Couplespeak™ Blog

Moving forward with therapy amidst Covid -19

To all current and prospective clients,
 
I hope you and your family are all well and managing this crisis reasonably well.
 
In the interest of safety and social responsibility I’m no longer seeing clients at the office, but instead via either
phone or video conferencing through Doxy.me, an easy to use, HIPAA compliant setup. 
All you’ll need to do is to wait for an email from Doxy.me/SusanLager telling you I’m ready to begin
your session, click on the link enclosed and you’ll be in my virtual “waiting room” until I let you into your session.
There’s no need for you to download any software or join anything. A Chrome or Firefox connection is best, but
Safari works as well. A laptop or iPad provides much better reception than an iPhone.
 
If you prefer, we can do a phone session if you don’t have access to a computer or would be more comfortable
with that. Just let me know what number you’d like me to call. 
 
*You will just need to call my VM at 603-431-7131 ahead of time to let me know your preference,
so we don’t take up your session time with these logistics.
 
I’m recommending that all clients who would be coming in for sessions under normal circumstances continue
their therapy this way, especially in these times of uncertainty, fear, anxiety, loss and isolation. All you’ll need
will be a private space and a laptop, iPad or phone for 50 minutes. This will allow you to continue our work in
the safety and comfort of your own home or private space.
 
If your are a current client I would expect us to maintain all sessions moving forward, especially in light of the
possibility that this crisis will persist for the next several months, according to infectious disease experts. Waiting
until this pandemic recedes to schedule a next session at the office may just be too ambiguous, creating a prolonged
limbo state for your relationship work. The same is true if you are a prospective client.
 
It’s of paramount importance to me that my clients have tools for support and continued growth during this highly
stressful time which challenges everyone’s fanciest coping skills, especially for couples who have already been
wrestling with relationship or family issues.
I hope you’ll avail yourself of this “new normal” way of working. 
 
Stay healthy and safe,
Susan

Some insight about managing your anxiety amidst Covid-19

(Here’s an article my cousin sent me I’m reprinting so all of you can benefit from the honesty and wisdom in it):

I have clinical anxiety. If the coronavirus scares you, this might help

I’m not a doctor, but what I’ve come to learn over 20 years is that you really can master your anxiety.

By Kara Baskin Globe Correspondent,Updated March 25, 2020, 2:08 p.m.
 
ADOBE STOCK IMAGE; GLOBE STAFF ILLUSTRATION

Editor’s Note: This story is part of a Globe Magazine special report, appearing in print on Sunday, March 29.

You might think that this is a terrible moment for someone with a clinical anxiety disorder. But here’s the thing: It’s like the rest of you have finally caught up with me. Hyper-vigilance? Insomnia? Catastrophizing? Extreme fear of uncertainty? Welcome to my Isle of Dread. Care for a cocktail?

I’m kidding, sort of. Panic disorder and extreme health anxiety have alternatively propelled and paralyzed me for two decades. For the most part, I exist as a fully functional human being thanks to 10 milligrams of Lexapro, an insightful therapist (now available on video chat), and long-practiced behaviors that keep me even-keeled.


But many friends, thankfully never touched by the cold paws of anxiety, are now asking me how to deal. They don’t know what it’s like to awaken each morning wondering what kind of mood they’ll be in, or to contemplate whether today will be the day that mortality — in the form of a rash, a lump, a tremor — descends. They have never gasped for breath, ridden the acidic wave of heart palpitations and clammy sweats, and clawed for reassurance like a feral cat only to retreat into a mind that offers no solace, only more questions.

Most people move through the world assuming it has a veneer of predictability, or what psychologist Luana Marques calls a “thin veil of certainty.” We are not wired to deal with open-endedness; under normal circumstances, for example, we can feel fairly certain when we go to the grocery store that we’re not going to contract a virus. That has changed.

“But uncertainty is there all the time, and we just don’t feel it,” says Marques, an associate professor of psychiatry at Harvard Medical School and president of the Anxiety and Depression Association of America. Anxiety sufferers know this intimately. You might be realizing it for the first time.


Please know that it will be OK. What I’ve come to learn over the course of 20 years is that you really can master your anxiety. I’m not a New Age guru or a doctor; I’m just a person who’s ridden it out. Here’s the trick: Don’t deny it. Accept that you are absolutely, 100 percent going to feel awful sometimes. I know, I know — the world is rife with mindfulness apps, breathing strategies, glamping retreats, and drugs aplenty to keep your unease at bay. These have their place. We cannot live in a state of heightened vigilance at all times.

But engaging with discomfort is its own therapy, too. It’s the most un-American thing ever, yet: You must sometimes feel bad. So accept the anxiety. Don’t blunt it; summon it. This sounds counterintuitive, I know, but anxiety isn’t a mark of shame to hide from people whom you assume are far more resilient than you. (They’re not.) It will continue to bounce on your shoulders like a thorny goblin until you grab it, stare it in the face, and have a firm chat.

“The first thing I’ve been making people understand is that anxiety is a normal response to a threat,” Marques says. “We want to run away from discomfort, but pushing anxiety away makes it worse. We’re living in times when most of us are comfortably uncomfortable at a minimum. Understand that by embracing our emotions and labeling them, we can ride the wave a little more smoothly.” It’s like surfing. You’ll be jostled by the ocean, tossed around, and eventually tumbled back onto the shore.


Of course, this is all academic until you’re hiding under a weighted blanket scrolling Twitter, wondering about that tickle in your throat. A behavioral way to cope is by doing something action-oriented, Marques says: cooking dinner with your kids, going for a walk. You’re forcing your brain to deal with what’s right in front of you.

Yet those of us with anxiety disorders also know that the only way out is by sitting with the discomfort until it dissipates. It’s like stepping into a hot tub and staying there until the water grows lukewarm. Acknowledge that you’re scared, and then tell yourself that you’ll sit, and you’ll breathe, and you’ll exist — yes, you will exist, minute by minute — until the feeling goes away. And, of course, reach out for professional help if you feel you need it.

Frame it as what we’re being asked to do in quarantine, on a smaller scale. Your mind is your own private bunker. You can’t just get up to leave, but when the door finally opens, think how much stronger you’ll be.

Passive Choices

Most of us like to think that usually things happen to us because we’ve made an overt decision – we enroll in a class, then we take the class, we buy certain foods, then eat them later, we drive in a certain direction and end up at our destination. Our mindset is that when these things go awry, its misfortune or an overtly bad decision or mistake on our own part or someone else’s part. And that can be true, but how about the choices we make by not doing certain things or avoiding and denying certain things? How about the role of procrastination in shaping our outcomes?

I worked with a couple awhile ago who were in a war about these other types of choices I call “passive choices.” The husband years earlier had been diagnosed with very high blood pressure and high cholesterol. About 10 years ago he was hospitalized for a burst aortic aneurism, survived it and had a stent put in. He was advised to eat a heart healthy diet and exercise regularly to avoid further cardiovascular problems. According to his wife he initially paid some lip service to those instructions, then proceeded to eat whatever he wanted, drink alcohol liberally, and almost never do any cardio exercise. So it was no surprise to her when last year he needed another stent elsewhere and a repair of the aortic stent, a serious, painful operation requiring extensive recovery and involving lots of caregiving assistance. Needless to say the wife was rips**t! It was clear to her that this was the life he had passively chosen, he wasn’t a victim of bad luck. He couldn’t understand why she had so little empathy for his plight, why so cold? Her retort repeatedly was “You CHOSE this! Your inaction, your avoidance, your denial set the stage for this! What did you think would happen, living the way you did? You CHOSE this life!”

(In this case, the husband’s most recent health crisis sat on top of his history of 40 years of smoking, not heeding warnings from his doctors and dentist, and not stopping until most of his teeth had to be extracted, followed by a disfiguring cancer of the jaw, so the wife’s bandwidth for empathy now was almost nil. It all felt totally predictable to her while he continued to feel like a victim of fate). Predictably, they didn’t have a good outcome in therapy, as she continued to feel like a scolding mother to a childlike man who refused to look at how he was making decisions with his attitude and behaviors every single day.

So, what’s the moral of this sad story? Pay attention to not only what you do in an obvious, concrete way, but also to what you do through inaction or denial.

  • Do you routinely put off paying bills until you get charged late fees? If so, you are choosing to create bad credit and financial complications. 
  • Do you neglect to return calls or emails from family or friends? If so, you are choosing alienation or conflict in those relationships.
  • Do you wait for a health crisis to follow your doctor’s advise? If so, you are choosing poor health.
  • Do you procrastinate meeting deadlines for tasks at your job? If so, you are choosing to get a lousy review, maybe even be earmarked for the next layoff.
  • Do you avoid hot topic conversations with your spouse or partner? If so, you are choosing to create a reservoir of resentment and distance between you two.

Instead:

  • Focus less on your benign intentions and more on how you play them out behaviorally. Good intentions mean very little if your actions aren’t lined up with them.
  • Realize that you can be a good person, making some bad passive choices.
  • Pay attention to the “handwriting on the wall – early markers of negative outcomes so you can steer in a different, more desirable direction.
  • Recognize that you make choices every day, both actively and passively, and that both kinds can create very powerful outcomes.

 

Rethinking Our Notions About “Productivity”

I’m sharing this beautifully written blogpost with you from Cindy Giovagnoli about expanding our definitions of “productivity.” This is a subject I find personally and professionally very relevant, and one that I think you may too, so I’m delighted that she gave me permission to reprint it here to share with you, my readers.

Cindy is a gifted photographer, artist, writer, podcaster, website developer, adventurer and nature lover whom I did a podcast with a few years ago about “Noticing.” She’s a funny, honest, wise old soul whose thoughts and ideas can be found at: StayCurious@CindyGiovagnoli.com.

Enjoy!                                                                                                                                                                                                      Susan

 

A few days ago, I took Chili Dog over to my favorite local running trails so that he and I could both stretch our legs and breathe in some wild air away from the sounds of cars and people and busy-ness.

It was drizzly and a little raw (Seattle winter, anyone?), but I actually love the woods in that weather- it feels extra quiet and mysterious and there tends to be fewer people on the trails.

As Chili and I began, I ran through my mental list of things “to do” while I was out there. I wanted to brainstorm a writing project and some website tweaks I’m making behind the scenes. I wanted to think about possible applications for some advice I’d heard on a podcast episode. Think through the structure of a class I’ll be offering locally in 2020.

I pulled up the “notes” app on my phone, ready to jot down what came to me. As I was looking down at my screen, a bigleaf maple leaf fell from the tree above me and landed across my phone.

How’s that for a sign from the universe?

As I peeled the enormous damp leaf from my phone, I realized that I’d fallen into a mindset trap that can sneak up on us without our noticing: the idea that “being productive” is the highest value on our time.
It was a Tuesday in the middle of the day- didn’t I have to justify my hours in the woods with some kind of work product?

There are two big problems with that idea:

(1) It defines “productive” as relating solely to work product, to tangible, measurable outcomes related to how I make my living. That’s a pretty narrow definition.

What about how I do my living? As in, the quality of my life? Of my days? They’re numbered, after all. Such is the reality of mortality.

So why wouldn’t my definition of “productive” include things that bring health, wellness, wonder, awe, peace, or simple joy to my days?

It should.

Walking in the woods, reading a novel, meeting a friend for great conversation over coffee, sketching in my journal, taking in an exhibit…even binge-watching Netflix in the right circumstances- these can all qualify as “productive” tasks when we broaden the definition to include the things that make our lives richer and more enjoyable.

(2) If we’ve decided that being “productive” (even in it’s broadened definition) is the absolute highest value we can place on our time, we’ve disregarded the power of blank space in our lives. And blank space is where a lot of magic happens.

Part of what led me to a “to do” list of brainstorming ideas while on a walk in the woods is the fact that I often have breakthroughs and game-changing ideas when I’m out on such an excursion.

But.

The reason that those breakthroughs and ideas happen is usually due to the fact that I’ve allowed my mind free time. I’ve allowed boredom and daydreaming and for my thoughts to wander where they will at random.

It’s amazing what can pop up when we allow our brains to do their own thing for a bit. It’s why so many ideas land on people while they’re in the shower.

Connections are made. Problems are solved. Ideas take shape.

But there’s no way to force this. There’s no way to prompt it.

We simply have to leave some blank space and then see what happens.

Sometimes that space will result in ideas or breakthroughs and sometimes it won’t. You never know.

At worst, we end up with a brain that got a bit of rest. Not such a bad deal, really.

So I invite you to broaden your definition of “productive” to include the things that add richness and meaning and joy to your life, regardless of whether they have a measurable outcome that makes money or not. And also to allow for some blank space for boredom and daydreaming and letting your mind wander at will.

I’d like to hear what that looks like for you, so hit reply and tell me- how do you define productive and where do you find some space in your days?

Stay curious out there!

P.S. I’m a little late this week, but I’ll be going live in The Curiosity Cabinet tomorrow at 12 noon EST. I hope you’ll join me for 10-15 minutes of talking a bit about embracing these ideas of re-defined productivity and the value of empty space in our lives!

Next 20 Minute BlogTalk Radio Podcast Sunday, 11/24 8:30 PM EST: “Take the Dread Out of the Holidays with Some Simple Strategies”

Don’t miss this next BlogTalk Radio podcast!
In this 20 minute episode I’ll share my insights about some of the common sources of holiday related anxiety and stress, and how being proactive and intentional can transform the season.

If you have a history of some really negative experiences related to the holidays, and struggle with how to make it all more manageable, even magical, then this episode is for you! I’ll help you see how some simple planning, realism, and clear boundaries can make all the difference. You’ll see how you alone, or you and your spouse may have the power to turn it all around to meaning, connection and joy.

Call in live with questions or comments at 877-497-9046. If you can’t make this (first ever) Sunday night podcast while it’s happening, you can stream it at your convenience anytime at www.BlogTalkRadio.com/SusanLager.

Hope one way or the other you can join me!

Susan

Blog Talk Radio Host

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About
Susan Lager

I am a licensed, board certified pyschotherapist and relationship coach in Portsmouth, New Hampshire. Through my psychotherapy or coaching services, I can provide you with skills and tools to transform your life.

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