You Can’t Teach Love – Or Can you? How Evidence-based Therapies Masterfully Tackle Self-Intimacy

Years ago I worked with a early-40s adult female client named Esther (alias), who had sought out cognitive behavioral therapy to put an end to a decade of near unrelenting depression. Esther’s hopelessness often felt palpably immovable. “I’m unlovable and always have been.” “Everything I do turns into a rotting disaster.” “I should be punished for my stupidity.” Esther would constantly berate herself with the messages she had received as a small girl. Despite having a high-paying job, a usually fulfilling marriage, two beautiful children, and a content pet cat at home, Esther remained unconvinced that she was anything other than an unlovable failure. And while she came to therapy with some motivation to feel better, she had limited hope in her ability to do so. In the first few sessions, she often questioned, “How am I supposed to get better? I’ve hated myself for so long.” She continued, “Everyone talks about this fantasy goal of learning to love yourself in therapy. Ha! Some crap. You can’t teach someone to do that,” she balked. “You can’t teach self-love? Yes you can.” I replied. And I’ve subsequently thought much about how we indeed target and teach self-love and self-kindness quite intentionally and effectively at CBT California.  Let’s take a brief look at how cognitive behavioral therapy tackles this…

CBT is the front line intervention for depression and many other mental health concerns, backed by decades of robust research. At depression’s core is often a deeply dug core belief of “I’m unlovable.” Core beliefs are messages we learn often early in life, which come to define how we see ourselves. When the “unlovable” core belief is activated, it’s as if dark and gloomy-colored glasses come over one’s eyes. With these gloomy glasses on, you can imagine how difficult it would be to interpret events around you without this gloomy biased tint!

A compliment from a co-worker may lead automatically to thoughts like, “They are just being nice” or “They are probably saying that sarcastically.” A hug from a caring lover may be met with some anger or disgust, prompted by quick thoughts like, “Don’t touch me. I don’t deserve this affection.” And as you can imagine, these automatic thoughts can lead to deep sadness and shame. You may want to push people away and isolate—further confirming your unlovable belief. What a vicious cycle…

In CBT, we work persistently and patiently with clients to help you chip away at the negative automatic thoughts that pop up when those gloomy glasses are covering your eyes. Maybe the gloomy glasses have been on for years, and maybe they have slid on in the past month or two. In any occasion, we will teach you tools for challenging your thoughts – starting with the day-to-day ones, and moving deeper to challenge the core belief at the root. This will take effort and motivation, which we will help you cultivate. Eventually, with a big dose of compassion, support from your therapist and lots of practice, you can and you will become an expert at challenging the inaccurate belief that you’re unlovable. You will learn to reprogram your thinking and heart to full buy into a new (more accurate) belief, namely, that you are someone with worth. You are worthy of love. You really are. Everyone is. But of course we can’t convince you of this. It may be worth you exploring…

By the way, after 4 months of CBT, Esther looked at me in our last session and said, “I can’t say everyday is a joy ride—far from it. But I can actually say I like the person I’ve become these past few months. Well, I guess I mean, the person I’ve always been.”

Author: Sara Rabinovitch, PhD
May 30, 2018

How to always get what you want and keep others happy: Part II

If you read part I of this post, you know that it is in fact not possible to always get what you want and keep others happy. This round is for the folks who are more invested in the latter…and I won’t use the phrase “people pleasers” here because I don’t find that to be quite accurate. The reality is that we are all driven by our own emotion. Some of us have a stronger emotional reaction to disappointing others than we do to giving up something that we want. When that happens, we find the most relief in accommodating others, so that’s what we do. This is a great strategy if your goal is to regulate your emotion. But what if your goal is to increase self respect or get your needs met in a relationship? If your default is pressing the relief button and giving in to avoid disappointing others, you may be contributing to a long term pattern that will diminish self-respect, build resentment, and possibly allow others to take advantage of you. Sound familiar?

The key is finding balance. In order to balance your needs and the needs of others, you will need LOTS of practice tolerating that initial spike of uncomfortable emotion (probably fear or shame) when asking for what you want or saying no. Your brain will have to learn that this is, in fact, not a threat. Once your brain has learned there is no threat (after you asking for what you want or saying no many times and overriding that emotion), the emotion will lose its function and you will likely be habituated to the experience. In other words, if you are not driven by your emotion, you can become more balanced in assertiveness. The result? Well, you will just have to see…

Author: Julie Orris, PsyD
April 10, 2018

How to always get what you want and keep others happy: Part I

Just kidding (laughing face emoji). Not possible.

I was recently informed by a highly valid and reliable measure (a Facebook quiz) that my personality is 97% driven by my assertiveness. Truth be told, that may not be so far off. Sounds like a good thing, right? Yes and No. When I look back on early adult years and the struggles I had in relationships, I can see how my assertiveness got in my way. I am a naturally direct communicator and have always been bold in approaching others. What I was not so natural at was reading the impact I was having and thus how asking for what I want or saying no was taking away from the relationship. I hadn’t yet learned that just because others say yes doesn’t mean there hasn’t been a cost. I didn’t understand the nuances of someone tentatively agreeing to something or hinting at disappointment when I said no. I have learned the hard way that to be assertive AND have healthy relationships means being highly intentional about the words I use and acutely attuned to the impact on the other. That means, when I ask my husband to  pick something up on his way home from a 12 hour work day, I must add things like “I know you have had a long day,  and if you are too exhausted I can do without cilantro tonight.” It means that if I am going to say no to something I have to tell the truth about why I am saying no. And if I can’t tell the truth, then I probably shouldn’t be saying no (so I have to show up). It means that I have to tolerate distress and not address most things that bother me because the cost to the relationship outweighs the impact on me or the importance of, for example, getting someone not to chew so loudly.  I know that when I acknowledge the impact my request or refusal has on the other person, it makes them feel better about it. So I take the extra step. I say the extra words. And I repair when I forget.

For those of you struggling on the other side of the spectrum, stay tuned. Next time on the blog: “What if I say no and someone gets mad at me?”

Author: Julie Orris, PsyD
February 27, 2018

Dialectiwhat?: Keeping it Shiny

It’s no secret to anyone who knows me that I am prone to anger. Yes, anger. Perhaps not the yelling, screaming, throwing, violent anger you are envisioning, but rather “what the crap,” “why the hell…,” “you can’t be serious,” kind of anger. Low level anger (i.e. frustration) is often activating. It cues me to stand up for myself or ask for what I want. It activates me to advocate for myself and others, and motivates me to fight obstacles to my goals when they present themselves. It is not, however, without cost. Unfortunately, we don’t get to choose the level of emotion that shows up in our bodies. When emotion is intense, it can feel impossible not to act on it. And this makes sense, right? If one of the functions of emotion is preparing us for action, then my brain and body are doing exactly what they are supposed to. This means that unless I have the ability to change my anger, I am at risk for acting on it in ways that are not adaptive. I am likely to snap at my spouse, yell at my kids, or at the very least get stuck in what I call the “stompy stomp.” The stompy stomp is what happens when we “white knuckle” anger, trying not to create a conflict. My version is quite charming – a collection of loud sighs, slightly firmer drawer closings, sarcasm tipping from humorous to insulting, and covert eye rolls. While I’m certainly not proud of these behaviors, they make sense to me. Unless I actually eliminate the anger or significantly reduce it, I don’t stand a chance against my biological drive to act on it. So how do we change emotion?

Opposite to emotion action taps into the connection between our behavior and our brain. Researchers have determined that by acting in ways that are inconsistent with the natural emotional expression, the emotion will diffuse. And trust me, it works. If you have ever been mid-argument with someone and had to shut it down because someone else entered the room, you know what I mean. I call it “keeping it shiny.” It’s the skill most of us would use if we got in an argument with our spouse on the way to dinner with another couple. It’s as if you are forced to hold the perspective of the entire relationship rather than the past 20 minutes. You may find it useful to talk more to the other couple rather than engage so much with your spouse. Or you may just keep the topics far away from anything that would breed more conflict. You may have to put more energy in at first, but by the end of the night you may have forgotten why you were fighting in the first place. At the very least, you would have to work pretty hard to bring back all that anger.

So, next time you feel angry try following these steps:

Label the emotion
Ask yourself “if I act on this will it serve me?”
If not, act opposite to your emotion. Keep it Shiny!!

Author: Julie Orris, PsyD
November 29, 2017