The Lighter Side of Transformation

with Lisa Wessan, LICSW

On the “Myth of Closure,” Ambiguous Loss and Complicated Grief

“Everyone experiences ambiguous loss if only from breaking up with someone, or having aging parents or kids leaving home. As we learn from the people who must cope with the more catastrophic situations of ambiguous loss, we learn how to tolerate the ambiguity in our more common losses in everyday life.” 

– Pauline Boss, Ph.D.

In my immediate family, several of my nearest and dearest have battled with cancer over the years…both of my paternal grandparents, may they rest in peace,  my dear first cousin Stephanie (may she live to be a super centenarian) and my delightful and fierce Aunt Yvette (known as “Auntie”), who is currently in the throes of post-rehab adjustment and palliative care.  It has been a long and grueling journey for all my loved ones.

Sometimes I struggle with feeling powerless, and living so far away from my family in Sarasota, FL. When they lived in New York, it was so much easier to visit. Sadly,  I can’t make frequent visits to Sarasota. The only “power” I do have is to send intentional healing and loving energy to my Auntie and family…and to practice radical acceptance so that I will function with some measure of inner peace here in my world.

Lately, my Auntie has been in and out of the nursing home,  and her life is severely compromised by her illness.  As harsh as this has been is for her, since April 2015,  I have also been witnessing how Auntie’s dying process is affecting everyone around her.

My cousins are fraught with anxiety and grief. Others are  a hot mess, watching Auntie dying so slowly, not able to process their feelings and find some relief.  Some people get trapped in the “Blame Game,” and are always looking to find ways to defocus their pain by pointing at others (that’s a separate article, worth exploring soon).

We are all coping with the ambiguity of Auntie being here, yet not here.  She is no longer resembling her true self as we knew her.  Sometimes she is delirious, sometimes she is too weak to talk. As her body deteriorates, she is no longer living the full and robust life she once enjoyed.

ambiguous loss1

This pain we are all experiencing has a name…it is called Ambiguous Loss.  “Ambiguous loss is a loss that occurs without closure or understanding. This kind of loss leaves a person searching for answers, and thus complicates and delays the process of grieving, and often results in unresolved grief.” (Wikipedia)

There are a variety of types of ambiguous loss.  One type is when people go missing and the body is never found.  For example, a person does not return from a sailing trip, or from a hiking excursion, or war, or they are kidnapped.  Their loved ones still feel a lack of closure because the body was not found.   “Maybe they will return…” lingers in the mind.

After 9/11,  all of us in NYC were processing personal and professional ambiguous loss for all of our New Yorkers who were lost in the pile of bodies that were never recovered.

Another kind of ambiguous loss is when people experience a new emotional boundary that hurts.  This happens when people get divorced, or when someone ignores you, stops talking to you, shuts you out of their life.  Any kind of break-up creates ambiguous loss, because the person is still here, yet not here. They are alive, but dead to you.   This is considered more painful loss than when someone actually dies.

ambiguous loss3

Medical illness and addictions cause ambiguous loss.

Ambiguous loss also occurs when a loved one has Altzheimers or dementia, and they no longer recognize social connections. Similarly, when someone is very ill, such as my Auntie, we have ambiguous loss because the illness is transforming our loved one into someone other than the person we always knew. We are mourning the living remnants of our loved one…so excruciating and bitter.

When someone is living with an addiction, this too causes their personal relations to deteriorate and they are not fully present for their loved ones. Again, they are here but not here.   I have a friend who had a beautiful daughter in Cambridge, MA,  who chose to be homeless.  Her daughter was an alcoholic.  My friend tried all methods of intervention and help. Nothing worked. My friend suffered with ambiguous loss for so many years. Her daughter was a pianist, absolutely lovely.   She died a few years ago,  at 35, and it was one of the most heart wrenching tragedies I experienced.  My friend is still recovering from this painful loss.

Learning to live a good life with ambiguous loss

I recently listened to a wonderful and insightful podcast interview with ambiguous loss pioneer Pauline Boss, Ph.D., who originally coined the term “ambiguous loss.”   Krista Tippett hosts Dr. Boss on her podcast, On Being.  You can listen here:

The Myth of Closure [UNEDITED VERSION, 1.5 hours]

The Myth of Closure [EDITED VERSION, 1 hour]

I prefer the unedited versions of Tippett’s interviews, because there are sometimes fascinating nuances that are deleted to make the long form interview fit into an hour. But I’m sure whichever one you listen to will be rewarding!

One of the ideas I took away from Dr. Boss’ talk was that we will never have complete closure from our ambiguous losses, or from our complicated grief.  What we can do is become  more adept at processing our negative feelings and difficult thoughts. Dr. Boss has some wonderful suggestions on the process.

Cognitive restructuring, which can be learned, is a big part of the solution.  Dr. Boss’ stories and explanations are very helpful in deconstructing the different kinds of ambiguous loss that we all have in our lives.

Even though I learned about ambiguous loss and complicated grief in graduate school, it seems I keep deepening my learning about it more every year, from clients who are struggling with painful divorce, adult children with addictions, my Auntie’s battle with cancer, and for all the ongoing loss of freedoms in the world that never seems to subside.

Fun fact: Ambiguous loss is clearly part of our psychospiritual journey — for it forces us to grow and move to new levels of compassion and acceptance of things we cannot control.  “Lack of power, that is our dilemma,” says Alcoholics Anonymous  (Bill W., 1976).  Yes, in our culture, we seek to control, cure, fix and manage everyone and everything as much as possible. We don’t like messy endings.

Yet what I have come to know, is that true mastery of life is being able to live in ambiguity with peace, even joy.  My life is far from perfect…yet I am more often feeling positive, grateful,  uplifted, inspired and anticipating good interventions that will transform it.

If we can learn to live in that “not knowing” place and be peaceful — that is a vast improvement on “hating ambiguity” and perhaps yelling at G-d or the Universe, or twisting into knots over why bad things do happen to good people…again, very messy, so annoying.

The truth is, when it comes to matters of love, there is no closure. As they say at the Grief Toolbox,  “Closure is not part of the grieving process, nor is it necessary for healing. A connection formed in love can’t be closed.”  Dr. Boss confirmed this with her years of research on ambiguous loss, leading to her forthcoming book on “The Myth of Closure.”

ambigousloss5

As Dr. Boss discussed in the interview, our Western culture wants neatly packaged endings and for everyone to move on as quickly as possible.   There is plenty of shaming that goes on, as in “Aren’t you over that yet?”

Sadly, our culture does not tolerate ambiguous loss very well at all.  It requires more Eastern, dialectical thinking.  To be able to say non-binary statements such as “She is alive, but also dead,”  “He is not here, but he is possibly still alive,”  or “She looks like Auntie, but this is not Auntie anymore,” requires a leap from dualistic thinking to a more dialectical thinking which allows us to embrace opposite beliefs without sinking into a deep depression or disruptive anxiety vortex.

Solution Focused Suggestions

For today, I invite you to learn more about ambiguous loss, and start to apply these non-dualistic, non-binary, dialectical thinking ideas to your situation.

  • Listen to the podcast above, and learn some skills to help process your ambiguous grief.
  • Perhaps find a good therapist who can help you learn to cope better with your struggles.  Good news: coping skills can be learned!
  • Learn to laugh at the absurdities, paradoxes and incongruities of life (Gavin, 2010; Wessan, 2013).
  • Practice your Distress Tolerance skills …join a Dialectical Behavior Therapy group.  You may then find it easier to work through the painful moments, and allow yourself to live in ambiguity with, dare I say it, some joy!

 

Onward and Upward,

Lisa Wessan

 

References

Gavin, J. (03 Sept 2010). Laughing with the Joys and Troubles of Life Leads to Growth. The Chelmsford Patch. Found at https://mirthmaven.blog/2010/09/16/lisa-wessan-interviewed-in-the-chelmsfor/

Pauline Ross, Ph.D. https://www.ambiguousloss.com/

W., Bill. (1976). Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. New York:Alcoholics Anonymous World Services. Fourth edition, Chapter 4, We Agnostics. P. 45. 

Wessan, L. (2013).  Using Humor and Laughter in Therapy. Focus Journal. National Association of Social Workers.  Vol. 40, No. 4. 3,11.

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

 

 

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Moving beyond binary thinking: what are dialectical and non-dualistical truths?

“Even when all the experts agree, they may well be mistaken.”  ~ Bertrand Russell

“In preparing for battle, I have always found that plans are useless,
but planning is indispensable.” ~ Dwight Eisenhower

“The reverse of truth has a thousand shapes
and a boundless field.” ~ Michel de Montaigne

“Whoever is winning at the moment
will always seem to be invincible.” ~ George Orwell

“Family values don’t stop at the Rio Grande.”  ~ George W. Bush

“Sometimes you need to get knocked down before you can
really figure out what your fight is.” ~ Chadwick Boseman

What do all these quotes have in common?  They are blending opposing beliefs into a non-dualistic framework, which is, for most of us, is not easy to hold in our minds without some cognitive dissonance.

As those of you who follow me know, I teach Dialectical Behavior Therapy Skills (DBT), which helps people live with massive emotional and cognitive dissonance and yet not have an emotional meltdown (or self harm from the pain).

For example, when you get into the DBT flow of consciousness, you realize that you can both love and hate someone.  You realize that on some level, you are amazing, perfect and rocking as is, yet you can improve.   You realize that you are sometimes brilliant, and sometimes really foolish, but still lovable, no matter what. You embrace the FACT that you inevitably will make mistakes, but you are NOT a mistake.  You are still awesome, lovable and worthy, no matter what cocka-locka-cuckoo stunt you got into, either consciously or unconsciously.

So dialectical thinking helps us get out of the black and white mental trap, the “All or Nothing,” Right or Wrong, Worthy or Unworthy, Perfect or Imperfect name game.  Practicing dialectical skills helps relieve so much of our nasty inner dialogue.  Over time, DBT gently muzzles the harsh inner Critic and lets us move forward with plans to grow, learn, change and improve ourselves, our relationships and our lives.

Borderline1

DBT makes it so much easier to “Disable the Label” of our diagnosis, gender challenge, financial issue, body image or weight issue and more.  As I’ve often said before, I believe DBT skills will someday soon be taught to everyone by the 3rd grade level.

It is essential that we all move out of this painful and extremely unproductive dualistic perfectionist damnation of ourselves and others!  Enough is enough, right? The exquisite radical acceptance that comes from dialectical thinking starts within, and then permeates into our relationships, politics and the world at large.

Yes, it is possible to temporarily hate ourselves for a few minutes for being a bit unconscious or even whacko in the moment, and then with the help of improved self-talk, gently shift back to a more bearable level of acceptance, possibly reach a more comfortable forgiveness level and then back to a more loving baseline. With training, this could be reduced from days/weeks of self hate to a few minutes…that’s a big win in my practice!

This DBT process uses evidence-based skills culled from the vast Mindfulness research, Interpersonal Effectiveness, Distress Tolerance and Emotion Regulation fields.  These skills help people move from being in the extreme of “Emotion Mind” or “Rational Mind” into their “Wise Mind” and function better on every level.

Ven diagram 1 Wise Mind

Here are some of the common myths that we deconstruct in our DBT groups:

“Dialectics reminds us of the many paradoxes that are built into our Universe:

  1. The universe is filled with opposing sides/opposing forces. There is always more than one way to see a situation, and more than one way to solve a problem. Yet two things that seem like opposites can both be true.
  1. Everything and every person is connected in some way, in the way that the waves and the ocean are one. It is also believed that the slightest move of the butterfly affects the furthest star.
  2. Change is the only constant. Meaning and truth evolve over time. Each moment is new; reality itself changes with each moment.
  1. Change is transactional. What we do influences our environment and other people in it. The environment and other people influence us.” (Linehan, 2015)

For today,  I challenge you to start letting go of your dualistic mind traps, and gently start to shift into a more compassionate, empathetic and dialectical mind set that will allow yourself and others to be good enough around you, as is, while you are all improving.  Here’s the emotional math: less judging, more inner peace.  Simple, but not easy!

Onward and Upward,

Lisa Wessan

 

Reference:
Linehan, M. (2015). DBT Skills Training Handouts and Worksheets. Second edition. New York: Guildford Press. Page 150.

 

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

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What should I do about my Fitbit rash and other electropollution?

Fitbit rash | 29 DEC 2018 |

 

Ever since I heard of this Fitbit technology I was concerned about the possibly harmful effects of the radiation on my health and body.  But my concerns were swept aside when my nephew shed 165 lbs. strictly by using his Fitbit daily, tracking movement, food intake and using all the app can do.  I was inspired, and thought maybe it could help me release my unwanted pounds, too.

So I have been using my Fitbit since last November…the good news is that I have been tracking 10,000 steps or more nearly every day and it is fun to see the counts come in and get cheered by my fellow Fitbit friends.  My overall health metrics are very good.

The less good news is that I have not released my extra weight in any significant way, plus I just recently developed a rash from my wearing my Fitbit daily.

I’ve discussed my multidimensional food challenges in other articles, so for today I’m just going to share about this Fitbit rash, because I care about and love my readers here who might also be getting hurt from your  wearable tech.

Research on the dangers of wearable tech

I suggest you search at Google Scholar online for “Dangers of Fitbit” and “Fitbit Rash” to see what’s been coming down the pike on this topic.   For me, these were the three most interesting articles from reliable sources:

Do I Need to Worry About Radiation From WiFi and Bluetooth Devices? by Catherine Roberts, Consumer Reports, 3/1/18)

Why a Fitbit Harms More Than Helps Your Health  by Sarah Pope (The Healthy Home Economist, 8/30/18)

Wireless Silent Spring  by Cindy Russell, MD      (WirelessSilentSpring_-SCCMA-Oct-2-2018.pdf)

Besides the unknown effects of the chronic wireless marination of our bodies, there is clear evidence in Dr. Russell’s  report in the SCCMA about the dangers of this radiation for our birds, bees, trees and other wildlife.

Robert’s article in Consumer Reports gives some excellent suggestions to curb the exposure to radiation towards the end of the article.

I’m not here to preach anything to anyone, I just love our beautiful Earth and want it to be sustained for 10,000 generations and more. Plus, I want to see the epidemic of cancer be reduced and eliminated.   It’s very possible that our environment is causing this massive cancer phenomenon and we can do something to curtail this now.

Oh my, I know you will be annoyed to hear this – but we need to pull back and be more mindful of how we use our devices here!

Fun fact: When I was younger,  in between my careers as a science journalist, talk show producer and psychotherapist, I was a full time environmental activist for a while. I served as the Executive Director of the Strategic Defense of the Environment Group (SDEG).  Our goal was to preserve as much of the rainforest terrain as possible,  more dramatically, “TO SAVE THE LUNGS OF THE PLANET!”

SDEG  did have a very successful conference in Rabat, Morocco in October 1995, covered by five countries’ television crews, with 5,000 attendees. In sum, due to SDEG’s efforts, legislation was revised and improved in Brazil to reduce the deforestation dramatically, so we definitely had a positive influence. Plus all the Ministers of Environment around the world got to meet each other and create useful networks.

Why I stopped being a full-time environmental activist:  after SDEG I chose to shift from a macro career dealing with global transformation issues to a more intimate micro focus, dealing with individuals’ and groups’ transformation process as a therapist.  At the end of the day, battling governments’ legislation issues was not for me.

Solution Focused

For today, I support a bunch of exemplary environmental groups that are doing the work for me, as it were!  You can donate to any of these organizations and know that your loving kindness will be doing great things for our planet (for a full list of my favorite environmental charities, just request it below in Comments):

The Environmental Defense Fund, Environmental Working Group, Natural Resources Defense Council

Do cell phones cause brain cancer, or other harmful side effects?

One of the many things I did learn at SDEG is that even in the 1990s scientists were concerned about the cell phone towers and how the electromagnetic fields (EMF) generating radiation were affecting the environment, and us.

Shameless fact: I was the last person in my family and circle of friends to get a cell phone because I had read so much scientific research at SDEG on the dangers of  EMF.  I still never put my cell phone next to my ear.

Not so fun fact:  there has been a huge rise in brain tumors located by our ears.  Conservative estimates abound, but you can find many studies warning us now. This is truly a dilemma for all of us, who love our cell phones (and other wearable tech).

So for today,  I am going to need to retire my beautiful Fitbit for a while…at least until my rash goes away.  Then I might wear it occasionally, but not daily.

This will be my version of Moderation Management!

Slowly, slowly, letting go of my beautiful Fitbit…sigh.IMG-7095

For yourself, think about what all this EMF radiation is doing to you. Learn more about electropollution and how it affects you here…

Onward and Upward,

Lisa Wessan

 

I’m bedazzled by the EMF radiation around me! But is it hurting me?  More will be revealed! IMG-7073

Copyright © by Lisa Wessan 2018. All rights reserved.
www.LisaWessan.com

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More PRESENCE, less presents…the Mindful holiday season

 

Maybe Christmas, the Grinch thought, doesn’t come from a store. – Dr. Seuss

Christmas isn’t a season, it’s a feeling. – Edna Ferber

For it is in giving that we receive. – Francis of Assisi

May you practice connecting with more Presence during these holidays, and have less of a need for presents…and I hope you and your loved ones have a healthy, joyful holiday season and New Year!

No matter what, each day is a new beginning…

Onward and Upward,

With warm blessings and love,

Lisa Wessan

 

IMG_9056

 

Copyright © by Lisa Wessan 2018. All rights reserved.
www.LisaWessan.com

 

 

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Holiday Blues? Pause and Take a Mental Laxative (Forgiveness 101)

For some people, the holidays are a very joyful and exciting time of year.  More parties, celebrations, shopping and gift exchanges coupled with lots of social stimulation.  It’s all good…for them.

But for others, who feel painful pressure to have “forced fun” and may not have strong intimate connections, lack financial resources, struggle with illness or addiction, these times are fraught with deep loneliness and uncomfortable feelings of “Compare and Despair” (Wessan, 2011).  For this group,  we are entering “The Red Zone.”  

The Red Zone  runs through  Thanksgiving, Christmas and New Year’s Eve…and perhaps for many Valentine’s Day is also included in this over stimulating, emotionally charged, addiction riddled time of year.

When I was younger, single and living alone in New York City,  I experienced the holidays as my Red Zone.   I loved my circle of friends, but many of them were married or had moved far away. They were not available for the holidays. I found my loneliness was most acute during this time of year.

As part of my coping with loneliness,  for many years I went away for New Year’s weekend to Pumpkin Hollow Retreat Center, in Craryville, NY.  Pumpkin Hollow is a beautiful place, with magical trails on lush Berkshire hills and a thoughtful and sensitive staff.  They used to facilitate a wonderful Silent Retreat over New Year’s weekend (I noticed now they have one in late January and May 2019).

There were moonlit walks in the woods, we ate delicious gourmet organic vegetarian meals , danced  around a huge campfire, hugged trees and meditated together in the silence.   The facilitators artfully helped us work through all the activities in silence, and I remember every year being amazed at how little language I really needed to get by and still feel peaceful and content.

For me, it was a relaxing and restorative weekend in the Berkshires, but I also I had to process some difficult feelings. 

 

Forgiveness 101

Being in the Silence can be a powerful cleanse,  as so many distractions are removed.  The Silence gives us time to deeply work through some acceptance and forgiveness issues, serving as a “Mental Laxative,” as  Iyanla Vanzant is known to say  (Vanzant, 2013). This is a perfect time to take a moral inventory of ourselves, and notice where we need to improve. 

Moral inventories vary, but at their core,  we make a list of the people we have harmed, consciously or unconsciously.  Then we make a list of the ways we hurt ourselves, consciously or unconsciously.  Finally, we make a list of our fears and regrets.  (The only way to do a moral inventory wrong is to not do it at all.)

All of this then requires a deep and thorough forgiveness practice, ultimately letting go of all of it.  Then it is done.  We have a fresh start.  

You can use this Forgiveness Prayer to help you get started.  Practice Suggestion:  Read it into your Smart Phone’s Voice Memo app (or tape recorder) very slowly. Pause 5-10 seconds between each line.  Save it, and then play it back to yourself with your eyes closed, allowing yourself to feel it deeply.  As faces and names to forgive bubble up in your consciousness, you can make a note of them to add to your lists.

For all those we have harmed, knowingly or unknowingly,
we are truly sorry. Forgive us and set us free.
For all those who have harmed us, knowingly or unknowingly,
we forgive them and we set them free.
And for the harm we have done to ourselves,
knowingly or unknowingly, we are truly sorry.
We forgive ourselves and we set ourselves free.
~ Author Unknown ~

Afterwards, we may also need to talk to a few people and apologize for our behavior (or in some cases neglect).  Hard Fact: In order to really feel healthy, whole, clean and strong  inside, it is essential to give our inner emotional pipes a good Roto-Rooter cleaning by resolving any awkward or tender hurts. Apologies and amends need to be in the process.  Fun Fact: Asking for forgiveness is the final piece in our quest for inner calm, or should I say, the Final Peace?!!  

But you don’t have to go away for a whole weekend to give yourself an effective Mental Laxative…you can carve out some time each day, or each week,  to sit quietly and review your life to forgive the imperfect moments. What worked well? What did not go so well?  Whom did you judge too harshly?  Even taking a brief inventory of your emotional interior will have huge pay offs in the long run.  

One more Mental Laxative Practice Suggestion:  set a timer for 10 minutes.  Do as much of your list making as you can in that time, and then stop.  It will be enough.  Do this on a weekly basis, or more frequently if you are ready. Ten minutes of taking a Mental Laxative twice a  week is a great beginning, perhaps once over the weekend and once during the week?  Do what feels right for you.

As you progress, this could ideally become a daily activity…and who would you be if you had no resentments, anger, unresolved grief and rage?  You would bloom on in a whole new way.

In addition, I believe that holding onto negative thoughts and unresolved anger, resentment, fear and grief will fester within, and eventually manifest into some kind of physical illness and/or mood disorder.  We need to keep all of our pipes clean!  Digestive pipes and emotional pipes, which actually work together in the big picture.

As the hallowed halls of the Mindfulness research and Functional Medicine have taught us, every thought becomes a chemical reaction in our bodies.  Please note, the Mind-Body connection is not philosophical, theoretical or conjectured.  It is grounded in science (Turner, 2014).

We need to be aware of this and carve out the time to release and let go of our negative and stinking thinking.  If we don’t, it will just putrefy within, and poison our relationships as well.

 

What is Reflective Listening?

Being heard is so close to being loved, that for the average person they are almost indistinguishable.  – David Augsburger

Another worthwhile activity to do if you find yourself being in the Red Zone now is to volunteer your time, talent and special treasure in places that will appreciate you.

Before I became a therapist, I used to volunteer at a Suicide Hotline called HELPLINE, at the Marble Collegiate Church in New York,  which for me, was an exhilarating service.  It was founded by the late, great Reverend Norman Vincent Peale, may he rest in peace.  (There is also an excellent Blanton-Peale counseling center located at Marble, with wonderful psychospiritual therapists on staff, see reference below).

Most Hotlines have a fascinating and useful training program which enhances all human relationships.  I first learned the power of Reflective Listening in my 10-week HELPLINE training, and it transformed my life. 

Reflective Listening is being able to let someone else talk and just be present for them,  listening quietly.  When they pause, then you reflect back the essence of what they have just said.  This feels very soothing and loving to the agitated talker. The person feels so validated by your Reflective Listening, it is often enough to help them  get “off the ledge.” Listening is a form of loving each other that soothes, heals and restores us.

Learning Reflective Listening  was the bulk of my HELPLINE training, plus there was also a lot to learn about making referrals and gaining trust. 

Coming from a culture of chronic interrupters and non-listeners, I had learned some ineffective communication habits over the years, which I continue to strive to improve.   The impulse to speak out and interrupt is fierce, but knowing that it compromises relationships and hurts people helps me to zip my lip, as best as I can.  For today, I remain a humble work in progress, that’s for sure.

My hope for the future is that the Hotline’s training program is something that will be  taught to all humans by the sixth grade. Similar to the skills learned in Dialectical Behavior Therapy (DBT, which should also be part of elementary school education) during training we learned about interpersonal effectiveness, mindfulness, distress tolerance and emotion regulation.  These skills give us the foundation for better emotional balance, and allow us to be more present for others’ pain and suffering, as well as our own. 

 

Ask yourself the magical question, “How can I be useful today?”

I understand that a Hotline gig may not be your cup of tea.  Volunteering at a soup kitchen, animal shelter, nursing home, botanical garden, museum, Indivisible, MoveOn or anywhere can also be very uplifting during the Red Zone. 

Nursing homes always need a river of volunteers to help with feeding, reading, translation services and transporting  non-ambulatory residents .  I learned this when I was in graduate school, as one of my internships was at the Jewish Home and Hospital for the Aged in the Bronx.  I was facilitating several  therapy groups each week, but there was a huge volunteer staff that coordinated all these helpful tasks for the residents.  I was so impressed with the volunteers’ compassion and zeal to help these nursing home residents.  

Yes, there is a time for self care, and then sometimes it is better to focus on others’ needs more than your own, to take a break from the painful  ME-ME-ME inner dialogue you might be having.

 

Transparency is Healing

Finally, being in the Red Zone totally in secret is just exhausting and no fun.  Be honest and authentic about your feelings — transparency is healing —  and see who matches your energy.  You might find a few people who also feel put upon and even hate the holidays — great — these will be your Red Zone buddies and comrades in getting through the muck of the season. 

Make it a point, however, to be victorious together, e.g.”let’s stay sober and clean through this nightmare,” or “This too shall pass. How can we be useful today?”  or “Let’s go for a hike and get away from the shopping madness.” Complaining is draining, so it’s important to find ways to support each other to rise above the chaos of the season.

Being able to laugh about it, the complete absurdity and paradox of Christmas especially, is so refreshing.  Whenever I see huge displays of gifts and glittery objects everywhere tempting us to buy-buy-buy, I chuckle to myself and think “What would Jesus say about all this?  Would He be happy with this display?”  Yikes.

I’m not judging, nay, nay,  I actually love the glittery Hand of G-d in all of this (Wessan, 2012).  But you know  the commercialization of Christmas becomes excessive and downright irritating at times — so I like to take a step back and think about the real reason for the season…our awesome connectivity, celebrating our Oneness, and the mystery of the Numinous in our lives.  

Another reason is the magnitude of  working through the bittersweet feelings of existence together and being brave enough to peacefully co-exist in this tumultuous world.   We can acknowledge the dialectical paradox, that sometimes we want to live and sometimes we don’t, but we choose life anyway.  We need to be courageous during this time, knowing that we are struggling in the Red Zone while “everyone else” seems to be having the best time ever. 

 

In Conclusion

For this holiday season, The Red Zone,  I encourage you to try something different:

  • Experiment with a daily or weekly Mental Laxative experience, or go away on a retreat for more in depth forgiveness work.
  • Volunteer somewhere that will give you  a chance to focus on someone else, take a break from “Poor me, Poor Me, Pour me a drink” thinking.
  • Give honesty a chance, come clean and tell a few people how you really feel. Defrost some of that hidden grief, rage, loss, loneliness, “Compare and Despair” and all the inner stressful thinking that puts a damper on your days.

I promise if you follow some of these suggestions you will feel lighter, brighter and perhaps, dare I say it, even more peaceful during this relentless Red Zone. 

Good health is wealth, go for it!

 

 

References

Dialectical Behavior Therapy Skills (DBT).   This is a four part psychoeducation program that covers Mindfulness, Emotion Regulation, Distress Tolerance and Interpersonal Effectiveness. It takes one year to complete the curriculum.

Turner, K. (2014).  Radical Remission: Surviving Cancer Against All Odds.   New York: Harper Collins. 

Vanzant, I. (2013). Forgiveness: 21 Days to Forgive Everyone for  Everything. Carlsbad, CA: Smiley Books.

Wessan, L. (2011, September 27). Compare and Despair: How Free Do You Want to Be?  Retrieved from https://mirthmaven.blog/2011/09/27/compair-and-despair-how-free-do-you-want-to-be/

Wessan, L. (2005, October 14) Forgiving is not condoning. (8 minute video)  Retrieved from https://www.youtube.com/watch?v=avBEdDJJGrk

Wessan, L. (2012, July 13). The Glittery Hand of God. (3 minute video).  Retrieved from https://www.youtube.com/watch?v=PT2lSvLft4o&t=4s

Blanton-Peale Institute and CounselingCenter, New York, NY,  for individual, family and couples counseling.  Accepts most insurance.  Highly recommended for quality psychospiritual therapy.  Founder: the late great Reverend Norman Vincent Peale. 

Pumpkin Hollow Retreat Center, Craryville, NY. Owned and operated by the Theosophical Society.  Organic vegetarian food served from their own farm, non-dogmatic, beautiful retreat center. Highly recommend, especially the retreats on Therapeutic Touch, and the Silent Retreat.

 

Copyright © 2018 by Lisa Wessan. All rights reserved.

 

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Up Next: New DBT Skills Groups on Distress Tolerance and Mindfulness in Westford, MA

#MirthMaven |

In the wake of the recent suicides of Kate Spade and Anthony Bourdain, people are now becoming more acutely aware than ever of how vulnerable we all are to thoughts of self harm.  Knowing that all the success, cash and prizes, fame and celebrity connections do not make a person happy can be mind bending for many people.

In my guild, we deal with self harm and suicidal ideation regularly and know how catastrophic it can be for families and loved ones to process and cope with a loved ones’ tendency to self harm.  Plus, we each have our own dark thoughts and need to learn to be able to observe, defrost and release those negative thoughts in order to function here at Earth School.

No one is exempt from this learning curve!  This is why I am confident that ultimately DBT and Mindfulness will be taught in all elementary schools as part of the required educational curriculum.

To that end…besides my basic and ongoing daytime and evening Dialectical Behavior Skills Groups (DBT), I have been asked by several concerned parents of challenging and high risk adult children if I could form a monthly DBT support group for them.   I have also been asked by my amazing graduates of the one year basic DBT program if we could have an Advanced Group that also meets monthly…

To fulfill that request,  below are the upcoming groups that are forming to meet the personal growth needs of our community. (For learning DBT Skills from a remote location, or if you are compromised due to health issues, I also use video chat sessions  to share this work).

Daytime and Evening 14 Week DBT Skills Group on Distress Tolerance and Mindfulness: August 16, 2018 – November 15, 2018  Thursdays, 3:15 -4:45 PM or 7:30 – 9 PM.

Monthly DBT Skills and Support Group for Parents of High Risk and Challenging Children, the first Wednesday of the month, 7 – 8:30 PM.

Monthly DBT Skills for Advanced Students, the second Wednesday of the month. 7 – 8:30 PM.

Please note: enrollment is ongoing. (Sorry, no walk-ins, you must pre-register for all above groups.)

Let’s turn your defeats into victories, and your scars into stars…Yes, DBT can help you shift from being IMPOSSIBLE to I’M POSSIBLE!

Onward and Upward,

Lisa Wessan

 

Copyright © by Lisa Wessan 2018. All rights reserved.

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WESTFORD, MA – New DBT Skills Group for Adults on Emotion Regulation and Mindfulness, (Dialectical Behavior Therapy) starts 03/21/19

I am excited to announce the next 14-week Dialectical Behavior Therapy Skills (DBT) Group in Westford, MA will be starting a new evening trimester on Thursday,  March 21, 2019, 7:30 – 9 PM.

We will be covering both the Emotion Regulation and Mindfulness modules.  (This is an ongoing group that has Open Enrollment Periods three times per year. This group is non-binary/co-ed, ages 18+, tuition fee applies/non-insurance based.)

Four leaf DBT

The Emotion Regulation module has four sections:

  • Understanding and Naming Emotions
  • Changing Emotional Responses
  • Reducing Vulnerability to Emotion Mind
  • Managing Extremely Difficult Emotions

The Mindfulness material includes:

  • Learning to be a good observer
  • Being non-judgmental
  • Staying in the present
  • Practicing being effective
  • Accessing Wise Mind (aka higher self, higher consciousness)
  • Understanding Reality Acceptance and detaching from negative or critical thoughts.

As DBT founder Dr. Marsha Linehan says, “It is difficult to manage your emotions when you do not understand how emotions work. Knowledge is power.”

For exact dates,  location, DBT videos and more details, please visit www.lisawessan.com or call 978.710.8039.

Onward and Upward,
Lisa Wessan

DBT Mindfulness

Copyright © by Lisa Wessan 2019.  All rights reserved.

 

 

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Each Day, a New Beginning

2018 New Year

Remember, each day is a new beginning, as it is written in Winnie the Pooh:

“What day is it ?” asked Pooh.
“It’s today,” squeaked Piglet.
“My favourite day,” said Pooh.

Some days may appear to be more special than others, but in fact each day is a special pearl of a day.  Let’s love the day, no matter what…experiment in feeling an attitude of gratitude for each breath you take.

Onward and Upward,

Lisa Wessan

 

 

 

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Beyond the Waiting Room: The Time Lapse and Gaps of Behavioral Health Care

This goal of this article is to provide insight into the “back office” of  behavioral health care practitioners, especially for our patients, and the administrators who work with us.

unavoidable-delay1

Even though I tell new patients that they need to allow for some “wiggle room” at the top of their session and at the end of their 45-50 minute therapeutic hour, there are always some who are hurt and upset when I am not punctual, and that would be for anywhere from five to fifteen minutes. I am writing this article for them… and my fellow behavioral health care practitioners, who may appreciate this illustration of what goes on while our patients are waiting for us.

One factor to keep in mind is that there are many different opinions on the “therapeutic hour.” Most insurance companies reimburse for a 45 minute session, a unit of time that they deem is appropriate for treatment. There is an ongoing debate on this matter.1

My patients know that they will get their full time here, whether we start at 2 PM or 2:10 PM. Most of the people I work with have no problem if I am a few minutes past the hour. They understand the ebb and flow of a behavioral health care facility, or they are conditioned to wait from previous appointments with other practitioners. There are just a handful of people that are in acute pain in the Waiting Room, and this article will hopefully soothe their concerns (until we can work through their attachment issues).

What do therapists typically do in that 10-15 gap between patients?   We are usually returning phone calls, making appointments, reviewing or writing notes, visiting the restroom,  and perhaps eating lunch, dinner or some kind of metabolic adjustment. There isn’t much time for a phone call, unless we have at least 30 minutes between appointments.  (Typically I don’t attempt to initiate  any phone calls unless I have that block of time available.)

Then we have the Unavoidable Delays which occur during these gaps:

Delay #1: Collateral calls between sessions. What is a collateral call?  That’s when we return urgent calls to your  doctors,  nurse practitioners, teachers, guidance counselors, lawyers, judges, concerned family members or call your insurance company.

For example, when I have a patient in the hospital, and her doctor wants to talk to me, he leaves a message in the morning “Please call me today as soon as you can before 1 PM.”  So what happens at  10:50 AM or 11:50 AM when I am returning his call during a 10 minute gap?  I call the doctor, and then his secretary tells me to “Please hold while I page him.”  I can be on hold for more than 10 minutes at times — waiting to find out how our mutual patient is doing. Naturally  I am concerned for my hospitalized patient’s well being and may also need to respond to the doctor’s questions. Plus, Medical Release forms may need to be signed and faxed so that we can speak without violating the HIPAA Privacy Rule2.

Am I concerned about you being in the Waiting Room?  Yes, I regret when this happens. But to remedy this challenge, when I have a collateral call to place — which may guarantee a delay  —  I immediately send you a “Courtesy Notice” via text.  I let you know that I am being detained, and that we will most likely meet closer to 11:15 AM, or 12:15 PM, or whatever is 15 minutes past your original appointment. I am always doing the best I can, given the urgent and timely nature of these collateral calls.

I am honoring your time as much as I possibly can, and I deeply care that you are waiting, but I also need to make these calls between seeing patients in my office. You need to know that I am not thoughtless, careless or indifferent to your waiting time. That would be an extremely false assumption.

Delay #2:  Longer sessions.  Sometimes a client is delving into a very difficult thought or memory, and is having a breakthrough at the 43rd minute of the 45 minute hour, often referred to as “Doorknob Therapy.”3.  Do I stop the client at the stroke of 45 minutes and say, “Sorry, we will pick this up next week.”  No, I allow them to finish their thought, or complete their process, especially when they are releasing a traumatic memory or having a major breakthrough or insight. Again, it’s just a few extra minutes past their usual time.

Please understand, I am not working at a bottling plant, popping caps on bottles,  where I can just flip the switch and shut down the conveyor belt. If I was a factory worker, or a bean counter of any kind, yes, this would be possible. But in behavioral healthcare, this is typically not possible.

you-are-fascinating

Delay #3:  Engrossed  listening, not watching the clock. The good news and the less good news…I am listening to your story,  you have my full attention, and I do not watch the clock every minute. I sometimes lose track of time while I am deeply concentrating on your words, and what is happening with you. This is a natural hazard of working in this field4.  Yes, there are ways to keep track of the time despite the process of  intensive reflective listening, putting together symbolic themes and meaningful interpretations for you.

Possible solutions for Delay #3: How would you feel if I set a timer for 43 Minutes?  Would you mind if a chime went off right before your time was up?  That is one solution for this delay. Other solutions involve keeping one eye on the clock and thereby removing myself from total immersion in your story. When I go over the hour due to engrossed listening, it is rarely more than 5 or 10 minutes. Yet this does anger some patients in the Waiting Room who feel miffed that I am a few minutes past their appointment time.

Delay #4:  Clinical meetings off-site. Sometimes I perform home visits for my elderly patients, or teens without wheels. Traveling from another location, where I was in a clinical meeting that ran later than expected, could cause a small delay.  Again, when I see that coming, I send a text with a Courtesy Notice.  During home visits, sometimes there are extra complications, or equipment needs to be ordered, and urgent paperwork needs to be processed which takes a bit longer. This is all part of the unavoidable delay caused by this off-site work.

In Conclusion

It remains questionable as to whether the 45-50 minute hour can be effective when processing deep trauma and chronic grief.  I do the best I can during this standardized treatment window, but you need to know that there are methods and techniques which do require longer time for maximum benefit, including Dialectical Behavior Therapy (DBT),  Eye Movement Desensitization and Reprocessing (EMDR), Hypnotherapy and other trauma treatments. These do not always fit into the 45-50 minute hour5.

In sum, this work occurs in a non-linear, sometimes timeless space that cannot be boxed into a precise unit of time if the practitioner is working with true empathy, compassion and a commitment to excellence6.

So the next time you are sitting in the Waiting Room, I hope you consider that one of these four delays are probably happening and that’s why you are waiting, hopefully patiently.

Suggestion: It would be an excellent use of your time to make a list of topics that you want to discuss with your therapist, or sit quietly with your eyes closed and scan your body and mind for what you are feeling in the moment, to get in touch with your inner world in the Waiting Room.  This will contribute to your having a more effective and successful quality of session and therefore you will be using your time with deeper purpose and meaning  in the Waiting Room. You could also write your check for your fee or copayment while you wait, also a good use of those minutes.  [Please refer to my article on “The Art of Waiting,” for your enjoyment and better understanding of this issue7.]

 

Finally, this is an important issue to discuss with your therapist. Chances are if you are impatient in the Waiting Room, you are impatient everywhere. You are not behaving this way only at this time. It’s how you roll, your Modus Operandi.  You may also discover that you are avoiding dealing with your painful issues and interpersonal conflicts by hyper-focusing on the 10 minutes you are waiting. 

You may be triggered by this short wait, and it is bringing up important tender golden threads from your childhood when you were neglected or kept waiting by a harsh relative.  But being condemning, critical and complaining of your therapist’s time delay will not help you in dealing with your inner troubles and your personal transformation process unless you discuss it openly with your therapist.  Ultimately, railing about your therapist’s time delay to your friends  will just keep you feeling like a victim, and you will stay stuck right where you are until you process this out with your therapist.

 

We are your Practice Human. In the best of all possible therapeutic relationships, you will feel safe enough to say anything to us, tell us exactly how you feel, what you think, and how frustrated you are with your waiting experience (or any other issue you are having with therapy).  This is all very useful and helpful in your journey towards wholeness.
When you practice improving your communication with us, you increase your interpersonal effectiveness in the world.  I always tell my people “This is the Huddle!  You come in here to defrost painful feelings, get some relief, regroup, strategize, learn some new skills, tools and methods, and then go out and practice.  The real work is done out in your life.”

 

If waiting for your therapist continues to be a huge issue for you, speak to your therapist about getting treatment for practicing Radical Acceptance8. Or if none of this fits for you, then just get a referral to see a different therapist.

At the end of the day,  you are always 100% accountable for your life.  As the captain of your ship, you can always sail on to the next safe harbor.

May you have the best life ever, and learn to process your “time issues” with love and grace.

Onward and Upward!

 

NOTES
____________________________________________________________________________

1. Goleman, D. (1984). The New York Times. Therapy: Critics Assail ‘Assembly Line’ sessions. By Daniel Goleman.

2. Health Insurance Portability and Accountability Act of 1996, aka the HIPAA Privacy Rule.

3.  Gould, C. (2014). PSYCHED. Getting to “The Good Part” of therapy.

4.  Lazarus, A. (1997).  Brief But Comprehensive Psychotherapy: The Multimodal Way. New York: Springer Publishing Company.

5. Ibid.

6. For this reason, some of my patients have double sessions, where we can do accelerated work and have the advantage of a 90 or 100 minute session to cover a broad reach of material successfully.

7. Wessan, Lisa (2016). PULSE. The Art of Living is the the Art of Waiting.

8. Brach, T. (2004). Radical Acceptance: Embracing Your Life With the Heart of a Buddha.  Bantam Dell: New York, New York.  [There are many sources for learning about Radical Acceptance, and it’s also included in the Distress Tolerance module of Dialectical Behavior Therapy.  Tara Brach’s book is a wonderful source for delving deep into the process of learning to accept reality and find peace with the imperfections of your life.]

© Copyright 2017 by Lisa Wessan. All rights reserved.

 

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The awe and wonder of giving blood…

Lisa Wessan, advocating for blood donation at Red Cross.

Lisa Wessan, advocating for blood donation at Red Cross.

For most people, during the month of December we look for ways to give extra love, charity, dinners, trips, gifts, bonuses…we are in an intense giving mode.   I wish for every dollar spent at the mall someone donated blood — saving approximately three lives per donation — now that’s massively good giving!

What’s great about donating blood is that you can give it away every eight weeks, at the most, or any amount of times after that during the year.  You can give at each seasonal equinox, or twice a year, whatever you donate, it’s all good.

Each time I give blood I am reminded of the great mystery of our blood, and how it works tirelessly to keep us alive,  coupled  with the awe and  wonder of the human body.  Plus the amazing process by which the Red Cross extracts my blood and delivers it to someone who needs it — just astounding.  So well done.  Bravo!  Kudos to the Red Cross for your exemplary service.

So here’s your reminder that an opportunity awaits you…do you want to raise your self-esteem? Do estimable acts!  Giving blood is a mood changer, uplifter and total Mitzvah blessing, in the full sense of the word.  Go for it! Click here to find nearest donation center in USA.

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