A crisis isn't a blessing. It's a snowglobe.

One of my pet peeves is when people say cancer (or some other major crisis) is a blessing. Anyone who has lived through a crisis knows it does not feel like a blessing. It’s stressful, saddening, enraging, frightening, and so many other feelings that most people would not typically describe as blessings.

A crisis is more like a snow globe. A snow globe is a clear liquid-filled ball with a scene in it and with lots of confetti that looks like snow inside. When you shake it up, the “snow” floats all around and, as it comes down, it settles in a different location.

A crisis, like a snow globe, shakes up your life, and all the aspects of your life-your work, your friendships, your family relationships, your identity, your medical and mental health all go in the air and then settle a little differently than they were before.

As you recover, you begin to put the pieces of your life back together. You will have choices about where you put all these pieces. You can try to put them back where they were before, though some things will be different or broken or not fit together like they did before. Or you can decide to put them back in a different order, which might be better than before, or it might not feel quite right either.

As a result, after a major life crisis has passed, many people are surprised to find that they do not feel relieved or transformed, they may feel worse, and not like themselves. That’s often the case when people are trying to put the pieces of their lives back the way they were before. The more transformative way to approach it is to take the time to decide what the best way is to take these pieces and make one’s life whole again. The new configurations may be different than you ever would have planned, but it might also be a beautiful and rewarding use of all your different pieces.

For this reason, some people’s lives do become better after a major crisis. It’s not that the crisis itself was a blessing, but that the introspection and readjustment of priorities that followed generated the positive change. Pain can be quite transformative, because it can force you to take stock of all the different pieces of your life. You can decide whether the pieces of your life are being put together in the way that serves you optimally. It’s like when you move—no one likes all the work involved in moving, but in the process of packing and unpacking, you manage to slough off things you no longer need, and you rearrange the items on a fresh canvas.

Why gratitude isn't just for Thanksgiving

Around Thanksgiving, many people reflect upon what they’re grateful for.  Many of us typically by rote the things we know we should be grateful for, such as a roof over our heads, and food on the table. Don’t get me wrong—I think most people should be grateful for those blessings, because not everyone has them. But I want to talk to you about being grateful far beyond the basics that we do once a year around a turkey, stuffing, and mashed potatoes (or whatever you eat to celebrate the fourth Thursday in November).

Our brains are wired to notice what is bad or dangerous. It makes sense, right? From a survival-based perspective, it’s much more important to remember which berries are poisonous, or how slippery the roads get when it rains or snows, or what sets off an already angry loved one, than to notice how delicious your coffee is, how great your last meeting went, or how nice your spouse’s smile is.  We’re hard wired to be much better at noticing what’s wrong rather than what’s right, and it’s probably served us quite well.  I’m not saying we shouldn’t notice dangerous or suboptimal situations, I’m just saying that we want to strengthen our capacity to notice the joys and pleasures too.   

Science backs this up too.  Gratitude improves physical and mental health.  It improves sleep quality, self-esteem and relationships. It even changes the brain. It sends increased blood flow to the hypothalamus, which manages numerous bodily functions, including eating, drinking and sleeping, and also influences metabolism and stress levels. It also is correlated with increased blood flow to areas which release dopamine, which can increase generally good feelings.

 As a side note, many people find the term gratitude practice to be too mushy or touchy-feely, so I sometimes call it “noticing the good.” Call it whatever works for you, but it’s a very simple and easy way to adjust our mind’s tendency to see the world through gray colored glasses, and to shift us towards a more positive (and often more accurate) worldview.

If you’re up to give this practice a try, let me step you through how to start. I like to make it pretty simple. Pick a time of day when you will notice the good.  It usually works best to pick a time that is linked to a behavior you do every day. For instance-some people do it before getting out of bed in the morning, others do it during the few minutes while waiting for their coffee or tea to brew, and others do it while drifting off to sleep.  Whatever time you pick, make it a time that’s easy to protect.  If you pick an arbitrary time, you might find that 4:15pm or 11:20am (or whatever you’ve chosen) lands in the middle of a meeting or appointment, or when you’re just not feeling like it, and you’ll skip it.

Then, select a number of gratitudes you plan to notice.  Selecting one can be an easy place to start, and you can work your way up to more if you like.  You might find that, at first, it’s not easy to find something to appreciate, but with time, you get quite good at noticing many, so you may adjust the number as time passes. 

Then, decide how you want to notice the gratitudes—do you write it down in a journal? Share it via email/text/phone with a gratitude partner? Say it directly to a friend or family member? Just notice it in your mind?  It’s best to know yourself and what sort of ritual will work best for you.  Sharing it with another person can serve a dual purpose. It can both hold you accountable to do it every day, and also you get the double benefit of your own happiness and hearing about the happiness of someone you care about. If you’re the kind of person who prefers being internal and more private in your practice, think about whether writing it down in a journal or on slips of paper that go into a jar might be right for you.  It can be quite affirming and uplifting to review a year’s worth of gratitude and happiness.

So now that we’ve laid the parameters, let’s discuss what you actually do when you sit down.  First, here’s what not  to do.  Never pretend to be grateful for something you don’t authentically feel in that moment.  Gratitude only works when it’s authentic.  So if you don’t actually feel grateful for a roof over your head, don’t worry about it, but also, don’t claim it as a gratitude that day.  Think about what you do feel grateful for. Maybe the light coming through the trees is particularly pretty, or you’re happy you didn’t get stuck in that traffic jam on the other side of the freeway during your commute, or you’re just grateful that this difficult day is almost over and you’ll get to go to bed soon.  If something doesn’t rise to your awareness right away, that’s ok, just relax and see what wants to bubble up.  Gently review the past 24 hours—where did you go, what did you do, with whom did you interact?  There’s likely at least one thing you can find that was nice, or at least, better than the rest of the day.  Even on a bad day, when it’s hard to find something to appreciate, you might find that it was nice that getting your kids to sleep, or finishing up your paperwork, or dealing with a difficulty person in your life, wasn’t quite as bad as you had anticipated. 


You will likely find that, after doing this practice for a while, you will start noticing the good throughout your day and think “this will be a good one to mention tonight/tomorrow morning.”  Noticing what is going well will start to become increasingly automatic, and your effortful observation of one item may start flowing into three or five.


You might not notice the changes right away—like any new habit, it may take a little time for its positive effects to show.  I encourage you to make a commitment to one month of a gratitude practice.  I think you’ll find that it becomes a lovely little sanctuary in your day that you’ll look forward to, and that you’ll start to notice the longer term benefits as well.  Give it a try and let me know how it goes.



Advanced health care directives

I want to talk to you about advanced health care directives. 

Wait, don't go.  Hear me out.  You may think you are too young (or young at heart) to have to think about these topics, but if you are unlikely to get a warning in advance that you or a loved one are about to have a serious health crisis. And if such a crisis emerges, you will need an advanced health care directive which appoints someone to make decisions on your behalf if you are unable to do so, and which advises that person on your wishes.

 If you are over the age of 21, you need to have a nuanced, fully fleshed out advanced health care directive. If you are over the age of 40, you will need to adjust it further to include instructions in case you eventually have a cognitive impairment such as dementia.

Most of us don't want to even think about the possibility of needing someone to make our health care decisions in the case that we become incapacitated. You may assume that your loved ones know what you want, and that it's unlikely and depressing to discuss, especially if you are young and/or healthy right now.  But let me paint you some pictures of what can happen if you don't have clear written instructions.

Here's one scenario: your beloved father has slowly slipped into Alzheimer's Disease.  He has always told you that he didn't want to be a burden to you.  Now, he cannot clean or feed himself, and you and your sibling are spending several hours a day helping him.  You think that he would want to be in a facility so that his children wouldn't experience him as an emotional and physical burden, but your sibling thinks he meant that you should keep him at home to avoid the financial burden. Because you have no way to find out who is right, you and your sibling are fighting more and you are both stressed by the feeling that you're not doing right by your beloved father.

Here's another scenario: you are in a car accident and have a head injury.  Your family doesn't know what to do.  There is no one explicitly designated as your health care agent, so the hospital asks your family to make decisions on your behalf.  This may include a parent you no longer have a relationship with, a sibling you do not trust, or an estranged (but not officially divorced) spouse. 

And even if you have designated your agent(s), do they know your wishes? Do you? Would your wishes be different if you are thirty or eighty? If you have young children and/or are married and/or are living alone? If you have had a lengthy illness? If your condition is curable? If your prognosis is good or poor? If the treatment was extremely costly? If you would likely have a high risk of being paralyzed or in pain or needing help with your daily activities?

We tend not to have these conversations or even let ourselves consider our wishes in such scary and undesired scenarios.

As someone who helps people through the aftermath of not having their wishes in writing, let me assure you that it is far easier to have a conversation now, rather than to have heartache later. 

Having to guess what your loved one would have wanted while you're going through the stress and emotional upheaval of a crisis is something no one ever wants to do.

And you definitely don't want your loved one to guess wrong about what you would have wanted, or put them through the stress of fighting with other family members about your wishes.

Of course this isn't fun, and many people just don't know where to start.  Happily, this is the easy part. There are forms available on the internet, and they're straightforward and have very clear instructions.  

1. The AARP has free Advanced Health Care directives on their website.  https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/

Print out a copy for your location and start filling it out. These forms are fairly basic, simply asking whom you would choose as your health care advocate if you are unable to do so, whether you would want life prolonged or not in end of life circumstances, and whether you'd want your organs donated or not.  You can always add more detail later, but please start with this.

2. Get your document notarized.  Don't skip this step.  Notarization will help your health care agent to feel confident that they are accurately representing your wishes, and will also help them to stand their ground if there are members of your family or inner circle who disagree with their choices on your behalf. 

3. While you've still got momentum, go to this website https://dementia-directive.org/ and print out the dementia directive. Basically, it defines mild, moderate and severe stages of dementia, and it asks you to check which of the four levels of intervention you would want, ranging from palliative care only to any intervention that might extend life. 

Of course, with all these decisions, I strongly encourage you to consult with your legal and medical providers, as well as with your loved ones, to confirm that the choices are right for you and your unique circumstances.  In addition, these topics may bring up emotions or thoughts that might be appropriate to explore with a licensed mental health provider. These are important issues, and they deserve your full attention and appropriate consultation.

I have seen too many people in my office, tormented by the family conflicts, or by the uncertainty of what their loved one would have wanted. Please, whether as a gift to your future self, or to the people who care most about you, take the time, and fill out these forms. 


How to apologize, even when you don't think you did anything wrong

I work a lot with couples, and there are often hurt feelings and pain between them, where both feel like they've been wronged, and they are each waiting for the other to apologize.  When they are asked to apologize, they will often say that they didn't do anything wrong and shouldn't have to apologize.

I often advise people to not wait for the other person to change, but rather to change themselves first. In other words, control what you can control (yourself), rather than another person, who is out of your control. 

If you're willing to take the first step to resolve a conflict between you and another person, here's what I'd suggest.

First, make sure you understand where the other person is coming from. Ask this person to explain the pain to you. Ask clarifying questions if necessary.  Try to restate your understanding of their unhappiness, without agreeing or disagreeing to the premise, and ask if you got it right.  

You might say "You are angry with me because didn't feel like I listened to your concerns, and you think I just pushed my own agenda without taking your opinions seriously," or "You're really lonely and hurt because I don't seem interested in physical intimacy with you."  Then follow your summary with "Did I get that right? Is there anything you'd want to correct or add?"

Do not use this time to tell them why they are not accurately perceiving the situation, defend yourself, tell your side, or do anything besides just clarify your comprehension.

Once you have fully understood their point of view, you can try to offer compassion. Again, you are not agreeing with the accuracy of their perceptions, you are only imagining how they might feel if that's how they experienced the situation. You can probably imagine how painful it can be to feel hurt, sad, angry, lonely, or whatever else the other person is feeling.

Now, once you understand their experience, and have some compassion for their pain, you can apologize.  To be clear, you are not accepting blame, and you are not agreeing with their version of reality.  You are being regretful that someone you care about is suffering as a result of your interactions together.

Here are a few examples of what you might say: "You really felt judged by me yesterday. I'm so sorry you felt so hurt," or "I am so sorry that our fight left you feeling so misunderstood," or "It was never my intention to cause you pain, and I am really regretful that our interactions hurt you so deeply."  

Note that this is not "I'm sorry you feel that way, but..." or "sorry, not sorry." It's also not just giving in and apologizing to make the problem go away.  Both of these approaches rarely bring healing or intimacy, but rather increase the distance and resentment.

I invite you to experiment with this approach in a disagreement you're having with someone who is close to you.  See if you can listen openly, imagine their suffering, and offer sorrow, regret and/or compassion for the pain this person is having.  Give it a try, and let me know how it goes.

Preparing for Medical Appointments

Many people don't have a lot of experience preparing for medical appointments.  If all you've ever done is gone for routine physicals and occasional assistance (mole checks, antibiotics for strep, etc.), you may not know how to best use your limited time with your doctor.

Once you've developed a medical diagnosis that needs to be regularly tracked, however, you might have a lot more doctors appointments. You might be going for second opinions, or to learn your treatment options, and you may have only a few minutes with your treatment provider to help you make very important decisions about your future.

So let me help you think about how to prepare for your appointments so you can make the most of the time you have.  

1) Make a comprehensive written list of questions.  Make three copies. If you need help preparing your questions, brainstorm with friends or family about what they would ask. Questions might include clarification of diagnosis, exploration of potential risks and benefits of possible treatments, prognosis and most likely course of disease, or eligibility for clinical trials.  

2) Bring a companion with you, ideally someone who is not overly emotionally involved. Their job will be to make sure all of your questions get asked, and that all of the answers are documented in a way that you will be able to review later.   They may end up doing very little, or they may end up doing all the question asking on your behalf. They are present as your advocate, and they will be available to step in to do as little or as much as you need.

3) Give a copy of your questions to your doctor when you walk in (or email the questions in advance, and then also provide a printed copy when you come in). Then, your doctor will have a sense of what you want to accomplish during the meeting, and your doctor might also be able to combine answers to multiple questions.

4) Block a significant chunk of time after your appointment to debrief, either with your companion, or with someone else that you care about and trust.  You may have emotional responses to the appointment that you need to process, or you might have missed some of what the doctor said and need to fill in the gaps. 

Doctor visits can be a very useful resource, and I hope these simple guidelines help you as you prepare for your next visit. 

Intimacy and Sex

When I ask couples what they most crave in their relationships, one of the most common responses I receive is for "increased intimacy." It makes sense--as humans, we tend to crave connection, and don't we all want to be closer to our partners?

Yet, when I ask what increased intimacy means to each partner, I don't always get clear answers.  They don't always know what it would look like if their goal for increased intimacy was met. Sometimes, the words sex and intimacy are used interchangeably, but they don't mean the same thing.

Of course, sexual connection matters for many couples.  Even when a partner is complaining about wanting more sexual frequency, if we explore more deeply, we may discover that it's about more than the actual physical engagement. It may be about the total focus on each other without distractions; or about being touched with care (not just sexually); or about feeling valued and desirable; or about stress relief, connection, and so much more.

I often see couples who are mismatched in terms of their desires regarding sexual frequency. They often feel stuck. One wants sex more than the other, so one partner feels frustrated and rejected, while the other partner feels harassed and resentful. But if we look more closely, perhaps there are ways to bridge the gap beyond trying to find some magical compromise regarding how sexual encounters per week/month/year.

The way I think about it, when we talk about sex, we have to widen the focus.  For instance, if Partner A says "I want to have more sex, and my partner never seems interested," we could explore what Partner A values about sex, and what s/he is missing when the frequency of sex is lower than desired.  We could talk about all the needs that sex can gratify, and explore what could also meet those needs. We can also explore what Partner B values about sex and intimacy--what fulfills his/her needs and increases connection? What does s/he like to do--kissing/hugging? intimate conversation? massage and sensual touch? Sex that is initiated by Partner B?

We might also learn about what the requests for sex feel like for both partners. Perhaps there are feelings of unequal power, rejection, guilt, anxiety, or anger. Do those feelings occur in other parts of the relationship? In working through those feelings about sex, we might be able to work through those dynamic patterns in other parts of the relationship. 

Then, if we can find ways in which each partner can get some needs met, and where the communication patterns can be improved, we will also increase goodwill, connection, and intimacy.  With this improvement, we might find that there is more common ground for negotiation about sex than we previously thought.  

Of course, these ideas don't just apply to the therapeutic office. They may also be useful in your own conversations with your partner. I invite you to consider what would happen if you simply asked your own partner what sex means to him/her, beyond the actual physical sensations of the act. You might learn something you didn't know before, and it might open up new ways you can satisfy and fulfill each other, and it may create some movement and openings in conversations about sex that had been stuck. Give it a try, and let me know how it goes. 

How to give and take a really great compliment

When I was in third grade, my teacher taught me that we had to use meaningful adjectives, and certain words were no longer allowed. Generic, vague words like nice, good, and fun were no removed from our lexicon. We had to find words that were more descriptive and rich.

I’d like to invite you to consider that you might want to try giving compliments in this way. Try to avoid the basic platitudes you might give the important people in your life. Don’t tell them they’re a good friend, or a helpful spouse(though that’s not bad), tell them how their specific actions make you feel. You can use the format “when you____________,” I feel _____________.“

Here are some examples: "when you give me a hug, I feel safe and protected,” or “the way you listen to me makes me feel like you really care about me,” or “when I think about how hard you work to take care of our family, it makes me feel grateful.”

We all hunger to be noticed and appreciated, and these types of compliments show that you’ve really paid attention to them, and that you value their specific gifts.

Accepting a compliment can also be challenging for some people. When someone says something kind, we might be tempted to deflect it (“No, you’re the pretty one”) deny it (“I’m not really smart, I just got lucky”) or try to minimize it (”oh it’s no big deal"). Let me make this formula very straightforward. Your only job is to appreciate that they said something kind to you. You don’t have to agree or endorse their opinions, just be appreciative that they thought something nice about you and then cared enough to tell you so.  And don’t be tempted to share the compliment either (“I feel the same way about you!” Or “you’re a really caring friend also!”). 

So you can say “thank you,” or “I appreciate it,” or anything else simple like that, but no more. If you’d like to return the compliment, say your thank you, pause, and then come up with a compliment of your own. It will likely be at least a little different, and will be received with so much more warmth and appreciation than if you just piggyback onto their compliment with a “you too!”

It can be really fun to figure out what you like best about the important people in your life, and it can definitely lead to a positively cascading effect, where you share your appreciation, which may lead the other person to share theirs, and everyone starts to feel more appreciated, which leads to more expressed gratitude and generalized good feeling It also feels so much better to focus on what gives you pleasure than what disappoints you.

Give it a try and let me know how it goes.

For difficult conversations, set your goals and intentions

I think a lot about how to have conversations about difficult topics.  Many people can do it within my office, but it can be really hard to do in the real world.

Here’s a quick tip that can be useful.  Before you enter into the conversation, think about what your goal is for the conversation. Is it to share your feelings? Is it to ask your conversation partner to make a change? Is it build intimacy? We often enter into conversation with unclear and tangled ideas of our purpose, which can really increase the potential for unhelpful conversations.

Once you’ve gotten clear about your goal for the conversation, then set an intention for how you want to behave in this conversation.  Would you like to be brave? Honest? A good listener? Compassionate? Pick one or two descriptions of how you want to be in this conversation. You might even choose to write it down somewhere you can see it while you are in the conversation, so you can remind yourself if you drift away from your plan.

Then, once you have set your goals and intentions, you might choose to share them with your conversation partner.  Here’s an example of how you might do it:


You: “I’d like to talk with you about our fight last night.  I’d like to share with you what it felt like for me-would you be open to listening to me? Is now an ok time, or should we pick a different time?”

(partner says ok)

You: “Thanks. I appreciate it.  I want you to know that I’m going to do my best to be forthright, but also to be kind in how I say things. I probably won’t be perfect, but I just want to let you know that’s what I’m trying to do. Is there anything I can support you in how you want to be in this conversation?”


My way of speaking may not be your style, so be sure to use your own language and style of speaking. The important thing is to be clear on what you’re trying to do before you open the conversation. When you have a framework for the conversation, I think you’ll be surprised at how much cleaner and more productive the conversation can be.

Forget about the facts--focus on the feelings

Many couples, when they try to tell me about an emotionally charged event, each tell me, with great confidence, completely different stories.  It’s astonishing. I work with bright, honest, perceptive people, and each would swear on their lives that their version of the truth is accurate, and their partner must be inaccurately remembering the event.  They will tell me what they were wearing, where they were standing, how those specific words and tones struck their hearts, and they can get really stuck arguing about whose recollection was correct.

Maybe this has happened to you with a loved one.  Have you ever gotten in a disagreement and ended up fighting about who said what to whom, never actually getting to discuss the actual point of contention?

We know that when emotions rise, our ability to accurately recall data is significantly impaired.  However, even if you’ve read the research studies on this topic, it may still be hard to believe that your confidently-held memory might not be exactly accurate.  

So let me tell you what I suggest.  

Let go of figuring out what actually happened.  It’s not particularly useful information.  Focus on what it felt like for you, and felt like for your partner-that’s what really matters most. Here are some examples of ways you might shift from who said what into connecting around the feelings.

You might say this:  “You know, we are not likely to agree about what happened at the party.  But it seems like you’re feeling really hurt. And maybe that’s more important than figuring out who said what.  Whatever I said, I never meant to hurt you.”

Or, you might say: “I am really angry about what happened between us.  I feel like I remember it correctly, but it seems like you remember it differently.  So regardless of what you said or didn’t say, I am feeling really upset.”

You and your partner may still fall back into insisting that your version of the truth is more accurate, but every time you can catch yourself and return to the conversation about your feelings, you’ll be having a much richer and useful dialogue.  You may still disagree, there may still be strong and painful feelings, but at least your conversation will be on an agreed upon reality (you can’t really argue about how someone feels), and it has potential for shared understanding and the growth of empathy.

"Just like me"-a tool to build empathy in challenging relationships

I do a lot of work with couples, and I notice that a common wish is for increased intimacy. Intimacy is sometimes a code word for sexual and romantic engagement, but often, people are referencing a genuine, heartfelt desire to feel more emotional and relational connection with their partners.

So what do I prescribe? Bubble baths a deux? Romantic weekends away? Sure, those are good, but the real need is to find a deeper and truer connection.  The challenge is to build a feeling of empathy for your partner, when you may be feeling that he or she is the reason that you are feeling so disconnected.

We cannot directly control others' behavior, so I always advise people to look for ways that they can change to create the relationship they want, rather than waiting for their partner to change.  I'd like to share a tool you can use to try to generate an increased sense of compassion and empathy for your partner. I've borrowed it from the meditation world, which has so many useful tools to help us stay calm and connected, even during challenging moments.

I call it "just like me."

First, reflect upon what you want out of a positive relationship. You might want to feel valued, loved, connected, supported, and safe in your relationship.  

Now, try to guess what your partner wants out of a relationship. You might have all kinds of ideas that don't sound quite as nice as your wishes. Maybe you think your partner wants to dominate you, or just wants your paycheck. Maybe you think they don't want to connect to you at all and just want to stare at their phone.

Let me tell you something that may surprise you.  Your partner is just like you.  Your partner wants to feel valued, loved, connected, supported, and safe in your relationship.  I know this because it's what we all want.  All people want to feel valued, loved, connected, supported, and safe.  Sometimes we don't act like it, but we all want it.

So when you're feeling distanced from your partner, think about what you want from the relationship at that moment and remind yourself that "just like me, my partner wants ______." You can use this tool when you're together, or when you're thinking about the relationship.  Just say to yourself "just like me, my partner wants to feel loved," or "just like me, my partner wants to feel connected." You don't have to forgive behavior that you don't like, or explain away past pains. Just acknowledge that just like you, your partner is a person who wants many of the same things as you do.

This can be very hard to do, but if you are able to find moments where you can remind yourself that you and your partner share the same basic needs. It isn't a magic bullet that solves all pain, but it does begin to create tiny moments of increased connection and empathy, and I believe it can be a tool to help rebuild connection in difficult relationships.

Give it a try, and let me know how it goes.

Why bad feelings aren't always bad

When an unpleasant feeling surfaces, most people aren't too happy about it.  It's natural to want to maximize pleasure and minimize pain. You wouldn't leave your hand on a hot stove-you would pull it back as quickly as possible and try to soothe any burns. It can feel the same with unpleasant feelings like sadness, anxiety, anger, shame, or jealousy. 

When these moments do come, they can cause many different reactions.

You might fall into the feeling and be completely absorbed by it- like nothing else in your world exists besides that feeling The feeling may take over your internal world, and all the other parts of you become small or even invisible to you. In doing so, you may also feel like you can't control your reactions (e.g., lashing out in anger, falling into a ruminative funk).

Or, you might try to avoid the feeling. You might attempt to distract yourself with busyness. The internet, TV, books, work, mindless websurfing, and alcohol/drug/food all might be used to try to take the attention away from your suffering.

Or, you might react against the feeling or against the person who is most associated with the feeling. For instance, if your supervisor gave you critical feedback that made you feel ashamed, you might lash out against him/her, whether silently or out loud. If a friend achieves something that you wanted, and you feel envious, you might minimize their accomplishment or push them away.

Unfortunately, while these coping strategies may feel useful in the moment, in that they draw attention away from suffering, they actually do not help you in the longer term. In fact, these strategies often decrease overall well-being and resiliency. It's my experience that when feelings are not acknowledged and/or processed, they can grow and even sometimes morph into what I call the unseen hands that push us around. They become the stories that we tell ourselves-the limits we perceive, the general feelings or irritability, anxiety or malaise. There's the general benefit of listening to ourselves, but there's a secondary and really important learning that can also come when we have an unpleasant feeling--it's information.

An unpleasant feeling can be a signifier that something might require change or attention. It can be an opportunity to improve yourself and make your life easier and more pleasant than it was before. 

Here is a way that I find useful to approach dealing with negative emotions so they can be tools for improvement in your life. These ideas come from teachers like Tara Brach (RAIN method), Chade-Meng Tan (Siberian North Railroad method), as well as from my own experiences helping people work through challenging experiences and feelings.

First, you must notice the negative feelings. It may sound obvious, but it can be very easy to go through daily life, not fully noticing your general sense of discomfort because it's so familiar. You may need to use physical sensations to guide you if it's hard to notice the emotional states. Watch for head or neck aches, digestive problems, clenched jaw, or shallow breathing (obviously, ruling out medical causes of these symptoms and seeking medical care if required). If you observe these symptoms, you might explore if they are signals of some unpleasant feelings or thoughts.

Once you've noticed the feelings (whether physical, mental, or emotional) congratulate yourself for noticing your feelings and treating the feelings (and yourself) with value and importance. That may sound obvious, but it's hard to do.  All people like to be treated like they are seen, worthy, and valued, and most people don't get enough of that feeling--both from themselves and from others. So give yourself a healthy pat on the back for caring enough about yourself to pay attention to your suffering.

Then, as simple as it sounds, pause and breathe. Take at least two slow, full breaths to calm down and get a little space from the sensations.

Now, get curious. Investigate what is happening. Get as interested as you can. Often, we think we know what the feeling is, but we're actually underestimating the complexity of the feelings. You might first notice one feeling, but try to discover what else is in there. Notice thoughts, feelings, and bodily sensations, and, if they change as you observe, notice that too (e.g., "I feel sad, and my throat feels really tight. I feel like everyone is happy except me. Now, I'm starting to also feel envious and a little bit angry at all the other people that seem happier than I am. Now I'm mad at myself for wallowing in feelings...") Take your time in this step. Be as kind and gentle and interested as you can, and try not to assume that you already know. You might discover thoughts or feelings you didn't realize were there.

After you complete your reflection, pause and breathe again, at least two breaths.  And then, this is your moment to learn. Did you learn something about yourself? Was there information in that bad feeling. Do you need to take an action? Is there something you need or want to say to someone (e.g., an apology, letting someone know that they hurt you, clarifying something that you might have misunderstood).? Is there a change you want to make (e.g., is it time to start looking for a new job? Do you want to get help in establishing or eradicating a habit that hurts you?) If you're not ready to take action, do you have ideas about what a future action might be? Even if you're not ready right now, it's good to have a vision of where you would like to get in your future.

**At any point in this process, if you cannot do any more, or need to pause, that's fine. This work sounds simple, but it can be very challenging to change lifelong habits. Even doing the seemingly small act of noticing (e.g., "my teeth are gritted, I think I'm angry about something.") is really useful in building a foundation of being aware and interested in your internal world**

It may feel initially painful to have to spend so much time focusing on a painful feeling or experience. However, as you begin to figure out what the negative experience has to teach you, you may find yourself feeling uplifted or excited by the possibilities for change. By more fully experiencing the problem, you may be able to think more clearly about possible solutions.


Feel the feelings, and then choose your actions

I was sitting next to a child on the plane recently. Our flight had been repeatedly delayed, and after we had finally boarded, we experienced further delays before takeoff. She was becoming increasingly agitated-getting an air sickness bag from the flight attendants, pacing, and talking tearfully with her mother, so I decided to see if I could help her.

I asked her what was wrong, and she said she wasn't nauseous, she was anxious. She said she didn't want to be on the plane, she wanted to be home. I told her I felt the same, and probably most people on the plane did as well. She told me that she was tired of waiting, and again, I agreed that I felt the same. She went through her list of unhappy feelings, and they were all very appropriate feelings- we were in an unpleasant situation, and it's quite understandable to not be happy when your flight is three hours delayed, with no clarity regarding when we would actually get home. She said she thought the plane should be turned around. She said she felt like she couldn't bear how frustrated she felt, and like she had to have relief right now. 

After she told me all of her feelings, and felt like I really understood how bad she felt, we were able to have a really rich conversation about how hard it was to tolerate how bad she felt. She felt like her pain had to be resolved immediately. She couldn't name what would happen if it wasn't resolved, but it felt quite urgent to her, and her anxiety was overwhelming.

So we talked about how it felt unpleasant and inconvenient and uncomfortable for many people on the plane. We talked about how it felt like this misery would last forever, but that it would pass soon enough, and that she would barely be able to remember this miserable feeling tomorrow. We explored if there was anything to be done (if the plane were turned around, she'd just have to go through this process again with a later flight, and many people would be very inconvenienced, including her). Since there was nothing we could do to change the current situation, we decided to talk about other things to pass the time until we were in the air on the way home. We talked about her dance competition, looked at YouTube videos, and chatted with her mother. Soon enough, we were in the air, and she fell asleep almost immediately and slept through the entire flight. Sure enough, when we landed, she barely could remember how bad she had felt before the plane took off.

I tell you this story because I think our experience on the plane is a great example of a common experience. We all have unpleasant feelings, and they probably happen more frequently and more unpredictably than we would like. My flight companion imagined a smooth and quick flight home. She was tired and craving the comforts of home, and probably had already planned out her peaceful evening at home. But sometimes life doesn't match up with our plans. I'd guess you can remember similarly frustrating or painful experiences that have happened to you in the past week. Life can be filled with ups and downs, and our feelings often are similarly volatile. 

When these challenges present themselves, tell yourself the full truth about how you feel, even if it seems unreasonable. For example, you can think "All these cars on the road need to get out of my way! I'm tired of traffic and I'm in a rush! I wish I could drive over all the cars so I could get home." Or "that other person won the prize/deal/promotion that I had really wanted for myself. It's not fair and it should have been mine!"  Your thoughts and feelings do not cause harm, and often just giving yourself permission to feel whatever you feel can release some of the tension. 

Try to be totally free in your mind to think or feel whatever you want.  Treat your thoughts and feelings as really important.  Listen to yourself thoughtfully and compassionately ("Oh, that line was too long and the people in front of you were rude? I'm so sorry that happened to you!" or "Your spouse was short-tempered with you when you needed a hug? That must have been hard!") Do not cut yourself off or talk yourself out of your feelings. Your feelings do not require action, so just try to notice them with interest and care.

Eventually you will notice that you're starting to repeat yourself, or that you have nothing new to say, or even that you are tired of thinking these thoughts.  At that point, you can take a deep breath, and make a choice about what to do next. Just because you feel a certain way doesn't mean you have to act upon it. You might feel hurt, angry, stressed, jealous, or sad. You might want to punch someone in the nose or run away crying. Those are all perfectly fine feelings and desires--but by acknowledging the feeling, you have the freedom to decide if you want to act on it.  And remember--feelings and situations often feel permanent, but often are temporary, so often, the only action required is to wait for it to pass and try to be as calm and patient as you can while you wait.

Quite often, when we give ourselves a little compassion and space to experience our feelings, we decide that the best choice is not to act on our feelings. It might be to take a deep breath; it might be to walk away from a conflictual situation, or to ask for some support from a friend or colleague. You may choose to let someone know that their actions have caused you pain or ask them to clarify the meaning behind their actions towards you. Or you may choose to just wait for the feeling and/or situation to pass, as my traveling companion and I did. If you do decide not to take action at this time, you may choose to explore ways to help provide comfort while you wait-perhaps a nap, deep breathing, chatting with a friend, watching a favorite show or exercising. 

If you do try this process, be patient with yourself. It can be difficult to be compassionate and curious while you're in distress.  After the situation has passed, you can reflect on what worked and what didn't work for you, and how you might modify your approach in future events. I look forward to hearing how it works for you.


Priorities and happiness

I think a lot about self-care.  A lot of people know that they should take care of themselves, but don't know exactly what that means other than some vague images of bubble baths and massages. There's no exact prescription for self-care, because each person's needs and desires are different. However, I can offer some ideas for how anyone can determine their own self-care plan.

First, you have to get to know yourself a little better.  You have to learn about your prioritiesThere are lots of things in this world that might be enjoyable, but we really want to learn what matters most to you. Take some time and reflect (or talk it through with someone who knows you well)--what would you do with your time if you only had five years, two years, one year, six months left to live? Most people answer these questions with things like: spend more time with family and friends, maybe more time in nature (beach or mountains), maybe more travel, or more artistic expression. There may be also things you haven't experienced yet that you don't want to miss.  Make this list good and long-don't worry about whether you can actually do any of them. Think of what makes you happy, but also what makes you feel fulfilled, what gives your life meaning, when you feel engaged and productive.

Then, really consider if any of these items are available to you. Often we cut off options because they might be difficult, expensive, time-consuming, or inconvenient.  But if you prioritize your well-being, you might be more assertive and creative in making some of those things happen.  Think about the idea of bucket lists--when people know they are dying, they often make the time and space to experience what they have dreamed of--swimming with dolphins, seeing Hamilton live on Broadway, or even gathering their friends and loved ones around them to spend time and enjoy each other. Could you possibly make any of these things happen, on a small or large scale, before you have a limited time to live?

It reminds me of when I was selling a home, and beautified it with landscaping, fresh paint, and fixing all the annoying little things that were broken.  It felt unnecessary to fix while I was still living there, because I didn't need the fixes, but then, after I fixed it, I felt kind of sad that I could have been enjoying these improvements while I was living in the home.

Similarly, why wait until you are running out of time to enjoy the things that might make you happier? You don't have to fly to New York to buy incredibly expensive theater tickets (but if you could, why not?), but do you love live theater? Maybe you might explore local theater, or even participate in theater yourself? If you wish you could go to Tahiti, could you go to your local beach more often? Could you save up for a trip to Tahiti, or fly to another wonderful, less expensive beach, or look for discounts on trips (you can put searches on online travel sites for sales on your desired destinations)? Have you always wanted to write a book? Maybe you can start with a blog, or interview people who have written books to find out what it takes, or start a short story, or take a class on how to write a book. There's always some way you can begin to explore your goal.

In summary, I want you to be happy, and I don't want you to wait. I want you to take extra good care of yourself, like you're important. If you prioritize your happiness, then take the time and interest to figure out what you wish you could do, and then explore how you can begin to add it in small or large ways into your life.

Small changes can make a big difference

I’ve been thinking a lot about all the things I’ve learned in my career about how to help people live the best possible lives. A lot of what we do in therapy is very individualized, but there are also some changes that improve quality of life for most people.  The trick is to make change in the right way.

Often, people approach change in one of two ways. Either they put off the change, because it seems too daunting and they’re too busy (or tired or overwhelmed or hopeless or stuck) to figure out how to implement it; or they dive in whole heartedly with a big change, but then lose momentum when it seems too hard.

Instead, let me propose this idea.  Make a small change.  Pick something really small you can change, and then, make it even smaller. You want to make this proposed change so easy that it’s almost embarrassed by how small it is.  With something so small, it’s easy to commit to it. 

Then, tell someone.  Ask them to join you in it, or ask them to check in with you about it. Many people love to encourage others to be happier and feel better.  Think of someone in your life who wants good things for you, or who is generally helpful. Then ask them to be your partner or helper.

Lastly, commit to this change for thirty days. Because we’ve picked something so easy and small, hopefully, it will be no big deal to try it for a month. After a month of trying something, you’ll have a really good sense of how it works for you, and if you want to keep it, modify it, or throw it out and try something new. (Caveat: If making a commitment for thirty days makes it too hard, then do it for a week. After a week, you can reassess.)

Now that I’ve described how to make a change, let me suggest a few changes that I think are helpful for many people.  Maybe one of them will sound like something you want to try. Or maybe one of these will spark an idea of your own.

1) Pick a time to go to sleep every night and commit to it. Ideally, it’s best to go to bed and wake up at the same time each day, but even picking a consistent bedtime makes a huge difference.

2) Sit in quiet reflection (meditation, prayer, breathing) for five minutes at the start or end of your day. 

3) Reflect on five things you are grateful for at the end of your day (I usually recommend doing it as you drift off to sleep). They can be big or small-it can even be gratitude that a difficult day has ended!

4) Spend ten minutes walking outside every day. While exercise is certainly useful in numerous ways, research suggests that doing so in a natural surrounding improves pleasure, vitality, and self-esteem, and decreases fatigue, tension and depression. 

5) Start each meeting with your own version of a three breath practice (originally learned from Chade Meng-Tan, Google’s Chief Happiness Officer). With the first breath, just notice how the breath feels. With the second breath, find something you can relax in your body. With the third breath, open to the possibility of joy (whatever that means to you).  You can modify this to suit your needs. Or even just take three quiet breaths before each meeting.  

So pick one of these changes to make, or pick one of your own.  Make it something easy, that you’re kind of excited to try.  I’ve found that as people begin to feel a little bit better, they have more energy to add more changes.  So don’t worry if your change seems small–each change makes it that much easier to make the next change.

I’d love to hear what small changes you’ve decided to make, and how it works out for you!


The importance of parking lot conversations

As many of you know, I practice psychotherapy with couples. One theme that I’ve been thinking about recently is how many of my clients have productive, painful, and fearless conversations together in my office, but find it hard to do so outside my office. In the safety of my office, they are respectful and brave, and show impressive capacity to stay with very difficult conversations. Often, the conversations are not quite finished when our session is over, and I encourage them to try to continue the conversation sometime before our next session. After all,  I want my clients to be able to talk through their challenges together without me, and I know that’s what they want too. And yet, these conversations often don’t happen unless they’re in my office.

There are lots of good reasons for this phenomenon, of course. It’s scary to talk about contentious topics, and having an impartial and trained mediator can make it feel safer. Life can get busy, and there often seems like there’s no good time when both parties can sit down together and calmly discuss hard issues. 

What I have noticed is that occasionally, my clients will stand outside my office door, in front of the building, or in front of their cars, continuing their conversations, following our sessions.  They’re able to hold on to the feelings they’re having, they’re able to keep going with the risk-taking and the trust. And even if it’s just for a few minutes, it’s such an important building block to having more and more of these kinds of interactions.

So if you’re in couple’s therapy with me, or with someone else, let me make this humble suggestion.  If you can’t have a big conversation outside of therapy, that’s ok.  You might have good reasons that you’re just not quite ready yet. Building new habits can be hard, so take the opportunity given by your therapy session and practice the skill of taking the conversation out of the therapy room, and bring it with you outside the door, or in the parking lot. Even just a few minutes spent practicing honesty and vulnerability and respectful conversation with your partner will build the capacity to continue having more and more of them.

You might be surprised to find out that the parking lot conversations will build in length or in depth, or that you might have similar, brief conversations the night before therapy or other times throughout your week. Like anything else, new skills take practice, and the best way to do it is little by little, building confidence and experience. 

So, give it a try. Before leaving your couple’s session and rushing off to your next commitment, take a few minutes and keep talking to your partner. Tell your partner the truth, or ask your partner what he or she still wants to say to you. Try to talk and listen (even if just for a few minutes–you can even set a timer for five or ten minutes, so you know it won’t drag on forever) with respect and honesty, and let me know how it goes!


Around here, it seems like the most common answer to the question of “how are you?” is “Busy!” followed by a laundry list of the many, many things the person is doing. It can involve professional responsibilities, social engagements, volunteer commitments, athletic involvement and hobbies, but it seems like most of us have schedules that are really, really full to the brim.

Often, these commitments sound fulfilling, interesting, and even fun, and yet it doesn’t seem to make people happy.  All this activity seems to make people feel tired, overstressed, and like they are in constant danger of falling off the back of the treadmill of life.

In addition, it makes it really hard for people to make room for positive changes they’d like to add to their lives. Maybe they’d like to have more time for friendships, or make time to meditate, or exercise more. In addition, it can often get in the way of deepening relationships, like working through conflictual issues with a partner, or spending more time (not just quality time, but quantity too) with their children. 

Those are all very real concerns, but I would even add one more issue that happens when we are very busy. It is very difficult to spend time getting to know ourselves.  Being busy can distract us from our feelings and reactions to how our life is developing.

My sister, who is one of the smartest and busiest people I know, tells me that “we all have the same 24 hours in a day, and we all choose how we want to spend it.” That’s true, and while it sounds simple, it’s actually a very complex and rich concept.  We each have 24 hours in a day, and the way we choose to spend it should reflect our priorities.

Unfortunately, if we really sit down and take a hard look at how we spend our days, we might find out that it doesn’t really reflect current priorities. Often, our time is spent doing things that other people want us to do, or what we think a good person would do, or what feels most urgent, but not necessarily what we would actually choose, if we were trying to build a life from scratch.

I’m not advocating that you should turn your life upside down in order to create your own personal pleasure party, far from it. I understand that there are real life commitments that are serious and real–if you need to work a job you hate in order to pay necessary bills, then that would likely reflect your priorities (making sure necessities are covered).

But many people, if they really stopped and looked at how they spend each day, would be disappointed to see how different it is from what their priorities are.  How much time is spent doing things you don’t like? How much time is frittered away doing things to distract yourself or recover from the hardship of feeling stressed or burdened?

I often use the tool of asking someone “if you knew you had five years left to live, would you change anything?” With five years left, you will likely continue to want to live a productive life (such as employment, creative expression, and/or volunteerism), but also will understand that personal meaning and relationships cannot be postponed.  

In my work, I often work with people who received an unexpected and devastating medical change. When their health status changes (such as dementia, cancer, spinal cord injuries), one of the most challenging and important tasks is to reassess priorities.  Most people find that they had been spending time on things that didn’t matter to them (people they didn’t care for, unrewarding jobs, commitments that were not meaningful), and readjusted their time to reflect it.

But for those people who do not have a big moment force a shift in priorities, it’s easy to let time pass without examining how you spend your time. I am inviting you to take an opportunity to reflect. You can do this in a focused way, by spending a week documenting the usage of your time, or you can do this in a more qualitative way, just noticing how much time you’re spending doing things, and wondering to yourself if you wish you could make changes.  What’s missing? What is there too much of?

You don’t have to make any changes at all. Just noticing is really important.  But you will probably want to change something, and if you do, I advise to make just one small change.  See how it feels to carve out ten minutes a day to meditate, or to not check email after dinner. Do you like it? Does it make you anxious? Was there a priority or meaning that you hadn’t seen before? You might be surprised by how attached we can be to familiar patterns and habits. So be gentle, and try just one small change.  Get used to it, modify it as needed, and once that feels like a stable part of your life, consider making another small change.

It may seem slow, and you may feel impatient–after all you’ve just noticed that your life doesn’t reflect your priorities!  You might want to change everything all at once. Try to take your time with this–you’re actually hypothesizing about who you are and what you want, and then checking out whether your ideas were correct or if they need modifications.

As you keep shifting and adjusting your prioritization, you will keep shifting how you spend your time. Hopefully, if you’re paying attention to how you feel in response to these shifts, you will begin to experience your life as more and more fulfilling.  You may still answer the question of “how are you?” with “busy,” if being busy feels meaningful to you, but it is my hope that you will also say “happy” or “fulfilled” too.

Let me know if you begin to experiment with exploring your priorities and how you spend your time and energy. I’d love to hear what you find out about yourself.


Try to learn something new about your partner

 recently heard a statistic that suggested that approximately 90% of the thoughts we have are not new–in other words, we’re re-thinking the same old thoughts most of the time.  We tell ourselves familiar stories about ourselves or others, ruminate on the same old hurts, wishes or worries, obsess about our to do list, but are we thinking something new that might be useful?

Often, we don’t even realize that we’re running through the same thoughts (about ourselves, about others). It might be your to do list, your regrets about the past, your fantasies or fears regarding the future, your disappointments in how others have behaved, but it’s likely that you have some thoughts and beliefs that run through your head regularly.

One of the most useful gifts that therapy can provide is to help people have new thoughts about their struggles. By asking thoughtful questions and creating an open, exploratory attitude together, we can begin to look at things in a different way, which may lead to different thoughts or understandings, which can than lead to different behaviors or feelings in response to the same experiences. 

Similarly, in relationships, we often have old thoughts about the other person: what their motivations might be, how they feel about us, how important we are to them, etc. These beliefs are often generalized, not flattering, and without nuance. In addition, these beliefs are sometimes inaccurate. One of the most useful things we can do in relationship is to check out those beliefs. We do this a lot in couples’ therapy, and I’ve found it to be such a useful process that I want to share some of the steps with you, in case you want to try them home.

I’ll try to show you how it would work with examples, but of course, each couple is different, and my style of language may not match yours. Try to make it as authentic and real as possible, and use this process as a framework, not a literal script.

As our example, let’s say you have a belief that your spouse doesn’t care about your needs.  You might be able to cite copious evidence to that effect. But have you checked it out? You might find out something that surprises you.

Before you ask, it’s important to ask in a way that opens up dialogue and exploration, which is hard to do when we feel hurt or judged or angry.  Here are some guidelines to help you communicate when emotion might be high:

1. Name the behavior as though you were an unbiased observer.  Do not add any inferences about the reasons or motivations behind the behavior.

Example “It seems like you’re often late coming home from work, even on nights when I have to go out.”

2. Describe the feelings that you have as a result. Do not tell them what you think they are feeling. Do not use it as a back-door way to insult them- “I feel like you are a jerk” is not a feeling. 

Example: “I feel frustrated and angry when I have to be late for my engagements when you are late coming home.”

3. Open up to them with curiosity and openness to their experience of the situation. It can be really hard to offer this opening when you don’t feel open, but see if you can take a deep breath and try. 

Examples:  “I wonder what your side of the story is?” “What’s going on for you on those nights?”

You might notice that I didn’t suggest anything related to problem solving here.  Most of my clients are very smart and thoughtful people–when the problem is clear, the solutions typically come easily. It’s tempting to try to rush to solutions, but the place where real change and progress can happen is in understanding each other. 

Take your time.  I’ll say that again, because it’s so important. Take your time.  When you partner shares his or her feelings, listen carefully. Your job at this moment is to try to understand his or her point of view. You will have your turn to present your responses later, but for now, you are just trying to really understand his or her perspective.  We can assume that very few people wake up in the morning thinking, “I wonder how I can hurt and shame those around me,” so let’s find out what is going on for your partner.

Once you’ve heard your partner’s point of view, try to say it back to him or her, to confirm understanding. If you’re not sure, you can ask clarifying questionsonly. Example: “I’m not sure if I have it all–I understood that you said that you find coming home to the noise and mess stressful, but I think you also said something about your fears about how I might be when you got home.  Can you say more about that?”

Then, once you think you really understand, try to state your understanding as clearly and non-defensively as possible. Example: “I think you said you’re feeling really stressed out at work, and you feel so overwhelmed by the pressure there that you can’t think about anything else. Did I get it?” 

As a final step, if you can, try to imagine what your partner is going through. What would you feel like in your partner’s situation? What might he or she be feeling right now? You can add that to your communications if it’s possible. Example: “Wow, so if I were in your shoes, I think I’d be feeling pressured and overwhelmed. That must be so hard.”

My clients tell me that they are often very surprised to learn what is going on for their partners-understanding the real feelings behind the behavior can generate empathy and compassion and decrease hurt and anger. The client who has been listened to often learns something new about him or herself, and also usually feels a new connection to the partner who has been listening and showing interest and care.

Then, and only then, is the opportunity for the listener to respond. You might find that all the things you had been saving up to say don’t feel quite as important any more. You might find that you have something different than you planned to say, so try to be as open and curious with your own thoughts as you have been with your partner.

If you’re able to follow these steps, I think you might be delightedly surprised at the new and different conversations and understandings that may emerge. Putting your defenses and strongly held perceptions to the side can be really hard-doing something new is usually hard. But if thinking the old thoughts and beliefs hasn’t yielded the outcome you like, try to discover something new, and see how that changes things.

And as always, let me know how it goes!


Make an emergency kit for your well-being

When people are going through difficult times, they often seek out psychotherapy or other emotional support.  But when times get better, they tend to stop therapy, and they often lose interest or momentum for self-exploration. 

I totally understand how people are most highly motivated for seeking help and internal awareness when they are suffering, but want to leave their pain behind and move forward into happier times.

I invite you to consider this alternate idea–when you have gone through the hard work to bring yourself out of the difficult times, you have probably learned some valuable lessons about what helps you heal, what makes life work better, and what causes pain.  I want you to be able to benefit from that hard won wisdom, and have it available for the next time things get hard.

It’s not pleasant to think about the fact that, just as bad times leave us, they will also return.  But life is like that-good times and bad times come and go. There are two good things about taking the time to pause and reflect on your emergence from the pain-1) There is often good learning that only comes from the hard times. Don’t miss out on that opportunity. 2) You can prepare for the next time with the experience of the past.

So don’t skip that next therapy appointment or put away your journal because you are feeling better.  Take this opportunity to learn the best practices for healing and handling a crisis, and also to celebrate all the good work you did to pull yourself through.  

Make yourself a letter, and treat it as your emergency kit.  Write down all the things you learned about yourself–did you take particularly good care of yourself? Did your internal voice get kinder? Did you reach out to supportive people in your life? Did you ask for help? Did you eat better? Prioritize sleep? What was it that helped you? Even if you changed nothing, and have no idea what you did, maybe the answer is that time was what helped. Whatever it is that helped you during your challenging time–write it down. 

You might even write it as a letter.  Here’s an example: 

“Dear self: If you’re reading this, it means that times are tough right now.  I want to let you know that these times pass, even though it probably doesn’t feel like it now. I want you to remember the things that worked for you in the past when you felt like this.  Even if you can’t believe that anything could help, maybe just give one or two of these a try. More importantly, remember-these times pass.  

(then list some of the best practices. Here are some examples)

1. Go to sleep every night at ten pm, no matter what.

2. Move your body for at least five minutes every day-more is better, but even a little bit is good.

3. Avoid sugar and alcohol-they seem like they’ll help, but they make you feel worse.

4. Bubble baths are good.

5. Get fresh air at least once a day, even if you’re just sitting on the front doorstep. 

6. Spend time with your favorite people only (maybe include a list of people who were particularly supportive to you in the past). Avoid the people who sap your energy or make you feel bad.

7. Play your favorite music all the time. Turn on the playlist I made for you of all your favorite songs.

8. Get back in touch with your therapist if you’re not seeing her right now. Don’t pretend it’s not a big deal-tell her you’re in a rocky time now and need help as soon as possible.

9.Watch stand-up comedy. You don’t think you’ll be able to laugh, but you will.

10. Meditate. It always helps.

And then, sign your letter with love. It’s a beautiful gift from your present day self to your future self.  

Even the act of making this emergency kit will help decrease your stress when these hard days come again. When we’ve been through hard times, we often get quite anxious about the idea that bad times might come again. If we already have a plan in place, it becomes a fact of life, rather than a monster under the bed.  Bad things happen, and we prepare for them, with the goal of providing comfort to ourself as we ride out the storm.


The top 5 things NOT to say to someone with cancer


I’ve worked with people who have (or have had) cancer for most of my professional life, and I’ve heard repeatedly about certain phrases which, however well-intentioned, can cause pain for a person recovering from cancer.  Of course, this information was gathered anecdotally, and not everyone will agree with this list.  It might even just be a way to open conversations with people you care about, to ask them how you can talk to them in a supportive and interested manner. 

1.     You look great!

I’ve heard people with cancer complain about this one a lot.  They want me to tell you that, even though their hair is growing back, or they don’t look quite so weak, they are still recovering.  They often feel like when people focus on how good they look, that they now feel pressured to be just as they were before. Remember, if the person is still undergoing treatment, or has recently completed treatment, even if they look fine, they may still be struggling.  Be sure to check in about how they are feeling before you start gushing about how their hair is growing back so nicely.

2.     Everything happens for a reason!/Cancer is a gift

This is the next one that I hear the most complaints about from my clients.  The implication here, they feel, is that they somehow deserved the cancer or brought it upon themselves.  Cancer, like so many diseases, strikes many people who never deserved such a painful and challenging disease.  If there’s a reason, other than unfortunate genetics, I haven’t found it. While cancer can bring positive changes to a person’s life, it can also bring a lot of very negative changes too, both during and following treatment.  The person with cancer may ultimately come to a place where they do appreciate the lessons learned,or new knowledge gained, but they will probably first have to deal with all their feelings about the not-so-sunny side of things.

3.     You know, that reminds me of this person I knew (insert really scary story here) who had cancer just like you.

Cancer is scary.  If you’ve been touched by this illness, you already know that.  It may be tempting to share experiences you or a loved one had with someone who is going through something similar.  However, remember that everyone is different, and hearing about worst-case scenarios can create even more fear than was already there.  If you want to empathize, you can simply tell them that, but it’s typically best to keep your worst case scenarios to yourself.

4.     How long are you going to use that excuse of cancer? It’s time to lift yourself up by the bootstraps and get back to living!

Cancer and its treatments are a huge trauma, not just physically, but also psychologically.  During treatment, people often are just focused on getting through this day, this treatment, or this surgery.  When treatment is over, there’s often a big emotional letdown.  Many people who have had cancer say that the emotions are even more intense after treatment has been completed.  Furthermore, the physical side effects, such as crushing fatigue, neuropathy (pain, tingling, and/or numbness at the extremities) and lymphedema (swelling of the arm), can last for a long time.  In my experience people tend to understate, not overstate their symptoms, and they often push through their pain or fatigue when they really should be recovering.  Please try to give them the space to recover.  They’ve been through a lot.

5.     I know just how you feel!

Remember: each person’s experience is unique.  Even people with the same diagnoses have different experiences, so don’t presume that you know how the person feels, even if you’re knowledgeable about the condition.  I’ve worked in the field for many years, and I still cannot know people feel about their condition until they tell me.  Be curious, be respectfully interested, and most people are glad to share their experiences.  You’ll learn something new each time!

Cognitive exercise that makes sense


I get asked a lot about people’s favorite things to do to exercise their brain. At the top of the lists are typically Sudoku and crossword puzzles. The people asking me are usually people who are already good at math and verbal expression. So I often respond with an old joke.

A man is looking feverishly for his keys under a streetlamp. His friend sees him there, and joins him in the search. After a few hours, the friend says, “ I just can’t find the keys. Are you sure you lost them here?” The man responds, “Oh no, I lost them about a half mile down the road, but the light is so much better here.” 

All the love for Sudoku and crossword puzzles is a similar case of looking for your keys where the light is best. It’s easier and fun to do what comes naturally, but you’re not likely to achieve your goals of brain fitness by these methods. 

The goal of brain exercise is to generate new and stronger pathways in your brain. If your brain is already well developed and skilled with words and numbers, it’s probably a lot of fun to do crosswords and Sudoku puzzles, but it’s probably not doing a lot to strengthen or generate new cognitive pathways.

So my challenge to you is to begin looking for your brain health in places where the lighting isn’t best, but where you’re most likely to find it. Think about what skill areas you have historically avoided. Some areas you might want to consider are: visual memory, verbal memory, visuospatial skills, processing speed, attention, artistic skill, physical abilities, mathematics, and verbal skills. Rank them from most commonly used to least commonly used, or from easiest to most difficult. If you’re having trouble, ask your significant other or a good friend. Then focus on developing your most challenging/least utilized skill areas.

Are you a slow and steady type who refuses to be rushed? Play timed games, like Perfection or Bop It!. Are you unable to draw a stick figure? Take the art class of your choice. Have you never been an athlete? Take a yoga class. Learn to square dance. Play soccer with your children, grandchildren, or coworkers. If your visual memory is poor like mine, play Memory (aka Concentration) with your favorite child friend. Are you a wordsmith who can’t do much with your hands? Play Tangrams, or Legos, or Tinker Toys. Or play with one of my favorite new toys, Super Plexus. And if verbal skills are not your strength, try Boggle or Scrabble, or even Scramble or WordTwist, right here on Facebook. 

You want to pick things that are a challenge, but also which are fun. If they’re not fun, you’re not likely to continue them. Find a buddy to join you in the merriment. Play children’s games with the kids in your life. Have a game night once a week at your house. Be open to doing things that aren’t in your natural skill set, and you might surprise yourself by the things you enjoy. I’d love to hear about what you’ve tried and how it goes for you.

And Sudoku and Crossword puzzles? You can keep doing them. It’s important and healthy to do things that are fun for you. Just don’t expect to find your keys there.