Thursday, 19 May 2016

Do you care too much what people think?

I cannot tell you how often I have heard clients say: "I wish I did not care so much what people think."  Whether your issue is with bosses, peers, parents, partners or even children, few of us have escaped becoming ensnared in trying to please someone else only to discover a sick feeling later of discomfort or even resentment.  After all, whenever you become too attached to what other people think, you are on a roller coaster ride over which you have limited control.  Your ability to feel good about yourself becomes contingent on another person's beliefs or mood and sometimes on whatever ideas are in vogue at the time.  Don Miguel Ruiz, the Mexican healer and famous spiritual writer, in his well known book called "The Four Agreements" talks about how important it is for good self esteem to not take to heart the opinions of others.  He tells us that when we no longer care so much what others think, it sets us free to be ourselves and to feel good about who we are.  Virginia Satir, the internationally known family therapist who spoke a great deal about self esteem used to say that the most important freedom in the world is to be able to say "yes", "no" or "maybe" to any request that is made of you.  The ability to say "no" is particularly crucial.  In its absence, we are at the mercy of anyone who asks a favor of us, makes a demand, or insists that we conform to their expectations of us. Yet, how do we focus on asserting ourselves rather than pleasing others?  It seems like this is more easily said than done.  To stop trying to please others, it is helpful to be able to identify what is fueling your need to please in the first place.

I was talking with a client the other day and we were discussing the "pleaser" in her and how deeply entrenched it has been.  She began talking about going along with others in order to avoid hurting other people's feelings.  She then spoke about her tendency to accommodate in an effort to be liked and in order to avoid conflict or criticism. We moved from there to discussing her poor self worth and whether or not she felt she deserved to have her own needs met.  While all these explanations seemed to have some truth to them, they still did not seem to get to the heart of the matter.  So we continued to peel off the layers and to her surprise and mine, we ended up in a completely unexpected place.  I asked her, "If you felt like you had the right to have your needs met...if you were not so afraid of making a mistake or of not being liked....if you did not tell yourself that others were more important than you...if you had the courage to assert yourself regardless of what others might you know what it is that you want?"  The question left her stymied and one could see that a light bulb had gone on when she admitted, "Probably not.  That seems like it would be a lot of work."  She reflected that she had no trouble identifying what she "should" want but that truth be told, she had little idea of what it was that she did want.

It is easy to lose yourself by giving over to someone important in your life in the hope that their approval will make you feel loved and valued.  Not only can significant others lead you to sell yourself out but societal messages are powerful too. There are tons of messages bombarding us all the time about what we should be and want in order to be attractive, worthy and successful.  Most of us without thinking go from the outside in.  We think about what others might want of us and then decide how to act. To be true to yourself, you have to do the opposite.  You have to go from the inside out; in other words, you need to tune in to your own feelings and desires first and then determine how you want to move forward in the world.  I understood what my client was saying. This is a lot more work than just going along for the ride and when you have been a chameleon most of your life, it's difficult to know where to start.   My client's long-term habit of going along with others had left her more and more unable and less equipped to access her own true feelings and preferences.

If you find that like this client, you have lost yourself in pleasing others and have difficulty knowing what it is you want, know that you are not alone and that there are things you can do to turn this around.  Learning to connect with your own wishes and preferences need not be onerous but rather can be an exciting adventure. It starts with being curious. Going about your life paying attention to the things you are attracted to and that you admire is a way to begin to collect data on what it is you like and what it is you want to create in your own life.  It is the pioneering work of finding out more of who you are and getting a more solid sense of self.  It is easy to get caught up in what will please others and what you have been taught you should want.  It takes courage to set these messages aside; to risk being disliked; to chance making a mistake; and to dare rocking the boat but the self -esteem that comes from knowing what you want, being able to articulate it and make it happen, is well worth the effort. There is an incredible sense of freedom and empowerment that comes from not caring so much about what others think, figuring out what you want and taking ownership of your own life.  As one client so humorously put it when embarking down this path of self discovery: "I feel anxious to meet myself but it is a good nervous... it's like preparing to go out on a blind date with yourself!"

Monday, 2 May 2016

Does illness have to lead to isolation?

We live in an age of technology where people now expect instant feedback and instant connection.   Yet, when you are sick, staying in touch is difficult.  Whether you are ill because of some mental health issue like depression or a chronic medical illness like MS, it is easy to become isolated.  Connection with others can well become compromised.  The unpredictable course of many illnesses such as colitis, bipolar disorder, crohn's disease, rheumatoid arthritis, diabetes and social anxiety means that one day, the ill person has it together and the next day, they do not.  Even the person who is sick may not be able to predict from one day to the next, how she will feel.  As a result, it is hard to keep plans and to stay in touch.  Plans may end up being cancelled last minute, e-mails and texts may go unanswered and phone calls may not be returned for weeks at a time. As one client with chronic fatigue syndrome said, "There is a lot of apologizing that goes with the illness...after so many cancellations, the question becomes should I make plans at all?"  Yet psychological research reveals hands down that social supports play a fundamental role in easing the stress of illness.  How can we get better at supporting those who are suffering out there?

A real difficulty that can result in people with chronic medical illnesses and mental health conditions being misunderstood is that often the symptoms of these illnesses are invisible.  The person looks O.K. and so it is hard for others to fathom why it might be that they are cancelling arrangements one more time.  In truth, however, it just may be that the individual has used up every ounce of energy they have just to get through the day and that they literally have nothing left over to give to anybody. Depending on the type of illness, the fatigue may be too great or the pain may be too disabling or the feelings of anxiety and despair may be too overwhelming to make connection possible.  For many, their lives have become very constricted and so they may feel that they have little to contribute when it comes to conversation.  Sometimes, people who are sick fear becoming a broken record or a burden to others.  Even when friends have been empathetic, after awhile their tolerance may wear thin.  So what can be done about this very real problem of social isolation that tends to accompany illness and often just compounds the stress?

For one, people need to become better educated and more sensitive to the social and emotional fall out that accompanies illness.  The symptoms may be invisible yet many of the conditions mentioned are so very prevalent.  Both sides are vulnerable and the effort to increase understanding is a two way street.  Health professionals and the public at large need to make every effort to listen and learn more about these illnesses and their impact.  Those who are ill, need to be more vocal and forthcoming with information.  When my clients complain about feeling misunderstood, I will often say to them: "People can only understand as much as you are willing to help them to understand." With the availability of technology and the wealth of information that is now available, send them an e-mail that best describes your situation and the nature of your illness.  I had one client with Bipolar Disorder send friends and family a YouTube video that he felt described his manic episodes spot on. Another client with PTSD after years of estrangement from friends and family, wrote a letter describing the devastating impact that this illness has had on her and her relationships.  Granted, some people may not be receptive yet others will be and it is important to steer oneself towards those who want to understand and be supportive. A liability is that keeping illness a secret from those who love and care about you, can fuel shame. The clients I see who seem to fare the best are those who have been able to speak out, talk about their illness, access support groups on-line, be seen and tell people the ways that their condition compromises them.  While not everyone might be empathetic, this is the only way to gain support and be validated.  As one client with MS put it: "The illness may be invisible but that does not mean that you have to be!"

Communication is key.  When someone is ill, do not be shy about asking what is going on.  Do not make the mistake of assuming that they don't want phone contact or company.  This may just fuel their sense of isolation.  Ask them what they need and don't forget to ask as well about their partner and children who may be experiencing isolation as well.  If a friend is not responding to your attempts to initiate, do not assume that they do not want contact or that you have done something to offend them. Check it out.  Only by sharing information about the situation can there be some attempt at forming creative solutions.  Maybe the person who is ill just needs you to accommodate them for awhile by coming over to their place where they can be more comfortable.  Maybe, there simply needs to be a mutual understanding that for a time, connection will be minimal or on hold; maybe brief, spontaneous contact when there is a window of well being can be arranged; or maybe the relationship will be lopsided for awhile with the well person doing the giving and the person who is compromised, receiving and maybe, just maybe, that's not only understandable but it's O.K.  As one wonderful mentor explained to me, giving and receiving is not necessarily tit for tat.  Instead, it is like there is one big pot of resources out there and you take when you need and give back when you can. When I told her that I did not know how I could ever possibly repay her for the help she had given me, she replied:  "One day somebody is going to need the kind of help that I have given you.  All I ask is that you be there for her and pay it forward."   You know what?  Indeed, as life turned out, she was right!