Therapy in 2019

My therapy appointment this week consisted of talking about:

  • how fucked we are by climate change
  • how infuriating it is that we’ve known that this was coming since the 70’s and nobody did anything about it except kick the can down the road until we’re so fucked that we can’t stop
  • how infuriating it is that the world wants to say “turn up your AC and recycle” as if 90% of carbon emissions didn’t come from big businesses and not personal consumption
  • how fucked the news and political climate is
  • how it’s impossible to plan for anything because nothing is normal right now
  • how powerless we are to make any kind of change
  • how paralyzing it is to be in a position where your life and livelihood are in danger and you have only the barest hint of influence as to whether or not you can continue to live
  • what I will do when the American economy collapses enough that I can no longer get my psych meds that keep my mood stable enough for me to be able to hold down a job
  • how do we live our values in a way that is consistent with our higher selves when we are essentially complicit in so much abject horror – even if we are “doing the right things” and writing our congresscritters and calling and phone banking
  • how long it will take for the forced-birth movement to take hold in Texas, and whether I’ll be able to get another IUD when I turn 44 or if I’ll have to hope I’m living somewhere else
  • that maybe my persistent suicidal ideation and anxiety issues are because human brains aren’t designed to deal with this level of meta-crisis that’s been steadily increasing

ACT and thinking about Values

So for the last six weeks or so I’ve been working through the ACT introductory program by Russ Harris called The Happiness Trap (note that it’s on sale right now, so if you’ve wanted to do this program, now’s a good time to snap it up). It’s a purchase that allows you six months access to all of the video content, but it’s designed to be an 8 week course – 8 modules that lead you through the basics of Acceptance and Commitment Therapy. It also comes with large swaths of downloadable PDFs and .mp3 files that you can continue to use even after your six months of access to the video format has expired.

What is Acceptance and Commitment Therapy? Here, from the Association for Contextual Behavioral Science:

Developed within a coherent theoretical and philosophical framework, Acceptance and Commitment Therapy (ACT) is a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values.

In short, it’s a new form of therapy that stems out of other types of CBT that focuses on mindfulness, acceptance, and defining and acting in ways that reflect your values instead of working extensively on ‘retraining your mind’ or ‘changing your thoughts’.

I was intrigued by this when it was introduced to me by a friend (who is an ACT trained psychotherapist doing a psychology doctorate), and sought out resources to get some additional “boost” because traditional CBT and talk therapy hadn’t done well for me in terms of helping me deal with specifically my anxiety. I do well most of the time at managing my bipolar, but my PTSD and anxiety have run me ragged for the last two years and I was tired of it.

So I enrolled in the course – which is not really therapy? It’s certainly not geared towards someone as mentally ill as I am (and it often is very negative about psych meds, which I find really to be the biggest disappointment and detractor from the program), but I figured I could learn something and so I’ve worked through the first five modules over the last six weeks.

Modules 1-4 worked on grounding, centering, and detaching from unhelpful (not negative, but unhelpful) thoughts. It introduced the idea of the choice point – a point where you’re making decisions that either lead you towards the life you want (towards moves) or away from it (away moves) and helped contextualize even small decisions in light of living a better life even if you’re still having a lot of unhelpful thoughts. This was useful, but harder for me – but the practice has been helpful, especially the idea of “anchoring” – which is a grounding and centering practice – you’d think with all my years of doing energy work I’d have come across this before, but I really like it. 

Anyway, module 5 introduced Values – the idea that each of us has values that we want to cultivate in our lives. Not goals – things that we accomplish – but actual values that define who we are and how we want to act. I’ve done a lot of work with this in my ADF work and because it’s hard not to take a look at what you value and who you want to be when you go through a massive life upheaval like a divorce, but I still found it valuable (hur hur) as the exercises helped me put my values into basically four buckets:

  • Kindness/Compassion/Lovingkindness – I value being kind and compassionate. I value self-care, and care of others. I value listening and asking questions and being in support of others, as well as being and living in support of my own needs. 
  • Honesty/Integrity/Right Relationship – I value being trustworthy and fair, and living with integrity. I strive to remove my own intrinsic biases and to always live with a strong relationship to my own truth.
  • Ambition/Pursuit of Knowledge/Pursuit of Growth – I value always striving to be better, to know and do more, to grow and change and adapt. I especially value learning new things.
  • Spirituality/Animism/Right Relationship – I value my spiritual life, and moving through the world as a spiritually aware person, who lives in right relationship to the world and to the Spirits. I value the world – persons both human and non human. 

Going through the exercises helped me realize just how much I’m already doing in my life that lets me express those values. It also surprised me that – though fitness and physical health values were shown as exemplars – my physical health didn’t show up at all, except as the value of self-care. I take that as a huge step – that I didn’t have a value of “fitness” – not that fitness isn’t important, but I especially didn’t think in the context of the questions asked (things like “when you are 80, what will you wish you had done more of) that I was going to think “I wish I’d spent more time going to the gym” or whatever. Like – I adore my yoga practice, and I go as often as I can, because it’s good for me physically, emotionally, mentally, and spiritually. It fits with many of my values. 

Anyway, it was an interesting set of exercises, and I’m finding that it stuck with me enough that I wanted to talk to my mentor at work about it. Of course, she’s out of the office for two weeks, but I still sent her an email (giving her a bit of context) about how we could work on ways for me to live out these values – especially my value on ambition and the pursuit of knowledge and expertise – in the context of my job.

In short, Module 5 was really profound, even though it wasn’t totally new information for me, and I highly recommend The Happiness Trap for people who want to live a more examined life, or who are struggling with finding ways to live their best life in the face of depression, anxiety, or other negative thought patterns that disrupt their choices. It’s built on the previous weeks very nicely, but I still use the choice point ALL THE TIME – I don’t usually actually write one down, but as I sit at my desk, I think to myself “okay, so I’m at a choice point where my brain is telling me I can’t focus or can’t move forward or don’t know what to do. Thanks brain, I know you’re looking out for me. Right now I want to move towards (X thing) – what’s the smallest step I can take in that direction”. And then I try to do that smallest step. Sometimes it’s “Go take your meds that you forgot to take at lunch”. Sometimes it’s “open the spreadsheet and set up the data so that you can begin to analyse it”. Sometimes it’s “Pull up all of the accounts in SalesForce so you can at least see if they’re there to start the process”. 

And I often find that taking a small step leads to other small steps, and that’s led me to getting more done, in spite or (or despite) the anxiety that is still lingering and still hanging around and tugging at my brain.

So that’s what I’ve been up to, alongside my weekly talk therapy sessions (which have been ACT focused as well, but not following a specific program, as well as focusing on bodywork as a healing modality for PTSD… but that’s a whole nother blog post). I’ll do a full review of The Happiness Trap once I’ve finished the program – I may go through the modules twice before I decide to be “done”, but so far I’m really appreciating the work I’ve done with it.

I will say though – you need to be able to set aside about 90mins to two hours each week for the modules if you plan on actually working through the exercises. I do it all in one sitting (usually on Monday night), but it’s VERY easy to break each week into smaller chunks – they’re already split up into modules that can be done independently. 

Good luck, and happy thinking!

Anxiety Hunger Trick

I have major issues with anxiety sometimes. Often, when I get really anxious, I am repulsed by food and don’t want to eat.

This is a major issue if I am lifting heavy, since I want to build muscle, and that requires calories and protein every day.

Last night I got home from work and the anxiety settled on my shoulders like a blanket, and I couldn’t stand the thought of food, even though I’d only eaten about 1500 calories so far that day. I know I need more food than that, but it was just gross to think about eating. I mentioned this on a weightlifting group I’m in, and they suggested I try having some pure sugar – just a spoonful of honey or a sugar cube – and waiting 15-20 minutes to see if I felt like eating.

I figured it couldn’t hurt. I mean – it’s honey. Either it would do nothing, or I might feel better. And sure enough, I felt better – and hungry – after about 15 minutes. I probably ate half a tablespoon of honey or so, not a whole lot, and then within 15 minutes I felt like I could handle some food. So I made myself a chicken quesadilla (since SSH had already eaten by then), and felt MUCH better.

So if you’re ever in a mind space where you know you need to eat something, but are not really able to convince yourself to eat, try giving your body just a little bit of sugar. I’m not sure WHY it works, but it sure did work for me.