For me, the end of the year is a time of reflection, appreciation and gratitude. It's when I carve out time to be proud of myself and my accomplishments of the year. It's when family rejoins, and tradition and ritual come to a focus. During this process of reflection, I find it natural to reflect on areas for growth, development and change.
However, over the years as I've progressed through my experience as a certified Cognitive Behavioral Therapy, CBT therapist in West LA, I've noticed difficulty in executing some of the New Year's goals I set for myself. I know I am not alone in this. Much has been written about the importance of setting SMART (Specific, Measurable, Attainable, Relevant and Time-bound) goals. In thinking about my past goals and in remembering discussions with friends and family, identifying goals is rarely the main barrier.
Too often I think our year-end reflections get filtered through a negative filter. Instead of dwelling on my accomplishments and successes, I tend to set goals that tap into my perceived inadequacies and dissatisfactions over the past year. Sadly, the outcome of this type of filtration is that I leave myself with a sense that I am, and/or my life, just isn't good enough.
Goals of this nature can become a checklist of tasks I "need" to or "must" do, and become a basis for my own feelings of inadequacy, lack of confidence and esteem, and tend to gain momentum throughout the year. Conducted through this lens, in the generation of goals, I struggle to finalize a thorough list of SMART goals and commit to executing them.
If you are someone who is able to carve out SMART goals for yourself, hold yourself accountable throughout the year and move forward in creating your ideal self and environment without distress, BRAVO! Keep up the excellent work!
However, if you find yourself struggling to set SMART goals or executing change within your life, I have a proposal for you.
In a prior post, I recommended:
We all drift from our good-enough selves. Being adaptable, resilient and committing time to reconnecting with our passions, purpose and cultivating a process to do so is most important.
Similar to the above quote, it is important to remember that we all drift from our true intentions and goals -- each and every one of us. Therefore, it is not helpful to berate ourselves for this sort of drift.
It has been much more helpful to think about the times in my life when I have lived according to my desired goals -- going to the gym on a regular basis, cultivating meaningful relationships, treating loved ones in a loving, compassionate manner -- and reflecting on how I was feeling at those times, what I was thinking in those moments and factors that led to drifting away from those ideal behaviors.
Typically, I find that when I cultivate such compassion for myself, I'm in a much better position to share compassion and nurturance with the world and others.
If you are interested in working on your goals in 2018 and think a therapist might be helpful in keeping you on track, please contact my West Los Angeles psychotherapy practice today for a consultation.
#goals #newyear #change #psychology #inspire #reflection
I believe being in an intimate, connected and committed relationship is one of the most difficult things to do on the planet. Divorce rates in California have been estimated to be as high as 60%.
In my Master's in Social Work coursework at University of Southern California, one of my favorite courses was Couples Therapy -- the interplay of seen and unseen dynamics, complexity of internal and external factors on the relationship, historical intimate relationships playing out in the present. Relationships are as fascinating as they are challenging.
One of the biggest challenges in my own marriage has been cultivating a shared story that carves a path of true North. Esther Perel's Where Shall We Begin has been incredibly helpful in seeing my marriage, and all of my intimate relationships, differently.
I think her ability to highlight the shared stories of humanity and relationship are so calming and reassuring, they bring us to a place of sameness, safety and support. From NPR, quote is specific to her new book on infidelity:
When you pick a partner, you pick a story, and that story becomes the life you live. ... And sometimes you realize, after years of living those parts of you, that there are other parts of you that have virtually disappeared. The woman disappeared behind the mother. The man disappeared behind the caregiver. The sensual person disappeared behind the responsible person.
I highly recommend listening to Perel's podcast as a portal to seeing you and your relationship differently. As an entry into the podcasts, as a self-defined heterosexual, hypermasculine male, I found Season One, Episode Five and Season One, Episode Seven to be most relevant.
Learn more about my Cognitive Behavioral Therapy psychotherapy practice.
#couples #therapy #masculinity #relationships #intimacy #love #support #psychotherapy #psychotherapist
I love thinking the majority of my thoughts are worthless without action. That I am an observer of, not subjected to, the electrical storm within my mind. A growing gale nurtured through my focus and attention.
I love thinking I can choose to engage and ignore my thoughts -- to give life to my deepest passion and exile my darkest anxiety. These are things I focus on within my West Los Angeles psychotherapy practice.
"...5% of our thoughts are actually meaningful and relevant..."
What an empowering reminder.
Here are a few of my favorite quotes from the Forbes article "A Better Way to Deal With The Negative Thoughts In My Head."
Shannon Kolakowski, PsyD notes:
“Defusion is the process of noticing your negative or anxious thoughts, such as ‘I'm going to be alone forever,’ and then responding to it with openness and curiosity as a distant observer,” says Kolakowski. “Rather than accept your thought as the ultimate truth, you recognize that thoughts will come and go, but you don't have to believe them or act on them. You become an observer, saying to yourself ‘I'm having the thought that I'm going to be alone forever,’ and then try to explore that thought with curiosity."
“Creating a new relationship with your thoughts is freeing,” says Kolakowski. “You may not be able to control what thoughts pop up, but you can control how you respond to them. And you can control what action you take."
Ajahn Amaro notes:
“We tend to think that our thoughts are oppressive,” says Amaro, “and that therefore we should make them go away…Oftentimes meditation instruction is about stopping your thinking, as if thoughts are a kind of brain disease, an infection, an intruder. But the very act of pushing them away, and adopting the sense that they’re intrinsically intrusive, actually makes them more powerful. Rather than relating to them in that way, there’s another attitude we can have toward them—not taking them personally.”
He adds that the vast majority of our thoughts are, at best, random, and at worst, destructive. “One of the first things I emphasize when teaching,” he says, “is that 5% of our thoughts are actually meaningful and relevant, and 95% are replaying movies, music, and recollecting. It’s mostly just debris. I often encourage people to look at it like listening to neighbor’s radio–you understand the content, you can hear the words; you might sometimes get excited about an ad, or a talk show. But you don’t really care on a personal level. You relate to your neighbor’s radio in a non-personal way—we can have the same relationship to activity of the mind. It doesn’t have to make a big story around the thoughts. It’s an attitudinal shift.”
#thoughts #thinking #shift #mindfulness #meditation #anxiety #givelife
I spent the better of my late 20's absorbing videos on Ted.com. I thoroughly enjoyed soaking in the latest research, creativity, authenticity and life experience. I am still a huge fan.
As I was reviewing old videos over the holiday weekend, I was struck with the words of Julian Treasure in the above video.
He carves out a powerful vision of conversation, compassion and connection:
"What would the world be like if we were speaking powerfully to people who were listening consciously in environments which were actually fit for purpose? Or to make that a bit larger, what would the world be like if we were creating sound consciously and consuming sound consciously and designing all our environments consciously for sound? That would be a world that does sound beautiful, and one where understanding would be the norm."
He calls out some high-level insights in speaking with others so they WANT to listen:
"I'd like to suggest that there are four really powerful cornerstones, foundations, that we can stand on if we want our speech to be powerful and to make change in the world ... The (acronym) is "HAIL" ...
'H: Honesty, of course, being true in what you say, being straight and clear.
A: Authenticity, just being yourself ... standing in your own truth.
I: Integrity, being your word, actually doing what you say, and being somebody people can trust.
L: Love. I don't mean romantic love, but I do mean wishing people well ... if you're really wishing somebody well, it's very hard to judge them at the same time.'"
Bravo Julian. I commend your wisdom and thank you for sharing your insights with the world.
My grandfather was an United States Navy Lieutenant Commander in the Pacific during World War II. One of my best friends, Army 82nd Airborne during OEF/OIF.
I can't imagine signing over my life to the unknown, and deeply respect their devotion to our Nation.
I've worked with veterans at the West Los Angeles Veterans Affairs as a volunteer and intern. I spent three years working at DMH's Veterans and Loved Ones Recovery (VALOR) program helping VA healthcare eligible and ineligible move forward in their lives. In my full-time position, I am still helping veterans link and engage with the VA.
This weekend is a reminder to me to celebrate their discipline, commitment and experiences. They deserve better.
Here's a portion of a piece I wrote a few years ago:
"Many homeless veterans have been through a great deal. Despite the adversity, they continue to demonstrate remarkable agility. I have seen them survive on jetties in Long Beach, in the iceplant on the sides of our freeways, and other areas not meant for human habitation. The odds of success are clearly stacked against them. Yet, after developing a trusting relationship with homeless veterans, I have seen them become more open to changing their lives. In fact, I have seen some of the most hopeless thrive once housed. To me, it is another reminder of our human potentiality. As a wise instructor once told me, “Your view of your clients as being either weak or strong is often a reflection of how you look upon yourself ... choose strength.”
I listen to WTF regularly. I find Marc Maron's conversations to be deeply intimate, connected and I find he also uses many techniques found in Motivational Interviewing and therapy to help his interviewee relax, open up and begin to share extremely personal details about their lives.
The conversation gets into mental health topics with AJ Mendez Brooks around 39 minutes. Highly recommended!
An open, first-person authentic account of life, career and relationships and the trials and tribulations associated with mental health challenges including depression, mania and suicidality, and some of the challenges in seeking support.
Lots of wisdom in this for all. Bravo Chris.
This post was originally featured on Vox.com
It was a Thursday night around 11, and I was making coffee in the office kitchen. I was just about to start my shift. But before I could finish stirring, my supervisor came in. She looked more worried than usual.
"Are you ready?" she asked me. "This guy's really going through it."
"I can take it," I said.
A month earlier, I'd decided to volunteer overnight at the Didi Hirsch Suicide Prevention Hotline. This was the time of night that drew the most hopeless of callers. Walking into my glass-walled cubicle, I set down my coffee, opened my notebook, took a deep breath, and picked up the phone.
"Hi, my name is Nick. I see your name is Johnny." I didn't wait for a response.
"What's going on tonight?"
A voice erupted on the line. Johnny was panicked, talking fast. There was so much intensity in his voice it was as if he were strapped to a detonating bomb. From his rolling R's and extended "o," I guessed he was Hispanic, young, but I never truly knew who was on the line. That was the point: strangers speaking with strangers.
When people call a suicide prevention hotline, they often don't know how to start the conversation. How do you tell someone you want to kill yourself? Johnny was no different. When I asked him what was wrong, he launched straight into a litany of terrible experiences, the worst of which was the end of a recent relationship. He was distraught. He felt helpless and unable to change his situation, and he was ready to end his life.
"Are you thinking of suicide?" I asked.
"Yeah," he replied timidly. I could sense he had never said the words aloud.
"And how are you thinking of killing yourself?"
"I'm going to jump in front of a train."
I took a deep breath. I was shocked. Usually the answer to that question isn't so specific.
"And where are you now?" I asked.
"I'm lying down on the train tracks."
My stomach churned. My throat tightened. My foot began shaking, and I closed my eyes. I felt a bead of sweat run down the side of my face. I needed to support Johnny quickly, and that meant meeting him on his terms. I imagined his each and every move. I focused on each sound I heard in the background. I tuned in to the tone of his voice, his cadence. I listened to his breathing, the sense of anxiety and dread building. The absence of sound or talking could be just as important. But I had to find something I could use to connect with this man, to join him in his suffering. That was the priority.
"What's that noise? It sounds like people." I asked.
"Just some drunk teens being assholes."
I could hear them in the background taunting Johnny: "Look at that idiot, what is he doing?"
"The world's against you tonight, eh, Johnny?"
"Yeah, nothing new."
"So it's not just tonight. You've been hurting for quite some time," I said.
"Yeah, no one cares. I've been doing this on my own for too long. I'm done."
"Have you shared how you've been feeling with anyone other than me?"
"Yeah, plenty of people. They just tell me to ‘suck it up,' ‘don't be such a downer,' or offer me a beer. I'm tired of feeling like a burden."
"You sound exhausted, hopeless even. You've been trying to connect with someone about what you're going through and encouraged to face it alone, until tonight."
Johnny was silent.
In the distance, I thought I heard the burgeoning sound of a train whistle. My heart rate quickened.
We all suffer. That's not just some Buddhist dogma — in my job as a mental health therapist in Los Angeles, I'm reminded that it's true every day. We may differ in the impetus of our suffering, the intensity of that suffering, and our response to it, but we share the universal burden. I've found accepting our own helplessness can be a transformational experience; so can joining another in their experience of pain. Unfortunately, many of us suffer alone.
After years in entertainment marketing, I decided to examine my life — I wasn't particularly happy, and I wasn't sure that my career was right for me. I sought out a therapist, and in treatment was asked a clarifying question: What times in my life did I feel most alive? I discovered it was when I felt connected to another person, not necessarily in space, but in conversation.
I reoriented my life around this revelation, allowing myself to explore a lifelong fascination with mental health. I joined the suicide prevention hotline, but quickly learned that a keen interest is not the same as aptitude or experience. I was surprised by the exhaustive volunteer training regimen for the hotline: It lasted months, each session opening with an in-depth lecture on a mental health topic followed by a series of group role-plays focusing on that day's topic. Until I began training, I hadn't realized how unprepared I was for my new career. I considered myself an empathetic person, a supportive friend, somebody who was caring to strangers — but I was severely mistaken.
It was during one of these training sessions — a Saturday afternoon role-play with a mentor — when I was confronted with the extent of my incompetence.
My mentor had a history of bipolar disorder. He struggled with suicidal ideation in his own life and had made serious attempts to end his own life. But his suffering made him especially adept at connecting with high-risk callers. He had an innate ability to join callers in their experience of suffering. In joining them, he created a shared experience, often the key to bringing a caller back from the brink. We began the role-play:
"All right, so in this scenario, I'm a 42-year-old man, I have no friends, I'm at high (suicidal) risk. I lost my job; my family has been dead for years. I have no attachments, a history of mental health issues, I'm not taking my medications, and I've pretty much given up," my mentor said. "You ready to start?"
"Sure, I said. I laughed nervously. I began the protocol for a call: "What's going on?"
My mentor started in as the caller. Using the details we'd agreed on for the scenario, he told a story so powerful and so rich that it seemed we were moving from a fictional story into his real life.
Suicide prevention training provides you with a basic format for each call: First, connect with the caller and assess the level of imminent suicide risk. Monitor level of suicide risk throughout the conversation. Second, determine underlying reasons for the call and explore those reasons with the caller. Third, brainstorm potential resources to assist the caller in improving his situation. Fourth, encourage the caller to call back as needed for further assistance or support. The hotline provided me with hundreds of pages of tips, perspectives, and stories of successful calls. But like becoming a new parent or climbing Mount Everest, no one can prepare you for the real thing. Only practice makes better.
"Are ... are you thinking of suicide?" I asked my mentor, stumbling over my words.
"Damn right! I've been thinking of suicide since I was 13. I've planned it out. I've attempted. I've felt the burn of the rope as it slid across my neck." There was no hesitation in his voice.
"And how might you take your life?"
"I dunno. There are so many ways, I haven't really thought about that."
My mentor's comfort in chatting about killing himself shook me. I didn't know how to enter this man's world. I couldn't join him in his aloneness. I didn't want to. I stopped the role-play.
"I have no clue what to say next." I said.
"Okay, then let's talk about what happened." My mentor said, breaking character. "You lost me. I didn't feel connected to you."
"Really?" I replied, still processing the role-play.
"Definitely. You felt distant. What was going on for you in that role-play?"
"It was hard to hear everything you were going through. I didn't really want to hear it."
"Absolutely. Makes sense why this guy is so alone, right? It's been hard for him to trust anyone to connect with his pain, his suffering. Most people don't want to be around that. They don't really want to hear it. They're scared or don't have the time. So he remains alone."
People join suicide prevention hotlines for myriad reasons. Some wish to give back, some have their own histories with suicide, some wish to experience a kind of pseudo-therapy environment prior to entering graduate school.
When I first joined the hotline, I did it for my ego. I believed my mere presence on the phone would be enough, that my knowledge would be enough, that I could change a caller's world in a word. But conceptual knowledge isn't enough. A voice on the other end of the line telling you it isn't worth it won't save anyone. My mentor during that session taught me the most important thing I've learned about suffering: People call suicide hotlines looking for a connection, for somebody who can join them in their anguish. Sharing our pain with others, just being seen in our experience of pain, can create tremendous momentum toward alleviating our suffering. Empathy is what saves people.
"We've been talking a lot tonight about the part of you that wants to kill yourself. But you called a suicide prevention line and are talking to me now. I wonder, is there a part of you that may want to live?" I asked Johnny.
"I guess. I mean, I'm pretty scared of this thing hitting me. I'm not sure I want to die."
"That's a powerful statement, and one to consider," I said. "In fact, I'm really glad you called tonight. It takes a lot of courage to pick up the phone, especially when a person gets to a place like where you are tonight. Placing your trust in a stranger, hoping they'll understand. That's hard."
I began to notice a shift in our conversation. Johnny's breathing had slowed. Some of his tension seemed diffused. But now I was sure I could hear a train whistle.
"That train sounds like it's getting closer." I stated, tempering my panic.
"Yep, it's coming right at me," he said definitively.
"Are you going to let it hit you?"
I couldn't believe I'd said something so directly. There was a chance my question would backfire, would cause Johnny to prove he was serious by letting the train hit him. I was terrified. This man wanted to die tonight, and I'd just reinforced his decision. I expected him to start yelling, to tell me his pain was real and if I didn't believe him, just wait.
But Johnny was silent. The pause gave me hope. It meant he was considering his options.
The train whistle grew louder.
Suddenly, Johnny took a deep breath and exhaled quickly.
"I think I want to live tonight," he said.
As soon as that last "t" came out, I heard the cacophony of a train passing by, the whoosh of air in the receiver of the phone. The train had passed by in what could only be inches.
My body shook with relief.
Nick Holt, LCSW, is a mental health therapist in Los Angeles serving the communities of Brentwood, Santa Monica, West LA, and Sawtelle. His expertise includes veterans, suicide prevention, and men's mental health.
This post originally appeared on HuffingtonPost.com
I spend my work week tracking homeless veterans around Los Angeles County. I meet veterans in the environments they feel comfortable in and as a result, I get the chance to know them intimately. That's why my job takes me from the northwestern canyons of Malibu, 47 miles south to the underpasses and riverbeds of Long Beach.
When I talk with others about my profession, many struggle to understand why I meet veterans in the field. My simplest response is this: Many of the veterans I work with do not see an issue with the manner they are living their lives. They have no interest in mental health; let alone think of themselves as someone with a mental health issue.
To connect with these veterans, it is paramount to gain their trust and respect. Put yourself in their shoes. What if I, a complete stranger, showed up at your office during lunch and starting talking to you about your life?
Invasive. Creepy. Awkward. Those might be some of your first thoughts. That's why I need time to establish a lot of trust, purpose and clarity in order to begin and maintain a connection -- and meeting veterans in the places they are most comfortable goes a long way to establish it.
In working with veterans for the past five years, I have learned a lot about their lives, thoughts, feelings, actions, intentions and outcomes. These learnings have reshaped the way I look at homeless veterans, myself and my community. Here are four lessons homeless veterans have taught me:
1) They remind me it is really, really hard to trust, but are still willing to try.
Many of the homeless veterans I work with have few social connections. They have been hurt throughout their lives, and distance themselves from further perceived pain. Their interactions (current or former) with loved ones often consist of critical, punishing, judgmental, accusational, contemptful and humiliating encounters. As a result, they avoid intimate or connected relationships with others, which continues their negative outcomes. However, if negative behaviors are not brought forth, they may be willing and open to creating a trusting relationship. Personally, I know this to be true. Numerous studies indicate alliance and rapport being some of the most reliable indicators of psychological outcome. This goes for mental health treatment as well as within our daily relationships. Establishing trusting relationships with others without aforementioned negative behaviors provides us a context for empowerment towards our greatest potentiality. If that attempt fails, we dust ourselves off and try again.
2) They have faced enormous challenges, but demonstrate resilience, bravery and hopefulness in their determination to try again.
Studies suggest people who experience trauma, a highly subjective term, are likely to recreate future experiences of trauma. Said differently, what doesn't kill you, doesn'tnecessarily make you stronger. In fact, if untreated, it can hinder you throughout your life. Research also indicates a significant link between homelessness and trauma. Many homeless veterans have been through a great deal. Despite the adversity, they continue to demonstrate remarkable agility. I have seen them survive on jetties in Long Beach, in the iceplant on the sides of our freeways, and other areas not meant for human habitation. The odds of success are clearly stacked against them. Yet, after developing a trusting relationship with homeless veterans, I have seen them become more open to changing their lives. In fact, I have seen some of the most hopeless thrive once housed. To me, it is another reminder of our human potentiality. As a wise instructor once told me, "Your view of your clients as being either weak or strong is often a reflection of how you look upon yourself ... choose strength."
3) The odds are stacked against them, but they remain humorous, playful and creative.
A view I hear repeatedly from homeless veterans about our society is that it is a rigid place often defined by haste, dysthymia and disgust. In spending years working to live, we miss out on so many opportunities to let loose. Through these individuals' personality, resilience, creativity, survival skills and foraging, they are often able to meet their daily needs. Despite the frustrations of getting public assistance, "returning to productivity" and the humiliation and exhaustion this process brings, they propagate a playful spirit. Play is vital for healing and connection, and tends to focus on the momentary. By focusing on the moment, homeless veterans remind me of the vitality of serenity and playfulness. Our approach to adversity helps us sustain and strive while seeking our goals, and caring for ourselves and others.
4) They are often ignored, but continue to express and assert themselves.
Homeless veterans know what they want and what they do not want, and they are happy to share their views with you. Unfortunately, their expressiveness and assertiveness can be perceived as aggressiveness (and sometimes is). But as long as the aggressiveness is not physically manifest, I believe it is more helpful than passivity and diffidence. One of my main tools in working with homeless veterans is developing assertiveness. By helping them better connect to thoughts, feelings, and behaviors and contrasting intention from execution, they are better able to achieve intended outcomes within their lives. Deepening our congruency (verbal and nonverbal, feelings and thoughts), consistency and cultivating a safe conversation with others in expressing our needs increases our likelihood of achieving our desired results, and providing for the opportunity of others to assist us in our goals.
These are a few lessons I have taken with me. These men and women continue to inspire and overcome, despite the odds.
NOTE: I am defining "veteran" as follows: A veteran is someone who, at one point in his/her life, wrote a blank check made payable to The United States of America, for an amount of up to and including their life. This is not how the U.S Department of Veterans Affairs defines services for veterans. In fact, my daily work is typically working with veterans who are ineligible for U.S. Department of Veterans Affairs services.
Mental Health and Therapy Writer. As featured on Huffington Post, Vox Media and elsewhere.