Healing Through Depression

I recently attended a wonderful seminar on depression.  The presenter first defined the disease of depression.  He conveyed that it is an illness that impacts three major areas in humans – emotions, physiology or energy, and thinking.  Then he talked about key areas of daily life to pay attention to that can help one heal through depression.  First, the 3 areas that depression impacts:

Emotions – sadness, irritability and “anhedonia” (the inability to experience pleasure) are often present.

Physiology or energy – there is a change in our sleep “architecture” (delayed sleep onset, don’t get to stage of deep sleep where healing and growth take place).  Fatigue is common, so we crave energy.  To gain energy, it’s common to binge on simple sugars, which increase our blood sugar, which increases insulin to combat the elevation in blood sugar, which then decreases our blood sugar, which leads to fatigue.  This is a vicious cycle, as at the end of the cycle, simple sugars are again craved.

Thinking – depression leads to a spacey, internally disorganized state.  This is different than traits of ADHD that leave one feeling distracted by external stimuli.  There is a feeling of hopelessness and possible suicidal thoughts.  Cognitive distortions are common, caused by interference in perception that are created by the cloud of depression.  Gaps in perception are filled in with negative assumptions about life.

Always with depression there are behavior problems of some sort, and subsequently negative feedback is received by the depressed person.  There is also always some degree of relationship problems, resulting in more negative feedback that helps fuel the cycle of depression.

Based on all of the above, the depressed person is left with a compromised sense of meaning, purpose and self.  Depression destroys one’s capacity to act and to feel a sense of confidence and purpose.

So that is a descriptive summary of depression.  Next, the speaker gave a prescriptive plan about how to grow into healing through depression.  He made a distinction between treatment, which is what is done to the person (such as medication), and healing, which is done by the person.  The things to be done by the person were simple, but for someone who has depression, may certainly not be easy.  But good to at least have a road map to healing.  Here are the areas that deserve special attention.

1. Sleep – how and when we sleep matters. Deep sleep is when our minds and bodies recover and heal.  With depression, sleep patterns are often disrupted or out of whack.  Important to have rituals around going to sleep that signal to the brain that it is time to shut down.  He shared that he has a cup of tea and does some reading, which becomes a signal to the brain to slow down when it is repeated as a nightly ritual.
2. Eat – how, when and what we eat all matter. May be good to add in Omega 3 fatty acids, and vitamin D.  As noted above, try to avoid getting stuck in craving cycles related to simple sugars and empty carbs.
3. Move – he said move instead of exercise, but it could certainly include exercise. But he stressed just moving – walking, playing – activating our physiology facilitates healing.
4. Breathe – find time in the day for deep, calming breathing – deep through the nose and out through the mouth.
5. Think – pay attention to thought patterns, especially negative ones and work to change them, orient them to the truth. This can often be the focus in counseling.
6. Learn how to speak effectively – being able to express our internal experience helps us feel understood and known, which facilitates our gaining of social support. We are social beings, and it’s hugely important to not feel alone and isolated.
7. Gradually by doing these things, we build back up our sense of meaning and purpose.
8. Tend – I like this word. Doing these things is about tending to ourselves, like we would a garden.  It implies that healing doesn’t just happen, we need to engineer our healing process, and this can give us a sense of empowerment.
9. Seek – fill in the blank here. Figure out what you want to do that gives you a sense of meaning and purpose, and then endeavor to do it.
10. Imagine – imagine yourself thriving, doing what you want to do. Also called visualization.

For the depressed person, he stressed that it’s really important to be patient.  Be patient with yourself and the process of healing.  It’s apparent that the 10 things listed above are in a way all of the things that are difficult to do when feeling depressed.  But they at least give a road map toward healing, especially since these areas tend to take a back seat when we feel depressed.  Lastly, he said there can also be a place for anti-depressant medication to help facilitate the ability to tend to oneself.

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The Problematic “Ironic Process” in Relationships

This entry is going to discuss a common relational challenge that is seen in couple’s therapy, called the “ironic process.”  This describes the vicious cycle that we can get into as couples when we try to get our needs met but are unsuccessful.

Here is an example:  Spouse A has a need for affection.  When it is not received, Spouse A gets upset and becomes angry with Spouse B.  When Spouse B is on the receiving end of anger, Spouse B shuts down, and is much less likely to give affection.  This makes Spouse A more upset and angry with Spouse B, which in turn makes Spouse B less likely to give affection.  A vicious cycle is created.

These vicious cycles typically lead to a distance being created in the couple.  A common trap to fall into in response to them is for each spouse to focus on taking care of themselves.  In today’s world, what this can look like is in the evening, Spouse A watches Game of Thrones in the bedroom while Spouse B watches Sportscenter in the family room (insert your own shows or activities, I just put in a scenario that I’ve heard about).  At a certain level each spouse is happy and getting what they want.  After all, it’s easier to take care of ourselves because we know what we want.  However, the couple in this scenario is not getting what it needs.  It’s not to say that couples always have to be together, or do the same things – we need to have some separation and independence to be healthy.  But if the separation is based on the belief that “I can’t get my needs met with my spouse” then we have a problem. 

As we go about taking care of ourselves individually, a greater and greater distance is created in the couple.  This can be very subtle, and may not even involve conflict.  But as time goes on, the spouses begin to resent each other, because they both know, at some level, that they are not actually getting their needs met, at least in terms of their marriage.  It may feel like things are better because of the lack of conflict and anger, but the chasm widens.

I believe that it is in this chasm where infidelity, pornography addiction, as well as other addictive or problematic behaviors can materialize.  These behaviors reflect a need trying to get met, often at a subconscious level, based on the lack of getting needs for intimacy and connection met in the marriage.  This is why, in therapy, we look at affairs as a symptom of something gone wrong in the marriage.  That certainly isn’t to justify a bad choice of having an affair, but it is an attempt to understand its genesis accurately so that the underlying problems can get addressed.

So what can the couple do?  The first step is to take note that there is a problem, either based on the anger that may be happening, or on the lack of connection for the couple.  Work at discussing it together, very slowly.  Try to have a non-defensive approach, and don’t blame.  Talk about your own experience – tune into what you are feeling at an emotional level and gently share that using “I” statements (when this happens “I feel…”).  This conversation can be very difficult, so it’s very important to take it slowly together, and if it gets too heated to take a break and come back to it later.

If the couple is able to communicate about their issues, the vicious cycle is brought to a conscious level, allowing each spouse to make conscious choices about how they express themselves and attempt to get their needs met.  In the example at the beginning of the post, Spouse A would have to see that when he/she doesn’t receive affection, that he/she gets angry, and that when he/she gets angry that Spouse B shuts down.  Now, instead of getting angry, Spouse A might learn to say or ask for what he/she needs or wants.  Spouse B might learn that when Spouse A gets angry, he/she shuts down or distances, and could work at staying present, and expressing how he/she is impacted by the anger.  In the end, bringing the dynamics to a conscious level serves to slow down the process for the couple, and allows them a better chance of achieving resolution, or at least deepening the discussion.  Likely the couple will get at personal issues for both of them, build mutual understanding and hopefully empathy.  I would suggest being mindful of the possible impact of family of origin issues, as they tend to have a pesky way of getting into our marriages, and be open to discussing those with your spouse.

Again, I would stress that this can be a very slow and difficult process, and often it is helpful to receive guidance from a therapist, minister, or other third party.  I was going to say “don’t try this at home,” but you actually might try it at home and see how it goes, and then pull in support as necessary.  

The Difficult Design of Marriage

In this post, I will look at the design of marriage, and how this design makes us grow and develop, both as individuals and couples. 

In short and putting it simplistically, it can go something like this – we meet, date, go through a honeymoon phase early in marriage, have kids, get busy with the manual labor of raising kids, look up at each other about 10 years in or so, and get hit with some kind of “crisis” that we need to work through as a couple.  If we don’t work through the “crisis”, we risk the possibility of divorce.  As we know, the incidence of divorce has gone up significantly over the last several years, and is now at a rate of roughly 50%.  One reason is that it has become more socially acceptable in our society, but I will examine these “crises” as another, related, reason for high divorce rates.

As spouses, we typically meet and connect in part around some area of our human formation where we are underdeveloped.  We fill in the gaps and support each other in a complementary way.  An example would be a spouse that is a strong decision maker, one that drives the decisions that need to be made for the couple, while the other spouse may be less decisive and more willing to let the other one lead.  The “non leader” spouse may be more of a reflective thinker than the “leader” spouse and consider all angles of an issue or decision, and may be quick to abide by the “leader’s” decisions.  In this example, the spouses complement each other in that they each bring a different strength to the relationship, and this may be very functional for the couple for some time.  However, there is also a setup here for a future crisis in that they may also each bring a different weakness to the relationship.  The “follower” may feel compelled to go along with the “leader” for reasons that relate in part to their underdevelopment.  And the “leader” may feel compelled to be in charge for reasons related to their underdevelopment.  Sounds like a recipe for a crisis!

To stay in the status quo of how we complement each other is not sustaining.  Another way to put it is that what brings us together, several years later becomes the thing that needs to be re-worked in some way or we risk it bringing us apart.  After a while, to use the example above, the “leader” may need to grow in the area of learning to follow, to give up some control, and the “follower’s” growth may lie in learning to lead and be more decisive, to put it in very basic terms.  But this growth as a couple is not easily attained.

Often each spouse’s underdevelopment relates to their family of origin experience.  Growing out of a pattern developed in our family of origin involves some pain and discomfort.  And since the complementarity of our spouse’s underdevelopment supports the pattern, it involves going through this pain with, and seemingly against, at times, our spouse.  Again, a recipe for a “crisis!”  This is not to say that they need to become equal in all areas, and that they can’t continue to complement each other.  But it is to say there needs to be some reorganizing that happens for the couple in order for it, and the individuals, to grow and develop.  What the issues are and what development needs to happen varies from couple to couple, and above is only one example of what this can look like. 

This “crisis” can feel scary – like there is something terribly wrong – and can make us question our spouses, ourselves, and our marriages.  Working through the issues involved in the “crisis” typically involves conflict, tests couple’s ability to communicate through the conflict to get to some kind of resolution, and often in the end requires a level of acceptance.  Resolution may not look like everything being all figured out and sewn up nicely, but may look more like an improved understanding of each other and oneself, an ability to empathize with the other, a positive resignation and acceptance of one another.  All of this results in the marital connection being built up, or at least maintained.  If couples are not able to or don’t commit to completing this task in their marriage, I believe it is during these “crises” when many divorces happen.  People end up believing, usually mistakenly I would say, that they can’t get through this difficult period, and may end up choosing to divorce.  Couples, and the individuals involved, that are able to work through this period end up stronger and more developed.  These “tests” happen, and need to happen, in every marriage, and are crucial to a healthy marriage.

As with anything that is designed by a power greater than ourselves – parenting, marriage, how we use our gifts in our life’s work – it involves, necessarily, a certain amount of pain and struggle.  As humans, and human systems, we need to be forged, cut, and formed.  This is a good, albeit rocky, process. 

So when things get difficult in your marriage, as they should and will, see it as an opportunity for growth and get to work going through it.  And if you need help, like many couples do, it’s better to get that help – a therapist, friend, family member – sooner rather than later, when it can feel too late.

The Perfect Youth Coach

I just witnessed who I think is the perfect youth coach.  He was my kid’s little league baseball coach.  As with most things that relate to excellence, it wasn’t one thing that made this guy the perfect youth coach, it was a multitude.  And it wasn’t about anything terribly flashy or showy, it was all very real and down to earth.  I’ll do my best to share my take on the attributes that I believe made him the perfect youth coach.

I think it starts with his philosophy that youth sports, baseball in this case, is not just about the sport itself.  It was about teaching kids life lessons – how to be a good teammate, friend, person and eventually, man.  He told the boys at the team party how proud he was that they were good teammates to each other, and that they were learning more important things than just winning, like what it means to eventually become good men. 

As with any team, there were varying degrees of talent among the boys.  But his philosophy was to let each boy play a variety of positions, which I think helped them build on whatever level of talent they had and improve.  He expressed to the boys that he expected failure – “errors and strikeouts are going to happen” – which of course is just true in sports, especially in baseball.  This allowed the boys to play relaxed, not fearful of being reprimanded for making a mistake by either the coaches or their teammates, and translated to their playing their best.

It was never about him, and at the same time he wasn’t trying to be humble.  He was self-deprecating, but only when there was something about which to deprecate himself.  He was always engaged and in the flow, in the moment.  I must say as a little aside, I enjoy watching people that are in the flow, to see their excellence shine through, whether it’s someone repairing a car, giving a speech, coaching, playing a sport, selling clothes…  I find myself a bit transfixed and mesmerized, and feeling that way was one clue for me that there was something special about this coach. 

He wasn’t in it just to win, and it was apparent that he didn’t see his team’s winning as a reflection of himself.  One of his assistants said it best in saying that he was all about kids, teaching, families, baseball and winning, “probably in that order.”  Winning wasn’t his priority.  What I found very interesting is that his team was 15-0 at one point, and went on to win the league championship.  They were also behind in something like 10 of the 17 games they won, and they won 6 one run games.  I know he would say that these aren’t the important parts, and I would agree, but it does go to show that his philosophy – instilling confidence in the kids, letting go of the outcome, being engaged in a positive process – resulted in winning.  One of his players said at the team party “he always taught us to believe in ourselves,” and this was said in a way that conveyed that that belief may not have been there if the coach hadn’t instilled it.  For coaches that are very interested in winning, this coach showed that winning is most likely to happen when all the other things are done right, and when winning isn’t the only focus.  It’s not a choice a coach has to make, whether to focus on winning or teaching kids important life lessons.  When done right, they occur simultaneously. 

He seemed to make all those around him better, or at least bring out the best parts of themselves.  I don’t think he had an overly dominant team from a talent perspective, but the sum became greater than the parts.  This even seemed true for his assistant coaches.  They were obviously a unit, each having the room to bring their gifts to the table and to be their best selves.  It showed in how they interacted and enjoyed each other, and the respect that was engendered among them.  I think a key concept here is trust.  He created an environment of trust, and trust helps people relax and do their best.  It even showed in the creativity of the cheers the kids made up in the dugout.  Another life lesson taught indirectly – trust yourself and others, and good things happen.    

Duplicating this coach’s success (and I’m not even referring to the won – lost record) would be very difficult, because we don’t all have the same gifts that he possesses.  But the principles that he stood for, and his philosophy about being a youth coach is something to be mindful of and to which other youth coaches can aspire.  I told my son to try to appreciate what he had just experienced this season, and in having the coach he had.  I think he does, but I’m guessing he might even appreciate it more in about 20 years.  And I think that’s a good thing.

The Problem with Too Much Anger

We are all human, and as parents there are times when we get angry with our kids.  I would even say that getting angry is ok at times.  It lets our kids know that we’re human, and that we have our limits.  This is one way we teach our kids about relationships – by being in relationship with them.

However, when our anger happens too often and is designed to manage our kid’s behaviors, it creates a problem.  Parental anger causes a fear reaction in kids, and even though this can be very effective in managing behaviors in the short term, ideally we want our kids to learn to manage themselves from the inside versus external forces.

Over time, when anger is used to manage behaviors, kids gradually become less fearful, and the anger becomes less and less effective.  Parents have to keep upping the ante to bring about the fear reaction to manage the behavior.  This can lead to various forms of abuse, and I think we can agree that is never ok.  What most of us that are not abusive parents are left with is a level of anger that ends up becoming more like white noise to our kids, and it leaves us feeling ineffective.  It can make us believe that our kids don’t respect us or that they are just trying to push our buttons.  We get in a pattern of needing to be angry longer and longer before our kids stop the problematic behavior.  This pattern takes a lot of energy.

Why do kids push parent’s buttons?  I’ll try to break it down.  Energy expended between people creates attachment or connection, which is a human need.  The misbehavior/anger cycle creates a negative connection with our kids, and for kids a negative connection is better than no connection at all.  And connections need to be fed to be maintained.  In the misbehavior/anger cycle, kids do their part to maintain the connection by misbehaving, and parents do their part by getting angry.  In a certain way this is ingenious on kid’s parts because they subconsciously are facilitating their connection with us by misbehaving.  It’s just that when it’s a negative connection it doesn’t serve their best interest or lead to their growth and development.

For kids to learn the right behaviors, their brains need to be online and active.  When we get in negative cycles, like described above, the part of the brain that allows kids to learn is shut off due to too much emotion.  Parents need to be calm enough in order to create the most positive, functional, and useful connection with their kids so that their brains can be in a position to learn.  

So how do we do this – have a positive connection, stay mostly calm and do discipline at the same time?  We need some kind of system, or plan for discipline, and what this looks like depends on the age of the child.  For young children, under the age of 10, an example would be to have a system of giving time-outs for misbehaviors, such as the 1-2-3 Magic technique (misbehavior – “that’s 1,” misbehavior “that’s 2,” misbehavior “that’s 3, take a time out”).  This removes the emotion from the discipline, and focuses on the behavior, not the child.  It gets us out of trying to convince our children to behave differently, arguing, yelling, power struggles, etc.  With adolescents, we can work at having discussions, noting problem behaviors, problem solving and if need be, discussing natural consequences for behaviors.  For example, if a child is getting poor grades, but is spending a lot of time playing video games, a natural consequence would be to set limits on or remove the video game time so that grades can be maintained.  This should happen through discussion where the parent maintains their calm, is able to listen, and in the end assert authority (if necessary) without anger. There is a tricky shift that needs to happen in discipline with adolescents, and I won’t pretend to cover it in this post, but suffice to say that it should include more give and take and discussion than the 1-2-3 timeout technique, for example.  It’s also crucial for parents to be aware of their own fears that get tapped into by their teen’s behaviors, which can lead to reactive anger and impede the discipline process.

I guess this post is another example of how being mindful of and aware of our own internal reactions as parents is important in helping us avoid common parenting traps, such as getting caught in a misbehavior/anger cycle with our kids.  And it’s important to have a plan about discipline on which we can rely, instead of relying on anger.

Sports Mirror Life

At the risk of being too sports centric in this blog, I must say I love when I get young clients in therapy that are athletes.  It’s not that I prefer them over clients that have other interests – I love all kid’s interests, whether they are about athletics, theater, chess, robotics, whatever.  I believe any activity that contains an element of performance can mirror life, and struggles that we have in life.  But I’m kind of a sports guy, so I’ll talk about sports here.  Name a therapy issue and I can relate it to sports.  Well maybe not any issue, but I’ll do a few. 

Feelings of anxiety and depression – in playing sports, as in life, we can have these difficult feeling states.  To manage them in a sport, it’s good to stay in the moment, to not think about the future or the past too much, and to focus on the game and task at hand.  If you worry about what might happen, it’s going to make you tight and you won’t perform your best.  If you worry about mistakes you’ve made in the past, same thing, you’re going to be hesitant and tight, just like in life.  Let go of the outcome.  And go ahead and be nervous or whatever else you’re feeling.  Just be mindful and aware of your feelings, that’ll give you your best chance to manage them and still perform.  

Dealing with failure – in baseball, a really good pro player fails around 70% of the time at bat.  When they don’t get a hit, they need to let go of it and come up the next time and focus on what they are doing, not on their previous at bat.  Learning how to fail and let go is one of the most important things in life, because we all fail at times.  If we are too concerned with it, we have difficulty performing in the moment.

Family Relationship Issues – in family relationships it’s good to have healthy boundaries, to know what you are responsible for and what you’re not.  In football (or any team sport), it’s important to stay within the boundaries of your role on the team.  If you are supposed to cover the middle, don’t try to cover for the cornerback on the outside or you’ll get beat up the middle.  And be sure to communicate with your teammates so that you’re all working together.  Speak up, be assertive and clear.  And if there is a disagreement or a breakdown, get together and look at what happened, be accountable for your part.  This is how relational systems work best, in teams, families or otherwise.

Academic Difficulties – you need to put in the work to succeed.  If you have a weakness, like kicking with your left foot in soccer, you need a lot of repetition to build up the muscle memory to improve.  No pain, no gain.  Just do it.  In school, as in sports, it is important to identify your strengths and weaknesses, and then find strategies to work with what you’ve got.  In school this can apply to finding strategies to manage ADHD symptoms, processing challenges, etc.  We often hear of the best athletes “putting in the work,” not just relying on natural ability.  Same is true in school. 

Bullying – you need to find the necessary supports.  In a sport, if you’re struggling in some way, feeling fearful or uncertain, unsure of your place on the team, talk to the coach and let them do their job.  They are there to support and help (at least they should be), and we all need it at times.  Knowing how to self-advocate is crucial in life.  We’re not always going to be strong or on top of our game, so knowing how to lean on a shoulder or ask for help is important.  With bullying, getting help from key adults (parents, teachers, principals) is crucial.

Trauma – in sports, if you’re hurt, sometimes you need to take a break.  It’s ok to sit out a game, there will be plenty more.  Injuries need attention and time to heal.  Psychological injuries, whether resulting from abuse, an accident, or something else, also need care.  They may need to be talked through and supported by family or a professional.  Knowing how to do self-care, take a break, and reach out to others is important.   

Okay, you get the idea – we may find answers about how to manage a life challenge by taking a look at how we manage a similar challenge in a sport or activity. 

Faith and Parenting

Parenting is a really hard job. There are times that I get stuck in negative patterns with my kids involving nagging, frustration and anger. Or I worry about one of my kids and how they’re doing, but I can’t always make it better. Or I try to make it better but I actually end up making it worse – I might inadvertently send the message that I don’t believe in them or that they aren’t capable. Often my own issue or fear is at play, but I displace it on to my kid. I think all of this would feel even more impossible if I didn’t have faith in God.

I should rely on my faith more than I do as a parent. What I often do in regard to my faith is wait until I’m at my wit’s end, not sure what to do, feeling kind of hopeless, and then turn it over to God. I find that I do this at times in my marriage as well. I think the common denominator between the two is that they are both about relationships, where I can’t always control how the other person or people are going to act and am left feeling a bit helpless and frustrated. I find that when I turn to God as a parent, things flow more smoothly. I feel a freedom in letting go and letting God, and tend to come up with my (or His) more creative parenting ideas. Unfortunately, if I’m not tracking, I mistakenly take credit for it and believe I did it on my own.

Often, the answers when I turn to God have a soothing message of “it’s going to be ok,” “don’t worry,” “you don’t need to be in control.” From this calmer state I end up having better boundaries, am less controlling, show more trust, am less perfectionistic and don’t expect perfection from my kids. Life tends to flow a little easier – others feel less pressured by me, I am more empathetic and kind, more relational, listen better, and am less interested in being “right.” (I should note that the answers you arrive at may be of a different nature depending on how you get stuck, but they will be what you, and your kids, need.)

Come to think of it, all of these responses fit better with Jesus’ greatest commandment – to love one another. Turning over my parenting problems to Him allows Him to take on what is His, and my letting go makes me more relational and loving to my wife and kids. An aside – isn’t it reassuring when we can see that His design works? Not that I doubt that He knows what He’s doing, it’s just that I am not always able to see or understand His design.

To be clear, I am not saying that we should forego all of our parenting responsibility and necessary decision making. God gave us a brain and we need to use it, be responsible, and make hard decisions as parents to say “no” or “yes” when needed. But I am saying that there are times when we get stuck in negative patterns with our kids, and have a hard time getting out of them. Often we are angry and frustrated in these times, and so are our kids. These are the times in particular where we need to slow down and say “God, I’m lost and confused, what would You have me do?” Or, “A little help down here?!” Then, wait for an answer. As you wait, your mind slows down, opens to new ideas, and you are in a receptive state to God. You notice a shift in your perspective and how you feel. It’s like a knot getting untied and loosened. This leads to answers about what to do and how to be.

I suppose you could make a completely secular argument here that you are just putting yourself in a different psychological state, and so you are able to come up with better parenting answers. I think that might describe the psychological process at a certain level, but I believe that the act of turning to a power greater than ourselves is what actually allows the psychological process to happen in the most perfect way. If we simply rely on ourselves, I believe we face more limitations.

What’s also interesting to note is that when we turn to God, we are being relational with Him, and He is being as a parent to us. I believe this is what He wants, and what is best for us. We are in a position of opening up to God, sharing ourselves, and receiving what He offers. It reflects the truth that we are dependent on Him. And with parenting being what it is, at once both the most rewarding and most difficult job, I don’t want to rely just on myself. I’ve already tried that – it doesn’t work that great.