  Emotional dishonesty is not being open with your partner about your feelings. If something is upsetting, then it is your responsibility (to yourself, partner, and relationship) to share your feelings. When you keep feelings to yourself, your partner will continue to be in the dark about how you feel, and an opportunity to be heard, validated, and comforted is lost.

Relational distance.  With enough emotional dishonesty, comes emotional distance. If you feel you can’t talk to your partner about your emotions, the distance between you and your partner will grow. The more you withhold your feelings, the more likely you are to feel confused, resentful, and alone.

This distance is exacerbated when the response to shared feelings is dismissive, critical, or lacking empathy. In session, couples regularly talk about how a major issue in their relationship is the mutual inability to accept how each other feel. The result is one or both individuals feel unheard, uncared for, and unloved.  

Sense of void.  Once the distance is large enough, it becomes a void. This usually occurs after months or years of relational dysfunction, and it’s one of the most challenging parts of couples therapy. Usually this void is accompanied by sadness, anger, and hopelessness. The individual shifts to self-preservation mode, fully believing that they are alone in the relationship.

Novel excitation.  Emotions are stirred by someone outside of the relationship. Happiness, excitement, and positive emotions are experienced that have been long absent in the current relationship. The "new" person highlights what is lacking in the current relationship. Usually those who are unfaithful describe the encounter as fulfilling what was perceived to be missing in life.

I’m guessing most have picked up on (maybe ad nauseam) of how emotions were mentioned in almost every sentence. That was for a reason. Emotions are the foundation of any relationship. I've never had a couple come into my office and say they are as happy as ever, but are having problems and need couples therapy.

Some may read this post and think I am condoning cheating. My aim here was to provide perspective on why someone might stray from a relationship. I will say that whenever a couple talks about infidelity, a part of therapy (with me, at least) is exploring the role each person played. The goal is for each person to better understand how each impacts the other.

Lastly, it’s important to check in with your partner regularly about your relationship. Don’t wait until it’s too late.  


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

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Isaac Newton the psychologist? The physics of relationships: Part II

7/23/2013

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In last week’s Part I post, I presented a parallel between Newton’s first law of physics and interpersonal relationships: the idea that each social interaction has an impact on our emotional state, and how the emotional impact is a product of the person and the content/delivery of the message. If you missed last week’s post, you can read it HERE.  

In this week’s post, let’s focus on what happens after the emotional impact. That is, what you are thinking and feeling after an emotional experience. The emotional aftermath is usually lost on what happened to cause the aftermath. So think about what happens to you after your parent/boss expresses disappointment in your performance, or when your spouse/family member praises you, or when your favorite TV show is cancelled?

There is no right or wrong answer to any or all of these questions. They may seem rhetorical but it’s worth asking yourself, “How do I feel?” after a situation. It doesn’t have to be a traumatic or highly emotional experience, it can be any experience. Sometimes I encourage patients to emotionally “check-in” with themselves at random times during the day. Why do this?

Good question, well for a few reasons:

1)  You will actually learn about your emotional world. 
     What impacts you, how, and for how long.

2)  Recognizing and identifying your emotions will help in 
    understanding and empathizing with others’ emotions. 
    It’s difficult to empathize or even emotionally connect 
    with others if your own emotional world is unclear.

3)  Introspective questions (e.g., How do I feel?)                    increase self-awareness and help you gain personal          insight. This comes in very handy, especially in              relationships.

4)  Sometimes asking yourself a simple question like     
     “How do I feel?” or “What just happened?” can slow 
     things enough to calm yourself and keep your 
     composure in a stressful situation. Think of how 
     many times you've reacted in a situation and then 
     reflected and wished you had a moment to think 
     before doing or saying what you did.

Gaining insight and awareness into how experiences influence your emotions will allow you to better prepare for similar situations that arise in the future. For example, if you get defensive or flustered during stressful situations, you can practice relaxation techniques when you are entering a stressful period of your life. Increasing self-awareness will allow for you to manage your feelings in a healthy, pro-social manner. So if you are aware that you are feeling defensive or flustered, then you could utilize a strategy that helps you return to a more relaxed, calm state.

How an experience affects you is as important as the experience itself. Everyone is busy, but I encourage you to take time during the day and reflect on the high, low, and average experiences of your day. Tap in to your emotional world; you’ll be glad you did.

As usual, feel free to share via facebook, twitter, etc.

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Isaac Newton the psychologist? The physics of relationships: Part I

7/18/2013

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Isaac Newton’s first law states an object is at rest or moves at a constant velocity unless acted upon by a force. The images that come to mind are probably two objects that act toward or upon one another: a baseball and a bat, two cars colliding, swirling your drink with a straw. Here, I’ll lay out how several aspects of the law of motion also apply to interpersonal relationships. 

A relationship is fluid. It evolves, shifts, and changes based on the interactions of the individuals. Relationships can vacillate from strong and sound to weak and tenuous as a result of the actions of one or both individuals. Newton theorized outside factors can impact the relationship between two objects; the same applies to relationships between people.

Thinking about the bat hitting the ball, there are two factors regarding the impact (Force): specifically the size of the bat (mass) and the speed at which the bat is swung (acceleration). Hopefully the F = ma equation came to mind (thanks, Dad). Now applying that equation to a relationship, think of the F as the emotional impact, the m as the person, and the a as the content and delivery of a feeling. The Emotional Impact is the product of a Person and the Feeling Delivered by that person. Emotions are certainly much more complicated than these two variables, but for now let’s keep it simple. I’ll discuss other factors in future posts.

For an illustration of m (the person), think about how you would feel if a loved one praised you compared to someone you had just met. More than likely, the praise from the loved one will have a larger emotional impact. How strongly you feel something is linked to who is delivering the message. In many instances, two different people give the same advice, but you might listen to one and dismiss the other. Why is that? Reflect on that question. Parents are driven batty by teens who ignore a parental suggestion and then respond “Great idea!”, when a friend makes the same suggestion.

As for the delivery and content of the message, a, the analogy I always use is your birthday and receiving a present. If someone presents a nicely wrapped gift with a “happy birthday!”, your experience is going to be different than someone giving you the same gift wrapped in a plastic bag with a “here”. The difference is clear, but it’s not always clear in relationships. In therapy, especially couples and family therapy, a constant theme is how to gift wrap feelings, both negative and positive. Just because the feeling is anger, sadness, or frustration doesn't mean it has to be expressed in a hurtful way.

Newton’s first law of motion focuses on being acted upon; the second part is how the object is affected by the act. I’ll touch on the second part here, and say more in next week’s post.

In relationships, this second stage is largely ignored in everyday life and consequently is a significant part of therapy. How do you respond after an emotionally-charged experience? People are more focused on what happened than on what happened after. Part of a relationship is increasing your emotional awareness. 

A complexity arises as an experience in one relationship can impact (positively or negatively) how you perceive and engage in other relationships. This is very evident in couples and family therapy where you have multiple individuals acting upon one another. I’ll write more about this later, but for now think about the solar system and what would happen if one planet suddenly shifted.

This is what makes relationships fluid and why laws and principles can’t completely capture relationships like it can with the sciences and math. Maybe it was serendipity, but Newton was on to something in regards to interpersonal relationships. Ironically, some psychologists argue that Newton would have been diagnosed with Asperger’s disorder in present day.

As usual, feel free to share. Part II, next week!


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What is therapy?

5/9/2013

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A question that seems easy to answer, but you’ll get a different answer from each therapist you ask. Sometimes I catch myself assuming when a person walks into my office they know exactly what they want and how therapy works. Most walk in knowing they need help; they just aren't sure what to do. My response is to describe my therapeutic approach so that the patient can get a feel for how I work, and to determine if my approach can be beneficial for their specific goals. I thought it might be helpful to share my approach in the next couple of paragraphs for anyone that is interested in therapy. 

Each person has a unique and authentic story. My goal is to provide a safe and empathic environment for you to better understand your experiences, both positive and negative. I wholeheartedly believe that psychotherapy is a collaborative process with both therapist and patient working together. My approach is to focus on symptom relief in the short-term; as well as to explore the present and past to increase awareness and change underlying psychological patterns. This process allows for personal growth, a sense of agency and belongingness, and greater satisfaction in life and relationships.

Many people have a hard time understanding how the past can impact the future. I hear, “the past is the past, you can’t change it,” on a regular basis. It is true, you can’t change the past, but you can certainly learn from your past. Exploring and understanding your past is a significant aspect of my therapeutic approach. There tends to be a pattern in our behavior; whether it’s punctuality, avoiding our feelings, or having an optimistic perspective. Part of therapy is understanding these patterns and how individual tendencies impact decisions, behaviors, and relationships.

So what areas of your life would be explored during therapy? All are on the table, but your childhood, adolescence, family history, relationship history, and coping mechanisms are themes that are always explored. Revisiting these life stages can provide much needed insight for current issues, and increase self-awareness. During the initial sessions, I’ll ask you to tell me about yourself, your family, your relationships, how you manage stress, and why you are seeking therapy now. Just reading this may seem overwhelming, but most therapists are skilled at knowing how to ask these questions without it feeling like an interrogation.

How do you know if therapy is right for you? People seek out therapy for many reasons, including: 

  • Feeling depressed most of the day 
  • General anxiety (nervousness, excessive worrying, difficulty concentrating)
  • Coping with medical issues
  • Psychological impact of major life events (marriage, divorce, death, physical injury, loss)
  • Addiction issues 
  • Personal issues (self-esteem, relationship difficulty, family difficulty)


The vast majority of people seek out therapy when they are having difficulty managing life stressors. What does "having difficulty managing life stressors" mean exactly? Well, if you are having difficulty with tasks that were once easy (e.g., work, school, daily activities, etc.), you are probably a good candidate for therapy. I do see the occasional patient that wants to be more efficient and productive than they already are, but that is certainly not the norm.

Therapy offers a nonjudgmental, supportive environment which allows for an open and genuine dialogue. Most people half-jokingly expect to lay on a couch; most end up sitting in a chair (some do lay on the couch). Making it to your first session is usually the scariest part, and most people report feeling more content, less anxious, and more optimistic at the end of the session. They are also surprised by the conversational feel of therapy.

I work with children, adolescents, and adults. I approach patients with their needs and goals at the forefront of psychotherapy. Psychotherapy is hard work; it can be challenging and painful, but such is life. With that said, I have found myself laughing with my patients, sharing stories and growing together.

I hope this short description has answered some questions, if not feel free to contact me with your specific concerns or thoughts. As always, if you find this post helpful, feel free to share.

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Why do relationships succeed?

3/19/2013

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If someone steps into my office, it's because there is a problem, usually a serious one. I'm still waiting for the day that someone walks in and says, "I'm doing great in all areas of my life and wanted to share that with you." Not sure what I would do. So instead of only focusing solely on how to solve particular problems, I also want to highlight the positive in everyday life. 

So why do relationships succeed? If you read my post on relationship failure (if not, you can here), then the concepts in this post should be somewhat familiar. Again, the major themes are communication, trust, and empathy. 

Before addressing the relationship themes, it may be worthwhile to stop and think about what success means to you in the context of a relationship. A successful relationship must have genuine communication, unconditional trust, and mutual empathy.

Communication. What is healthy communication? Most of you will say being open, honest, and sincere with your partner. All of that is true. Healthy communication involves each person being heard and respected. Being heard is more than someone looking at you when you are talking. It is the active participation of the other in attending to you. It includes both communicative (i.e., verbal acknowledgement, response) and non-communicative gestures (eye-contact, body language). 

The more attentive you are to the other person, the more genuine the connection. So put down the smart phone and make eye contact (don't worry, your facebook page will still be there). If the other person does not have your undivided attention, then the other will be less invested in the conversation. For that moment, the other person will be less invested in you. How do you feel if you are talking to someone and they are multi-tasking? People in successful relationships emphasize the importance of genuine communication between partners. 

Trusting your partner and the relationship. Trust is following through on what you say you are going to do. This includes major commitments (i.e., honesty, faithfulness, integrity) as well as the smaller details (i.e., daily responsibilities, punctuality, etc). It may seem silly to have your relationship impacted by forgetting to do the dishes. However, I've had many couple sessions where people express that the lack of commitment to the small things becomes a big issue over time. No one is perfect, everyone makes mistakes. You can either acknowledge your limitations and work to improve or make excuses. One builds the relationship, the other hurts it.

Trust is knowing that something is important to your partner without your partner having to tell you repeatedly. I’m not saying you should be a mind-reader. However, you should be attuned to what matters to your partner. By being proactive or even active, your partner will notice that you are trying to meet their needs. This goes a long way in the process of building trust. 

Trust is strengthened by being honest with each other. Being honest does not mean you are an open diary all of the time; it can include saying, “I’d rather not talk about it now, maybe later?” This type of statement sends two messages: "I’m not in a good place right now, but I do want to talk about it with you at some point." At a deeper, relational level, this statement also says, "I can be vulnerable with you and I trust that you won't use my vulnerability against me." This is a subtle but very powerful component of a relationship (I'll write more about that in a future post titled "It's about the process"). When you feel weak and need support, a good partner will be there for you. These moments strengthen the relationship and builds trust.

Empathy. The concept of empathy is known by many, but the application can be a challenge. Empathy is the awareness of another person's feelings. The common metaphor is "put yourself in the other person's shoes." Training yourself to be empathic is a great skill to have for any relationship. A question to ask yourself is "How might the other person be feeling right now?" It's that simple. Empathizing with your partner does not mean you are wrong, or they are right. It means you are trying to understand and connect with your partner's emotional world and actions. Empathy involves setting aside your feelings (no, not dismissing them) for a moment and connecting with your partner's feelings. This may not solve the issue, but it can strengthen your relationship. 

Reflect on your current relationship and even past relationships. What went wrong? What went right? What can I change? I imagine that the answers to these questions will involve one, two, or all three of the relational themes. 

Healthy relationships are a combination of minimizing the unhealthy and maximizing the healthy. It's not an either-or scenario: you can't just avoid the negative or just emphasize the positive. If you want to be a physically healthy person, you have to minimize junk foods AND have a healthy diet. A relationship is work, but I can't help but reflect on something my dad says to me (all the time, I mean, all. the. time.): If something brings you happiness and success, is it really work?


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 
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Depression: It's not about if the glass is half-full or half-empty

3/1/2013

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Glass half-full or half-empty?  Based on your response, your worldview could tend to be more optimistic or pessimistic.  We are all familiar with the expression.  So I chose to mention it for a couple of reasons: 1) it's familiar 2) I'd like to use a similar analogy to explain depression.

There are a number of theories that explain depression from a genetic cause to environmental factors to an imbalance in specific neurotransmitters.  There are a number of ways to conceptualize and work with depression.  I will describe one approach here, the glass of water approach.  I was first introduced to this approach by my supervisor during internship, a very skilled therapist.  Before I go further, I have to emphasize that depression is complex, not every depressed person fits into what I describe below.  Each person is unique.

Think of yourself as a glass of water, neither half-full nor half-empty.  Now let's take a moment and focus on the actual water in the glass.  The water is the accumulation of single drops of water.  Think of each drop of water as a life experience.  It doesn't have to be a major experience, it could be any experience.  Anything from your first day of school to what you had for lunch. Both positive and negative experiences, they all accumulate in the glass.  As you have more experiences, the water level rises, drop by drop. 

For someone struggling with depression, the water in their glass has more drops of negative experiences than positive ones, or the impact of the negative experiences is greater than the impact of the positive.  Sometimes that is actually the case and sometimes that is the perception.  Part of therapy is determining whether the individual's perception is accurate or distorted.  Let's assume accuracy, the depressed individual has more negative experiences than positive.  So what can be done?

My approach is not to sugarcoat what has happened. Bad things happen in life, there is no getting around that. It's a part of life.  For depressed individuals, It is often suggested to focus on the positive or to look at how the negative might be a positive.  Sometimes this approach is effective, many times it is not.  The glass of water approach acknowledges the negative experiences and focuses on how "drops" of positive experience can be added to the water in glass.  The belief is that your experiences are real, they have shaped who you are. The negative experiences were painful.  Let's focus on figuring out how positive experiences can be added to your glass.  

A new positive experience does not replace a negative experience, but it may neutralize the impact of the negative experience.  The more drops of positive experience into the glass of water, the less likely that the negative experience will have a profound, lasting impact. 

For example, if you have a bad morning followed by a bad afternoon, you'll probably be in a bad mood that night. However, if you have a bad morning followed by a pleasant afternoon, you will probably be in a better mood than the previous example.

What is a positive experience?  Simply, an experience that brings you happiness or joy.  A potential hurdle, especially with depressed individuals, is they can truly feel there is no positive or pleasurable aspect of life.  It's a huge challenge to even think about something positive.  
A positive experience may be a non-negative experience. In that case, simply providing support and care may be the main focus of therapy, with occasional analysis of the depressive episode.  One strategy is to explore what brought you pleasure before the depression arose (e.g., spending time with family and friends, alone time, exercising, music, reading, being outside, etc.). Talking about these experiences can ease the depression and bring about hope and some level of optimism.    

So if you are struggling with depression, ask yourself what brings you joy, what eases the pain.  If you are able to come up with a list or ideas, follow through with them.  

This has been a simple description to a complex issue.  For the sake of brevity, I kept this short.  I hope no one was offended or thought that overcoming depression is always easy.  That certainly was not my intent.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 
 
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Praise, praise, praise...

2/25/2013

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Both praising and criticizing are equally important in relationships, but unequally utilized.  More often than not, we are focused on the criticizing aspect, especially as parents.  The rationale is that certain rules need to be set, held, and maintained.  Boundaries are reinforced by teaching what not to do and stating what rules should be followed.  It's human nature to curb negative behavior; it should also be natural to reinforce positive behavior. 

I would estimate that 99% of the couples that come for an appointment talk about what is wrong with their relationship. Topics include harmful behaviors to the relationship, why the other person change, and how each is frustrated and exhausted with the other. They are taken aback when I ask how they met, and to express what they like about each other. This technique can transform anger into genuine care and love in the blink of an eye. No special trick here, just asking each person to talk about the positives of the other can provide a nice moment and valuable insight into the relationship.  

What's the point of shifting from a negative to a positive experience?  There are numerous reasons, but the most important is that your ability to communicate and connect with others is greatly increased if you are in a good place, emotionally and psychologically.  You will be more relaxed, less defensive, and more open to having a meaningful, intimate conversation. 

Talking about the positive aspects of someone or a relationship doesn't heal emotional wounds, but it can certainly help. Much in the same way that praising someone helps to balance out criticism. Whether you are in a one-year or fifty-year relationship, a friendship, or a romantic relationship, it always feels good when someone compliments you.  

That is why it is always important to remember to praise the other.  Even if it is something the other person has done for years (e.g. walking the dog, making meals, taking care of the bills, etc.), it is nice to be appreciated. A simple thank you or acknowledgement does just that; it appreciates the other person, it shows that you are aware that the other person is giving effort, and it's a pleasant moment. With enough praise and appreciation, a moment of criticism, even hurtful criticism (everyone has done it), can have minimal impact. 

So remember to be vocal about the good as much as the bad.  When critical, keep it constructive.  When praising, keep it within reason.  Too much of anything is too much. 


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Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

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    Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN.

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