Sleep Issues: Exercises and Worksheets

Sleep :  Are we getting what we need from the sleep we get

We often hear how important it is to get enough sleep… the right kind of sleep. Even setting the alarm on a cell phone can trigger an electronic lecture. “Join us to learn better sleep habits.” Many of the suggestions we hear make perfect sense for dealing with sleep issues. Go to bed at the same time every night rings true to us. It follows that if we have regular bedtimes we will fall asleep easier. We know our bodies respond to habitual behaviors. We’ve trained them to do so. However, reality steps in and we find it almost impossible to get to bed at the same time every night, let alone get up at the same time each day. Where do we go from here?

sleep issuesThe following material is excerpted from the Coping with Sleep Issues Workbook by Ester R.A. Leutenberg and John Liptak, EdD.

Many people feel that their sleep issues are just a normal part of their everyday life. Sleep issues can be disruptive and leave one feeling tired and sluggish throughout the day. These issues can continue, get worse, and become a sleep disorder.

Identifying and awareness of your sleep issues will help. Things pertaining to your sleep habits that you take for granted may be okay, or they may not be okay. Use the following information to help you document your sleep issues.

If you know or live with someone with sleep problems, send them a link to this blog and ask the person to do the exercises. Even better, interview the person by asking the questions posed below, and writing the answers down.

Your responses will also serve as a guide to take to your medical provider who can guide you to healthier sleep.

Click here for a set of printable worksheets covering the following topics.

 

My Sleep Issues

Name ______________________________________ Date ______________________

How many of the items below that pertain to you and/or your situation? Describe your experiences in your journal or print out a copy for your use of the worksheet.

While Sleeping …

I am able to recall a frightening nightmare.

I am afraid I will leave the house when I sleepwalk.

I am confused upon waking after I sleep walk.

I am hard to console when I awaken after sleep walking.

I am often sleepy during the day.

I am sweaty and my heart is pounding after a bad dream.

I dream about doing work while I am sleeping.

I awaken out of breath.

I am confused if someone wakes me up.

I awaken feeling frightened.

I engage in aggressive behavior.

I awaken sweating and breathing fast.

I awaken with a dry mouth.

I awaken with a sense of panic.

I awaken with my heart pounding from fear.

I cannot fall back to sleep when I have a nightmare.

I do not respond to others when walking in my sleep.

I feel scared at the end of my dreams

I have difficulty staying asleep.

I often choke or gasp during the night.

I often have headaches in the morning.

I scream and shout.

I snore loudly.

I wake up and sit upright with a look of panic on my face.

I walk around while I am sleeping.

I will often scream while sleepwalking.

My dreams feel like they threaten my safety.

My dreams become more disturbing as they unfold.

My nightmares are so realistic they are scary.

Others say my breathing stops when I am sleeping.

 

Sleep issues can become worse if not treated. Treatment usually consists of a combination of cognitive-behavioral activities like the ones in this workbook as well as medication. Consult and bring the three pages that you just completed with you to a medical or sleep professional to ensure you are doing everything possible to treat your sleep issues.

 

My Self-Care Sleep Habits

Sleep habits are often dependent on wellness habits that you display during the day. Think about some of your wellness habits and how they may be negatively affecting your ability to sleep at night. In the chart that follows, write about how you can make positive change in your wellness habits.

Self-Care Habit My Present Self-Care Habits How I Can Take Better Care
Example

Eating habits

I eat a heavy snack an hour before bedtime.

 

I can take a light snack a few hours before bedtime.

 

Eating habits

 

 

Consistent bedtime rituals

 

 

Exercise

 

 

Intake of liquid

 

 

Medications/drugs legal or illegal

 

 

Nap during the day

 

 

Relaxation

 

 

Stress

 

 

Other

 

 

Highlight each Self-Care Habit you can change immediately to ensure healthier sleep.

 

Exercise for Better Sleep

There is a specific correlation between stress and a lack of sleep. Research has shown that exercise is critical in the reduction of stress. Physical activity earlier in the day can be a key factor in your ability to let go of some of the stress and sleep well. Answer the following questions in your journal or print a copy of the worksheet for your use.

  • What types of exercise do you do regularly (jogging, walking, swimming, aerobics, etc.)?
  • How much time do you spend regularly in the activities above?
  • Which types of exercise do you like best? Why
  • Which types of exercise do you like least? Why?
  • What exercise classes would you like to take?
  • What stops you from taking those exercise classes?
  • Are there any team sports that you could join?
  • Why don’t you exercise more? (Be honest!)
  • How can you compensate or overcome the reasons you do not exercise more?

 

Nutrition Influences of Sleep

Your food habits may have an influence on the amount and restorative power of the sleep you are currently experiencing. Journal about your current food habits, and then identify changes you would be willing to make. Note your current habits about the food group in question, and then identify the changes you want to make.

Proteins (example: milk, eggs, meat, poultry, fish, dried beans, oats, rice, whole-grain bread, whole-grain pasta, cashews, broccoli, peanuts)

Fats (example: butter, cheese, chocolate, pork, bacon, beef, veal, hotdogs, margarine, mayonnaise, canola oil, lunch meats)

Bad carbohydrates (example: sugar, corn syrup, sodas, doughnuts, cookies, cakes, pies,sugary cereals)

Good carbohydrates (example: potatoes, sweet potatoes, fresh fruit, fresh vegetables, corn, oats, wheat, soybeans, black-eyed peas, kidney beans)

Vitamins (example: liver, fresh fruit, fresh vegetables, whole-grain bread, milk, cheese, salmon, tuna, potatoes, poultry, peas, soybeans, whole-grain cereals, seafood, carrots, seeds)

Drinks (example: water, alcohol, coffee, sweetened fruit juices, sodas, hot tea, iced tea, lemonade)

 

Stress Management for Better Sleep

The relationship between stress and your ability to sleep well has been well documented. People who are experiencing a great deal of stress do not typically sleep well.

Write down the stress management techniques listed below that you will commit to trying.

  • Avoid hot-button
  • Be assertive with others – you have needs and wants too.
  • Breathe deeply.
  • Do not try to control what cannot be controlled.
  • Eat nutritionally.
  • Enjoy life’s simple pleasures.
  • Express your feelings in a safe, effective manner.
  • Focus on the positive.
  • Forgive yourself and others.
  • Journal about your feelings associated with stress.
  • Keep and prioritize a to-do list.
  • Learn how to say “No” when you feel overwhelmed.
  • Look at the big picture of life and see where your issue fits in.
  • Manage your time well so that you have time for yourself.
  • Plan your time effectively.
  • Prepare and accept that unexpected problems will arise.
  • Relax with calming music.
  • Schedule time for Yoga or stretching exercises.
  • Spend less time with people who stress you out, if you can.
  • Take control of your own environment.

 

Sleep Concerns

People who have sleep problems or disorders often have concerns when retiring for bed because of some of the issues that go along with their sleep patterns. Going to sleep with these concerns, and worrying about falling asleep, can make it more difficult to fall asleep. Sometimes, talking or writing about the issues will help.

In your journal identify three of your concerns associated with your sleep.

 

Taking Worries and Fear to Bed

We often worry and fear things we cannot control. Read the Serenity Prayer out loud. Make photocopies of it, cut it out, and tape it to your bathroom mirror, by your bedside, or any places where you can easily see it and re-read it.

God grant me the serenity

To accept the things

I cannot change;

Courage to change

the things I can;

And wisdom to

know the difference.

 

Bed-Time Self-Care

Print out this page. Cut out the tips below that pertain to you, and those you need to remember. Post them in places that you will see them. (bathroom mirror, refrigerator, etc.)

Reduce your liquid intake before bedtime.

 

Refrain from eating a large meal or snack before bedtime.

 

Remember that your bedroom is for sleep and intimacy only.

 

Get at least seven hours of sleep.

 

Have a bedroom free of and electronic products.

 

Turn your alarm clock around so that you cannot see it from bed.

 

Don’t go to bed unless you are sleepy.

 

Go to sleep and rise at the same time each day – even on weekends.

 

Avoid watching television shows that are upsetting before bedtime.

 

If you aren’t asleep in 20 or30 minutes, get out of bed until you are tired.

 

Keep a comfortable room temperature. Cool, but not cold.

 

Think positive thoughts as you are falling asleep.

 

Establish relaxing bedtime rituals.

 

Maintain a healthy diet.

 

Consider the things you have to be grateful for as you are going to sleep.

 

Make sure that your bedroom is quiet.

 

Review the good things that happened during the day as you get undressed.

 

Free your mind as you get into bed.

 

Avoid alcohol before bedtime.

 

Use caution with sleeping pills that can become addictive.

 

Do not allow cats or dogs in bed with you no matter how much you love them.

 

Exercise regularly but not three or four hours before bedtime

 

If there are noises, use a fan or white noise to block out the sounds.

 

Avoid stimulants like nicotine and tobacco before bedtime.

 

Avoid caffeine several hours before bedtime.

 

Lower the lights a few hours before bedtime

 

Finish eating anything an hour before bed.

 

Reduce the number and time of naps during the day.

 

Make an appointment with a medical professional.

 

Make an appointment with a sleep professional.

 

 

Using Mental Imagery

Mental imagery (or guided imagery) harnesses our brain’s natural tendency to create vivid mental representations of our beliefs, desires, experiences and goals. It’s also a simple, inexpensive, and powerful tool for soothing symptoms and creating positive change. The use of mental imagery has been found useful with some sleepwalkers as well as people with other sleep problems.

Mental imagery is using memories of visual events to project a mental picture in your mind.

An example:

I picture myself at a beach in Delaware where I used to live. When I begin to feel anxious or stressed I can project myself back to that beach and begin to feel relaxed and sleepy. I just close my eyes and picture myself sitting in the sand. I notice how blue the water looks and how white the waves appear as they come in. I imagine walking along the beach looking for seashells. I smell the fresh air and hear the seagulls chirping above. The sun is warm on my body and I feel safe. With each breath I take I imagine breathing in the beautiful, vivid colors that are present. This is my personal paradise.

 Now, write out a pleasant imagery scene that you will like picturing and remembering.

Before going to sleep each evening, you can begin to imagine this scene vividly.

 

Support for My Sleep Issues

In overcoming any sort of sleep issue, regardless of how minor or severe, support is important, and sometimes critical. Support can come in many different forms and from many individuals in your life. In the following boxes, list people whom you can rely on to suggest healthy lifestyle changes and activities that allow you to have a healthy bedtime sleep.

Make a list in your journal of all those who could support and help you with your sleep issues. Note how you believe that person can help you. Possible supporters could come from medical professionals, sleep issue professionals, family members, friends and acquaintances in the community, people with whom you work at a volunteer job, spiritual sources, or other groups you might know. Print the worksheet for your use if you wish.

Click here to download printable worksheets related to this article.

Racism?

Racism is Not a Thing of the Past

We like to believe that we have conquered racism. There is no such thing as being pulled over by the police for driving while being brown anymore, right? Click here to read the story about Nubia Escobedo from November 16, 2017.

We all hoped bias against black children in school was gone in the 1960’s.  Not so. The reality is quite different. Read this article in the American Bar Association’s Journal about its impact today.

Racism discussed in the Social Well-Being WorkbookWhen I think of the size of this problem I am overwhelmed into inaction. What can I do…no, what can all of us do about this pervasive issue? Here are some suggestions from Ester Leutenberg and John Liptak from their workbook, Social Well-Being that we can all manage.

AWARENESS

  • Become more aware of your own perceptions and biases. Think about your biggest bias when it comes to diversity and whether it is valid for ALL people.
  • Observe and listen when speaking with people from cultures different from your own in order to become more aware of their values, beliefs, customs and feelings.
  • Do not view everyone from the same point of reference. Instead, have empathy and attempt to “put yourself in the shoes” of other people when communicating.
  • Be aware of the differences in the ways that people from various cultures communicate.
  • Meet people from other cultures, take time to learn about them, and share your experiences.

RESPECT

  • Treat everyone the way that you want to be treated.
  • Give equal consideration and understanding of the viewpoints of others, and value those views with equal importance.
  • Be open-minded and non-judgmental when communicating with people from backgrounds different from your own. Think about how you can be more open-minded and non-judgmental.
  • Develop an awareness of how cultural differences make life more exciting. Think about how boring life would be if everyone were the same. Make a plan to experience and explore cultural differences.
  • Allow yourself to experience things that are different from what you are accustomed to.

VALUE

  • Diversity enriches your life. Think about some of the ways it does.
  • You learn the most from people whose beliefs, perspectives, and experiences are different from yours.
  • Diversity challenges stereotypes, encourages critical thinking, and prepares you for a global society and economy.
  • Diversity prepares you to be a good global citizen who is ready for a complex and pluralistic society.
  • People with different backgrounds, skills and experiences bring new ideas and fresh perspectives to all facets of life and career.

Try these easy suggestions above. They are great starting place for what should be a life-long effort for change.

For a different spin on the issue read this article about white fragility.

Unpacking White Privilege

Unpacking White Privilege: An Experiment in “Going There” with White Relational-Cultural Practitioners

By Lisa Eible, DSW, MSW, LCSW

Transforming Community Relational Cultural TheoryWe were an informal group of educators, social workers, and therapists who felt deeply moved by ongoing race-related violence, and the difficulty in talking about race-related topics, even among RCT practitioners. We formed an informal group to examine our own white privilege and to address race-related issues and have been meeting for the past year and a half. As the poster describes, we are focused on further development of our personal and professional lenses in the application of RCT to racism (interpersonal and systemic). We seek to understand our individual and collective journeys and to further develop Relational-Cultural theoretical constructs related to racism. We expect and plan further work on this topic, as our group work continues. Lisa Eible may be contacted at lmeible@yahoo.com.

From its inception and early beginnings, Relational-Cultural theory (RCT) has been characterized by co-creation. Jean Baker Miller strongly held to the notion that the work itself was “in relation”—that is, ever changing in a context of mutual learning and impact (Miller, 1976). In this rich collaborative tradition, a group of Relational-Cultural practitioners began working together on a personal, professional, and theoretical journey related to racism and white privilege after the 2015 Jean Baker Miller Institute (JBMTI) in response to yet another national race related tragedy—the Charleston, South Carolina church shooting. A call to action developed there for further RCT work specific to issues of racism and white privilege. Miller (1976) cited the importance of a “good conflict”; and authors such as Ayvazian and Daniel Tatum (1994), Daniel Tatum (2004), Jordan (1997), Tatum and Garrick Knaplund (2004), and Walker (2002) addressed racial issues. Our group thought there was another layer of “unpacking the knapsack” of white privilege which needed to be done (McIntosh, 1989).

A call was made for conference attendees and other RCT practitioners who were interested in working on issues of racism.  It was decided that the group would be composed, at least to start, of those who identified as “white”.  We observed, in the group’s conception, a need for “us to work on our own issues” and not place additional stress and expectations on our sisters and brothers of color to help us “get it”.  This was a decision made in love and protection, not with the purpose of exclusion. It was also a place to start, not a forever decision.

Initially, two groups of social workers, therapists and educators from across the United States and Canada were established and began meeting in Fall, 2015, via on-line meeting forums. While all group members identified as “white” and “female”, there were cultural, religious, and sexual orientation differences among group members. The initial goals were to raise each person’s individual awareness of their own privilege and to name how it impacted the lens through which they experienced the world.  The longer-term goals of the group are to contribute to the Relational-Cultural theory literature as it relates to issues of race, diversity, and white privilege, as well as to develop some sort of individual or collective social action agenda.  The two groups combined to form one group after the first series of meetings due to a smaller number of participants at that point, and has continued as such through April 2017.

A closed Facebook group was set up to share information that included materials such as worksheets, journaling, readings and videos (ex. Race—The Power of an Illusion, Wealth: America’s Other Racial Divide). Survey Monkey was used to gather data from the nine participants in the final group. In response to the question, Have you changed as a result of your participation in this group, participants answered:

  • I feel more empowered to speak up on issues of privilege and racism…this group has provided connection and a safe learning place for my continued growth.
  • I am angrier. In a good way.
  • I am more knowledgeable about the history of racism and institutional privilege in the United States and more aware of how it has affected my habitual perceptions.
  • I have become more conscious of my white privilege and have initiated numerous conversations with other white people about white privilege.
  • I speak up in uncomfortable situations, whereas before I would be silent. Even if I don’t think I will change anyone’s viewpoint, I make it known that there are other perspectives.
  • My self-awareness has increased though I know I have to keep learning. I also appreciate the access to resources…. I use and will continue to use these resources to expose others in my community. I see it as my responsibility to educate other white people.

In response to the question, “What was your biggest learning/takeaway from this experience/group dialogue,” they replied:

  • I still have a long way to go with my understanding of privilege. This process is a marathon not a sprint.
  • I was once again struck by the importance of taking time for the growth process to unfold, and to continue to hold the responsibility for learning rather than looking outward to people of color to educate me.
  • How helpful it is to have an ongoing white affinity group to learn with.
  • That I have the option to deal or not deal with racism and privilege, whereas others are confronted with it daily.
  • We are all uncomfortable and will all make mistakes (embrace and acknowledge the mistakes).
  • I would say becoming sensitized to the pervasiveness of my privilege. Once your eyes are open, it’s impossible to “unsee” things. And the group has given me courage to act.
  • Hearing the complexity with which some of my colleagues describe their own growth in this area has helped me grow too.

When asked about their experiences and observations, they cited scheduling and technology issues as well as the emotional nature of the interactions. One participant seemed to summarize the emotional impact: Several group members noted that the group provided support in tolerating the shame about unacknowledged privilege, opening participants up to greater consciousness and action.

Since the initial series of meetings, the group has continued to meet, and further published work is anticipated and planned. Our group members include: Christina Borel (christina.borel@gmail.com), Denise Dojka (dmdojka@comcast.net), Lisa Eible (lmeible@yahoo.com), Shannon Finn (finnshannon@hotmail.com), Lisa Frey (Melissa.Frey-1@ou.edu), Catie Green (cagreene@email.wm.edu), Lynne Lieberman (llieberman@comcast.com), Betsy Nordell (bnordell@wellesley.edu), Audra Sbarra (as455@nyu.edu), Harriet Schwartz (harrietschwartz14@gmail.com), Erica Seidel (drericaseidel@gmail.com), and Gail Walker (GW8215724@aol.com).

References

Ayvazian, A. & Daniel Tatum, B. (1994). Women, race and racism: A dialogue in black and  white. Boston: Wellesley Centers for Women Publications.

Daniel Tatum, B. (2004). Racial identity development and Relational Theory: The case of black women in white communities. Boston: Wellesley Centers for Women Publications.

Jordan, J.V. (1997). Women’s growth in diversity: More writings from the Stone Center. New York: Guilford Press.

McIntosh, P. (1989, July/August). White privilege: Unpacking the invisible knapsack. In Peace  and Freedom Magazine (10-12).

Miller, J. B. (1976). Toward a new psychology of women.  Boston: Beacon Press.

Tatum, B. & Garrick Knaplund, E. (2004). Outside the circle? The relational implication for white women working against racism. Boston: Wellesley Centers for Women Publications.

Walker, M. (2002). How therapy helps when culture hurts. Boston: Wellesley Centers for  Women Publications.

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship
RCT: It’s All About the Relationship

LAUGH! Using Humor as a Stress Management Tool

Laugh laugh laugh laugh laugh…

Don't Get Mad Get Funny - Laugh

Expressions such as, “Oh, just laugh it off” or “Don’t be such a sour puss” don’t make me smile. They make me more annoyed than I was before someone tried to lighten my load. Furthermore, I often snap back with something pithy such as, “Great! What other trite expression can you offer?” Not helpful to anyone. Leigh Anne Jasheway in Don’t Get Mad Get Funny offers a path to find healthy laughter that actually works.  The following is excerpted from her book.

Finding Your Funnybone

Before you can begin to use humor as a stress management tool, you need to understand some things about your sense of humor and your ability and willingness to smile, giggle, or laugh so hard it hurts. Everyone has a different sense of humor and unless you are attuned to yours, you will end up missing many opportunities to use your humor skills to deal with life’s little unexpected miseries.

A recent study reported that the average American five-year-old child laughs out loud around four hundred times a day, while the average adult laughs out loud only fifteen. Young children are truly hedonistic – when something is no longer fun, they stop doing it. We adults call that a short attention span.

A boy laughs while readingReaching adulthood does require a degree of buckling down and getting serious. Let’s face it – there are things we have to do whether we want to or not. But so many of us have lost the sheer capacity for fun, joy, and laughter that even when we have the opportunity, we miss it.

Many adults face a debilitating disease that has never been medically diagnosed: humor impairment. Humor impairment is the inability to find humor even in situations that are funny to most other people. My personal term for this state is constipation, because if you can’t release your emotions through laughter, you emotional and spiritual systems are “backed up”.

Your level of humor constipation is often a result of the environment in which you grew up. If laughter was always present in your family, your ability and willingness to laugh with others is probably great. On the other hand, if, like me, you grew up in a family where laughter was frowned upon, you will probably find it more difficult to express humor in front of others.

But, as with any other behavior, you can change. I grew up in a family where expressing any type of emotion was seen as a sign of immaturity. As a result, I was a most serious child, preferring Edgar Allen Poe and Sylvia Plath to the daily comics. I married a man who believed that neither laughter nor tears were acceptable or desirable. Today, however, I make my living teaching laughter and comedy and performing as a stand-up comic. My background has truly taught me how bleak and unhealthy a life without humor can be. (By the way, I still love Edgar Allen Poe and Sylvia Plath, but now they rub shoulders on my bookshelves with books by Dave Barry and Rita Rudner.)

Take this short quiz to determine how willing and able you are to laugh at life and its foibles.

Your Laughter Profile

  1. During an average day, I laugh out loud, snicker or giggle:
    1. Once or not at all
    2. Two or three times
    3. At least once an hour
    4. Constantly, I’m under medication
  2. When I am alone and read, see, hear, or think something funny, I:
    1. Smile to myself
    2. Laugh out loud, but look around to see if anyone saw me
    3. Laugh out loud and find someone with whom to share the funny thing
    4. Take a cold shower
  3. In the past year, I can remember:
    1. At least one time I spent at least a whole minute laughing
    2. At least two to five times I spent at least a whole minute laughing
    3. More than five times I spent at least a whole minute laughing
    4. I can’t remember – what was the question?
  4. When I’m around other people, they laugh and joke:
    1. Never
    2. Sometimes
    3. Often
    4. I never hang around other people, they might laugh at me!
  5. When faced with daily crisis (the dog peed on the rug, I missed the project deadline again, my daughter needs brownies for school NOW!) I respond with a laugh:
    1. Never
    2. Sometimes
    3. Often
    4. Only if it’s someone else’s rug, deadline, or child
  6. I do things intentionally to make myself laugh:
    1. Never
    2. Sometimes
    3. Often
    4. That might hurt!
  7. The people I spend most of my time with:
    1. Leave me feeling drained and depressed
    2. Don’t really affect my attitude
    3. Make me laugh a lot
    4. Usually steal my lunch money
  8. I can name:
    1. One thing that almost always makes me laugh
    2. Two things that almost always make me laugh
    3. At least three things that almost always makes me laugh
    4. My closest relatives
  9. I laugh at myself:
    1. Never
    2. Sometimes
    3. Often
    4. Only when I’m not in the room
  10. I do silly things on purpose (wear strange buttons, make funny noises, and do things to see how others will respond):
    1. Never
    2. Sometimes
    3. Often
    4. No one ever notices
  11. When I hear people laughing at work, the first thing I think is:
    1. I wish I could get paid to goof off
    2. I wish I knew what the joke is
    3. How wonderful that they’re having a good time, I think I’ll join them
    4. That it’s Saturday and I shouldn’t even be here

How to score your laughter profile

Give yourself the following points for each letter: a=0 b=1 c=2 d=3. Then add them up to obtain your total score.

If your score is less than 5, you are suffering from humor malnutrition. Someone probably told you “Grow up, get serious!” and you did. In order for you to find the humor in daily events, you will have to start slowly – first by convincing yourself that humor is an acceptable emotion and one that is healthy when used regularly.

If your score is from 6 to 15, you occasionally have a good laugh, but your life lacks humor regularity. Remember, laughter is like exercise – you have to do it regularly to get the full benefit. Use it or lose it! You’re good at expressing humor when you find things funny, but your goal now is to try to find humor in those things that usually make you angry, annoyed, or irritated.

If your score is from 16 to 20, you are humorously fit! Not only do you approach life with the right amount of humor and benefit from it, you also probably make other people’s lives more enjoyable. You should become a friend and role model for people around you who need the healing power of humor yet who don’t seem to be able to use it in their lives.

If your score is from 21 to 33, you’re downright silly, aren’t you? Don’t stifle those childish instincts! Sure they told you in school that the class clown would never go anywhere in life. But they were wrong! Look at Chris Rock! He’s taking it to the bank.

Click here for a printable version.

Your Humor Compass: Where do you find the funny in life?

Friends laugh togetherNow that you have a better idea of your ability and willingness to use humor on a daily basis, it is important to understand the kinds of things that you find funny. After all, just as our taste in food or art varies, so does our taste in what is and is not funny to us.

An important note here: You do not necessarily have to laugh out loud to find something funny. One of my best friends and I went to a movie together a few years ago. I laughed so hard I couldn’t see through the tears. She sat there quietly. Afterwards, she said the movie was one of the funniest she had seen in years.

Ask yourself the following questions to determine the types of humor that you will be able to use to most effectively manage your stress.

  • Do you laugh more at the physical or slapstick humor you find in the Three Stooges, I Love Lucy, Perfect Strangers, and The Mask, or do you prefer verbal humor, or do you enjoy both?
  • Do you have a strong sense of humor ethics? In other words, do you find certain specific types of jokes to be offensive rather than funny?
    It is important for you to understand the types of humor that distress you rather than tickle you. They may include stereotypical jokes, put-downs, or humor about certain subjects that are too close to your heart for you to find them fanny at present.
  • Do you like jokes that focus on things you have in common with the comedian?
    Studies indicate that many people do prefer humor that speaks to their own personal experience, which means that we often prefer comedy from people who are similar in age, race, or gender.|
  • Do you like topical humor, jokes that build on current events?
    Late night humorists are scheduled to appear on television after the news to help people cope with the negative images painted during the evening newscast. If this type of humor is appealing to you, you can try, yourself, to find humor in your local newspaper and nightly news report.
  • Do you like wordplay and puns?
    An interesting thing that I have discovered is that different types of humor appear to be more or less popular in different parts of the United States. When teaching humor classes, I have noted, for example, that people from the Midwest tend to enjoy the humor of puns more than people from other areas of the country.
  • Do you prefer humor that stands on its own, or do you like props and gimmicks?
    Some people find Gallagher extremely funny (for those of you who don’t know, he’s the guy famous for smashing watermelons on stage). Others think he’s just silly.
  • Do you regularly find humor in things that aren’t necessarily meant to be funny?
    For example, do you make jokes about commercials, billboards, medical forms, or warning labels on food packages?

Answering these questions for yourself will help you identify the types of humor to seek out, as well as the types of humor you yourself may attempt in order to reduce your stress and have more fun in life.

Mental Health Issues: Erasing the Stigma

Erasing the Stigma of Mental Health Issues

Managing Intense Anxiety WorkbookExcerpted from Managing Intense Anxiety Workbook
By Ester R.A. Leutenberg and John J. Liptak, EdD

Mental health stigma can be divided into two types. Social stigma is characterized by prejudicial attitudes and discriminating behavior directed towards individuals with mental health issues. Perceived stigma is the internalizing by the people with mental health issues of their understanding of discrimination.

The following worksheets will help you learn to change the stigma of mental health issues and deal with their impact in a more effective way. Click here for a printable version.

The Stigma of Mental Health Issues

People who experience mental health issues in their lives are prone to reoccurring symptoms. When this happens, they often have a stigma placed on them by other people. Often the stigma attached to this issue stops one from moving forward—being unable to talk about it for fear of being judged or labeled. We can erase the stigma of any mental health issues by starting to discuss it with one person at a time, and taking the time to explain the anxiety you lived through in the past.

Let’s start with people with whom you have already shared your story.

With whom have you discussed your issues?

 

What did you say? What was this person’s reaction? What did the person say?

 

How did you feel?

 

Family

 

     
Friends

 

     
Acquaintances

 

     
People in your community or your house of worship

 

     
Other

 

     
Other

 

     

 

If any one of the above reacted in a negative way, to what do you attribute that reaction?

__________________________________________________________________________________

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If we stamp out the stigma attached to mental health issues, shed the shame and eliminate the fear, then we open the door for people to speak freely about what they are feeling and thinking.

~ Jaletta Albright Desmond

Journal about what this quotation means to you. How can you do your part to erase the stigma of mental illness.

Glenn Close said, “The most powerful way to change someone’s view is to meet them … People who do come out and talk about mental illness, that’s when healing can really begin. You can lead a productive life.

Name a time when you have changed someone else’s view – about anything.

 

 

 

How did that feel to you?

 

 

 

 

 

Name a time you were tempted to talk about your anxiety issues, but didn’t? Why not?

 

 

 

 

 

Write about a situation in which you talked about your anxiety issues.

 

 

 

 

 

 

How did that feel? How did it work out?

 

 

 

 

 

Who is a trusted person you can talk with and begin to heal? Anyone else?

 

 

 

Who is a trusted person you can ask for a referral of someone to talk with in order to begin to heal

 

 

 

Anyone else? In an ideal world, how can you lead a more stable life?

 

 

 

 

 

How can you contribute to changing stigma?

 

 

 

 

 

Ways I Am Treated

Think about some of the ways that people treat you because of the symptoms you show due to your mental illness. In the spaces below, write about those who treat you unfairly and why.

I am criticized by my family and/or friends …

 

 

 

 

 

I am ignored by my family and/or friends …

 

 

 

 

 

I encounter problems at work …

 

 

 

 

 

I encounter problems at home …

 

 

 

 

 

I am subjected to teasing or harassment …

 

 

 

 

 

I am laughed at …

 

 

 

 

 

I treat myself unfairly by …

 

 

 

 

 

I treat myself fairly by …

 

 

 

 

 

The Stigma of Going to a Mental Health Therapist 

Many people have pre-conceived ideas about anyone seeking therapy.

Do you know of anyone who has gone to a mental health therapist? Write what you know about

the experience. ______________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

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Here are some facts about mental health and mental health therapy.

  • Mental health includes how you act, feel, and think in different situations.
  • Mental health problems can be caused by many different things including medical health issues, abuse (emotional, physical, verbal, sexual), stress, worry, loss of a relationship, food issues, ADHD, STD’s, family changes, addictions, traumatic event, problems, wanting to build up self-confidence, etc.
  • If someone goes to a mental health therapist, this does NOT mean the person is crazy. Mental health therapists treat people the same as any other medical doctor treats problems.
  • There needs to be a good connection between you and the therapist. Your therapist should be someone you feel you can trust.
  • This might take a few meetings and/or a few therapists, to find the right one for you.
  • Non-judgmental people who truly care about you will not judge you in a negative way. They will be proud of you for seeking help.
  • The therapist does not assume that you have a mental illness. The therapist assumes something is troubling you, knows that no one leads a perfect life, and admires you for trying to make changes in your life.
  • The therapist’s job is to help you understand what’s going on.
  • The therapist will not tell you how to live your life, or how to think, act, or believe.
  • The therapist is not an advice-giver, but will help you think about how to increase your quality of life.
  • The therapist may have some thoughts, and with you, will help you make changes.
  • The therapist can help you to increase your life management skills.
  • The therapist will help you recognize and express your feelings in a healthy way.
  • The only person who can “fix” your problems is you, but a therapist will help you with an action plan.
  • The mental health therapist may suggest that you see a medical doctor for medication.
  • Therapy can be a slow or long process. Being open and honest, and wanting to feel better, will make the difference.

Place an X by the facts that you were not aware of.

What are your concerns about talking with a mental health therapist?_ __________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

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After learning about these facts, consider making a commitment to speak with a counselor or therapist.

National Military Appreciation Month

May is National Military Appreciation Month

Excerpted from Veterans: Surviving and thriving after trauma
By Ester R.A. Leutenberg and Carol Butler, MS Ed, RN, C

Forward by John Sippola, LTC, ret., MDiv

Veterans front coverDeclared by Congress in 1999, May was selected National Military Appreciation Month as a month-long observance honoring the sacrifices of the United States Armed Forces.  There are more military related observances during the month of May than any other month, so it is an appropriate time to celebrate the men and women in uniform.  During May, we recognize Loyalty Day, VE Day (the end of World War II in Europe on May 8, 1945), Armed Forces Day, Military Spouses Day and Memorial Day.

War casts a long shadow. For far too many service members and their families, the initial expressions of welcome, joy and relief are soon overshadowed by hidden wounds to mind, body and spirit. Too many veterans find they are engaged in yet another desperate battle. And, in this hidden war after the war they discover enemies they feel ill-equipped to fight. Aftershocks of war-related trauma and dangerous undertows of depression sabotage their mission for a more satisfying life in community. Moral injury drowns the quest for inner peace, and substance abuse undermines hard-won gains.

Initially, homecoming is happiness, applause and affection, but reintegration to daily life does not resume as they knew it. Veterans, their partners and families have changed. The labor market may not welcome their skills; their finances may plunge. Statistics show alarmingly high suicide and unemployment rates.

Help abounds via the Department of Veterans’ Affairs, Department of Defense, Wounded Warrior Project and numerous governmental and private agencies. Many veterans are reluctant to seek assistance due to the perceived stigma of asking for help; others are too overwhelmed, unaware of available resources, or receive little or no help for other reasons.

As more veterans return from combat, society is increasingly aware of their needs. They will be directed toward professional and spiritual counselors. Veterans differ from other abuse survivors; they have seen atrocities and experienced horrors most civilians cannot comprehend. Their intelligence, determination and resilience that served our country are now needed to save themselves, to heal their invisible and visible wounds.

One of the issues Veterans face is how to problem solve when they are overwhelmed with problems. They often need help finding a way to break their difficulties down to something manageable. The exercise, Problems Can Be Opportunities, will help them discover a way to prioritize their issues and work through a solution…a solution that works for them. A facilitator’s guide is supplied here.

A downloadable version of the exercise “Problems Can Be Opportunities” is found here.

 

RCT: It’s All About the Relationship

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship

 

It’s All About the Relationship

By Julie Kim, MSW, LICSW 

Transforming Community Relational Cultural TheoryFrom: Transforming Community: Stories of connection through the lens of Relational-Cultural theory

Edited by: Connie Gunderson, PhD, LISW, Dorothy Graff, PhD, LICSW, & Karen Craddock, PhD, EdM

As a student counselor with Health Services at the University of Minnesota, Duluth, I am sharing a personal story relating insights and experiences about surviving systems of oppression to living. Learning about Relationship-Cultural theory (RCT) clarifies the impacts of racism and oppression and helps people of color move from survival and isolation to building a foundation to live a meaningful life. RCT reflects my values, validates my personal experiences, and has taught me about the power of connection and healing. Julie Kim may be contacted at juliek@d.umn.edu.

“It’s all about the relationship” is a phrase Connie Gunderson says quite often. It couldn’t be more true, as I reflect on my life journey so far. Relational-Cultural theory (RCT), developed by the work of Jean Baker Miller, identifies the concept of chronic disconnection, a disconnection which promotes condemned isolation to such a degree that relationships are feared and persons have a sense they do not deserve loving relationships filled with understanding.

As a Korean girl, adopted at a young age into a white family, and growing up in a predominantly white community, I began my journey into condemned isolation. Being told daily that I didn’t belong, I wasn’t wanted, and I needed to go back to my country was reinforced through people’s attitudes and by systems I was involved in every day. Always feeling a sense of being left out, of being different, I was a label of ridicule, especially because of my appearance. Hearing comments such as: “Chink, you would be cute if your eyes were bigger. Can you see out of your eyes?” was a normal occurrence. I experienced an additional sense of condemned isolation because, since I was not fully Korean, I didn’t fit into the American culture and I did not belong in my home country. “Where do I belong?” and “Where do I fit in?” were common questions that continued until I reached my early 30s.

Learning about racism and beginning to understand the personal consequences of racism turned my world into wonder, curiosity, and the unknown. “What am I supposed to do with this information?”, and “Will it change my life?” At the time I remember thinking: “It was never my fault.” This was a defining message that promoted internal change. I began to seek people who would support me for the way I looked; who understood my life experience; and who accepted my authentic self; an authentic self no longer ruled by fear, people’s glares, or by people asking me personal questions about whether or not I was a “foreigner”, or why I was in the United States.

Living authentically didn’t come easy at first. I constantly questioned myself about whether or not my perceptions and ideas were valid. However, as I moved into deeper questions and reflections, my relationships became deeper and more intentional. Feeling accepted and understood was profound and life changing and I started to believe “I do matter” because my relationships reinforced this every day.

My journey continues and I am constantly reminded of my story as I listen to college students of color share their experiences which are very similar to my own. My goal is to help them recognize that they are enough, their multiple identities matter, and to teach them to live authentically. I say this because I know that no one can do this work alone or in isolation. For example, I was provided the opportunity to teach an all student of color course and in doing so, we created an environment that was not influenced by institutionalized systems already in place. In looking back, the students and I created an environment from the basic tenets of Relational-Cultural theory that modeled interdependence, empathy, mutuality, and connection. SunNy Vang, a class participant, summed up the learning experience for all by stating:

My experiences with relationship building in our class began from a place of vulnerability. As a person of color, I struggle tremendously with a sense of belonging. Knowing that I do not “fit” nicely with what is considered normal or customary; I learned to appreciate it and to acknowledge that I have more to contribute to my community. These awarenesses did not happen overnight. We had discussions every day that reflected our reactions, thinking processes, and how we felt about a number of awesome and sad things. We all came from different places and our stories were welcomed. We connected on a far deeper level compared to other classes.

The students and I focused on building empathic relationships, and it truly fostered a responsive and relevant teaching and learning environment in ways that included much more than racial, social, and ethnic demographics. We supported each other by validating and embracing each other’s knowledge, values, experiences, and differences. We all became more mutually responsive persons. I’m truly grateful for the students, as their insights and experiences have helped me to grow and continue to heal. Connie Gunderson was right, “It’s all about the relationship”.

Difficult People: How to Deal with Them

Types of Difficult People and How to Deal with Them

Excerpted from Coping with Difficult People
By Ester R.A. Leutenberg and John J. Liptak, PhD

Coping with Difficult PeopleDifficult people are everywhere. Difficult people are those who frustrate us to no end. (In fact, others may view each of us as a difficult person.) We encounter difficult people at home, in the workplace, school, grocery market, anywhere. Often how much they affect us depends on our self-esteem, ability to recognize “hot buttons” and effectiveness of communication skills. Although one meets many different varieties of difficult people, we have suggested six types that seem to be the most common. These difficult people will have some or all of the following traits:

WHINERS are people who find fault in others and everything they do, blame others for what happens in their lives, and know for certain what should be done but rarely work to improve or correct a situation. They whine in a high-pitched tone, cry and grumble to complain about problems rather than working to fix them or find solutions for them. They are often able to see problems that need solutions, but choose to complain about the problems rather than working to solve them.

KNOW-IT-ALLS are people who think that they know more than everyone else. They believe they have more knowledge and expertise and have all of the answers, and they know they are always right. They do not like to be corrected and will often be impatient, defensive, defiant and sarcastic with people who disagree with them, or they shut down or argue without reason. They feel they are experts on all subjects, behave arrogantly and take exception to anything said to them.

AGGRESSIVE PEOPLE are often angry, impatient and explosive. They use strength, coercion, force, and power to make their point. They often intimidate others into agreeing with them or giving up their point of view. They are critical of people who do not agree with them, and they use ridicule, belligerence, accusations, and verbal, emotional, and/or physical abuse as a way of putting people down. People who interact with them feel a need to be cautious (as if they are walking on eggshells.)

PASSIVE PEOPLE are hard to understand and hard to get to know. They are usually shy, quiet and reserved; they simply want to blend in and not be noticed. They rarely share their opinions or assert themselves to get their views across. They do not talk or share a lot and do not feel the need to respond to questions, especially personal ones. They often appear aloof and detached.

NEGATIVE PEOPLE are usually pessimistic people who will always say such things as “that will never work” and “we have tried that in the past.” They are skeptical that anything will turn out right or be right. They drag others down and make everyone’s environment as negative and as pessimistic as they are. They are unable to see the positive in anything and will always believe that things will not work out.

YES-PEOPLE are super pleasant and agreeable. They usually promise something that they cannot deliver. They seek approval and are afraid to say no to other people, especially the important people in their lives. They say what people want to hear and will agree with each person’s opposing views or opinions.

Here is a model that you can use to build positive relationships with difficult people.

In this model, participants can deal effectively with difficult people in their lives by following a few critical steps including:

  1. Identify the person’s personality type and what makes the person so difficult for others to handle.
  2. Learn and utilize critical communication and listening skills to build a positive relationship.
  3. Cope effectively with the person.
  4. Learn skills to respond effectively and/or to confront the person.

Sounds simple. Now for some tools to help.

 

Interacting with Whiners
Don’t . . .

 

•       agree with the person’s complaints

•       get defensive

•       counter-attack

•       say “You’re such a whiner”

•       be tough on the person if it’s not their usual style

•       be sarcastic (“poor poor you”)

 

Do . . .

 

•       listen attentively

•       ask clarifying questions for precise information

•       ask “how could it be better?”

•       create a problem-solving scenario: “What if…”

•       be supportive

•       kindly point out the person whining when he/she might not realize it

•       listen for a bit and then try to solve the problem with the person

 

 

Interacting with Know-It-Alls
Don’t . . .

 

•       attack the person’s ideas

•       put yourself or your ideas down

•       ask the person cite their source debate

•       think the person doesn’t know a lot –they might!

•       try to make the person look bad

 

Do . . .

 

•       listen attentively

•       respect the person

•       paraphrase the person’s points

•       suggest alternatives to the person’s viewpoint

•       remain neutral throughout your conversations

•       keep your humor

 

 

Interacting with Aggressive People
Don’t . . .

 

•       argue

•       retaliate

•       escalate the hostility

•       fight against the person

•       try to win the argument

•       take the behavior personally

•       submit to their wishes

•       wait for them to run out of steam

 

Do . . .

 

•       divert attention, if possible

•       offer information that explains your situation

•       look for common interests and agreement

•       remain calm

•       acknowledge the person’s feelings

•       explain your feelings using “I” statements

•       set limits on violence and aggression

•       walk away if necessary

 

 

Interacting with Passive People
Don’t . . .

 

•       fill in the silence with conversation

•       exclude the person in activities

•       complete the person’s sentences

•       talk too much too soon

•       ask too many questions or appear nosey

•       exclude the person in conversations

•       assume the person is disinterested

 

Do . . .

 

•       ask open-ended questions

•       provide opportunity for the person to speak

•       wait in silence

•       be attentive

•       expect responses

•       find a topic the person has interest in

•       be playful, fun loving and friendly

 

 

Interacting with Negative People
Don’t . . .

 

•       agree with the complaints

•       get defensive

•       counter-attack

•       think it is a reflection on you

•       accept blame

•       spend more time with the person than you need

•       lose focus on your own energy and positivity

 

Do . . .

 

•       listen attentively

•       ask clarifying questions for precise information

•       ask “how could it be better?”

•       create a problem-solving scenario

•       be supportive

•       remain detached

•       say, “now tell be something positive”

 

 

Interacting with Yes-People
•       Don’t . . .

 

•       help them out by doing the work they agreed to do, and aren’t doing

•       get caught up in their need for approval

•       ask more of them than they can do, even if you know they’ll say yes

•       let them get you in the middle by saying yes to say yes to someone of a different opinion

•       give them praise when they say yes, again

 

•       Do . . .

 

•       help them turn down activities

•       be clear about priorities

•       show them ways to say no

•       if they do accept a task, help them create a timeline for completion

•       help them set boundaries

•       build a relationship and try to talk to them

•       make suggestions for alternatives

 

 

For each of these types of negative folks answer the following questions:

The person I know that behaves as a _____________________ is ______________. (It is suggested that you use code names that only you will recognize for this exercise.)

This person behaves_____________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

My strategy for dealing with this person has been ____________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

A better way I might deal with this person __________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

 

A downloadable version of the above is information is available here.

Recognizing Unwanted Thoughts and Feelings

Recognizing Unwanted Thoughts and Feelings

Managing Unwanted ThoughtsExcerpted from Managing Unwanted Thoughts, Feelings & Actions Workbook

By Ester R.A. Leutenberg and John Liptak, PhD

People who encounter unwanted thoughts, feelings, and actions face frightening experiences. They may have a difficult time distinguishing between what is real and what is not real. They usually regret what they thought and felt, and/or how they acted. They find that often this interferes with their work, school, family relationships, and interactions with friends and people in their community. Unwanted thoughts, feelings and actions can cause confusion, be difficult to deal with, and disrupt any setting. Mental health issues contribute to unwanted thoughts, feelings and actions. When adults experience these symptoms, they are typically challenged by being and remaining in touch with reality. They have difficulty coping with the stressors and demands of their daily lives.

How Do Unwanted Thoughts, Feelings and Actions Issues Manifest Themselves?

Because there are so many bizarre ways these feelings can manifest themselves, disturbances can be very difficult to identify and manage. It is critical to be aware of, to understand, and to acknowledge how symptoms are commonly experienced. Although most or all symptoms do not have to be present, those that are present will typically cause significant distress and/or impairment in daily functioning. Listed below are some possible symptoms:

Agitation Cold manner Confused thoughts
Dangerous actions Delusions Detached from others
Difficulties in the workplace Disinterest in maintaining personal hygiene Disorganized speech
Feelings of entrapment Flat affect Forgetfulness
Hallucinations Inability to understand and accept reality Inability to communicate well with others
Inability to express emotions Inability to make good decisions and judgments Inability to think clearly and rationally
Inappropriate behavior Incoherent speech Increased drug/alcohol use
Intense anxiety Loss of appetite Loss of interest in everyday activities
Loss of touch with reality Mood swings Problems maintaining relationships
Problems in school Rigid actions Strange actions
Suicidal thoughts Unusual movements Withdrawal from others socially

Intense Anxiety

Sources of Unwanted Thoughts, Feelings and Actions Issues

As with many different types of psychological problems, the origin of these unwanted thoughts, feelings and actions issues are difficult to pinpoint. Because of their complex nature, these issues are often brought on by one or a variety of these sources:

Genetics and Biology

Psychotic disturbances often run in families and thus researchers believe that they are inherited, but that is not the only cause. A complete medical and psychological history should be collected by a medical professional to identify family members who may also have experienced disturbances with unwanted thoughts, feelings and actions.

Brain Chemistry

The structure and functioning of the brain has been shown to have an effect on the incidence of psychotic disturbances. Chemicals in the brain (neurotransmitters) that communicate between neurons, also seem to play a role. In addition, the structure of the brain found in healthy individuals is different from that of people who experience disturbances with unwanted thoughts, feelings and actions. An examination to explore the structure and functioning of the brain should be conducted by a medical professional.

Life Events

An inability to cope with major stressors can be a factor in disturbances in thoughts, feelings and actions. Some of the major stressors might include traumatic shock or abuse. An examination of the person’s life events that may be causing unwanted thoughts, feelings and actions needs to be conducted by a medical professional.

Medical Conditions

Disturbances with unwanted thoughts, feelings and actions are more likely to occur in people with poor medical health in general, or those who suffer from an existing psychological problem. A medical history can reveal conditions that might induce problems in thoughts, feelings and actions, and should be examined by a medical professional.

Substances

A history of problematic drinking, tobacco, marijuana or other drug use has been associated with the development of disturbances with unwanted thoughts, feelings and actions. A history of a person’s drug, tobacco and alcohol use should be examined by a medical professional. People experience many different types of problems related to unwanted thoughts, feelings and actions.

In order to help participants deal successfully with unwanted thoughts, feelings and action issues, facilitators need to have a variety of assessments and activities to help their participants open-up and begin to feel they can manage the symptoms of their unwanted thoughts, feelings and actions and realize that they are not alone.

When to Worry?

Disturbances in unwanted thoughts, feelings and actions are difficult to manage because they blur the line between what is real and what is not real. The good news is that people can develop the skills needed to manage the symptoms and progress forward to begin enjoying life more. Unwanted thoughts, feelings and actions that accompany many of the mental health issues that people deal with daily can be a very frightening way to live. People who experience these issues over time are at risk of having a serious mental illness and need to seek a medical professional.

Suicide Warning!

People who experience severe bouts of unwanted thoughts, feelings and actions are often at risk for suicide. Sometimes they can become irrational and think that the only way to escape the pain is to attempt suicide. Remember to take any talk about suicide or suicidal acts very seriously.

Signs of suicidal thoughts
Withdrawing from family, friends, and activities of interest in the past Increasing use of harmful substances
Giving away possessions Expressing severe hopelessness about the future
Making a plan for dying by suicide Calling or visiting people to say goodbye
Getting legal affairs in order Engaging in reckless actions
Talking about killing or harming self Expressing feelings of being trapped with no way out
Purchasing a weapon

 

Serious Mental Illness

If participants have a serious mental illness, they need to be taken seriously. Facilitators can take an active role in their finding help immediately. All disturbances of thoughts, feelings, and actions need to be thoroughly evaluated by a medical professional, and then treated with an appropriate combination of medication and group and/or individual therapy.

Self-care: indulgence or essential?

Self-care: indulgence or essential?

Many of us have been brought up with the idea that taking care of ourselves in any way but the most basic healthy eating and exercise is selfish. We should think of others first. We should take care of our kids, our community, our church, our friends, our coworkers, our pets before indulging ourselves. The list of priorities goes on and on. Where do we put taking care of ourselves? Self-care often winds up at the very end of the list…the place where we never arrive.

What we really need are what Nikisha Brunson, co-founder of Urban Bush Babes describes as “everyday healthy rituals that help keep your body and mind energized.” For one person it might mean spending an hour each day knitting, for another reading, for yet another a soothing bubble bath. Each of us is different except for that one outstanding issue: we need to care for ourselves to maintain the energy we need to care for others.

Yoga Class Self-CareSelf-care is not just for the self-indulgent “women who do lunch.” It is for every one of us. It is crucial to finding peace of mind and to finding what is needed within ourselves to give back in this uncertain and often scary world.

Self-care is especially important in times of grief. It is easy to bury oneself in the details that crop up when you have experienced a loss. The following exercises are excerpted from Griefwork: Healing from Loss by Fran Zamore, LISW, IMFT, and Esther R.A. Leutenberg. They are applicable to all of us, whether we are experiencing a loss or just experiencing our day-to-day life.

Are you doing enough for yourself? Download “Self-care Domains” and keep it handy. During the next couple of weeks fill in what you do for yourself in each of the five domains: Physical, spiritual, social, emotional, and intellectual. You will find that many activities are applicable to more than one domain.

Here are some examples:

Going to exercise class

  • Physical because it is good for my body and my health
  • Social because I have friends and/or acquaintances in the class
  • Emotional because I release some anger and/or frustration when I exercise

Walking/hiking

  • Physical because of health benefits
  • Spiritual because I walk in nature and find that to be my spiritual connection
  • Emotional because walking is a stress-buster for me

Self-Care Man ReadingReading

  • Intellectual because I’m stimulating my brain by thinking
  • Social because I go to a book discussion group
  • Emotional because I’m reading escape novels
  • Spiritual because I’m reading uplifting book

At the end of two weeks, review what you have entered in the self-care domains. Make an effort to add new things in areas you’ve neglected.

Self-Care Exercises

WAYS TO NOURISH (OR CARE FOR) MYSELF (Download here)

Check ‘nourishments’ that you would be willing to commit to do in the next month.

On the blank lines at the end add some of your own activities. Get involved in something new.

  • do a craft or hobby
  • write in a journal
  • exercise
  • call a friend
  • meditate
  • take a long warm bath & light a candle
  • go to a place of worship
  • listen to music
  • go to a movie, even if I cry
  • read
  • go to a museum
  • work in the garden
  • care for a pet
  • volunteer
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________

Journal about your self-care. Remember you are writing for yourself. Don’t worry about spelling, sentence structure, and the like. Just write your thoughts as they come to you. Refer to this entry when you are feeling guilty for taking time for yourself.

Self-Care Man Hiking

LEISURE (Download here)

Leisure or recreational activities serve many healthful purposes, including self-care. Some can be intellectually stimulating and some promote socialization. Others are healthful because they are a physical outlet. Still others may provide a needed spiritual dimension.

ACTIVITY SUGGESTIONS:

Accomplish something…bicycle to the store

Be alone…meditate

Be a spectator…go to a sporting event or concert

Be sociable…accept an invitation to a social gathering

Be spiritually uplifted…take a walk in the park or go to a house of worship

Compete in a sport you like

Continue to learn…take an adult learning class for credit or audit

Exercise alone…walk on a treadmill at home or go for a walk in nature

Exercise with others…ask a close friend to go with you

Keep emotionally stimulated…discuss issues openly with trusted friends / family

Keep mentally stimulated…do crossword puzzles, play Jeopardy

Keep physically stimulated…join a health club

Relax…take some sunscreen, a magazine, and sit outside

Return to a hobby from the past…find an old train collection in the attic and set it up

Be creative…participate in arts, crafts, knitting, sewing, writing

Journal about your self-care. Remember you are writing for yourself. Don’t worry about spelling, sentence structure, and the like. Just write your thoughts as they come to you. Refer to your list when you are at a loss for something to do just for yourself.

RCT: The Power of Connection Through Student and Professional Mentorship

Relational-Cultural Theory Series Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice

Relational-Cultural Theory (RCT) in Practice:

The Power of Connection Through Student and Professional Mentorship

By Connie Gunderson, PhD, Jane Larson, MSW, Corrie Ehrbright, MSW, Vanessa Thoennes, MSW, Amy Anderly-Dotson, MSW, Anthony Klar, MSW, Ashley Tuve, MSW, Will Wales, MSW

Relational-Cultural theory (RCT) recognizes the primacy of relationship, and emphasizes the intrinsic human desire for connection through mutual empathy, radical respect, community and social justice. The purpose of this paper is to share the voices and experiences of MSW students who completed an advanced practice course in Relational-Cultural theory at The College of St. Scholastica in Duluth, Minnesota with the instruction of Dr. Connie Gunderson. Core aspects of learning included the opportunity for students to collaborate with faculty at the Jean Baker Miller Training Institute at Wellesley College in Boston, Massachusetts and participate in a mentorship program with RCT practitioners throughout the USA and Canada. Their experiences demonstrate that with the power of connection and the value of intrinsic inter-relationship mutual learning, growth and change are possible as students integrate Relational-Cultural theory into field placements and other professional settings. Connie Gunderson, PhD, LISW may be contacted at cgunderson@css.edu.

This article shares the voices of MSW students who completed a course in Relational-Cultural theory at The College of St. Scholastica. It will briefly describe the course curriculum for your frame of reference and focus on students’ learning and reflections of their professional growth during the course, and the implications of applying RCT in clinical social work practice.

 

Brief Introduction to Relational-Cultural Theory

Relational-Cultural theory evolved as a developmental and psychological model in the 1970s through the collaboration of four women psychologists, Jean Baker Miller, Irene Stiver, Judith Jordan, and Jan Surrey, in Boston, MA. These women, along with other scholars and practitioners, began to challenge mainstream, traditional psychologies of human development that were grounded in a belief of the separate-self. From their perspectives, psychological theories that valued and fostered a separate-self worldview, based on individualism and autonomy, promoted a culture that was fundamentally antithetical to the health and wellbeing of persons and communities. In refute, the women posited that health, well-being, and growth are based on the primacy and centrality of relationship and relational movement rather than the focus of acting in one’s sole interests (Miller, 1976). This paradigm shift in thought and action has affected how counseling, therapy, organizational development, and policy changes are understood and practiced. In 2012, an editor at the American Psychological Association recognized Relational-Cultural theory as one of the top ten psychological theories of our time (Carlson, 2012). This is a tribute to the scholarship of the women who dared to challenge the status quo in the field of psychology.

 

Relational-Cultural Theory (RCT):

An MSW Course Curriculum

In the fall of 2014, MSW students at the College of St. Scholastica had the opportunity to study Relational-Cultural theory and its approach to human development, clinical practice, and social justice.

The course curriculum included an in-depth exploration of RCT theory, collaborative mentorship with RCT clinical practitioners, an introductory training experience at the Jean Baker Miller Training Institute at Wellesley College in Boston, MA, and two community-based educational events, hosted by the College of St. Scholastica and the Duluth community, featuring Dr. Judith Jordan and Dr. Connie Gunderson. The course was designed to engage students to learn about growth fostering relationship with each other, RCT mentors, and RCT scholars. The students were encouraged to reflect and practice the tenets of RCT in all aspects of the course. To assist in this process, students worked in small groups with RCT mentors to examine RCT through comprehensive literature reviews and collaborative discussions. Each small group critically reflected on how the theory and tenets applied to clinical social work practice.

A student reflected that RCT mentorship was a unique way to build relationship and foster learning:

I feel very fortunate to have had the opportunity to work with our mentors. They brought a wealth of experience, wisdom, knowledge, and fun to the table. They were willing to answer questions, share resources, and offer guidance. Most importantly, they brought themselves to the relationship and, I believe, we did as well. In true RCT fashion, our mentoring relationship was one of a reciprocal nature with all of us engaged in mutual learning.

This next section includes brief summaries of the students learning and reflections of some of the primary RCT tenets.

 

Basic Tenets of Relational-Cultural Theory

Mutual Empathy

Mutual empathy is one of the essential factors necessary for growth in relationship (Jordan, 1986). According to Hartling and Miller (2004), mutual empathy is not a static one-way process, nor is it a relational courtesy, but rather a complex skill that helps us “know” another person’s experience. To be empathic requires vulnerability. Jordan (1992) likens mutual empathy to a “life-giving empathic bridge” where people with different views and perspectives can come together and engage in dialogue that creates change (p. 2).

The practice of mutual empathy in therapy encompasses not only empathizing with clients’ experiences but also with their strategies of disconnection (Miller & Stiver, 1994). It is also a corrective experience allowing clients to build positive relational images and know they can have an impact on the world and the people in their lives which, in turn, contributes to a sense of empowerment (Walker, 2004). As clinicians, being mutually empathic also means identifying and empathizing with our own experiences and strategies of disconnection which can interfere with the ability to be fully present and engaged with our clients (Jordan, Walker, & Hartling, 2004).

Walker (2004) notes that all people deserve to be treated with dignity. Radical respect is a key aspect of mutual empathy. Without radical respect it is unlikely that clients would allow themselves to be vulnerable enough to authentically engage in a relationship. The practice of mutual empathy is paramount – without it, healing cannot take place. A student allowed herself to experience mutual empathy as she wrote:

Boston was an opportunity for me to join and experience the special bond the class already seemed to have. I wasn’t sure what to expect. When I walked into the airport the morning we were flying out, ready to cry over the fact I had to leave my babies, two of my classmates greeted me immediately with smiles, hugs, and words of reassurance. It was in that moment that I knew I was going to be part of something special. Special seems like an understatement here. The bond we all created in Boston was nothing short of extraordinary, and that bond continues to grow.

 

Authenticity

Authenticity is being able to fully represent oneself honestly in relationship (Jordan, 2004). When we are able to be authentic we are able to better know, understand, and discuss our thoughts and feelings with others (Miller & Stiver, 1997). The benefits of authenticity have been stressed in many fields including psychology, sociology, philosophy, and spiritual traditions (Chen, 2004). For example, a recent study on authenticity, life satisfaction, and distress indicated that the ability to be authentic in relationship was connected to an increased feeling of life satisfaction and decreased levels of distress (Boyraz, Waits, & Felix, 2014). As an example of this, a student wrote:

Authentic interpersonal relationships are critical to client health. Yet so many clients come to therapy in a state of profound isolation. RCT is refreshing because the focus is on healthy and authentic relationships, rather than on symptoms of mental illness.

Another student reflected:

The RCT class was like nothing I expected. The class was small and intimate. We got to know each other’s quirks and personalities on a deeper level. This was something new for me, since I was used to blending in, and being unnoticed. In the RCT class I was visible. When I spoke, people heard me, and that was something I had never experienced before. In this environment I learned my voice was accepted. For the first time, I realized I could make a difference outside of the classroom, and connect with others on a deeper level.

These results support the importance of helping clients share their personal stories, explore thoughts and feelings, be true to themselves, and feel free to engage in meaningful ways with others.

 

Social Justice

As clinicians it is important to understand that chronic exposure to social disparities, such as race, gender, and class-based stereotypes, are painful and foster self-doubt and feelings of unworthiness (Comstock et al., 2008). RCT invites clinicians to think beyond symptom reduction and remedial helping interventions (Comstock et al., 2008). Clinicians are encouraged to explore the social challenges and barriers clients may deal with on a daily basis. For example, Birrell and Freyd (2006) describe in their article, Ethics and Power, how cultural oppression, social exclusion, and other forms of social injustices underlie the pain that individuals in marginalized and devalued groups routinely experience in their lives. During the training in Boston, Dr. Maureen Walker explained that although oppression is often institutionalized at societal levels, it is necessarily enacted in the context of interpersonal relationship, therefore the fragmentation caused by the violation of human bonds can only be healed by new and healing human bonds (Walker, 2014). While at the training in Boston, a student became more aware of an important social justice issue while attending a lecture by author, Allan G. Johnson, who wrote The Gender Knot. The student noticed:

During the training, I was introduced to new perspectives about gender and privilege in our culture. I began to understand how white males have a status of unearned privilege in our society. As a white male with this unearned privilege, I became increasingly aware of how I may be perceived by others based on this unearned privilege alone. For example, I recognized how women are often discounted in our culture by being referred to as “guys.” This demonstrated how “male dominant” our society is.

As a clinical social worker, it is critical to be cognizant of the deep-rooted issues of power and privilege and to be able to address clients’ experiences with their environments and systemic assumptions and practices from a relational human rights perspective.

 

Boundaries

Many traditional therapeutic models view boundaries as a rigid line of separation. Clients may be subject to what the therapist determines as rules or boundaries. This perspective often carries connotations of control and separateness. From an RCT perspective, boundaries are viewed as an opportunity for connection and a place of meeting and exchange (Walker & Rosen, 2004). One method that fosters a power-with relationship is a conversation initiated by the therapist with a client at the beginning of the relationship. To create an environment that is mutually respectful and safe, therapists and clients need to discuss and clarify the purpose and focus of their therapeutic relationship. Here, boundaries are discussed and mutual agreements are developed to establish a constructive therapeutic relationship. For example, therapists respect clients by focusing on the clients’ needs during the therapy hour, and only use a “judicious use of self” when offering feedback and responses. Clients respect therapists by honoring the therapists’ need for personal privacy inside and outside of the office. This is critical in establishing a positive relational connection (Walker & Rosen, 2004). During the semester, there were discussions about the need for healthy professional boundaries. A student reflected:

I have struggled with the some of the traditional models of mental health treatment. For example, a therapist who is intentionally aloof and objective (if that is even possible) exudes judgment and superiority. Sadly, I have witnessed clinicians who repeatedly tell clients what is wrong with them, interpret clients as manipulative and treatment resistant, and unilaterally design treatment plans that clients must follow or face significant consequences. This does not model a growth fostering relationship, or offer a client a safe place to be vulnerable. An RCT clinician tries to relate with a client in a professional manner with mutual empathy, fluid expertise, a judicious use of self, clear boundaries, and clarity of purpose.

 

Power

RCT focuses on safe and healthy therapeutic relationships. So the concept of power is central to RCT. Power is present in every relationship. How power is perceived and manifested is critical. RCT suggests that power is defined as the ability to facilitate change (Jordan, 2010). For example, relationships that strive to acknowledge and respect each person’s ability to contribute, while recognizing the different roles and needs each person may have creates an environment that supports empowerment, connection, and growth (Miller & Stiver, 1997). The students explored how they experience power in their work with clients and in their organizations. Recognizing how people use power to interact in relationship has been insightful. One student wrote:

The privilege of going to Boston to learn from the founding scholars of RCT was life changing for me. It’s not every day that someone like me, has the opportunity to meet people like Dr. Jordan, Dr. Banks, and Dr. Walker. They generously supported our efforts, and they invited us into mutually responsive relationships. How amazing to be invited to call or e-mail them with a question, or a thought, and get a response! How amazing to be asked to share our personal experiences, so they could learn from us.

 

Constructive Conflict

Relationships are not static. They are quite dynamic. In therapy, clients and therapists naturally move along a continuum between connection and disconnection (Comstock et al., 2008). Disconnections and resulting conflicts may cause fear. Conflicts in therapy can be seen as pathways for transforming misunderstandings to empathy, and for building bridges between one another through collective relational struggle (Comstock et al., 2008). RCT suggests that with increased mindfulness and a willingness to address inevitable conflicts that occur in therapy in a constructive “win-win” manner, clients can feel safe, become more attentive and responsive to relational movement, and gain confidence in their ability to grow in relationship. A student reflected on her insights about the importance of providing a safe climate for conflict and struggles to occur:

I have learned so much about the value of relationships and the importance of building them with clients. Many clients have experienced loss and trauma and are searching for safety, so it is important to be able to provide that for them.

RCT has changed my interactions with others – I find myself listening more and asking more questions rather than offering solutions right away, which has always been my instinct. I have learned how to create a space that is open and safe. Through this course I have found my voice and been able to share what I have learned about RCT outside of the classroom.

RCT has also taught me the importance of fostering and maintaining relationships that have already been established, to know when disconnections occur, and how to work through them in respectful ways.

 

Connection and Disconnection

Therapists will likely work with clients who have been referred by social services, the courts, and other programs. Clients may wish for connection with a therapist and hope that the therapist will care enough to listen and understand their story, and, at the same time, clients may feel ambivalent and guarded about treatment. The desire for connection and authentic engagement may be overshadowed by protective strategies to stay out of relationship and to feel safe – to be relationally disconnected (Jordan, 2005).

A disconnection is defined as a psychological rupture that occurs when a child or adult is prevented from participating in a mutually empathetic and mutually empowering interaction (Miller & Stiver, 1997). According to Miller and Stiver (1997), two key features are necessary to bring about re-connection. A person must be able to take some constructive action within the relationship to make one’s experience known. And the other person in the relationship must be willing and able to empathically respond in a way that supports a new and better connection.

Clients’ disconnections are not the only ones that need to be respectfully responded to. Therapists bring their own strategies of disconnection to a therapeutic relationship. The need for connection, based on mutual empathy, with other professionals is recommended for all who are working in clinical practice. Thus, it is important for therapists to participate in professional supervision to support their own personal and professional growth. One of the fundamental beliefs in RCT is that one never needs to be isolated because of the power of connection. A student wrote about her struggles with connection:

I had a profound life changing experience when I went to the Jean Baker Miller Training Institute. Before leaving for the trip to Boston, my hope tank was on empty. I had been compassionately working for a rural agency. I was devastated when the agency suddenly eliminated my position. When I left for Boston with my cohort, I wanted to isolate. It was what I knew. However, while in Boston, I rediscovered who I was as an individual, a spouse, a mother, and as a social work professional. I realized I had been lost for over two and a half years. My life had been weighed down with shame and guilt. The environment I had been working in created these lonely and negative feelings. I noticed that the most fearful and difficult part of my journey in graduate school has been exploring who I am and who I am becoming. I have had to force myself to look at the positive attributes, skills, and passions that are inside of me.

 

The Five Good Things

A culture that fosters growth and is grounded in radical respect, hospitality, and community offers an environment that provides us with The Five Good Things: a sense of zest, clarity about ourselves and our relationships, a sense of worth, an enhanced capacity to participate in our world, and a desire for more connection (Jordan, 2010). From this perspective, life’s journey is inherently relational. For example, we grow through and towards relationships during our lifetime, rather than towards separateness and independence (Jordan, 2010). One student expressed her ideas: “We wish to feel safe and to offer safety to others. We wish to give and receive love and kindness. We strive to increase our capacity for relational growth by developing mutual empathy, mutual empowerment, and resilience.” Another student wrote about her experience with The Five Good Things:

Because of this course, I have zest in the face of the most trying time of my life. I have more clarity about myself, others, and my relationships than ever before. I have a sense of worth and an enhanced capacity to be productive. Most of all, for the first time in my life, I have the desire for more connection, and for that I am grateful.

Another student added how RCT concepts are intertwined:

Last year, at the beginning of my RCT journey, Dr. Gunderson spoke about The Five Good Things, growth fostering relationship, mutual empathy, and authenticity. Until then, I had never heard how these concepts could be linked together. I knew instantly, I found a “theoretical home”. Everything, from that point on, has been moving me towards learning how to live and practice RCT in my personal and professional life.

The course taught students to apply theory to real life situations. Students were able to engage with peers, mentors, clinicians, educators, and scholars. They created a safe place to explore, struggle, and support each other to develop personal and professional skills critical for comprehensive clinical practice.

 

Future Collaborations

The College of St. Scholastica has integrated RCT into the Masters of Social Work curriculum. There are plans to offer RCT as an undergraduate course to first year students to assist them as they adjust to college life. It is clear, scientific studies are continuing to emerge with data that supports RCT and demonstrates that humans are neurologically wired for connection (Banks & Hirschman, 2014). To assist in providing ongoing evidence in this field of study, Graff, Gunderson, and Larson completed and are in the process of publishing a study on the C.A.R.E. program with MSW students (Graff, Gunderson, & Larson, 2017). This is in the process of being published. This study focused on the relevancy of the C.A.R.E. assessment tool and specific C.A.R.E activities for the relational health of students.

In addition, in collaboration with the Jean Baker Miller Training Institute and Wellesley Centers for Women, engaged CSS faculty and staff, current students and alumni, along with other professionals organized the Transforming Community: The Radical Reality of Relationship Conference in June, 2016. We are currently establishing the cornerstone at the college and with our community to offer ongoing training in Relational-Cultural theory/ therapy in Duluth, MN.

Clearly, the “relational movement” is alive and well on this northern Minnesota campus and in our local community as CSS faculty and students introduce RCT in field placements, professional settings, and with clientele. Collaboration between the College of St. Scholastica and the RCT scholars and practitioners from Boston and elsewhere in the USA and Canada demonstrate that change is possible as we work collaboratively to foster healthier relationships for students, clients, and professionals.

 

Conclusion

Professional social work education integrates theory and practice and teaches students to engage, assess, and intervene with clients in a wide range of settings. RCT suggests working from a paradigm that places the focus of clinical assessment and intervention on relational development and interaction. From a relational perspective, we approach persons and their environments with a belief in intrinsic inter-relationship. We see the challenges for human rights through a relational lens. We incorporate a relational perspective into how we make policy decisions. For some, this is a significant shift in thought and action.

As the St. Scholastica MSW students graduate and move into the clinical world, integrating the tenets of RCT into their work may not always be easy. A student noted that she has much to learn as she embraces a relational paradigm in her personal and professional life.

I still feel like an infant or a toddler with RCT. I am still in wonder of everything. I am learning and exploring. I realize that RCT is not based on a set of facts to memorize, or quick steps to follow. It is a way of living and being with everyone and everything around me. This theory takes time to develop and understand.

Yet, as more practitioners and organizations truly recognize the centrality of relational interdependency, and as research continues to confirm that we, as humans, are literally hardwired to connect, and as persons consistently challenge power-over systems that intentionally isolate and marginalize “others”, a relational movement that is already underway will be ever-present to foster well-being for all persons and for the planet in which we live.

 

Acknowledgements

The students of the advanced course in Relational-Cultural theory would like to thank those who offered their assistance while writing this publication. We thank Dr. Gunderson for her endless support throughout the course. Her guidance challenged each of us to explore new ways to connect and relate with others.

We thank our mentors. We are grateful for their willingness to stand with us as we explored the tenets of Relational-Cultural theory. Their experience and insight enhanced our learning and broadened our perspective of social work.

Finally, we thank Dr. Amy Banks, Dr. Judith Jordan, and Dr. Maureen Walker. The training experience was life changing for us. We are moved by your passion for intrinsic human connection and your willingness to support each of us as people and professionals.

 

References 

Banks, A., & Hirschman, L. A. (2015). Four ways to click: Rewire your brain for stronger, more rewarding relationships. New York: Penguin.

Birrell, P.,. & Freyd, J. (2006). Betrayal and trauma: Relational models of harm and healing. Journal of Trauma Practice, 5(1). doi: 10.1300/J189v05n01_04

Boyraz, G., Waits, J.B., & Felix, V.A. (2014). Authenticity, life satisfaction, and distress: A longitudinal analysis. Journal of Counseling Psychology, 61(3), 498-505. doi: 10.1037/cou0000031

Carlson, J. (2012). In e-Connections Newsletter. Spring, 2012. Wellesley, MA: Jean Baker Miller Training Institute, Wellesley Centers for Women

Chen, X. (2004). Being and authenticity. New York: Rodopi.

Comstock, D., Hammer, J., Strentzsch, J., Cannon, K., Parsons, J., & Salazar, G. (2008). RCT: A framework for bridging relational, multicultural and social justice competencies. Journal of Counseling and Development. 86, 279-287.

Graff, D., Gunderson, C., Larson, J. (2017). [Assessing MSW student’s health and wellness with the C.A.R:E. program]. Unpublished raw data.

Hartling, L. M., & Miller, J. B. (2004). Moving beyond humiliation: A relational reconceptualization of human rights. Excerpts from a paper presented at the Summer Advanced Training Institute: Encouraging an Era of Connection, Wellesley College, Wellesley, MA.

Jordan, J. V. (1986). The meaning of mutuality. Work in Progress, No.23. Wellesley, MA: Stone Center Working Paper Series.

Jordan, J. V. (1992). Relational resilience. Work in Progress, No. 57. Wellesley, MA: Stone Center Working Paper Series.

Jordan, J. V. (2004). Relational resilience. In J. V. Jordan, M. Walker, & L. M. Hartling (Eds.). The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. New York: Guilford Press.

Jordan, J. V. (2005). Commitment to connection in a culture of fear. Work in Progress No. 104. Wellesley, MA: Stone Center Publications. doi: 0.1080/02703140802146423 Jordan, J. V. (2010). Relational-Cultural therapy. Washington D.C.: American Psychological Association.

Jordan, J.V., Walker, M., & Hartling, L. M. (Eds.). (2004). The complexity of connection. New York: Guilford Press.

Miller, J.B. (1976). Towards a new psychology of women. Boston: Beacon Press.

Miller, J.B., & Stiver, I.P. (1994). Movement in therapy: Honoring the “strategies of disconnection. Work in Progress, No. 65. Wellesley, MA: Stone Center Working Paper Series.

Miller, J. B., & Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston: Beacon Press Books.

Walker, M., & Rosen, W. B. (2004). How connections heal: Stories from Relational-Cultural therapy. New York: The Guilford Press.

Walker, M. (2004). How relationships heal. In M. Walker & W. Rosen (Eds.). How Connections Heal: Stories from relational-cultural therapy. New York: Guilford Press. Walker, M. (2014). The Power of Connection. Jean Baker Miller Training Institute Lecture. 24. – 26. October 2014. Wellesley, MA: Wellesley College.

Mindfulness Meditation and the Opioid Crisis

Mindfulness Meditation

Almost everyone in the US is aware of the current opioid crisis we are enduring. Millions of addicted are added each year. Since 1999 the use of opioids has increased five-fold. Statistics from 2016 (the latest available) show that 42,000 people died of opioid-related issues in just that one year.

What can be done to alleviate this crisis? In a paper titled “Mindfulness Meditation-Based Pain Relief: A mechanistic account”, Fadel Zeidan and David Vago report that research supports the claim that the widespread use of opioids to alleviate chronic pain has led to the exponential rise in misuse and addiction. Their paper further states that mindfulness meditation could very well be a narcotic-free tool to reduce chronic pain. (Vago, Zeidan, 2016.)

Mindfulness, research has learned, is an excellent complementary treatment for a variety of health and wellness concerns and aligns with scientifically-backed theories in modern psychology. The importance of increasing resiliency in the face of the inevitable difficulties, both physical and mental, can’t be reinforced too often. Although mindfulness-informed practices don’t magically change life circumstances, they can help cope with rapid change, life transitions, and physical symptoms (i.e. pain) as well as enable us to more fully savor success. (Torney, 2018.)

Mindfulness Meditation 30 ScriptsWith the above information in mind we present the following from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1& 2 by Julie T. Lusk.

Relaxation and visualization can heal the body, mind, and spirit. Progressive muscular relaxation and conscious breathing help relieve tension and stress. Guided imagery encourages people to experience internal harmony, to heal emotional and physical upsets, to increase body awareness, to enhance relaxation, to get in touch with the healing source of energy for emotional and spiritual strength, to receive direction from their own inner guide, and to connect with the environment.

Here are some tips to help you use these mindfulness-meditation scripts effectively with your clients.

Working with guided meditations

Everyone is different, so each person will experience guided imagery uniquely. These individual differences should be encouraged. During a guided meditation, some people will imagine vivid scenes, colors, images, or sounds while others will focus on what they are feeling, or experience it as a concept. This is why a combination of sights, sounds, and feelings should be incorporated into the meditations. With practice, it is possible to expand your participants’ range of awareness.

By judicious selection of images you can help deepen their experience and cultivate their awareness in new areas that can enrich their lives. For instance, a person who is most comfortable in the visual area can be encouraged to stretch his or her awareness and increase his or her sensitivity to feelings and sounds. (See Flower Meditation below.)

Be careful, however, when presenting themes and techniques that are unfamiliar to you. Since people respond in a variety of ways to visualization, avoid generalizing about the benefits of any given script.

If your groups are composed of people who are emotionally ill or especially fragile, be sure you have the necessary special training or professional guidance before introducing them to visualizations.

Preparing the group or individual

Some type of physical relaxation sequence should be used prior to every guided meditation. Breathing properly is essential for complete and total relaxation. Unfortunately, very few people take full breaths, especially when under stress. When a person consciously uses deep breathing correctly, stress is reduced and the mind can remain calm and stable. It is important that people focus on their breathing, with full deep breaths through the nose. Before beginning any guided meditation, briefly describe the images you will use and ask if they make anyone feel uncomfortable. People who are afraid of water may find images of ocean waves to be frightening rather than calming. Be prepared with an alternate image. Let participants know that if they become uncomfortable, they may, at any time, open their eyes and tune out or change the visualization. As you read a script, people will follow you for a while and then drift off into their own imaginations. They will usually tune you back in later on. If they know this in advance, they won’t feel as if they are failing by being inattentive. So tell them this is normal and to let it happen.

Choosing the right atmosphere

Select a room that has comfortable chairs for sitting or a carpeted floor for lying down. Close the door and shut the windows to block out distracting noise. If possible, dim the lights to create a relaxing environment. Low lights enhance the ability to relax by blocking out visual distractions. If the room lights cannot be controlled to your satisfaction, bring along a lamp or night lights. Adjust the thermostat so that the room temperature is warm and comfortable. If the room is too cool, it will be hard to relax and remain focused. Suggest that people wear a sweater or jacket if they think they may get cold. If distractions occur—a noisy air conditioner, traffic, loud conversations—try raising your voice, using shorter phrases and fewer pauses, or incorporating the sounds into the guided meditation. For example, you might say, “Notice how the humming sounds of the air conditioner relax you more and more.” Or, “If your mind begins to drift, gently bring it back to the sound of my voice.”

Using your voice

Speak in a calm comforting, and steady manner. Let your voice flow. Your voice should be smooth and somewhat monotonous. But don’t whisper. Start with your voice at a volume that can be easily heard. As the guided meditation progresses and as the participants’ awareness increases, you may begin speaking more softly. As a person relaxes, hearing acuity can increase. Bring your voice up when suggesting tension and bring it down when suggesting relaxation. Near the end of the guided meditation, return to using an easily heard volume. This will help participants come back to normal wakefulness. You may tell participants to use a hand signal if they cannot hear you. Advise people with hearing problems to sit close to you. Another option is to move closer to them.

Pacing yourself

Read the guided meditations slowly, but not so slowly that you lose people. Begin at a conversational pace and slow down as the relaxation progresses. It’s easy to go too fast, so take your time. Don’t rush. Many script authors use ellipses…to indicate a brief pause. Spaces between paragraphs would suggest a longer pause.

Leader’s notes and script divisions should not be read out loud. Give participants time to follow your instructions. If you suggest that they wiggle their toes, watch them do so, then wait for them to stop wiggling their toes before going on. When participants are relaxed and engaged in the imagery process, they have tapped into their subconscious (slow, rich, imagery) mind—and they shouldn’t be hurried. When you’re leading the meditation, stay in your conscious (alert and efficient) mind. Pay careful attention to all participants. You may have to repeat an instruction if you see that people are not following you. To help you with your volume and tone, pace and timing, listen to a recording of yourself leading guided meditations.

As you reach the end of a meditation, always help participants make the transition back to the present. Tell them to visualize their surroundings, to stretch, and to breathe deeply. Repeat these instructions until everyone is alert.

Using music

Using music to enhance relaxation is not a new idea. History is full of examples of medicine men and women, philosophers, priests, scientists, and musicians who used music to heal. In fact, music seems to be an avenue of communication for some people where no other avenues appear to exist.

Your music should be cued up and ready to go at the right volume before you start your meditation. Nothing ruins the atmosphere more quickly than having the leader fool around trying to get the audio going. Jim Borling, a board certified music therapist, makes the following suggestions on the selection of music:

Tips on Music Selection

  • Custom select music for individual clients or classes whenever possible. Not everyone responds in a similar fashion to the same music.
  • Matching a person’s present emotional state with music is known as the ISO principle. If you can match the initial state and then gradually begin changing the music, the person’s emotional state will change along with the music. If a person is agitated or angry, begin with fast-paced music, and then change to slower-paced selections as relaxation deepens.
  • Choose music that has flowing melodies rather than disjointed and fragmented melodies.
  • Don’t assume that the type of music you find relaxing will be relaxing to others. Have a variety of musical styles available and ask your clients for suggestions.
  • Try using sounds from nature like ocean waves. Experiment with New Age music and Space music, much of which is appropriate for relaxation work. Classical music may be effective, especially movements that are marked largo or adagio.
  • Adjust the volume so that it doesn’t drown out your voice. On the other hand, music that is too soft may cause your listeners to strain to hear it.
  • Select music based upon the mood desired. Sedative music is soothing and produces a contemplative mood. Stimulative music increases bodily energy and stimulates the emotions.
  • Select music with a slow tempo and low pitch. The higher the pitch or frequency of sound, the more likely it will be irritating.

Processing the experience

You may wish to add to the richness of the guided meditations by asking participants afterwards to share their experiences with others. This can be facilitated by creating an atmosphere of trust. Ask the group open-ended questions that relate to the theme of the exercise. Be accepting and empathetic towards everyone. Respect everyone’s comments and never be judgmental or critical, even if people express negative reactions. 

Caution 

Do not force people to participate in anything that may be uncomfortable for them. Give ample permission to everyone to only do things that feel safe. Tell them that if an image seems threatening, they can change it to something that feels right or they can stop the imaging process, stretch, and open their eyes. Emphasize to participants that they are in total control and are able to leave their image-filled subconscious mind and return to their alert rational conscious mind at any time they choose. Likewise, clients may want to explore what feels uncomfortable to them in the safety of the experience. Advise participants that it is not safe to practice meditation or visualization while driving or operating machinery.

Integrating the mind, body, emotions, and spirit opens up vast inner resources of intuition, wisdom, and personal power. The mind and body are one, and what you believe and feel is reflected in your body. Sometimes your thoughts may lead to illness, aches, and pains; and other times, they lead to exhilarating feelings of joy, pleasure, and peacefulness. Likewise, the condition of your body and the way it is feeling affect your thoughts. This is why it is impossible to worry when you feel relaxed.

So many of us live as if fragmented—thinking of one thing, saying something else, acting one way publicly, while feelings, moods, and emotions provide a constantly changing and inconsistent undertow. Guided meditations will help you focus on using the mind body connection to heal the body and emotions and to bring thoughts, words, actions, and feelings into harmony and alignment.

A definition of mindfulness

Mindfulness is the moment-to-moment attention to the present without judgment or reactivity. Mindful breathing and other mindfulness practices help you to achieve moment to moment awareness in a non-judgmental, detached way, thereby increasing the amount of time per day spent in rest and digest mode. Conscious attention to breathing is common in many forms of meditation and is used by top athletes to enhance performance. The following exercise will help your clients breathe mindfully. Download the following Mindfulness Breathing exercise here.

Exercise:

  • Sit in a comfortable position either on a chair with your feet on the ground, or on the floor with your legs comfortably crossed. Sit tall with your spine extended so that your breath can enter your entire torso. Relax your shoulders down and move your shoulder blades towards each other.
  • Place one hand on your abdomen and the other above your chest near your collarbone.
  • Inhale deeply from the bottom of your abdomen. Feel the expansion pressing against your lower hand.
  • Continue to fill your torso until you feel the hand on your upper chest expand. Hold the breath for one second.
  • Release the breath from the chest to the abdomen. Picture a cup of water emptying from the top to the bottom as you exhale. Note how it feels to be empty of breath just for a second before your next inhale, then repeat this long, slow even breath nine more times. Return to the breath count as your mind wanders, which it naturally will.
  • Return to natural breathing. Take a moment to stretch, and write about your experience in your centering journal. Don’t worry if mindful breathing feels awkward or uncomfortable. It will feel more natural the more you practice. Remember, these are muscle responses. You can’t throw a football like Tom Brady or play the trumpet like Wynton Marsalis right off the bat, either. Practice, practice, practice.

Now your client is relaxed and breathing properly, try reading one of the following scripts, using the tips above to make it as effective an experience as possible.

 

Flower Meditation (Download Flower Meditation exercise here)
Julie T. Lusk
Excerpted from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1
By Julie T. Lusk.

Time: 20 minutes

In this visualization script, participants increase their ability to imagine seeing, touching, smelling, and feeling.

Note: Obtain fresh flowers for participants before using this script.

Feel free to modify this script. For instance, flowers could be substituted with pine cones, sea shells, etc.

Script

Visualization

Place the flowers at eye level in front of you … Gently gaze at them without straining your eyes … Look softly at the shapes of the flowers, stems, and leaves … Become aware of their shapes and sizes. See their colors.

After you have spent a few minutes looking carefully at the flowers, close your eyes and visualize the flowers in your imagination. When the visualization becomes difficult, open up your eyes and look at the flowers once again. Close your eyes once more and recreate a vision of the flowers. Repetition will increase your ability to visualize images in the mind’s eye.

Touching and Feeling

Reach out and touch the flowers, stems, and leaves. Take your time to discover how the flowers feel … Explore the softness of the flowers and the feel of the stems and leaves. Discover their moistness, noticing the variety of textures.

Investigate the physical sensations of touching the bouquet of flowers. Run your fingers through the bouquet and listen to the sound of touching them … Allow the sense of touch to sink in through your fingertips and into your memory.

Stop touching the flowers and close your eyes. Experience the sense of touch through your memory … When the memory of touch begins to fade, reach out and touch the flowers with your fingers. And then imagine touching the flowers once again.

Smell

Bury your nose and take a full, deep breath. Let the flowers tickle your nose. Smell the fragrance and the freshness of the flowers. Enjoy.

Remember how the flowers smell and recreate the aroma in your imagination. Keep practicing until you are able to imagine the scent of the flowers from memory.

Thoughts and Feelings

Sit quietly and reflect upon the magnificence of the flowers. Open yourself up for new insights and realizations.

Integration

Relax, close your eyes, and imagine looking at a glorious bouquet of flowers … You may imagine any kind of flower you wish…roses … daisies … mums … baby’s breath … marigolds … bird of paradise … any type of flowers you wish.

See the radiant colors … the rich reds … luscious yellows … deep purples … pure whites … soft pinks … gorgeous oranges … all the shades of green.

Become aware of the textures … patterns … and shapes of the petals … Look at the leaves … and the stems … Observe the flowers in their various degrees of unfolding.

This time, imagine reaching out and touching the flowers … .Feel the softness … their moistness … the texture of the petals … leaves … and stems … Imagine rubbing the flowers with your fingers … Touch the flowers … Feel them.

Experience touching the flowers … Run your fingers through the flowers and listen to what you hear.

Now imagine the scents and fragrances of the flowers … Breathe in their perfume … Smell the aroma … Fill up your lungs with the fresh smell of the flowers.

Take some time to reflect on the diversity and beauty of the flowers that grow for our enjoyment … Think about the life cycle of the flower … Enjoy.

Pause

When you’re ready, open your eyes and stretch.

Repeat the above instruction until everyone is alert.

 

Sun Meditation for Healing (Download Sun Meditation for Healing exercise here)
By Judy Fulop and Julie T. Lusk
Excerpted from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1
By Julie T. Lusk.

Time: 10 minutes

In this script, participants experience the healing power and energy of the sun as they imagine it warming and relaxing them.

Script

Allow yourself to become as relaxed and comfortable as you can … Let your body feel supported by the ground underneath you.

Slowly begin to see or feel yourself lying in a grassy meadow with the sun shining it’s golden rays gently upon you … Let yourself soak in these warm rays … taking in the healing power and life giving energy of the sunshine.

This magnificent ball of light has been a sustaining source of energy for millions of years and will be an energy source for millions of years to come … This ancient sun is the same sun which shined down upon the dinosaurs … upon the Egyptians while they built the pyramids … and it now shines upon the earth and all the other planets in our solar system and will continue to do so forever.

As the sun’s rays gently touch your skin, allow the warmth and energy to flow slowly through your body … pulsing through your bones … sending healing light to your organs … flowing to your tissues … recharging every system … and now settling into your innermost being … your heart center.

Sense your heart center glowing with this radiant energy. If you wish, give it a color … Take a few moments to allow this warm and healing energy to reach your innermost being … physically… emotionally … mentally … and spiritually.

Pause for 30 seconds

As this healing energy grows and expands, allow yourself to see, feel, and sense this energy surrounding your being … growing and growing … Allow this energy to grow further and fill this room … this building … surrounding this town … spreading throughout our state … to our country … and out into the world … and finally throughout the universe … reaching and touching and blessing all.

Pause for 30 seconds

You may share this healing energy and power with anyone you’re aware of right now … Mentally ask them if they are willing to receive this healing energy … If they are … send this source of healing energy to them … giving them the time they need to take in this energy and make it theirs in their own heart center.

Pause for 30 seconds

Now take your attention back to your own heart center … Find a safe place within you to keep this healing and powerful energy … a place to keep it protected and within your reach … Give yourself permission to get in touch with this energy whenever you wish.

With the warmth of this energy in your being, begin stretching, wiggling, and moving … Slowly open your eyes, feeling alive, refreshed, keenly alert, and completely healthy.

Repeat the above instructions until everyone is alert.

Conflict Management Styles

What is My Conflict Management Style?

Excerpted from The Conflict Management Skills Workbook
By Ester R.A. Leutenberg and John Liptak, PhD

In many ways, conflict is a basic fact of life. We have all experienced conflict in our personal and professional lives. Because conflicts are disagreements resulting from people or groups having differences in attitudes, beliefs, values or needs, there will be times when conflict is inevitable. People experience differences in any relationship. That conflict exists is not a bad situation, as long as the conflict is managed effectively. Resolving conflicts can be beneficial and lead to growth and maturity. Outcomes of constructive conflict management will increase confidence in several aspects of life management:

  • awareness that problems exist and need to be solved
  • creative problem solving and decision making
  • sense of well-being
  • motivation and energy to take action
  • implications / attitudes / responses of empathy and caring
  • commitment to relationships
  • impact of respect, trust and commitment.

Any conflict has the potential to be incredibly destructive to a relationship. Managed in the wrong way, it can lead to extreme differences between people that can quickly spiral out of control. Each person will experience this Negotiations Model based on their point of view in a conflict as they use the following format to help them resolve their issues / problems:

Negotiations Model Conflict Management

The following are types of conflict management styles. Read the short description of each style and then journal about the following three questions for each one.

What I like about this style.

What I don’t like about this style.

When does this style work, or not work?

Compromising

People with a Compromising Conflict Management Style try to find a solution that will partially satisfy everyone. This is often called the middle-ground approach because participants are willing to negotiate and come up with a compromise in the situation in which both people feel satisfied. They may also be willing to sacrifice the compatibility of their relationship with others in order to reach an agreement. They give a little to get a little, and they believe that both sides should make concessions in order to reach a resolution. They have discovered that it is important to back off from some issues in order to gain on other issues.

Competing

People with a Competing Conflict Management Style attempt to achieve their goals at all costs and as quickly as they possibly can. They take a firm stand and know what they want. They usually insist that the other people let them have their way, regardless of how much it affects their relationships with others. They operate from a position of power and are usually more concerned with having their way than with the feelings of others. No matter what the cost, winning is the most important thing for them. The use of this style can leave people feeling unsatisfied and resentful.

Avoiding

People with an Avoiding Conflict Management Style usually are willing to give up their own goals to maintain relationships with other people. They would rather hide from and ignore conflict than resolve it. They may give up personal goals and display passive behavior creating a personal loss situation. To do so, they generally avoid conflicts within important relationships. They may avoid other conflicts by physically removing themselves from the environment or by not coming into contact with the others who represent the potential for conflict. They may avoid others psychologically by not speaking or by ignoring them and another conflict situation, and subsequently, the conflict often goes unresolved.

Giving-In

People with a Giving-In Conflict Management Style usually give up their personal and professional goals so that other people can achieve their goals. They usually value their relationships with others so much that they attempt to smooth over the situation and give them their way. For them, the goal is often of no importance but the relationship with the others is of high importance. By giving in, they avoid the risk of a confrontation so they can continue to get along with the other people.

Collaborating

People with a Collaborating Conflict Management Style tend to want to meet the needs of all people involved in the conflict. They can be highly assertive, but are more than willing to cooperate effectively and acknowledge the importance of everyone involved. They are interested in bringing together a variety of viewpoints to get the best possible solution for everyone. They want all sides to be satisfied. They support open discussions, brainstorming and creative problem solving to come to a consensus.

Please enjoy these three conflict management worksheets and exercises:

Conflict Management Quotations
Conflict Management Process Steps
Causes of Conflict

National Nutrition Month – Seven Steps and Downloadable Worksheets

March is National Nutrition Month

Healthy Food National Nutrition MonthIn that spirit we hope the following article, along with the available downloadable worksheets, will help you reach out to your clients struggling with this issue. Much of the information is excerpted from the Nutrition chapter in Physical Well-Being Workbook by John Liptak, PhD, and Ester R.A. Leutenberg.

In today’s world one would think that with information provided by schools, health care professionals, and social media everyone would be aware of what to eat and what not to eat: The basics of good nutrition. Not so. The U.S. Department of Health and Human services offers the following information about the nutritional status of our citizens.

(Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html on March 7, 2018).

  • Typical American diets exceed the recommended intake levels or limits in four categories: calories from solid fats and added sugars; refined grains; sodium; and saturated fat.
  • Americans eat less than the recommended amounts of vegetables, fruits, whole-grains, dairy products, and oils.
  • About 90% of Americans eat more sodium than is recommended for a healthy diet.
  • Reducing the sodium Americans eat by 1,200mg per day on could save up to $20 billion a year in medical costs.
  • Food available for consumption increased in all major food categories from 1970 to 2008. Average daily calories per person in the marketplace increased approximately 600 calories.
  • Since the 1970s, the number of fast food restaurants has more than doubled.
  • More than 23 million Americans, including 6.5 million children, live in food deserts – areas that are more than a mile away from a supermarket.
  • In 2008, an estimated 49.1 million people, including 16.7 million children, experienced food insecurity (limited availability to safe and nutritionally adequate foods) multiple times throughout the year.
  • In 2013, residents of the following states were most likely to report eating at least five servings of vegetables four or more days per week: Vermont (68.7%), Montana (63.0%) and Washington (61.8%). The least likely were Oklahoma (52.3%), Louisiana (53.3%) and Missouri (53.8%). The national average for regular produce consumption is 57.7%.
  • Empty calories from added sugars and solid fats contribute to 40% of total daily calories for 2–18 year olds and half of these empty calories come from six sources: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.
  • US adults consume an average of 3,400 mg/day [of sodium], well above the current federal guideline of less than 2,300 mg daily.
  • Food safety awareness goes hand-in-hand with nutrition education. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year.
  • US per capita consumption of total fat increased from approximately 57 pounds in 1980 to 78 pounds in 2009 with the highest consumption being 85 pounds in 2005.
  • The US percentage of food-insecure households, those with limited or uncertain ability to acquire acceptable foods in socially acceptable ways, rose from 11% to 15% between 2005 and 2009.

National Nutrition Month – Seven Steps and Downloadable Worksheets

In their book the Physical Well-Being Workbook Ester Leutenberg and John Liptak, PhD, offer a seven step plan to foster better nutrition among our clients. Downloadable worksheets for each step are available by clicking here.

The first step is to assess the level of the client’s knowledge about nutrition and what habits they have – good or bad – that can be identified. A downloadable assessment tool is attached to this article that asks questions such as do you start your day with a good breakfast? Do you make good low-fat food choices? What kind of snacks do you eat? Do you plan your meals ahead or wing it? How much salt do you consume? Do you limit the amount of sugar consumed each day? The tool is quite comprehensive and can be scored by the client. A range of scores and what they might mean is included.

The next suggestion is to develop a group of people who will support the client upon his or her journey. Not all friends will do so. We all know folks who say things such as oh come on, one more bite or beer or piece of pizza or chocolate or cookie or cake or whatever won’t hurt. It’s just one more. Finding people who are supportive is one of the most important steps. Just as AA provides sponsors for recovering alcoholics, those recovering from bad nutritional habits need someone to call when their resistance is low, when the call of that chocolate cake becomes too much to withstand.

Step number three is to begin a nutritional journal. Questions such as the following, among others, can be pondered and answered by the client:

  • How can I improve my all over plan?
  • How can I plan better meals?
  • How can I choose healthier but satisfying snacks?

Next the client is asked to set goals for themselves. Using the SMART acronym (specific, measureable, attainable, realistic, and time-specific) goals are selected. How will the goal be measured, how attainable and/or realistic is it, within what deadline will it be accomplished, and how will this help are entered in a chart that can be posted in a handy place to remind the client of where they are going. There is a tip chart supplied for those who are having trouble identifying their goals.

In step five the client is guided through the process of monitoring their success. Both by charting and journaling the client explores what they are doing, what they accomplished, and how they felt when they accomplished a goal. Reminding ourselves of what we’ve done right and how that made us feel is important to being willing to take the next step. When we are dying for a taste of a Mimosa for breakfast on a Sunday morning we need to remember how it felt last week when we didn’t have one but ate a fresh orange instead. A ripe, tasty orange, fresh and full of juice, can be satisfying. Remind your clients to record the tactile sense of what they are doing as they accomplish their goal. How did the orange smell, look, and feel in their hand as they peeled it? Did they see the squirts of juice reflected in the sunshine coming in the window? Did they get sticky from the juice? Was is sweet or sour?

When having difficulty sticking to the next goal, advise the client to re-read their journal and/or behavioral change chart. Suggest that they sit quietly and remember the sensations they recorded and experience them again. It will give them the strength to step up to the plate again.

Rewarding oneself is next. What kind of rewards will work the best for the individual client? Ask them to brainstorm what they would find fun yet still within the pursuit of better nutrition. Perhaps tickets to the local pro team might not be a good choice if the client has indicated that part of going to a game is to pig out on hot dogs and beer. The same would hold true for a trip to the symphony concert if it includes cocktails and dessert following the concert.

What small rewards would work? Large rewards? Things they can do alone and still be fun? Things they can do with others who are also seeking to improve their nutrition. Remind them that affordability is important.

Self-affirmations are also good rewards. A list is given of possible phrases such as I shopped today for the whole week, or I drank more water today. The client is asked to write them down on sticky notes and paste them where they will frequently be seen.

The final step gives tips for motivating behavior modification as the client seeks to improve their nutritional planning habits. Many of these seem quite simplistic, but not many of us observe them all, all of the time. Here’s a sample list:

  • Read food labels
  • Rely on your social network created in step two.
  • Wash your hands before and after handling food.
  • Keep your fridge clean, store food in the wrappers in came in or other suitable containers.
  • Use paper towels to dry food off and throw them away afterwards.
  • Don’t leave food sitting out. Put it in the fridge.
  • Pack a good lunch that you like to avoid the pitfalls of fast food.
  • Plan, plan, plan!
  • Avoid too much salt.
  • Avoid too much fat, saturated fat, and cholesterol.
  • Drink plenty of water.
  • Eat low fat evening snacks such as popcorn, yogurt, fresh fruit
  • Plan a balanced diet
  • If you drink alcohol, do so in moderation.
  • Use the internet to find reliable and complete food information.

If your clients follow these seven steps (download worksheets here) they will find the path to better nutrition. Here is another great source for good nutritional information: https://www.hhs.gov/fitness/eat-healthy/how-to-eat-healthy/index.html.

Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice

Relational-Cultural Theory Series Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy

Combining the Neurobiology of Relational-Cultural Theory and Clinical Practice

By ELIZABETH (LIBBY) MARLATT-MURDOCH, LPCA, LCAS-A, CTRTC, CCTP

Since learning about Relational-Cultural theory (RCT) and relational neuroscience, they have become key components of my approach to mental health and substance abuse treatment with my clients. Using relational neuroscience in my work has been a particularly useful tool for depathologizing clients’ experiences and helping them to understand that we are hard-wired for connection with others. Elizabeth (Libby) Marlatt-Murdoch may be contacted at libbymarlatt@yahoo.com.

Your brain is shaped by your mind—including your conscious and unconscious experiences, your body, the natural world, human culture, and relationships (Hanson & Mendius, 2009). Relational- Cultural theory (RCT) is a psychological theory that acknowledges the radical power of relationship. RCT posits that throughout the lifespan, individuals grow through and toward relationship, and that culture has a profound impact on these relationships (Jordan, 2010). Relational neuroscience provides evidence that the brain is designed for connection and that without connection we cannot thrive (Banks, 2015). The neuroscience of Relational-Cultural theory offers a window into the mind and calls attention to the need to address not only an individual’s relationships in therapy, but also the social context in which they exist (Banks, 2015). Based on experience as a clinician, Relational-Cultural theory and relational neuroscience can positively impact individual outcomes in healthcare and psychotherapy as well as improve relationships and quality of life by providing a way to depathologize individual’s experiences. Sharing an understanding of relational neuroscience as it relates to RCT can be essential in promoting mutuality and growth in relationships in many areas. Multidimensional models for psychoeducation can provide key elements in accomplishing this.

Considerations and Connections

Sharing information on relational neuroscience with others can be powerful. Education is one way to begin this process. More specifically, psychoeducation, which is defined as information that is presented to individuals with a mental health condition and their families to help empower them to manage their condition in an optimal way (Bauml, 2006). So providing psychoeducation to clients about how the brain is hardwired for connection, and cannot thrive without healthy mutual connections, empowers individuals to push back against the hyper-individualistic social pressures that can undermine their health and well-being (Banks, 2015). In treatment, this knowledge can inform the process between client and clinician as they collaborate to come up with a plan to assess and improve the individual’s relational skills and to discover how previous relationships have impacted the client’s welfare. Outside of treatment, this same information may encourage individuals to evaluate their current relationships for mutuality, and provide the catalyst they need to seek more mutual relationships in an effort to improve their quality of life. The feelings of empowerment that come from this psychoeducation process can cultivate hope.

Relational neuroscience also has the power to depathologize an individual’s experience for them. In a culture that sees development as a means to independence and ignores the devastating impacts of social pain, having knowledge to educate individuals about connection as a basic need can normalize an individual’s experience of pain as it relates to social exclusion can be powerful (Banks, 2015). At the 2016 Transforming Community conference, Banks and Craddock presented their STOP SPOT model for empowering individuals to identify and address the pain of social exclusion. Social Pain Overlap Theory (SPOT) proposes that social pain which is the result of damaged or lost relationships, and physical pain which is the result of physical injury are experienced in the same part of the brain (Eisenberger & Lieberman, 2005). In the STOP SPOT model that Banks and Craddock presented at the conference, an individual must first See Stratification, then Talk and Tell their individual story related to the stratification or exclusion. The next steps they proposed are Open Outreach and finally Partnered Protest and Production.

Based on clinical experience, the ability to teach someone that his or her brain is working and responding in the way that it was designed to often results in the client or individual feeling validated. Instead of experiencing the shame or embarrassment of feeling like they are broken or their brain is broken; the client experiences a sense of safety and compassion from the therapist. This safety and compassion are necessary for the client to heal from the damage that may have resulted from relationships that are not mutual, are chronically disconnected, or in other ways are experienced as traumatic. Relational neuroscience empowers individuals by depathologizing her/his experience. This often results in increased self-compassion.

According to Walker at the Transforming Community conference, compassion is bearing witness without judgment. She also described in her ARC3 Model of Empathy that Awareness, Receptiveness, Curiosity and Courage, plus Compassion are all necessary ingredients for empathy. According to her model, Awareness is being mindful of “what is”; Receptiveness is being open to innovative and possibly conflicting knowledge; Curiosity and Courage are about embracing constructive ambiguity, vulnerability, and limitations. Relational neuroscience has the potential to depathologize a persons’ sense of self leading to less shame, which in turn opens that person up for more vulnerable relational skills of compassion and empathy. In the words of Alamaas (2016) “it is only when compassion is present that people will allow themselves to see the truth” (para. 1). The feelings of empathy and compassion that are created through the psychoeducation process can be essential for clients in working through difficult experiences and for cultivating healing and hope.

Understanding of Neuroscience in RCT

To understand the neurobiological roots of interdependence we must start with understanding the brain. The reptilian brain, also known as the brain stem, is designed for regulation of the most basic functions such as heart rate and respiration, and is also involved in rapid mobilization of the brain and body for survival (Hanson & Mendius, 2009; Siegel, 2010). The paleo-mammalian brain, also known as the limbic system, works closely with the reptilian brain stem and is designed for creating our basic drives, emotions, memory, and is essential in establishing relationships and forming emotional attachments to others (Hanson & Mendius, 2009; Siegel, 2010). And finally, the neo-mammalian brain, also known as the cortex, “represents the three-dimensional world beyond the bodily functions and survival reactions mediated by the lower, subcortical regions,” is involved in creating ideas and concepts (Siegel, 2010, p. 19). According to Banks and Craddock (2016) “being a part of a group is so critical to humans that our nervous system literally uses the same alarm (the dorsal anterior cingulate cortex) to register the distress of physical pain or injury AND social exclusion” (para. 3).

Additional evidence for this concept is provided in studies that show the link between connection and survival. Research has shown that the human brain responds in a similar way to both food and connection, that the brains of neglected orphans from World War II did not have enough neural activity to support life, and that relational trauma impacts our mental and physical health and well-being long term (Bowlby, 1969; Center for Disease Control and Prevention, 2016; Hanson & Mendius, 2009). By looking at the different levels of the brain, we can begin to gather insight into how the basic need for survival led to the development of connection as a basic need in mammals.

Relational neuroscience has the power to shed even more light on love and belonging as a basic need. In fact, the research has shown that “lasting strength comes from being centered, and held within healthy relationships” (Banks & Craddock, 2016, para. 21). Banks’ (2015) C.A.R.E. program was designed to illustrate how individuals can strengthen the neural pathways in their brains to encourage closeness and connection. In Bank’s C.A.R.E. acronym, each letter represents a quality of a healthy relationship dictated by the functioning of one of four neural pathways of connection. In this model, she describes C is for Calm which represents the feeling that you get when you have a well-toned smart vagus nerve. She also explains that when we encounter potential danger, or when we are feeling stressed, the subcortical regions (primitive brain) becomes active and helps prepare the person to deal with the threat.

According to Banks (2015), this primitive brain often makes decisions that negatively impact our relationships. She indicates having robust relationships helps to keep a person’s smart vagus nerve well-toned, which in turn makes our relationships calmer. She describes how having a well-toned vagus nerve will allow us to mediate the primitive brain’s response and prevent it from taking over; and, as a result, we are healthier and have greater mental clarity. In the C.A.R.E. model, Banks (2015) describes A is for Accepted, and represents the sense of belonging that comes when your dorsal anterior cingulate cortex (dACC) is functioning properly. This part of the brain is described by Eisenberger & Lieberman (2005) in their ground breaking work, Social Pain Overlap Theory (SPOT). Banks (2015) explains the dACC acts as an alarm for social exclusion; being chronically excluded or isolated can result in an over-reactive dACC, which means the alarm can go off even when others are welcoming. She describes R as Resonance you feel in healthy relationships, which is facilitated by the action of the mirror neuron system. She further states that when an individual’s mirroring system is healthy the individual is able to understand other’s experiences, actions and feelings by creating an internal neurological template of the same experience, action or feeling (ex. noticing you are crying while watching a movie where the characters are sad and crying). She clarifies that if the mirroring system is unhealthy, it results in the individual having difficulty understanding others and can cause difficulty for others in understanding the experience of the individual. She describes E as Energy which represents the feeling of euphoria and zest we get in healthy relationships if our brain’s dopamine reward system remains closely attached to connection. She further relates the purpose of the dopamine system is to reward the brain and body for activities that promote survival—including approach behaviors, such as mating.

Unfortunately, when individuals do not get enough dopamine from healthy relationships, they may turn to unhealthy alternatives or addictive behaviors such as using drugs, gambling, or compulsive shopping (Banks, 2015). In this case the individual is rewiring their dopamine pathway away from connection and relationships, so that even when they are in relatively healthy relationships they may not derive energy and motivation from them (Banks, 2015). In summary, the C.A.R.E. acronym combined with describing how the qualities of a healthy relationship reflect the functioning of the four pathways for connection provides a solid, basic understanding of relational neuroscience.

Models

Banks (2015) cautions that concepts of neuroscience often appear more clear than they actually are.  We must always respect the complexity of the central nervous system and what we have yet to discover. When starting the process of psychoeducation as it relates to the brain, it can be helpful to begin with some basic information about the brain. For example, the brain weighs approximately three pounds and is comprised of 100 billion neurons (Hanson & Mendius, 2009). Neurons connect via synapses and get their signals from other neurons through these receiving synapses and the signal is usually a burst of chemicals called neurotransmitters (Hanson & Mendius, 2009). Neural signals represent a piece of information according to Hanson & Mendius (2009), and the mind can be defined in a broad sense as the totality of those pieces of information. It is important to recognize that no single area of the brain is exclusively responsible for regulating relationship, which means creating healthy relationships is an easier task if your central nervous system is integrated, balanced, and flexible (Banks, 2015). Every interaction an individual has with the world changes the brain in some way, and individuals are capable of neurogenesis (creating new connections in the brain) as well as neuroplasticity (altering existing connections in the brain throughout their lives) (Banks, 2015; Siegel, 2010).

Visual aids for use in psychoeducation, such as Siegel’s hand brain (2012) or van Eys’ felt brain (personal communication, July 7, 2016), allow individuals to see how the brain works so they can change what the brain does. Siegel’s hand brain (2012) provides a portable and accessible brain model for neurologists and clients alike. His model is quite simple to create: take your thumb and fold it in towards your palm, then put your fingers over the top. He describes how the wrist represents the spinal cord, the palm represents the brain stem, the thumb folded inward onto the palm represents the limbic system, and the fingers covering the thumb represent the cortex.

To understand how the brain works, it is helpful to differentiate between parts of the brain that we have conscious control of from those we do not. In Siegel’s hand brain model (2012), if you raise your four fingers then you separate these two areas. He describes the four raised fingers as representing the cortex which is the part you have conscious control over. He elaborates that the thumb folded over the palm represents the subcortical regions that are beyond our direct conscious control. The importance of this distinction can be further emphasized by pointing out that the fear activation response takes 50 milliseconds, which is about 1/20 of a second, whereas conscious thought takes 500-600 milliseconds, or half a second (Cozolino, 2010).

Using Siegel’s hand brain model (2012), you can get a visual understanding of the first component of the C.A.R.E. program—Calm. He illustrates the process of “flipping our lids” by unfolding the fingers that were covering the thumb and palm to expose the rest of the hand which represents the limbic system and brain stem. When a person is triggered, the individual’s primitive brain is responding without the protective inhibition of the cortex—the logical/rational part of the brain (Banks, 2015). When this happens, Banks (2015) indicates the individual’s brain is not experiencing the feeling of calm that results when the individual can use their well-toned smart vagus nerve to mediate the response of the primitive brain. The Siegel hand brain model (2012) can be taken one step further by showing clients the location of the vagus nerve which runs between the right hemisphere (right two fingers) and left hemisphere (left two fingers) of the brain down through the limbic system and (via the parasympathetic nerve) into the brain stem and the rest of the body. Providing a visual representation of the location of the vagus nerve can increase understanding for the client about the role a well-toned smart vagus nerve has in calming both the brain and the body. In simple terms, when an individual has good smart vagal tone, they are able to accurately read a situation or person as safe and respond with engagement behaviors that result in enhanced connections and mutuality in relationships (Banks, 2015).

The second component of Banks’ C.A.R.E. program (2015), Accepted, involves the dorsal anterior cingulate cortex which is located deep in the frontal cortex, and can be illustrated using the hand brain model by showing the underside of the two middle fingers (Siegel, 2012). In Siegel’s hand brain model (2012), the two middle fingers represent the middle prefrontal cortex, which includes the dACC. It is important to emphasize that the dACC is part of an alarm system that responds to physical pain and injury as well as social exclusion, both of which are dangerous if left unaddressed (Banks, 2015). Both individual relationships and culture can impact our dACC explains Banks (2015). Developmental models that focus on independence and promote interpersonal competition often stratify and judge human differences creating an over reactive dACC, and consequently reactive pain pathways (Banks, 2015; Banks & Craddock, 2015).

The third component of Banks’ C.A.R.E. program (2015), Resonance, reflects the functioning of the mirror neuron system which is located in the parietal, frontal, and temporal lobes. In Siegel’s hand brain model (2012), the four fingers represent the cortical areas of the frontal and parietal lobes while the thumb represents the temporal lobe where the amygdala is located. It can be helpful to explain that the area of the cortex (four fingers) that is activated depends on the particular behavior or feeling that is being mirrored (Banks, 2015). In the hand brain model, Siegel (2012) indicates that the fingers overlap the thumb and palm illustrating how mirrored messages are created in the cortical areas and then transferred downward into the limbic system, then into the brain stem, and on into the body. He clarifies that these messages are transferred via the insula, also known as the “information superhighway” between the mirror neurons areas and the subcortical regions of the brain. The existence of the mirror neuron system is further evidence that we are biologically hardwired and evolutionarily designed to be interconnected (Banks, 2015). In fact, individuals understand what others are thinking and feeling by imitating them internally (Banks, 2015).

The final component of Banks’ C.A.R.E. program (2015), Energy, involves the social motivation system/dopamine reward system. This is located in the mesolimbic dopamine pathway, which travels from the brainstem through the limbic system, into the anterior cingulate gyrus and orbitomedial prefrontal cortex (Banks, 2015). This pathway can be identified on Siegel’s hand brain model (2012) by placing the pointer finger of your free hand on the palm of the hand brain model, moving it up to and through the thumb and ending at the fingers that represent the cortex.

Figure 1: Van Eys’ Felt Brain or Brain Puzzle

Another model or visual aid for making Relational Neuroscience accessible to clinicians and clients is the van Eys’ felt brain (personal communication, July 7, 2016), also referred to as the Brain Puzzle (see Figure 1). She indicated that this model was designed to create a basic understanding of the brain and its functions and to illustrate and facilitate an understanding of the body’s alarm system response. She described the felt brain as made of several pieces of felt: a large blue piece of felt shaped like the cortex labeled “thinking brain”; a pink piece of felt shaped like the brain stem added to the bottom right of the cortex; pieces of green felt and orange felt labeled “feeling brain” and representing the limbic system placed directly under the cortex and in front of the brain stem; a light orange almond shaped piece of felt represents the amygdala which together with the limbic system and brain stem is labeled “reacting brain”. She indicated that a felt star is used as a visual representation of a trigger and is placed over the top of the amygdala. She further explained that after the star has been placed over the amygdala a black piece of felt shaped like the cortex is placed over the top of the cortex to represent the idea that the cortex is not online during an amygdala highjack. This model, much like Siegel’s hand brain (2012), can be used to communicate a wealth of information about neuroscience, including RCT’s relational neuroscience. The felt brain model can be used to communicate the elements of the C.A.R.E. program in much the same way that the hand brain model was adapted.

Both of these models can be used in an interactive way. Clinicians can ask their clients to mirror the movements of the hand brain and/or work with their client to assemble the Brain puzzle. The felt brain model described by van Eys (personal communication, July 7, 2016) was created by van Eys and Tisthammer in 2015 and also includes a script containing informal language interspersed with scientific terms that makes the script easy to read and easy to follow. Their script even includes opportunities for discussion, encourages the user to change it in any way that makes sense for the audience, and even explains an amygdala highjack—which is the same principle discussed in the first component of Banks’ C.A.R.E. program (2015), Calm. This script by Van Eys and Tisthammer (personal communication, July 7, 2016) states in part:

Now, the limbic system cannot think…it can only feel and react. Only the blue part, the thinking brain, can think. Sometimes, the limbic system gets a danger signal and it gets afraid. It feels and reacts. So the brain’s alarm goes off because the reacting brain recognizes danger. So, let’s put this red star on the amygdala to show that the brain got that kind of danger signal. Let’s call this the “amygdala alarm.”

When the alarm goes off, the brain sends out chemicals that give our body energy to cope with danger (or “to handle the danger in order to get safe”). Our hearts beat faster, we breathe more rapidly, there is more energy sent to our muscles so that we can fight or run away from the danger. Or sometimes, we freeze or hide so that the danger won’t come to us.

Here’s an important thing: only the parts of our brain that help us survive are working when the amygdala alarm goes off. The other parts of the brain shut off until we have learned that we are safe; we will talk later about how we can recognize “triggers” so that we can quickly know that we are safe and turn the alarm off. The thinking part of the brain isn’t working because it isn’t needed at this time. (p. 7-8) There are a number of things that may be taken from these two multidimensional models that can make relational neuroscience more accessible to practitioners.

  • First, simplify the concepts of neuroscience appropriately in order to more effectively educate others.
  • Second, build a foundation for understanding by introducing the intended audience to fundamental facts about the brain by using basic language to convey the message.
  • Third, think outside the box and adapt existing visual aids or models to work for a new objective—in much the same way that the hand brain and felt brain models have been adapted to provide psychoeducation on relational neuroscience.
  • Fourth, promote understanding by asking open-ended questions, gathering feedback, and experimenting with interactive methods instead of just using the model as a visual aid.
  • Finally, use caution in deciding when it is appropriate to use relational neuroscience with clients or other individuals; this comes from experience and the ability to be attuned to those we serve.

Transforming Community Relational Cultural TheoryThe importance of sharing relational neuroscience with our clients has been supported by a number of considerations based on the tenets of Relational-Cultural theory. Psychoeducation on relational neuroscience has the ability to empower the individual to make changes in addition to depathologizing and validating the individual’s experience. This can often result in increased levels of compassion and empathy necessary to be with the pain that can result from relational trauma, loss, exclusion and/or isolation. Learning and sharing relational neuroscience represents a practical opportunity to enhance well-being, develop compassion, and reduce suffering through cultivating healing and hope.

 

References

Alamaas, A. H. (2016) Compassion leads to the truth. Retrieved from: http://www.ahalmaas.com/glossary/compassion

Banks, A. (2015). Wired to connect: The surprising link between brain science and strong, healthy relationships. New York: Penguin.

Banks, A., & Craddock, K. (2016). Stopping the pain of social exclusion. Retrieved from: https://www.wcwonline.org/News-Events-Extra-Information/full-article-stopping-%09the-pain-of-social-exclusion-full-blog-article

Bauml, J. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, (32)1.

Bowlby, J. (1969). Attachment and loss (Vol. 1). New York: Basic Books.

Center for Disease Control and Prevention. (2016). About adverse childhood experiences. Retrieved from: https://www.cdc.gov/violenceprevention/acestudy/about_ace.html

Cozolino, L. (2010). The neuroscience of psychotherapy: Healing the social brain (2nd ed.). New York: W.W. Norton & Co.

Eisenberger, N.I. & Lieberman, M.D. (2005). Why it hurts to be left out: The neurocognitive overlap between physical and social pain. In K. D. Williams, J. P. Forgas, & W. von Hippel (Eds.), The social outcast: Ostracism, social exclusion, rejection, and bullying (pp. 109-127). New York: Cambridge University Press.

Hanson, R., & Mendius, R. (2009). Buddha’s brain: The practical neuroscience of happiness, love & wisdom. Oakland, CA: New Harbinger Publications.

Jordan, J. V. (2010). Relational cultural therapy (1st ed.). Washington, DC: American Psychological Association.

Siegel, D. (2012). Dr. Daniel Siegel presenting a Hand Model of the Brain. Retrieved from https://www.youtube.com/watch?v=gm9CIJ74Oxw

Siegel, D. J. (2010). Mindsight: The new science of personal transformation. New York: Bantam Books.

Unmet Needs of the Troubled Child

Unmet Needs of the Troubled Child

What Do You Do With A Child Like This?Excerpted from What Do You Do with a Child Like This? Inside the Lives of Troubled Children, by L. Tobin

It is not difficult to determine a troubled child’s primary unmet needs. An unmet need is made obvious by the child’s inability (1) to delay meeting that need; (2) to express that need; or (3) to elicit a healthy response from others to that need.

If a child cannot wait to have a need satisfied, you will probably spend a lot of time fighting it: trying to keep the child from talking, touching, or eating.

If a child feels a need but is unable to express it, the absence of this natural response will become conspicuous. You may notice that he has no friends, doesn’t like to play, or is afraid to laugh.

If a child no longer believes that others will fulfill his needs, you may be confused by the contradictory nature of what the child elicits from you and others. For example, unable to make friends, the child appears intent upon making enemies; or unable to experience structure and consistency in his life, he sets out to create hourly chaos.

Troubled children are distinguished most clearly by the frustrated expression of needs. They actively elicit the opposite of what they really need.

To identify a child’s unmet needs, ask yourself: “what makes this child different? What does he spend his time doing or avoiding? What self-defeating response does he elicit that appears to be the opposite of what he really needs?”

The Need for Acknowledgement

Troubled child looking out a windowI raise my hand each morning and tell you that I am “present,” but no one ever talks to me. I walk to school alone. No one asks me how I feel, wishes me a good day at school, or even acknowledges that I am awake. Until someone stops long enough to look into my eyes, touch me, awaken my spirit, welcome me into the world, let me know that I matter—until then, how can I be sure that I am really “present?”

—Kayla

  • The child who cannot wait for acknowledgment may pester for attention.
  • If she cannot express the need for acknowledgment, she may appear lonely, lost in the crowd.
  • If she no longer believes she can get acknowledgment, she may withdraw or rebel.

Being acknowledged by someone, welcomed into the world each morning, is as important to a child as a good breakfast. Acknowledgment “breaks the fast” of a lonely night, providing essential nutrients for the spirit.

  • Who could the child check in with each morning before class? A favorite teacher, principal, janitor?
  • What morning responsibility would give importance to his presence? What first-hour activity could put him in contact with at least one other student—get him involved?

The Need for Communication

Mom and Dad fight a lot. Sometimes they hit each other. That’s what I wake up to most days. I get in fights on the bus. The kids pick on me and I have to fight back. That’s what my life is like before I come to class. Some days it’s worse. You tell me to talk to you about things. Well, every morning is a story—a story I have to tell someone before I can try to get on with my day.

—Elena

  • The child who needs to tell her story, may annoy you by not being quiet.
  • If she doesn’t talk about her troubles, she will worry about them and be distracted.
  • If she believes no one cares about her problems, she may be troublesome, constantly acting out.

Children with home problems come to school emotionally loaded. The earlier you deal with it the better.

  • What short morning class routine could free you to speak with the child, if only for a short time?
  • Could the student write in a journal on difficult days? You could respond in writing later.
  • Could you provide peer counselors or arrange time with a close friend?

The Need for Socialization

I live with my grandparents. There are no other children to play with. Weekends are so boring. School is the only chance I get to be with other kids. I’m not very good at making friends—I haven’t done it much; but it is exciting to be with everyone. I want to learn to play and talk to other kids. These are the kids I’m going to spend the rest of my life with. I wonder if they’ll like me?

—Kyle

  • The child who has an unmet need for socialization may talk constantly.
  • If he hides his longing for friends, he may be isolated, a loner.
  • If he is frustrated by his inability to make friends, he may be aggressive and set out to make enemies.

Boys relational cultural theoryUltimately the child’s personal and job success as an adult will be determined more by an ability to get along with others, than by specific skills.

  • Which children have few opportunities to be with other children outside of school?
  • Which first-hour activities could be done in pairs or small groups—even if only for selected students?
  • Which kids have the most to learn from each other, and how can you facilitate this connection?

The Need for Humor

Dad doesn’t laugh much since Mom left last year. He comes home from work with a lot on his mind. He gets upset when I giggle, so I try not to get silly anymore. Friends don’t come over these days. Our home is not much fun anymore. So when I go to school I sometimes try to make people laugh. I go to school earlier and earlier these days. Does life really have to be this serious all the time?

—Roderigo

  • The child who needs laughter in his life, may become the class clown.
  • If he hides his need for humor and fun, he may become overly serious, the “adult” child.
  • If he believes he will never find joy and laughter in life, he may appear cynical, morose, or even sadistic.

Humor heals.

  • There is healing power in laughter. Could you laugh at yourself more often, more heartily? Could you model the human comedy of errors and self-forgiveness?
  • Are there situations that could be lightened with a joke or a story? How will you do it?

Children running and playing

The Need for Physical Activity

My brother and I live in the city in a small apartment. He’s in third grade and likes school. He wakes up at 5:30 each morning, runs around the house and drives us all crazy. I get up at the last moment and drag myself to school. My mind tries to work but my body wants to be in bed. His body wants to work. We’re very different, but we’re both in trouble with teachers before 9:00.

—Jared

  • The child who needs physical activity may appear sleepy or overactive.
  • If he avoids activity, he may appear listless, unenthusiastic.
  • If the need for activity is frustrated, he may appear resistant and unwilling to undertake activities.

All vertebrates stretch to begin the day. Tension flows out of active muscles. All bodies need activity and oxygen to stay awake, and, with kids, all you need to do is provide the occasion.

  • Could you begin the day with a stretching routine? And repeat it throughout the day?
  • Could you begin some activities with a series of deep breaths?
  • You move about the room as you supervise students. Students also need to move frequently. Could you accommodate that need by scheduling short breaks?

The Need for Structure

My world changes every day. I never know who will be at my house in the morning. Sometimes Mom wakes me up; other times I have to get up by myself. I never know if there will be food for breakfast. Sometimes my sister shares my room; some nights I live with my Dad. I never really know what I will come home to at night, or where we might be next month.

—Juanita

  • The child who is trying to create structure in her life may constantly ask, “What do we do next?”
  • If her need for consistency is hidden, she may be resistant to any change in routine.
  • If she has given up on trying to discover order in her life, she may be chronically unprepared and appear to thrive on chaos.

Child learning in classFor many children, school is the one constant in their life, the one structure they can depend upon. You may notice that even those who hate school and everything about it are seldom absent.

  • Post and review the schedule every day, noting even insignificant changes.
  • Which children need to be informed individually of any changes in the structure of the day?
  • Which routines should be followed consistently, every day?

The Need for Relaxation

My family argues. Each morning my older sisters fight over the bathroom. Mom doesn’t like mornings so she yells at all of us. Dad yells at Mom. The radio in the kitchen drowns out the television in the next room. I walk to school with my Walkman blaring so I don’t hear the traffic and sirens in our neighborhood. I come to school already stressed out.

—Philip

  • The child who needs to relax, may appear reclusive, withdrawn, or exhausted.
  • If he doesn’t know how to relax, he may remain agitated, nervous, and “wired.”
  • If he is under severe stress and is frustrated in his efforts to deal with it, he may appear oppositional and despondent.

Relaxation is a direct route to enhanced learning, creative problem solving, anger management, stress management, and general health. It is what we placed kids in “time-out” to acquire. We know now that relaxation must be taught. Books, CDs, and MP3s are available to help us teach relaxation skills.

  • How could you include relaxation instruction in your classroom? Deep breathing before a test? Neck and shoulder stretch during a test? A relaxation CD or MP3 to bring them back to a peaceful world?

The Need for Encouragement

Since first grade I have hated school. I don’t read well and I’m not very good at math. I make a lot of mistakes. My parents say I’m lazy—that I never try to do my best. I used to try. Now I just do everything I can to avoid work. I don’t want anyone to see how stupid I am, so I never turn in my assignments. I know I would just fail anyway. I don’t know why they make dumb people like me go to school anyway.

—Kara

  • The child who needs encouragement may seek constant reassurance.
  • If she is afraid of failure, she may say, “I can’t,” and avoid trying.
  • If she becomes discouraged by failure, she will say, “I won’t,” and refuse to try.

Find the occasion to answer these questions for each child.

  • What is it you like about me?
  • How am I unique?
  • What do I do well?
  • How can I affect my world?

All students come to school with unmet needs. Most have the ability to delay these needs. Troubled children focus on nothing else until these needs are met. Meet the needs early or consume your time fighting them. The choice is yours, not theirs.

Transforming Community Through Disruptive Empathy

As part of our ongoing series on Relational-Cultural Theory, we present Maureen Walker’s keynote address from the conference referenced below. Dr. Walker gives an excellent history of the RCT movement and her vision of the future guided by its principals.

Read the first part of the series, What is Relational-Cultural Theory? here.

Transforming Community Through Disruptive Empathy

Keynote Address, June 9, 2016
Transforming Community: The Radical Reality of Relationship Conference

By: Maureen Walker, PhD

As the Director of Program Development at the Jean Baker Miller Training Institute of the Stone Center at Wellesley College, Dr. Maureen Walker explores the linkages between social-cultural identities and relational development, as well as the impact of power arrangements on mental health. Through her publications and her work as an educator and licensed psychologist, she often uses Relational-Cultural theory as the lens to illustrate the interface between spiritual practice and social justice. In addition to journal articles and several papers in the Stone Center Works in Progress Series, she is the co-editor of two books which convey her strong interest in disruptive empathy as an essential practice for all who are engaged in the work of transforming community. Dr. Maureen Walker can be contacted at maureen@maureenwalker.com.

Here we are at a Kairos moment. We have the gift of this time to contemplate, collaborate, and challenge each other as we engage a very special project: transforming community. When we talk about community, we often do so in ways that take for granted a level of shared assumptions and expectations. We come with our shared assumptions, hopes, and expectations, but we each come with our particular claims on community: claims that may be at once aspirational, insistent, and conflictual. The radical reality of our relationships is that we ourselves are in the throes of transformation. And who are we?

Four decades ago, our “we” was self-described as “five, white, well-educated women” who found a community of place at Wellesley College, specifically the Stone Center. Who are “we” now—this motley collection of us—gathered here in 2016? And more pertinent to our purposes over the next four days, who do we hope to become?

When Connie Gunderson and I first talked about the theme of this talk, I have to say I was completely undaunted and completely in love with the title: Transforming Community through Disruptive Empathy. All of the right words were put together in one evocative phrase. But then the inevitable happened; the more I reflected on the title the more aware I became that I really didn’t know what it meant. And that was okay. Because the more I participate in these kinds of gatherings, the more I make peace with the reality that my starting place is often in a state of profound befuddlement—which is also okay particularly since I’m never content to stay in that place alone. I invite other people into it with me. So I started asking: What comes to mind when you hear the word community? What makes community different from an organization, or working group, or network? It’s probably not surprising that the first associations that came to mind were words like trust, like-mindedness, nurture, commitment, and belonging. And just to make sure our thoughts were not overly lofty, we threw in reminiscences of the Cheers Bar, the setting of a popular 1990s sitcom. Community, according to the promotional jingle, is a place “where everybody knows your name, and they’re oh so glad you came”—even if they give you a hard time once you get there. In other words, community is a place where we can be known; people miss us when we don’t show up; and, perhaps, someone even cares.

We are social beings—born to thrive in connection with each other—so it is no surprise that we find the life blood of our dreams, our values, and our expectations in community. We feel more alive when we are bound together by captivating ideas; we feel that we matter when we are in pursuit of compelling goals. Right here, right now, we are enlivened as we gather around this evolving body of work that we call Relational-Cultural theory. Right here, right now we are enlivened as we gather to insist on our right to forge a narrative of human possibility to heal the suffering in the world as we know it now. We are here—right now—to press our righteous claim and lay the groundwork for future we want to call into being. And somewhere, perhaps not too far away, so is the Ku Klux Klan. They too are enlivened by their connection to a communal narrative, perhaps one that promises to restore America to its greatness. Like us, they are captivated by a vision of possibility. The content of that vision may be different from ours; but, like us, they derive meaning from their connection to a narrative grounded in an imagination of justice, fairness, and the right order of relationships. We learn every day about young people who are drawn into terrorist activities—whether it is the terrorism of ISIS or the terrorism that led Dylan Roof to murder nine people in a house of worship. They too have an audacious vision of possibility and a yearning to belong. So right here, right now, a question worth asking ourselves is: What makes our claim on community different from theirs?

They have a compelling mission – just as we do.

They have powerful rituals – just as we do.

They believe they are right – just as we do.

Let me be very, very clear. I am not in any way suggesting some kind of moral equivalence between the mission of KKK and of this assembly gathered here tonight. What we share in common, however, is the fact that we come together to forge a narrative about power—the power of belonging. Relationship, like any currency of power can be used to dominate and exclude; to determine who is in; who is out; who can never belong; and, in the extreme, who must be destroyed. When we talk about our own beloved community, we often speak of Ubuntu as a relational ideal: that cultural ethos of “I am because we are”. What I am saying tonight is that as much as we might aspire to build our communities around that narrative, we cannot take refuge in linguistic niceties. “I am because we are” speaks to relationship as a currency of power. And unless we are mindful of how we do that power, “I am because we are” can quite easily devolve into “I am because we are” and “we are because you are not”. We all know that it can happen: that there can be a “disconnect” between our explicit narratives—who we say we are in relationship—and, our implicit, sometimes largely unconscious narratives—how we actually do our relationships. We all know that as much as we might like to associate the dogma of disconnection with corporate board rooms and the global political stage, an implicit narrative of disconnection can play out in our class rooms, clinics, and churches—presumptive spaces of health, hope, and healing. It’s a fair guess that we all have known the heartbreak of good work gone bad—when we embarked on some noble mission, with righteous ideas and fierce resolve and noble intentions, only to find that our good intentions are not enough. Unless we are mindful of how we do the politics of belonging, we too are susceptible to the same faults we so readily recognize in others.

And speaking of the others, who do we think they are? Two great thinkers, Albert Einstein and Jean Baker Miller, have given us our theoretical foundation to start answering that question. If we truly believe as we say we do that separation is an illusion, then we are free to embrace disruption. If we truly believe that we grow through relationship for the purpose of relationship, we can free ourselves from the constrictions of the ego—those boundaries ostensibly built to protect us—to ensure our survival against those pesky intruders who are trying to invade our borders. We are also freed from constricted notions of community that are defined by ego boundaries. “We are” because “you are not” is simply a variation on a very old theme that we must use our boundaries to protect us from each other. Indeed, we may be tempted to follow the advice of no less a personage as Freud and use our boundaries to protect us from what we perceive to be intrusive stimuli.

At core of our communal narrative as Relational-Cultural practitioners is the notion of boundaries of spaces of meeting and transformation. Jean Baker Miller (1976) put it this way: the essence of life is movement and change. She went on to say that we become more fully human by engaging difference—not just theoretical difference—by engaging real bodies whom we perceive to be other, opposite, and even enemy. So who do we think we are? And who do we think the others are? If we truly believe that as we say we do, then we are challenged to continually interrogate our notions of self and other. [Frankly, that scares me! I don’t want to be Donald Trump…which is not too much of a problem because I’m pretty sure Donald Trump doesn’t want to be me either.]

But isn’t that the very fear that causes us to misuse the power of belonging? Isn’t that the very fear that can cause us to weaponize our relationships—to use our relationships as fortified boundaries against engagement and inclusion? We do that not because we are bad people, but because we want to protect that which we know to be good. When we narrate our history and our hopes, we talk about growth through authentic connection.

And the radical reality of that narrative is that it calls us to transformation. The radical reality is that the power of belonging can support and propel us toward ever more expansive enactments of our humanity.

Or… we can ignore the call to transformation. We can say what we have is so good and so never want it to change. But to do so is to become reduced to a smaller and smaller version of what we call community.

So what are we to do? How can we use our powers of belonging—our powers of relationship—to foster hope and healing? It is important for us to start by asking the question “who are we” to develop an explicit, well-articulated narrative. But it is equally important for us to notice how we live the question: to embrace community as process, community as movement, and as evolving narratives of co-creation and human possibility.

I propose that we start with disruptive empathy. Disruption and empathy: I know—the words don’t seem to go together. But it captures the paradox of relationship, and what Keltner (2016) calls the paradox of power. And actually if we refer back to the foundational tenets of Relational-Cultural theory, the pairing of these two words may not be as peculiar as it might initially seem. When Judy Jordan defined empathy about three decades ago, she described it as a process of thinking and feeling, of joining with clarity and awareness (Jordan, Surrey & Kaplan, 1983). In other words, empathy requires engagement with paradox. Disruptive empathy both anchors and overturns.

It leads us to challenge our most sacrosanct notions of community while grounding us in the shared power of belonging.

Just a few days ago, I witnessed this shared power of belonging enacted on the sidewalks of lower east side Manhattan. There were two gentlemen in conversation, one of whom definitely appeared to be homeless, and the other, who if not currently homeless appeared to be quite familiar with that condition. The latter gentleman was explaining to his companion how to obtain services, what would happen on certain days in one agency or another, how to avoid getting caught up in a bureaucratic tangle when searching for shelter. And I thought: now that is power. Jean Baker Miller (1976) defined power as the capacity to induce responsiveness—a relational energy. Similarly, Keltner (2016) defines power as the capacity to make a difference, particularly through connections with others. In other words, power is not the exclusive province of the rich and the famous—as the burgeoning growth of reality TV would have it—the rich and the infamous.

And here’s the paradox. Power is also intoxicating. Keltner (2016) describes it as a dopamine high. We are not much soothed and made to feel calm by it, as we are made to feel more confident, more competent, and more deserving of whatever it is that we want. We now have tons of research showing that feeling powerful makes us—all of us—more likely to use others to our own advantage: whether that’s cutting in line or taking up more space than we need, or consuming more goods than we need, or taking candy from a baby. [Literally, not metaphorically.] In other words, the paradox is that this same power that can be used for good can foster a sense of entitlement and exceptionalism. Of course, we can see how this plays out in the world of national and global politics, but it happens in small ways as well. Let me give an example. I spend way too much time in my favorite grocery store in Wellesley, MA. It’s a very special store and all of us who feel like very special people like to shop there. I can’t count the number of times I have seen loving, suburban mothers trying to shop with their children in tow—all the while grabbing fruit for their children to eat while they shop. What I’m saying is that they haven’t paid for it. And I’m thinking: why isn’t this called shoplifting? I don’t see any signs that say “this is free; you can take it”. Yet they feel entitled to appropriate someone else’s property for own use. [A client of mine once told me that’s the key to all successful shoplifting: you just have to believe it’s already rightfully yours.] I’m fairly certain the store owners calculate theft into the cost of goods sold; so, in fact, we’re all paying for that bunch of grapes. I’m also fairly certain that the shoplifters are upstanding, law-abiding, good-hearted mothers who are just doing the best they can to mollify cranky toddlers. I’m not saying they are bad people. I am saying they are people who are so comfortable—and confident about their status in this specific culture of shoppers that they feel entitled to exercise power without question. Whether it’s in a grocery store or a community of scholars and practitioners, disruptive empathy counters this sense of exceptionalism by anchoring us in awareness. It focuses our attention on the text of our narratives, as well as the context and the subtext. I think of it as relational corrective. To the extent that we are prone to deny our power—or to use it without regard to its impact on others, it prompts us toward mindful appreciation of what is real, what is present, and what is emerging in relationship. In our communities, disruptive empathy helps us to see what we prefer not to see; it helps us face down our implicit narratives that define who can be one of us—and who cannot. Disruptive empathy gives us the courage to name reality as we see it—to tell our multiple and conflictual truths—the cliques, the secrets, the taken-for-granted understandings that build impenetrable boundaries that may belie any explicit story we might tell about ourselves. It helps us to speak the unspeakable with humility and compassion and an occasional dose of good humor.

There is something that is core to our humanity that impels us toward authenticity. We want to be real; we want to be known. Yet we know that the central paradox of relationship is that we are often afraid of being known. We are drawn to community because of our deep yearning to be known and connected. Ironically, our fear of being known sometimes results in an implicit narrative framed around isolation and subterfuge. Not because we want to lie, but because community brings us face to face with what Audre Lorde (1984) called our fear and loathing of difference. This is the same fear and loathing that might deceive us into believing that we can use the master’s tools to dismantle the master’s house. This is the same fear and loathing that would cause us to shirk away from good conflict. Again, the explicit narrative of relational-cultural community is that conflict is both inevitable and necessary for growth. And growth means change—transformation. You simply can’t grow and keep the same boundaries. That brings us again to the heart of disruptive empathy—respect for otherness. We don’t have to settle for pseudo-empathy or sentimentality. I find that absolutely liberating, because it means that we don’t have to always pretend to like each other all of the time. The good news here is that disruptive empathy is not about mutual attraction. I should be clear: I think mutual attraction is a good thing, but we don’t always have to go along to get along. There is no way that strong-willed, creative, and passionate people will avoid going into conflict with each other. We do have to enter conflict with respect, curiosity, and openness to the possibility that we just might learn something.

You also have to care enough to go into conflict. I say that as a personal confession: I know that one of my preferred strategies of disconnection is being nice. I know that because my family has told me so—many times. It often sounds something like: “Okay – sure. Peace out”. Let me say that there may be times when that strategy is absolutely appropriate. It may be all the relationship can bear—at the moment. But let us also be clear: a lot of exclusion and relational violence happens under the guise of being nice. Being nice—pseudo-empathy—is the antithesis of authentic engagement; it fortifies our boundaries against the other; it is refusal to invest the time and energy required to sustain relationship. Pseudo-empathy is a refusal to relinquish our attachment to the relational images we have stored in our brains about how our relationships should work. Disruptive empathy, on the other hand, reminds me of a quote by the 13th century poet Rumi: “Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there.” (Moyne & Bark, 1999, p. 8).

What happens in that field between rightdoing and wrongdoing? For one thing, anxiety happens. No one wants to feel anxious. Interestingly, the poet W.H. Auden (2009) encourages us to seek truth in the kingdom of anxiety…to go into the land of “unlikeness”…to stay in the here and now…to encounter rare beasts (the other)…to have unique adventures in the world of the flesh.

Jean Baker Miller (1976) was slightly less poetic, but just as clear—that we become more fully human through embodied engagement with difference. Becoming more fully human requires a little bit more of us than an eloquent theory or good intentions.

Let me give a quick example. One of our traditions at Harvard Business School—probably much like other schools—is that very senior administrators or faculty will hold informal lunches with small groups of students. This is a favorite ritual: the students get to feel good about themselves and the hosting faculty or administrator can feel good as well. At one of these lunches hosted by a senior faculty, an African American male student recounted his recent encounter with campus security. He had been detained, had a flashlight shone into his face, and had been required to produce his student identification because someone fitting his description had committed a robbery in a nearby neighborhood. He was hurt and angry—and actually reeling in disbelief that all of his accomplishments (which included a law degree from Yale) did not protect him from the indignity of racialized bias. When he told his story, his listeners were appropriately horrified; and the hosting faculty, a white male, suggested that he report the incident to another high-level white female administrator. So far, so good: Everyone is acting with the best of intentions. Later that month I was inadvertently included on part of an email trail. A part of the trail was meant for me; the other part was a private debriefing conversation between the two higher-level administrators—clearly not my business, but of course I read it! And the conversation went something like:

Female: “He certainly had very strong emotions”.

Male: “Oh my, I hope he spoke to you respectfully”.

Female: “It wasn’t too bad. I just hope he will channel his anger appropriately”.

I later met with the student, and his mirror neurons were fully functional. He knew what had happened in the field. People, who might have exercised their power to facilitate change and cultural healing, used it instead to curate his narrative of heartbreak. We have a choice when we enter into the field between rightdoing and wrongdoing: we can wrap ourselves in our protective boundaries, or we can shed the mantle of entitlement and become open to the possibility of learning something—maybe even becoming something new.

Our beloved scholar Irene Stiver (1997) taught us that when we enter that field of anxiety, between right-doing and wrongdoing, we must move out of the protective boundaries of image and authority and orthodoxy and toward relationship.

It is in this field of anxiety—between right-doing and wrongdoing— that we might exercise our power to say just one true thing. The poet Mary Oliver (2006) remarks on the important of silence.

To create a silence in which another voice may speak is at the heart of community transformation. It doesn’t sound that hard; in fact, it sounds like just the kind of thing we say we want to do. But we would do well to recognize from the outset that making a space for other voices is in fact a disruptive process. It may quite literally take us out of our communal skin. Fifteen years ago we probably couldn’t have imagined that our skin/our boundaries stretch from Waban Pond to the shores of Lake Superior. But here we are tonight, making a space into which other voices may emerge and speak to our communal narrative.

When I was very young, my primary babysitter was my great grandmother. I was about four years old and I thought she was about 217; and, frankly, we did not get along. I don’t know what I could have done at four years old to cause her to characterize me in this way, but she would complain to my mother that I was “mouthy” and “brazen”. To her enduring consternation (and mine) she would complain that I, “Always wanted to have the last word.” I confess that I still struggle with that, and sometimes as a community, so do we.

We have struggled long and hard to speak our truths to a power-over culture that did not always care to listen. And we have become quite good at it; we have filled vast spaces with our spoken word. And we have defined ourselves with our spoken word. This year 2016 is the 49th anniversary of the publication of Jean’s book, Toward a New Psychology of Women. After 40 years, we might say that we have established ourselves as members of the pantheon of thinkers and theorists who are trying to tell the story of what it means to be fully human.

Now, right here, we are gathered as a community because it is equally radical to listen: to embrace the reality that the practice of empathy may just disrupt who we think we are. Listening leads to transformation and what makes this radical is that we live in a culture that posits impermeability as a measure of strength. In fact, we are taught to fear that if we listen too well—if we allow ourselves to be influenced by others—we may lose our selves. Perhaps that is precisely what community calls us to do: to loosen our death grip on this construction of images, expectations, and entitlements that we call self. The paradox of listening to another voice is that we may come to more deeply appreciate who we truly are and who we may truly become.

In Relational-Cultural practice, we have a narrative about the transformative power of mutuality—of being influenced by voices of others. To listen to the voices of others is an act of courage; it is to open ourselves to disruption and to risk knowing that which we thought was the final word has dissolved. The final word has not been spoken, and that, perhaps, it is not for us to speak. By no means am I talking about moral relativism. I am talking about moral humility. I am talking about the courage to stand for what we believe is right, without being self-righteous. This is the space where courage and compassion grow precisely because we encounter our indivisibility—our common humanity. This is the space where we lay down our sword and shield, and study war no more.

I can think of a no more beautiful example of the practice of disruptive empathy than the story told of C. P. Ellis and Ann Atwater in Davidson’s (2007), a book that I highly recommend: The Best of Enemies. Ellis and Atwater both grew up in Durham, North Carolina, in a culture where deeply entrenched racial segregation was the way of life. Segregation by race and class defined the narratives of identity and possibility: this is who you are and this is all you can become (Davidson, 2007). C. P. Ellis grew up as a poor white boy, who regularly witnessed his father’s humiliation when he had to step off the sidewalk, so that the “big white men”—men with money—could pass (Davidson, 2007). He grew up hiding under stairwells, so that his school mates wouldn’t see that all he had to eat for lunch was a lard sandwich, but he became a “somebody” (Davidson, 2007). He, like his father before him, was eventually inducted into the Ku Klux Klan, and he rose to leadership as the Exalted Cyclops (Davidson, 2007). Ann Atwater grew up poor and Black and female in this same culture (Davidson, 2007). She was deeply intimate with the indignities of being poor and Black and female—all of which according to the cultural narrative would relegate her to a status of nobody-ness; but she too became “somebody” (Davidson, 2007). She became one of Durham’s most audacious and outspoken advocates for civil rights; she was a single mother, and housing activist who could not be silenced (Davidson, 2007). During the 70s, in the midst of the cataclysm of racial violence sparked by school desegregation, Atwater and Ellis were brought together in a series of meetings called a charrette, where they were to tell their truths and listen to the truths of the other (Davidson, 2007). As C. P. Ellis described it:

Here we are, two people from the far end of the fence, having identical problems, except her being Black and me being White…The amazing thing about it, her and I, up to that point, [had] cussed each other, bawled each other, we hated each other. Up to that point, we didn’t know each other. We didn’t know we had things in common. (Atwater, 2016, para. 13)

When C. P. Ellis died in 2005, Ann Atwater took her rightful place seated with the family; and when questioned, she said, “CP was my brother” (Davidson, 2007, p. 6).

By practicing disruptive empathy, Atwater and Ellis learned how to tell their own truths and how to listen to the truths of the other. They never backed down, but they created a pause—a silence into which another voice could speak. The poet Paul Williams puts to words so well the truths that I needed to learn as a “mouthy and brazen” little girl; the truths that every community needs to learn, that Ellis needed to learn, that Atwater needed to learn; and it is this:

When you just have to talk,
Try being silent.
When you feel reluctant to say anything
Make the effort
To put what you’re feeling into words…
Look and see
if you’re willing to trust
yourselves
to misunderstand each other
and go from there…
Listen as if.
Listen as if you can’t always tell
what the truth is
Listen as if you might be wrong,
Especially when you know you’re right.
Listen as if
you were willing to take the risk
of growing beyond
your righteousness
Listen as if
love mattered.

And at the end of our days, isn’t love what community is all about?

 

References

Atwater, A. [Web page]. (2016). Retrieved from https://en.wikipedia.org/wiki/Ann_Atwater

Auden, W. H. (2009). For the time being: Xmas Oratorio. In R. Housden (Ed.), For lovers of God everywhere: Poems of the Christian mystics. US: Hay House Inc. Davidson, O. G. (2007). The best of enemies: Race and redemption in the new south. Chapel Hill, North Carolina: University of North Carolina Press.

Jordan, J. V., Surrey, J. L. & Kaplan, A. G.(1983). Women and empathy. Wellesley, MA: Stone Center Working Paper Series.

Keltner, D. (2016) The power paradox: How we gain and lose influence. NY: Penguin Press.

Lorde, A. (1984). Sister outsider. CA: Crossing Press.

Miller, J. B. (1976). Toward a new psychology of women. Boston: Beacon Press.

Moyne, J. & Bark, C. (1999). Open secret: Versions of Rumi. Boston: Shamble Publications.

Oliver, M. (2006). Praying. Thirst. Boston: Beacon Press.

Stiver, I. (1997). A relational approach to therapeutic impasses. In J. V. Jordan (Ed.), Women’s growth in diversity: More writings from the Stone Center. NY: Guilford Press.

Williams, P. (1990). How to tell the truth. Nation of Lawyers. Used with permission by Cindy Lee Berryhill.

Disruptive Empathy - Transforming Community

An Engaged Workplace is a Productive Workplace

Is everybody happy? Creating an engaged workplace environment.

Conventional wisdom once was that employees didn’t have to be happy or be in a workplace environment where there was a culture of civility to be productive. They didn’t need to be engaged with the company. Fear of being fired, fear of being humiliated in front of coworkers, fear of being demoted or downgraded publicly were considered effective management tools. You didn’t need to like the people you work with and you didn’t need to share their values. You could come to work and do your job well without feeling invested in your workplace. After all, work is not personal. Many firms had policies forbidding relationships among employees.

With the millennium came newly designed studies of the workplace. New technology allowed researchers to look at the brain activity of employees. These studies verified what we knew intuitively. For example, a study in England completed in 2013 showed that people who were happier at work had an increase in productivity of around 12%. Research conducted by the likes of neuroscientists Richard Davidson and V.S. Ramachandran and scholars such as Shawn Achor increasingly point to a simple fact: Happy workers are better workers. Those who are engaged with their jobs and colleagues work harder and smarter.

And yet, there are an alarmingly high number of people who aren’t engaged. According to a sobering 2013 Gallup study reported by Steve Crabtree only 30% of the U.S. and Canadian workforce is engaged at work. Not very many people are truly “emotionally and intellectually committed” to their organizations. Crabtree says:

Far too many couldn’t care less about what’s happening around them. For them, Wednesday is “hump day” and they’re just working to get to Friday. Then there’s the other end of the bell curve — the nearly one out of five employees is actively disengaged. These people are sabotaging projects, backstabbing colleagues, and generally wreaking havoc in their workplaces.

Disengaged, unhappy people aren’t any fun to work with, don’t add much value to the workplace, and impact our organizations (and our economy) in profoundly negative ways. It’s even worse when leaders are disengaged because they infect others with their attitude. Their emotions and mindset impact others’ moods and performance tremendously. After all, how we feel is linked to what and how we think. In other words, thought influences emotion, and emotion influences thinking.

Let’s agree. Feelings at work are important and matter for the success of our endeavor.  Science is on our side: there are clear neurological links between feelings, thoughts, and actions. When we are in the grip of strong negative emotions, we can’t think straight. We focus mostly — sometimes only — on the source of the pain. We don’t process information as well, think creatively, or make good decisions. Frustration, anger, and stress cause an important part of us to shut down—the thinking, engaged part. Disengagement is a natural neurological and psychological response to negative emotions.

What can individuals do, if they feel their workplace falls short of what they need to be engaged, happy employees? Here is a list of questions excerpted from The Essential Work Skills Workbook by Ester A Leutenberg and John J Liptak, EdD that will help. Answer them and think about what they mean. Choose the most important to you and then ask for a meeting with your supervisor. This is a good chance to address your issues in a positive way. What is the value statement of your workplace? How does that mesh with your personal values?

  1. How can you redefine your role at work so it is more meaningful to you?
  2. How does your workload compare to others’ workloads in the organization?
  3. What expectations does your supervisor have of you? In what ways are these expectations realistic? Unrealistic?
  4. What capabilities are you not using at work?
  5. How can you tell your supervisor that you have too much work to do?
  6. What can you do to manage your time better?
  7. How is your work interfering with your personal life?
  8. How can you use your energy more effectively at work?
  9. What part of your role do you not understand?
  10. What can your supervisor do to make your work tasks more clear?
  11. How can you communicate to your supervisor that you are unclear about certain aspects of your work?
  12. What changes have occurred in your organization that have increased your work stress? Have these changes made a difference in the values of your workplace?
  13. Do you feel you are valued by your organization? If not, why not?
  14. What position within the organization would you like to be doing and how would this allow you to use your talents and skills more efficiently?
  15. How can you show your supervisor that you are capable of doing other work? Make a list of your untapped talents and share them with your boss.

Here is a link to an article from Entrepreneur Magazine that addresses important issues on this topic: https://money.usnews.com/money/blogs/outside-voices-careers/2015/04/22/12-ways-to-be-an-engaged-employee.

Is it possible to have an engaged, happy workforce? It certainly is. I work in just such a place. Here at Whole Person Associates we are engaged in what we do, we are civil to each other, we care about the quality of our products. We like each other. The result is a workplace that functions efficiently, produces great products, and has excellent customer relationships.

Whole Person Associates Staff: Engaged Workplace

Whole Person Associates staff: In front, Deb Lutkevich, back row left to right, Jack Kosmach, Carlene Sippola, Peg Johnson, Adam Sippola celebrating Deb’s 25th anniversary at WPA.

Ten Principles for Using Icebreakers

Excerpted from Icebreakers a la Carte

By Sandy Christian, MSW and Nancy Loving Tubesing, EdD

All groups need icebreakers. The world is full of shy people who need focus and a very specific way to talk frankly about themselves. Icebreakers provide a vehicle for sharing select personal information, freeing people from constraining anxiety, and guiding participants into authentic, purposeful, often touching conversations.

Icebreakers are not just for getting acquainted. They are especially useful for groups of strangers; but even well-acquainted groups can use icebreakers to ease into a course or group discussion, provide focus for group activities, and establish the proper climate for learning. From first meetings to final farewells, icebreakers pave the way for people to be real.

Icebreakers make the group, and its members, attractive to participants. Not everyone will like everyone else in a group, but the more people are attracted to other participants, and discover common interests, goals, and values, the more eager they will be to participate. Icebreakers induce people to share in spontaneous ways that stimulate lively interaction and draw people to one another.

Icebreakers affirm the rights of participants. Everyone who joins a group has human rights: to be recognized as individual, to have input into some group decisions, to have an equal opportunity to participate in the group, to establish goals and work towards them, to have others respect personal privacy, and to have the group be a safe, secure place in which not one is belittled or degraded. Icebreakers direct participants into activities and behaviors that uphold and affirm these rights in words and actions.

Icebreakers should be relevant to all participants. Everything you do should be relevant to the culture of the group, and its members. Icebreakers as well as other group activities should be presented in the context of participants’ life experience and be relevant in language, values, and style.

Trust is the most important variable to consider when using icebreakers. Icebreakers help establish trust and contribute to its strength throughout the life of the group. The bottom line is, “Can I be honest here and say what I really think and feel?” If the answer is no, the group is constrained from lively, spontaneous communication and deterred in its purpose. Icebreakers remind people, over and over, that open, heart-searching communication is like a wind blowing the group spirit in the right direction.

Icebreakers are vehicles for shaping open group systems. The best environment for learning is an open system, one that accepts and welcomes diverse people, invites honest communication, expresses warmth and affection freely, challenges individuals to grow, shares warmth and affection freely, challenges individuals to grow, shares power and will its members, provides support for people who need it, respects personal boundaries, and honors the limits of the group itself.

Icebreakers provide a way of quickly introducing these values to the group in action and words. Since the rules of the system are often decided in the first few minutes of interaction (without ever talking about them, just by watching each other and the group leader for clues about how to behave), it’s all the more important that icebreakers be used early on to lay the foundation for an open system.

Equal, active participation is an implicit goal of all icebreakers. Successful groups are the responsibility of all participants. The more you inform people about their choices, the more they can take responsibility for group learning. Knowing what the leader has planned, why a particular activity was chosen, and what their roles want responsibilities will be, helps group members make clear decisions about how they want to participate.

Most groups need a balance of activities. Too much of any one thing creates a lop-sided group; overly friendly, chatty groups may never get down to business, while “all work and no play” groups may suffer from boredom. Most groups function beset with a mixture of activities, some light-hearted, others serious.

Experiential, holistic learning is ideal. Learning involves the whole person: mind, body, spirit, relationships, and emotions. When group activities incorporate all these aspects of learning and accommodate the different learning styles of individuals, the chances are great that group members will have a complete experience, one they can integrate with previous experience and apply to everyday life, resulting in a genuine change of attitudes, perceptions, feelings, thoughts, and behaviors.

*For use with your clients: Cartoon Captions, a zippy method of applying humor to challenging situations. Be sure to check out the two variations.

Icebreakers a la Carte

Sexual Harassment – Have We Turned The Tide?

The current spate of prominent figures being accused of sexual harassment and then fired from their positions of power gives the impression that the tide has turned…cases of sexual harassment will be heard and appropriate action will be taken against the perpetrators.

According to NPR in an article by Yuki Noguchi,

…in actual courts, such cases filed by workers against their employers are very often dismissed by judges. The standard for harassment under the law is high, and only an estimated 3 percent to 6 percent of the cases ever make it to trial.

That stands in stark contrast to the large pool of people who say they have experienced sexual harassment. In surveys, a quarter to half of women say they’ve experienced sexual harassment at work. But only a small fraction — estimates range around 5 to 15 percent of women — report their complaints to their employers, largely due to fear of retaliation. Legal experts say the high dismissal rate of sexual harassment cases also has a chilling effect.

-Yuki Noguchi, National Public Radio Correspondent

Legal standards for harassment are tough. The same article from National Public Radio continues:

In a 1986 decision, the Supreme Court said the behavior needs to be “severe or pervasive” in order to qualify as harassment, whether it’s on the basis of sex or race. …judges’ interpretations of what qualifies are out of step with common sense and standard office policies.

-Deborah Rhode, director of Stanford’s Center on the Legal Profession

It often takes a kind of cultural consciousness raising moment like the one that we’re having now to force a reevaluation of standards. Everything that we’ve seen on the #MeToo hashtag suggests that there’s a lot of pent-up fury out there, and more of these women are going to seek legal recourse and attorneys in this social climate are going to think they’re more likely to win and get substantial damages.

Sexual Harassment

Indeed, Cincinnati employment attorney Randy Freking says his office recently has seen an uptick in potential clients alleging sexual harassment, against the backdrop of more and more allegations going public.

Freking says he only takes cases that have a decent shot at winning, and warns his clients that even the strongest cases always have a good chance of getting dismissed. And the emotional cost can run high.

Retrieved from https://www.npr.org/2017/11/28/565743374/sexual-harassment-cases-often-rejected-by-courts January 18, 2018

Very few people realize that judges just have this power to toss cases out, despite the fact that the Constitution has a right to a trial by jury,” Freking says. “And for a woman who has been sexually harassed, and been victimized by their employer like that, and then just have that OK’d by some federal judge? It just absolutely rocks your world.

-Yuki Noguchi, National Public Radio Correspondent

But…times they are a-changin, right? And things are improving for those who need protection of the law. Somewhat. One of the difficulties is addressing the myths of what is and isn’t sexual harassment. Another is making sure that employees recognize the gender power structure that is there.

While we wait for the courts to catch up with reality here are two exercises, from the book Confronting Sexual Harassment, that you can use in the workplace or with your clients to help get a handle on the complicated issue of sexual harassment. The first exercise deals with the myths that abound about what it is and what it isn’t, who is and who isn’t being sexually harassed.

The second exercise helps participants examine gender power and its relationship to sexual harassment. Participants create their vision of a model equal gender power organization.