Written by: Sonia Heidenreich, LGSW
D.W. Winnicott was one of the first psychoanalysts who focused his work on children and the parent-child relationship, and I have really admired his work since being introduced to his writing in graduate school. [If you’ve been reading this blog with regularity, you might have already heard me referencing him. His work was extremely influential on a range of theorists and clinicians that came after him, and if you’re curious, you can borrow my book--Playing and Reality.]
This might sound odd, but I thought about the quote up above when I came home the other day and couldn’t find my cat. (I know, I know—crazy cat lady alert.)
When I finally found her curled up in her favorite place underneath the couch, and I laid down on the floor and stared at her, without disturbing her from her hiding place. Before I had even reached out a hand to pet her, she started purring up a storm, clearly so delighted to have been found. I wondered how much she had also enjoyed knowing that I was looking for her. “It is a joy to be hidden,” I thought, “and a disaster not to be found.”
I first read this several years ago now, but it’s never far from my mind. To me, this captures something innate inside all of us: We want to have our own private experiences of the world, we want to feel like our own unique selves, and yet at the same time, we want to feel seen and understood by those around us.
I’ve also been thinking recently about the idea of finding an inner gaze, or of the power of truly gazing inward. We spend so much time with our attention focused outward, whether it’s on other people, on our work, or maybe it’s social media or whatever external stimuli that pulls our attention outside of ourselves. All of this is okay, and even necessary, but it can also be alienating. When we spend too much energy focused on external things/people/experiences, we almost forget how to look inward, to notice ourselves, and fundamentally to be with ourselves. It’s only when we are willing to shift our gaze from the external world to our own internal experience that we offer ourselves the opportunity to ask and answer essentials questions—questions like: Who am I? What is important to me? Why am I here? What do I care about? What do I want my life to mean?
Getting back to Winnicott: I think that in order to allow ourselves to be found, in a metaphorical sense, by important others in our lives, we first need to practice knowing and finding ourselves. We can do this by practicing shifting our gaze inward, with a practice as simple as closing our eyes, taking a few conscious breaths, and really and truly sitting down in stillness with ourselves.
In yoga, this relates to the concept of a drishti, or gaze. We hear about this most often we we’re told to think about fixing our gaze on something unmoving as we’re trying to balance in a challenging posture, and this is a good moment to find a drishti. Certainly, standing in a tree pose and feeling ourselves wobble back and forth is a perfect moment to practice finding our gaze, and sometimes that is a good way to practice. It’s also good practice to close our eyes, take a breath, and get really quiet and present with our own thoughts.
In therapy, we learn to sit with ourselves in the presence of another person. At first, it’s uncomfortable to share our private, personal thoughts out loud, but as we get used to it, we notice (I hope) that we feel better in some way afterwards. It’s often hard to pinpoint why exactly we feel better, but I hypothesize (as would Winnicott, I think) that it has something to do with feeling seen or being found by another person, and then leaving with an enhanced capacity to look inward and truly see ourselves.
Written by: Lauren Barris, LCSW-C
It’s no secret that what the weather is doing – whether it’s sunshiny or raining cats and dogs – can have a BIG impact on our daily mood. And lately, it seems like we’ve been getting a lot more rainy days than sunny ones. When I noticed how this weather was impacting my own mood, as well as the reports I was getting from my clients, I decided to write up some tips on how to handle these rainy day blues.
Tip No. 1: Notice it!
That’s right. My first tip is surprisingly simple, but this one is not to be underestimated. It is far too easy to roll out of bed on a gray, gloomy day, with our mood reflecting that, all the while having no clue why we are feeling so down. So, step number one is to check in with yourself when you start your day. Notice what your mood is doing (and what it might be doing to those around you…) and take stock of reasons why this might be happening – AKA those looming, ominous clouds outside your window!
Tip No. 2: Validate yourself
Remind yourself that it makes sense that you might be feeling a bit down because of the weather. People have known for a very long time that the weather impacts our moods, and it’s absolutely nothing to be ashamed of. Validate for yourself that the weather sucks! It may be impacting your social plans, your exercise routines, your allergies or physical wellness (headaches, body aches, etc), the stressfulness of your commute, and it may even be causing damage to your home or community. These are real sources of stress, and simply taking the time to validate that feeling down is a reasonable and understandable reaction to these things can work wonders. It’s hard enough to deal with a low mood – you don’t need to be judging or blaming yourself on top of it.
Tip No. 3: Make up for it
None of us can change the weather, but we can change some things about our daily routine. Make up for the nasty weather by upping your self-care regimen. Maybe opt for a special latte (or tea) in the morning instead of your usual go-to. Maybe wear something bright and colorful that can off-set the gloom for both you and those around you. Practice noticing things about the weather without judging them negatively – notice just the sound the rain makes, the way the air feels, or the color of the sky, without tying it to anything positive or negative. Finally, treat yourself to some extra self-care at the end of your day too, whether that means curling up on the couch in your favorite sweater with a warm cup of tea, cooking a special dinner for yourself, taking a long hot shower or bath, or maybe just getting some extra sleep. The important thing about self-care is that these should be intentional, mindful activities that make you feel good AND are good for you in the long-run. If you indulge in your favorite sugary latte or snack one day, just make sure you don’t do it every day, and if you give yourself a mini-vacation to watch an episode of a favorite show, don’t let it turn into a binge-session. Self-care should be sustainable, enjoyable, and should make you feel good about yourself both in the moment and after.
I hope these tips help to brighten a few of these rainy days. Stay dry out there!
Written By: Emma Ur, Administrative Assistant
We are lucky enough to live in a time with technological advances happening every day – from smaller creations that add convenience to our everyday lives, to monumental discoveries in the medical field that save lives, and everything in between. I would say the invention of the smart phone, and the apps that come along with it, falls in the “in between” category. These days, there is an app for virtually anything you can think of. In my earlier college days, I discovered quite a few apps that simply made my life easier (shout out to Uber and Grubhub). But as I was rounding out my time as an undergrad, I was introduced by my peers to the plethora of apps out there that can aide any person in their mental health journey. Listed below are a few (free!) apps I tested out and categorized by what they assist with:
*Disclaimer: While I do not recommend using apps as a replacement for mental health care and treatment by any means, they can seriously help you in between appointments and sessions, as well as in your day-to-day life. *
Headspace: I’m just going to start off by saying I use this app every day and I am obsessed! Meditation was never something that came easy to me, but this app really walks you through it in a super simple and relaxing way. You can set how long or short you want your meditations to be, and there’s also different “packs” that cater to different needs and scenarios, such as managing anxiety or feeling restless. Though the overall app is free, the packs are only free for the first 30 sessions, and then you do have to subscribe to get full access of the app. My favorite part about this is there’s a section that specially caters to kids! So if your little one struggles with focusing, sleep, or nerves, you can sit through these guided sessions with them. Meditation and mindfulness are beneficial to anyone, at any age or stage in your life, and I would highly recommend you give this app a try.
Calm: This app also works wonders if you are a beginner to the guided meditation world, and gives you the opportunity to work your way up to a more advance level of the practice. Like Headspace, you can choose which interval of time for your meditation, ranging from 3 to 25 minutes, allowing some time for self-care, while also keeping yourself on schedule. What I really loved about this app was the “Sleep Stories” feature; the name is self-explanatory, but as someone who always struggles falling (and staying) asleep, I was pleasantly surprised how effective they were! There’s also a section with a collection of breathing exercises, which is perfect for when you need a quick time-out from life, but don’t need to go in full meditation mode. While these two apps are very similar, they are also different in a lot of ways, so if you’re not clicking with one, give the other a try!
Moodpath: When searching for this in the App Store, underneath of the name it reads “your mental health companion”; which is the absolute best way I could describe this app. It was made specifically for detecting symptoms of depression, however after reading reviews, I learned that Moodpath has been incredibly helpful to people with other diagnoses as well. The Apple App Store describes it as “an interactive mental health screening and improvement program”. Essentially, once you download this app, it asks you a range of questions at different points in your day regarding your emotional well-being. It then checks in with you daily over the course of two weeks, in order to properly track your mood; at the end of it all you will be given a personal assessment that will assist (key word here) in predicting whether or not you show signs of depression. The great thing about this app is this assessment can be available as a pdf, which you can there share with a mental health professional, who could then use this as a baseline in your diagnosis. I believe this app is best used alongside therapy, but should definitely not be used to self-diagnose.
Daylio: This app is another one of my personal favorites. If you’re into the new bullet journal craze, I would describe this as having very similar aspects, but as a virtual version. First of all, Daylio gets an A+ for aesthetics because is equipped with super cute emojis to represent the mood you’re feeling, and these emojis are then color-coded, so you can easily track your mood in the app’s built in calendar. This app is perfect for someone with a busy lifestyle, because it allows you to keep a personal journal without having to type anything out! All you have to do is pick your mood and activities for that day and Daylio does the rest. Everything you enter is compiled in an easy to track format via the calendar and statistics section, allowing you to be more aware of habits and patterns, thus being able to do something about the ones you want to change. This app is definitely user-friendly for all ages, and I would recommend it to anyone who is trying to make a change in their life.
These two apps essentially do the same thing: remind you to take your medication. This can be very important, for depending on what your treatment plan is, you may need to take some medications at certain times of the day, or on a busy day, you may need to be reminded that you already took a medication so you don’t accidently double up. I would highly recommend both of these apps, especially to families with children taking medication, or to someone who is taking multiple medications. Though they both have the same purpose, they do share some differences:
Medisafe: I would classify Medisafe as a “no frills” app; it’s straight and to the point. Ranked as #1 by pharmacists and physicians, this app gets the job done. It is extremely user friendly, from children to elderly, everyone should be able to benefit from how visually simple the layout is. Once set up, it will remind you to take your medicine on time, every time. Not only does it track your medications, but it also syncs to the Health app that comes with Apple products (this app is also available on Android and other brand phones), allowing you to see your glucose levels, blood pressure, pulse, etc. while you’re taking a certain medication. If you’d like someone to keep you accountable, you can add a friend or family member who will be notified when you are supposed to take your medicine, to help you from missing a dose. This app also gives you access to coupons for pharmacies, and reminds you when you’re in need of a refill! Medisafe is definitely ranked #1 for a reason.
Mango Health: If you want your medicine reminders to be a little less clinical and a little more fun, this app is for you! You’d never think taking care of yourself could be not only fun and easy, but also rewarding. Yes, this app’s main function is to keep you on schedule with your medication(s), but it does so much more! Similar to the Fitbit craze, Mango Health gives you points for each day you complete a task, i.e. take your medicine correctly; these points unlock rewards, which range from gift cards to donations to different charities. You can also set healthy reminders for yourself such as drink water or track your food. The app will automatically keep a log of everything, which makes referencing your health and medication history so much easier at your appointments. One feature that I think is super important is Mango Health will alert you if there are any drug interactions with any of the medications you’ve entered, as well as compiling a list of possible side effects of medications. I don’t know about you, but I love an app that makes something more fun than it actually is, so this app gets an A+ in my book.
Written by: Sonia Heidenreich, A.M., LGSW
How do I know when I’m ‘done’ with therapy?
Lately, I’ve been thinking a lot about how to help my clients know when they are ‘done’ with therapy. This isn’t because I want to stop working with them, but rather because I want to honor the work that they’ve done and the growth that they’ve experienced. As therapists, we call this process “termination.”
You’ll notice that I referred to it as a process, and that’s because in an ideal world, we would take time to talk together about the idea of ending therapy, review progress you feel you’ve made, talk about future aspirations, and then say goodbye. It’s a lot to accomplish and can feel like a lot to take in, so I always prefer to take some time (at least one or two sessions, minimum) to engage in this work.
As a client, this can be an emotionally complex process. You might wonder how you’ll know when you’re ready to end therapy, you might worry about hurting your therapist’s feelings by talking about terminating, or you might feel sad or worry about missing the relationship that you have with your therapist. Even though it’s a different kind of relationship than you have with other people in your life, it can carry with it emotional closeness, trust, and a real bond.
Let’s address each of these potential questions one by one, with the intention of bringing greater clarity to this process.
Q: How do I know I’m ready to end therapy?
You can know in a variety of ways. The first is by calling on your intuition: What does your inner wisdom tell you? Do you feel steady, resilient, and capable of weathering the inevitable challenges of life? Check in about the reasons that brought you to therapy in the first place—did you come wanting greater clarity about a situation or relationship, or to learn new skills or ways of relating to others? What evidence can you point to that these goals were achieved? What evidence can your therapist remind of you that demonstrates progress towards your goals? When the evidence is plentiful, you might be ready to consider terminating.
Q: Okay, I think I might be ready, but I’m worried that I’ll hurt my therapist’s feelings if I talk to her about it. Maybe I should just ‘ghost’ instead.
You will never, ever hurt a therapist’s feelings by talking about progress you feel like you’ve made and your readiness to move on without her help. That is precisely our job, so when a client is ready to terminate, I consider this barometer of my effectiveness at my job. Of course, we all care about our clients and so will have our own human feelings of sadness about saying goodbye to you, but trust that we can manage our own feelings, and we cherish the opportunity we had to help you to live your fullest, most meaningful life.
On the subject of ‘ghosting’ (or just not showing up to sessions without talking about it): I get that it can be hard for many of us to communicate in a direct way. Sometimes, it’s easier to just stop showing up than it is to confront your desire to end treatment. Also, if you’re ending treatment because you feel like your therapist isn’t helpful anymore or it’s just not a good fit, you might worry even more about hurting her feelings. I urge you to be brave, and to have this conversation directly. Not only will it be helpful to your therapist to learn about what helped and what could have been better, it will also be very good relational and interpersonal practice for you as you learn to be direct and communicate your needs clearly and respectfully. In therapy, we practice relating in a new way to someone else (our therapist) and use this practice to help us in other relationships. This a perfect opportunity to practice! Trust yourself to be able to handle this conversation, and also trust that your therapist is trained to facilitate and manage this challenging part of the therapeutic process.
Q: I’m worried that I’ll really miss my therapist, and the thought of ending therapy makes me really sad.
Okay, first of all, that wasn’t really a question. (Kidding!) My truest answer to this question is--it’s okay to feel sad. As with any other important relationship, feeling like you will miss someone is an indication of the closeness, trust, and depth of the relationship you built together.
I’m reminded of a 6-year-old client I worked with a few years ago. We worked together for a year and spent the last month of our time together talking about termination and preparing to say goodbye. We made a book together to consolidate his sense of progress, planned a special celebration for his last session, and all seemed to be going well. At our last meeting, while we were eating ice cream sundaes, he turned to me and said, “But how will you remember me when you don’t see me anymore?”
I was moved by his question, and struggled to answer at first. Then, I thought about something that Donald Winnicott, one of the first psychoanalysts who focused on parent-child attachment, said about attachment and self-concept. To paraphrase, he talked about the importance of knowing that we are ‘held’ in the mind of another person even when we are not physically present with them. This trust that we continue to exist in the mind of another gives us the sense of security and inner coherence to move bravely into unknown situations, to be fully present in our friendships and relationships, and reminds us of our own continuity and worthiness.
With my young client, we talked about how I would remember him, things that would remind me of him, and took a picture together. I explained how important he was to me, and we talked about other important people in his life who he had lost and how he remembers them. These people continue to be held in his mind, and he would continue to be held in mine.
Termination doesn’t mean goodbye forever, but rather that you are strong and capable of braving the storm with your own inner wisdom to guide you.
Written by: Lauren Barris, LCSW-C
Mindfulness: Paying attention, on purpose, to the present moment.
That’s it. Simple enough, right? Now, there are many different definitions of mindfulness floating around these days, and far be it from me to tell you which one to ascribe to. What I will say is that the definition given above (based on Marsha Linehan’s DBT) has helped me tremendously not only to make sense of mindfulness, but to remind myself how to do it in moments when I am struggling. Whether you are practicing mindfulness while breathing, sipping your morning coffee, driving to work, distracting from physical pain, playing a sport, or creating art, it has got to have those three components – you’ve got to have your attention on the task, in that moment, on purpose. It’s important to remember that no one stays in a perfectly mindful state all the time. Our brains are far too busy for that. Our brains like to multitask (and often need to!), and our attention gets pulled away by distractions all the time. If you are driving your car and all of a sudden your child starts vomiting in the back seat, you better believe you’re gonna have part of your mind on the road and part of it on your kid, and anything less might not be effective at all, let alone safe. BUT, when you choose to practice mindfulness, you are making the choice to let go of distractions, even if just for a moment. Every time your attention is pulled away (and it will be), your task is to notice that, and to gently pull it back to the present moment, as many times as it takes, without judgment.
So, what’s the big deal? Well, the big deal is that we have started to figure out that mindfulness can actually be a very powerful treatment for depression and anxiety. The difficulty is that when are in pain, when we are overcome with sadness, or filled with fear and anxiety, throwing our full attention onto that moment is often the last thing we want to do. But the thing is, if we want to have a shot at managing those negative emotions, we need to first notice them, pay attention to them, and experience them. If mindfulness is our goal, our task is to notice our emotions, observe them for what they are, lift out the judgments, sit with whatever waves come over us, and notice that we are still okay. When we see the emotion for what it is, rather than running from it or shutting it away, we can make an intentional choice about how to proceed. Perhaps the emotion is a warning sign that we need to change something, or leave a situation. Perhaps it is caution getting us to check out the facts of a situation! Perhaps it is a relic of times long past, and when we stop to think, we realize that it does not actually fit with the situation we are in. Emotions have all sorts of important things to tell us, and if we put all of our energy into avoiding them, we will never benefit from the information they bring.
Although mindfulness of emotions is a big part of why mindfulness can help treat depression and anxiety, mindfulness is not just about noticing the painful stuff. Mindfulness does not discriminate! So the next time you are doing, well, literally anything, try it out. Pay attention, on purpose, to the present moment. With neither positive nor negative judgment. I think you will find you are able to be more effective in whatever task you are doing, and you may even be able to experience pain without all the extra suffering. But don’t take my word for it; to read more on this, check out the following article: “Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process.”