Book Review: The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture by Gabor Mate

This is such a great book but it is HEAVY. I had to take frequent breaks so I didn’t become too overwhelmed by the content. There are so many good quotes, I don’t think I’ve ever highlighted a book as much as I did this one.

The Myth of Normal is an examination of the larger social forces at work and how it impacts our bodies and minds. It examines North American cultural values that are rooted in capitalism. It looks at the ways our medical establishment is trained to ignore trauma and stress as factors in disease, despite them having a very strong correlation. It offers alternative ways of looking at disease that are rooted in self compassion and in partnership with the body. It normalizes the human experiences of emotion instead of pathologizing it.

Here are a few favorite take aways from the book that I will expand on:

1.    A New Take on Depression

2.    Redefining Trauma

3.    The role of Capitalism and our Mental Health

A New Take on Depression

“Depression appears as a coping mechanism to alleviate grief and rage and to inhibit behaviors that would invite danger”

This quote comes from the chapter that examines our human need for authenticity and connectedness. We are taught at young age that certain behaviors are desirable and others are not. Well meaning adults teach us this because they want us to have relationships and it’s true that certain behaviors will make this challenging. Unfortunately, it also teaches us that parts of ourselves are bad and need to be hidden, which creates stress.

The author suggests that depression is more of a reflection on how our relationships are going. People may involuntarily enter a depressed state when they are suppressing emotions like grief, rage, insecurity, and anxiety in an effort to maintain relationships. It’s such an interesting and more empowering way of understanding depression than just “it’s a chemical imbalance and it’s out of your control”.

Redefining Trauma

“Emotional injury during development can have physiological consequences, even without abuse or neglect….The most powerful predictor of your functioning in the present is your current relational connectedness and then the second most powerful component that we see is your history of connectedness”

This is such an overlooked area in our field. If you’ve read my page on trauma then you already know that I prefer a more expansive definition of trauma. That’s because I’ve seen how detrimental emotional injury can be. It effects our ability to feel safe and trust others. It keeps people from having relationships all together, which is detrimental to our mental health.

Capitalism and Mental Health

“The structure of Capitalism creates a situation where people’s value relies on their capacity to consume”

So many people I know struggle with low self esteem.  Many times, it goes back to feeling like you don’t measure up to your expectations.  We know these expectations come from somewhere, but have you ever stopped to think about where?  American values are around having a lot of stuff and doing a lot of things.  These values ultimately support Capitalism’s mission – to make a profit.

I think it’s so important to understand how larger systems impact our mental health.  If we can understand the flaw in the system we can then start to dismantle the hold it has over us. 

I went through ups and downs while reading this book, but ultimately I think it’s a very important contribution to the field of mental health.  It is lengthy, wordy and opinionated at times.

I gave it 4/5 stars.

Book Review: Dark Places by Gillian Flynn

I decided to pick this book up this July because I was in the mood for a mystery/thriller. I never had the pleasure of reading Gone Girl but I loved the movie SO MUCH. Gillian Flynn is a mastermind when it comes to unexpected plot twists.

Book Description from Goodreads:

Libby Day was just seven years old when her evidence put her fifteen-year-old brother behind bars.

Since then, she has been drifting. But when she is contacted by a group who are convinced of Ben's innocence, Libby starts to ask questions she never dared to before. Was the voice she heard her brother's? Ben was a misfit in their small town, but was he capable of murder? Are there secrets to uncover at the family farm or is Libby deluding herself because she wants her brother back?

She begins to realise that everyone in her family had something to hide that day... especially Ben. Now, twenty-four years later, the truth is going to be even harder to find.

Who did massacre the Day family?

This book is about the murder of Libby’s family. When she’s just a child, she hears the murder happen and believes her brother was the one that did it. Now at age 24, she is living alone and running out of money. This leads her to a group of amateur detectives that believe her brother is innocent and will compensate her to help them with the investigation.

We learn in the book that the family is under a lot of stress. Her father leaves the family and does not contribute. He comes in and out of their lives inconsistently whenever he needs money. He is abusive to her mother and abuses drugs and alcohol. Libby’s mother is struggling to provide for the family and is just barely making it. In huge debt from buying the family farm and not making any profit, she is depressed and barely keeping it together. The weight of all the stress her mom is carrying impacts the relationship she has with her children. She acknowledges not showing them enough affection and barely telling them she loves them. Her brother Ben has a lot of responsibility - to make up for what his dad isn’t doing, which makes him angry and resentful towards his parents. This leads to him getting involved with all kinds of risky behavior.

Libby has an assortment of problems after losing her family. As a child she has a violent and unpredictable temper. She is often depressed and in and out of the mental health system. Libby has no friends, family or support system, other than charitable donations. She doesn’t know how to connect with people because she doesn’t trust them. She steals things she likes and things she needs. She’s also quite fearless, unapologetic, and clever. Her ability to understand people like herself eventually leads to her finding the truth.

I really enjoyed this book! It’s captivating with twists and turns. You also can’t help but feel for the characters and their suffering. Libby’s story gives us an example of how trauma effects children and adults. In her case, she becomes numb, difficult to connect with, and developmentally stunted. She even talks about this in the book at some point, saying that she never learned how to be an adult. But she also has these survivor qualities - courage, intelligence, and grit.

I gave it 5/5 stars.

Create More Joy

Remember when you were young and could spend hours playing? I remember jumping on the trampoline, playing barbies with my cousin, and my absolute favorite — dress up! It gave me the opportunity to put on clothes I didn’t get to normally wear and pretend I was someone else. It was so much fun and just writing about it now, I can’t help but smile as I think back on those times in my life.

Play isn’t something we normally think about for ourselves when we become adults. Unless we spend time with children or have young animals in the house, play is often long forgotten once we hit a certain stage in life.

But finding ways to play as an adult can really help your mental health. Life is so serious, play helps us step away for a bit and learn not to take things so seriously. It also gives us a little dopamine rush, which promotes feelings of accomplishment and reward. Add a friend in and you’re also going to stimulate oxytocin, which makes us feel warm and connected socially. Both of them are great antidotes to stress.

So what does play look like as an adult? I define play as an activity you’re doing just for the fun of it. Ideally it’s something that really holds your attention and brings joy into your life. I tend to cycle between reading, playing video games, and sewing. My mind isn’t able to wander very much because they are all mentally stimulating. If I find myself trying to turn it into an accomplishment, that’s a sign I need to step back and remember why I’m doing it.

If you find yourself struggling to identify hobbies, don’t be too hard on yourself. Try thinking back to things you liked to do when you were younger and had less responsibility. Our teenage years are rich with activities that we likely “tried on” when we were figuring out who we wanted to be. Try something new or tackle that thing you’ve been thinking about doing forever. Life is short.

Why am I so afraid of change?

It’s that time of year. The leaves are changing colors, there’s a refreshing coolness in the air, we’ve been able to zip up our hoodies and get back outside without sweating to death— it’s such a welcome change after the exhausting humidity and heat of the summer. Especially in the Midwest, there’s something that just changes in the air when this time hits. It’s when we start to shift from the stimulating and energetic rhythms of summer into a slower and relaxed pace.

It’s got me thinking about change. If only it was as effortless as the change in season. The seasons change predictably and we know what to expect during that time, but change is rarely like this in the real world. Whether it’s something we’ve planned all along or something that happens to us outside of our control, change often brings up fear when you’re an anxious person.

What if this is the wrong decision?

What if I have regrets?

What if I fail?

What will people think?

One reason this happens is because we can’t predict what’s going to happen next. Our brains just don’t like that, so it draws on similar past experiences to try and prepare you for what’s ahead. Also our brains are negatively biased so they remember painful or scary experiences stronger than positive ones. Thanks brain! When you’re feeling fear, you may be re-experiencing something from your past that seems similar to what you’re going through now.

The faith you have in yourself also plays a big part. Many times when I’m exploring fears with my clients, it boils down to one thing — I CAN’T HANDLE IT. Self esteem issues come up often when we’re faced with a challenge.

If you have trouble coping with change, start by noticing your thoughts in relation to it. Next, try to challenge that thought. You’re still here aren’t you? Did you actually die or fall apart or did you just experience discomfort? Discomfort sucks but it certainly doesn’t kill you. If you’re really having trouble here try using radical acceptance, which looks like “I don’t like that this is happening but I accept that I can’t control it”.

There’s no way to avoid changes in life. Like the seasons, things are going to happen, welcome or not. We might hate winter and complain, but most of us don’t sit around ruminating about it. We accept that it’s inevitable and move on. Now changes in life are not that simple of course, but to some degree we have to find a way to accept things that we don’t like. Just this simple exercise increases your ability to handle stress and that in itself makes your self esteem better.

Can you get over trauma?

People who experience a trauma often want to just move on and get over it. It’s not uncommon for a person to experience something unimaginable and decide that they are going to just pack it away neatly into their memory and never think of it again. Sometimes this strategy works for awhile, particularly in the short term and one might feel they have successfully moved on from it. But most often, eventually it creeps back in and not always in a very obvious way. This is because traumatic experiences shape the way that you view yourself, the world and relationships.

Changes in Self Image look like:

• I am broken

• I don’t know how to make good decisions

• Feelings of worthlessness

• Taking too much blame for relationship issues

Changes in World View might look like:

• Panic attacks or trouble with crowds

• Seeing the world as a cruel and scary place

• Overgeneralizing groups that share characteristics with your perpetrator (i.e. all men are bad)

• Being scared to be alone or be in unfamiliar places

Changes in Relationships might look like:

• Being suspicious and mistrusting

• Not allowing yourself to get too invested in a relationship

• Avoiding conflict

• Being afraid to express yourself

The beliefs you develop after a trauma matter…

Beliefs shape how we respond to things. They either help us engage in behaviors and activities that enhance our quality of life or get in the way. People that have developed many negative or exaggerated beliefs tend to have a hard time in many aspects of their lives. Trauma can get in the way of things that truly lead to fulfillment like love, companionship and self esteem.

So how do I get over it?

Unfortunately you don’t ever fully get over it but you can learn to live with this better. Just by reading this you are increasing self awareness into your patterns. But beyond that, a big part of living with a trauma is finding ways to face the pain and not avoid. Avoidance keeps you stuck in the pattern. You experience negative feelings, images or physical responses and you rush to numb them with distractions (i.e. social media, food, substances, keeping busy, work). Trust me, I get it. Sometimes avoidance is ok and you don’t have a choice, but you can’t spend your life running away from these feelings. You have to find a way to accept them and it starts with self compassion. It’s ok to feel angry, sad, scared…you’ve been through a lot.

Consider telling your story…

This might feel very scary and I get it, you’ve been avoiding this for a long time. Telling your story is part of the healing process. You can write about it, talk to a professional, or share what happened to you with someone that you know will support you. Telling your story is important because it helps you let go of feelings of shame. Shame thrives on secrecy because your negative beliefs just continue to circulate without being checked. Just by simply sharing your story it gets rid of the secrecy. You might even find that facing it isn’t as scary as you imagined.

Adopt a survivor mindset

Getting stuck in a victim mindset doesn’t help you heal. Victims think that they are doomed to a life of misery because of their experiences. They don’t think that getting better is a possibility and there’s no point to taking any steps towards healing. Survivors think they are capable. They own their stories, they accept their raw emotion, and they take care of themselves. Sometimes they even use their experience to grow by finding meaning in their suffering.

Unfortunately there is just no quick and easy fix to trauma healing. If there was, therapists would be completely on board with it. It’s human nature to want to avoid suffering and these steps take a lot of work. But in the end, it can lead to a more fulfilling life. Finding meaning in suffering, learning to let go of these negative beliefs, and being kind to yourself in the process restores hope.

What is Mindfulness?

“Paying attention on purpose in a particular way to the present moment non-judgmentally”

As complicated as Mindfulness may sound, it’s actually very simple.

Mindfulness starts by cultivating curiosity into your experiences. We often work in autopilot mode, which is when we don’t have to actually break down the steps or pay attention to what we are doing. Our body just knows what to do without thinking about it. This is how our brains work so we can free up space to process other important information. This is why you don’t have to re-learn how to walk, drive a car, cook meals, etc.

Unfortunately, we also can go into autopilot mode with our dysfunctional habits too. Think about the last time you sat down to eat a meal when you were overly hungry. Can you even remember the flavor of the food? The texture? Was it crunchy? Salty? Spicy? Warm? Cold? Soft? How did you feel while you were eating it? Did you notice when you started to feel full? If you’re like me, you might have went through the entire experience without noticing any of these things. Maybe even ate way more than you needed to and had to deal with a stomach ache afterwards.

This can also happen with our thoughts. Humans spend a lot of time lost in thought and if you are a person who deals with depression or anxiety, often those thoughts are worries about the future, regrets about the past, wishing things were different, or beating yourself up for not being the person you want to be.

Mindfulness practices allow us to bring more awareness to our experiences. It allows us to step out of autopilot mode and give us a choice in how we react. We can make choices about how we respond to stress, nourish our bodies, speak to ourselves, and communicate with people.

Like any helpful skill, we have to actually take the time to practice it. You can start by bringing your awareness to these experiences that you spend in autopilot mode. Use curious questions and engage your five senses- touch, taste, smell, sounds and sight. What sensations come up when you sit outside? What sounds do you hear? How does the air feel? Do you notice any smells? Open your eyes and start describing what you see. If you need help, you might do better with a guided meditation. There are so many resources out there on the internet at your disposal.

“Mindfulness is not mysterious. It is practical. It is more than a set of techniques to add to one’s toolbox. It involves personal practice and a willingness to be with our own thoughts and feelings with greater acceptance and less reactivity.” - Elena Rosenbaum, “The Heart of Mindfulness-Based Stress Reduction”.

How do you choose a therapist?

So you’ve finally decided after months of agony that it’s time to get into therapy. With so many options out there, how do you narrow it down? Especially right now with so many therapists starting practices, it can be overwhelming trying to figure it out. I’ve come up with a few strategies that I hope can help you.

What do you value?

Take a moment before you read on to think about what matters to you most in your life. You can use the following questions as a guide:

How do you spend your free time?

What issues really get under your skin?

What causes you to stress and worry?

When do you feel your happiest?

It’s important to have an idea of your values because they play a role in how you choose a therapist. For example, if you really stress and worry about meeting new people, then you’re going to want to find a therapist that has content you can research. Or if you find technology really frustrating to use, then you’re going to do better with a therapist that offers in person appointments, and so on.

Here are some common values that I’ve come up with to assist you. While all these things might be important to you, try to narrow it down to just one. It will help you be more decisive about your criteria.

Money

One of the first things that come up for people when they think about seeking therapy is the cost. Luckily most insurance plans cover mental health, but that doesn’t always mean it’s going to be 100% covered with no cost to you. Sometimes insurance plans have high deductibles and co pays, making it an added expense. It can be difficult to get past the financial worries and you might find yourself questioning whether it’s worth the cost.

But don’t let this stop you from investing in it. Try to think of it more as an investment into a better quality of life. Therapy allows you to discover things about yourself and make choices about how you respond to the stress in your life. How much is more peace in your life worth to you?

Time

What about your time? If you’re a person who values your free time over everything else, then you might be better off finding a treatment program that is time limited. This could be through an Employee Assistance Program, a therapy workshop, or intensive counseling where you meet with your therapist several times a week for a short period of time to work through a specific problem.

On the opposite end, maybe you value taking your time with things and just want someone to vent to. If this is what you’re looking for, then you are going to want to find someone in a private practice setting. Your insurance doesn’t always cover this type of therapy, so you might have to pay out of pocket, but you also have more flexibility in your treatment. There’s often less paperwork, less of an agenda, and more time to openly explore.

Professional Experience

Another thing to think about is area of expertise when finding a therapist, If you are a person who values education and experience, then you will want to consider finding someone who has narrowed down their areas of expertise. When therapists narrow down their selection criteria, they often are more experienced with that specific issue and genuinely enjoy working with it. I work best with adults and am not afraid to admit that I am not very good at working with children, so my areas of expertise reflect that.

Shared Experience

There is nothing wrong with using factors like your therapist’s race, gender, orientation, or age to narrow down the search. There are just some experiences that you might not feel comfortable talking about unless you feel that your therapist can relate to it. But beyond this, shared experiences can also mean their hobbies, interests and values. Although a therapist needs to keep some information private to keep the boundary clear between therapist and client, most therapists are comfortable sharing a little about their personal lives.

How to Practice Self Care: 5 Areas to Consider

What image comes to your mind when you hear people talk about Self Care?

For most people, it might bring up an image of someone, usually a woman, spending a day at the spa, having a bubble bath, or going on an extravagant vacation. And while these are definitely forms of self care, it often makes a person feel as if it is more about living a life of luxury than a necessity for good mental health. When we don’t engage in self care regularly, we start to feel a lack of joy, purpose and meaning in our lives. The effects of stress become more noticeable as well, which might lead to social isolation, overeating, sleeping too much, or difficulty relaxing, to name a few.

In order to engage in self care, you have to start by looking at it as a necessity rather than a luxury. It’s like brushing your teeth to prevent a cavity, you must do it in order to prevent the effects of stress developing into something more serious. But what is it exactly?

Self care are the actions you take to bring balance in your life and reduce the effects of stress. It helps to sometimes break them down into categories. My personal favorites are physical, emotional, spiritual, relationship, and practical:

Physical - The actions you take to better your physical body. This often includes things like going to the doctor for your check ups, moving your body in ways you enjoy, sexual gratification, eating regularly and choosing foods that make your body feel good.

Emotional - How you take care of your emotional needs. Things like writing in a journal, practicing yoga, crying, not judging yourself for your emotions, poetry, listening and creating music, and talking about our feelings to someone we trust.

Spiritual - This doesn’t mean that you have to be religious or believe in God, it simply means finding purpose and meaning in your life that goes beyond just you. Examples of spiritual self care are things like being in nature, grounding yourself, engaging in volunteer work, meditating, praying, and practicing gratitude.

Relational - How we nurture our social connections. Like spending time with family and friends, playing with your kids, talking on the phone, texting your significant other, belonging to a book club, a Facebook group or online forum. It could also mean getting away from relationships that are toxic to you.

Practical - Taking care of your business. This is an area that I find often gets overlooked in the various self care assessments I’ve come across. I think it’s so important though because chores, bills, tasks that we don’t want to do are a part of our lives and when we neglect them, we often suffer. This might look like keeping a planner, making to do lists, hiring a maid service, ordering your groceries online, meal prepping, or scheduling important appointments and sticking to them.

So now that you know these different areas, take some time to reflect on your habits and please don’t judge or criticize yourself too harshly if you find you aren’t doing these things enough. If you are looking for more tools to help you assess these areas, one of my favorite self care assessments is in The Intuitive Eating Workbook by Tribole and Resch.

How to deal with Anxiety

If you’re reading this, my guess is that anxious feelings are all too familiar to you.   That feeling of wanting to escape the situation so you don’t have to feel sick to your stomach or trouble sleeping at night because you just can’t shut your mind off.  Or maybe it’s that chronic tightness in your neck, back and shoulders causing you pain and the thoughts like “I just can’t handle this”.  Maybe you’re recognizing that you often avoid doing things that others seem to enjoy, like going shopping, going to parties, getting your haircut, or calling people on the phone.  Whatever your story may be, these anxious feelings are causing you some distress and you want relief.  Here are some practical tips to help.

Stop Yelling At Yourself

When you notice those anxious feelings, it’s not uncommon to feel frustrated with yourself.  Let’s say you’re anxious about going to a party and an hour before you’re about to leave you start to feel sick to your stomach.  You might start having thoughts like “Ugh…Why can’t I just be normal?”  “Why does this always happen to me?”  “I SHOULD like to hang out with people” “Just stop.  You’re being ridiculous” and so on.  

While these thoughts may come and you shouldn’t spend a lot of time being angry at yourself for having them initially, they often make your anxiety worse because not only are you adding anger to the mix, you are also putting pressure on yourself.  Instead, try noticing these thoughts and practicing some self-compassion.  A great way to do this is to imagine someone you love coming to you with this issue and how you would respond to them.  Most likely, you would say something kind and hopeful, not degrading and hurtful. 

Just Let it Happen

This might seem counter intuitive, I know.  You’re here to figure out how to make this go away so why on earth would you want to just allow it to happen?  Well let me explain.

When you start to put pressure on yourself to think, feel or behave differently, it makes your anxiety worse.  I mean if it were that easy to just stop, you would be doing that already.  Sometimes just giving yourself permission to have your feelings can stop it from escalating.  Rather than thinking “I have to stop this from getting worse”, try replacing it with a thought like “It’s ok to feel this way.  This isn’t going to last forever”.  Letting these feelings wash over you is sometimes the best way to manage them.  Instead of focusing on taking the feeling away, focus on trying to make yourself more comfortable until it passes.  This will look different for everyone, but it could be something very simple like taking a hot bath and focusing on your breathing.  Putting on a show that makes you laugh.  Listening to relaxing music while you do the dishes.  It doesn’t have to be anything fancy. 

Move Your Body

You knew exercise was going to be on this list.  I know it seems obvious, but maybe I can shed some new light on why this is the case.  

The Fight or Flight Response plays a major role in anxiety.  When your stress levels start to escalate, your body responds physically because of the release of cortisol and adrenaline into the body.  The more stressed a person becomes, the more the body is preparing itself to respond to the problem.  Whether it’s to leave, confront, or freeze in some cases, your body is ready for action, not for logical thinking.  This is why it is sometimes difficult to calm down when you’re highly anxious, even though you can see sometimes that your thoughts are not logical.  

So when you’re highly anxious, it is sometimes better to release that built up tension in order to help the body relax itself.  Going for a walk, a run, doing jumping jacks, playing basketball, riding your bike, cleaning the house—it doesn’t matter, just move your body and get your heart rate up for a little while. 

Examine Your Boundaries

So far we’ve focused more on how to handle anxiety in the moment and I hope that you’ve got some fresh ideas.  I’d like to shift more towards common causes of anxiety, one of which is having poor boundaries.  

Boundaries are the limits we put on relationships to keep ourselves happy, safe, and satisfied.  When we have good boundaries with people, we are able to communicate our feelings, say no to things we don’t want to do, and accept the emotions of others without feeling the need to fix or change them.  On the other hand, when we have poor boundaries, we start to feel the weight of the world on our shoulders.  We take on projects at work that take away time to engage in our hobbies.  We follow our spouse around and keep asking “What’s wrong?” despite he/she telling us they feel fine .  We spend money to go to events we have no interest in going to because we don’t want to disappoint our friends.  While these things are totally okay to do from time to time to build relationships, it becomes a problem when it’s a pattern because you sacrifice your own needs. 

I could probably (and will probably) write an entire blog about boundaries and why they are important,  but the take home message here is that when you sacrifice your own needs, you often start to get angry and resentful.  This can cause anxiety on a regular basis because you become torn between what you want and the pressure to please others. 

Avoid Avoidance

Another cause of anxiety is engaging in avoidance behavior.  This is when you find yourself avoiding things that cause you stress in an effort to reduce the anxious feelings.  Avoidance can be something obvious like turning down an invitation to hang out with friends because you fear being awkward and it can also be more subtle, like not expressing your feelings because you don’t want to upset someone else.  You get some relief in the short term, so you might be wondering why this is a problem.

Well, it’s because avoiding things on a regular basis to manage short term anxiety becomes a long term problem.  When you don’t force yourself to work through your anxiety and see you can handle stressful situations, you start to think you can’t possibly handle it the next time it comes around.  So the next time you get that invite to hang out with friends, you are going to feel even more anxious because you haven’t practiced those social skills in awhile.  

While these tips can certainly help, don’t be afraid to seek professional help if anxiety is causing you problems.  Whether it’s something you deal with daily or if you’re going through a short period of it due to stressful life events,  talking it out with someone can really be beneficial.  You don’t have to manage it all by yourself.