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 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:

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


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

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.


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.



Alamaas, A. H. (2016) Compassion leads to the truth. Retrieved from:

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:

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:

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

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?”


  • 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.


  • 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?


  • 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?


  • 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.


  • 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.


  • 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.


  • 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.


  • 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

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
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?



Atwater, A. [Web page]. (2016). Retrieved from

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:

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 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.


Relational-Cultural Theory

What Is Relational-Cultural Theory?

By Judith Jordan, PhD

Transforming Community Relational Cultural TheoryExcerpted from Transforming Community

Relational-Cultural theory (RCT) posits that we grow through and toward relationships throughout our lives and that growth-fostering relationships are the source of meaning and empowerment. The Five Good Things (Miller & Stiver, 1997) characterize these “good relationships”: (1) zest, (2) clarity, (3) sense if worth, (4) productivity, (5) a desire for more connection. We need connection the way we need air and water. Relationships are central to our lives, not secondary or peripheral. Self-interest is a social prescription rather than a biological imperative.

What has come to be known as Relational-Cultural theory was created in the late 1970s by a collaborative group of four women clinicians (Jean Baker Miller, Irene Stiver, Janet Surrey and myself). Foundational to the model was the work of Jean Baker Miller who wrote her best-selling book Toward a New Psychology of Women in 1976. Seated in Jean’s living room in Brookline, Massachusetts, beneath an antique quilt (undoubtedly the creation of several women from another era with a recognizable pleasure in creating something together) these four women came together to better understand clinical practice and the psychology of women. Jean Baker Miller could see the ways in which theories of personality and development, written by men (mostly white, well-educated, straight men), when applied to women, often led to distortions in understanding. Jean invited us to listen to women, to hear their stories, to understand their needs and motivations, to see strengths where others often saw weakness or deficiency. As we tried to represent women’s voices we sought to understand the impact of race, culture, sexuality, and sociopolitical power issues. Thus began a re-working of the dominant psychological theories of the time. The journey would take us from a celebration of the Separate Self to an appreciation of the centrality of relationships in our lives. Much to our chagrin, critical feedback from marginalized people pointed to the irony that in trying to describe “woman’s voice” we committed the very same hubristic error we had accused male theorists of. We presented our model as if there was one, homogenous voice of women. We have worked hard to listen to and represent the range of experience of women and to move beyond our own white privilege with its incumbent blind-spots (and other sources of unearned advantage such as class, sexual orientation, gender.) We have tried to represent many of the voices of women. We sought to “challenge assumptions of a powerful mythic norm that would define woman as a white, economically privileged, able-bodied, and heterosexual female. Unchallenged, this norm becomes a standard against which all women’s existence is interpreted and evaluated” (Jordan, Walker & Hartling, 2004, p.3).

RCT examined the ways in which chronic disconnections from empathically failing and non-responsive relationships early in life get encoded as relational images which shape our expectations for current relationships. Acute disconnections offer opportunities for re-working earlier relational failures; in fact when we can represent our authentic feelings and find respect, responsiveness, and empathic attunement we build trust and a sense of relational competence. When, however, disconnections are disregarded and a person is treated as if he or she doesn’t matter, she learns to twist herself to fit into the relationships with powerful others in her life (e.g. parents for children; bosses for employees). The misunderstood individual becomes less and less authentic, mutuality ebbs, and the disconnection becomes chronic. In such situations we see depression, low energy, confusion, immobilization, isolating, self-blame; the opposite of The Five Good Things of zest, worth, clarity, productivity, and desire for more connection.

Boys relational cultural theoryTraditional models of psychological growth at the time that we began our theory building (late 1970s) emphasized that humans move from dependence to independence; that the goal of healthy development is to be able to stand on your own two feet, to be independent, to be rational and autonomous. Unrealistic standards for adulthood left many people, both men and women, feeling inadequate and ashamed. In many ways, the restrictions placed on boys in terms of emotional vulnerability (necessary for the formation of mutual relationships) and demands for unattainable self-sufficiency (to encourage functioning in a hyper-individualistic society) are deeply destructive for boys (Stone, 2011).

In the last decade, modern neuroscience has validated almost all of the early tenets of Relational-Cultural theory: We need relationships like we need air and water; exclusion and isolation create real pain for people; the brain is wired to register the pain of exclusion in the same way it registers physical pain or absence of water and oxygen. We are simply hardwired to connect. We come into the world with the underpinnings of empathic ability (mirror neurons). Just as we need others for survival, we need to give to others and to participate in the growth of others. This model points to the mutuality of human growth. Our inevitable interdependence provides us with a sense of meaning and belonging. When society sets up expectations that are at odds or clash with our neurobiology, when a connection-seeking being is met with cultural conditioning that valorizes self-sufficiency and standing on your own two feet, emotional stress and physical ill health ensue. Chronic stress, resulting from this mismatch wreaks havoc with our overall well-being. We now know that exclusion and isolation cause pain… real, demonstrable neurobiological pain. We know that there is amazing plasticity in the human brain; we also have learned that empathic attunement alters brain function. We are born with an impulse to connect which is not based only on satisfaction of biological needs. We are hard-wired to connect. We need to engage in and participate in relationships that go beyond just needing others to take care of us or resonate with us. We have a need for mutual empathy, resonance; we need to contribute to others. And we need to build community together.

Intense AnxietyWhile this work was quite controversial in the late 1970s, modern neuroscience, with its revealing functional MRIs, has confirmed almost every position put forth regarding the power of connection in people’s lives. Social Pain Overlap Theory (SPOT) has demonstrated that the pain of social exclusion (or even the anticipation of exclusion) travels the same neuronal pathways to the same brain area (the anterior cingulate) as physical pain (Eisenberger & Lieberman, 2004). This tells us that relationships are essential to our survival; physical injury and isolation are both wired to demand our attention, to send out survival alarms.

Although initially the model was widely accepted by many female therapists (“It’s what I knew in my heart about therapy and people”), other traditional therapists at first overlooked it, then labeled it “dangerous”, and later often concluded: “We knew it all along. Relationships heal.” While RCT is a relative newcomer to the psychological community, it has gained widespread acceptance, and has engendered a significant amount of research (Jordan, 2010; Jordan, in press). The American Psychological Association invited RCT into its “Psychotherapy monographs series”, noting it was one of the ten most important psychological theories in North America.

While originally anchored in the need to correctly represent the psychology of women and bring about changes in the practice of psychotherapy, RCT has been increasingly applied more widely. A small sampling of RCT research shows it has been used to better understand

  • organizational dynamics (Fletcher, 1999)
  • counseling theory and practice (Comstock, 2005)
  • diversity and marginalization (Comstock et al, 2008; Frey, 2013)
  • social justice (Gunderson, 2012; Gunderson, Mueller, & Teichert 2013)
  • men (Englar-Carlson, Stevens & Scholtz, 2010; Lombardi, 2011)
  • eating disorders (Tantillo & Sanftner, 2010)
  • addiction (Covington, 2008; Gahleitner & Gunderson, 2009; Gahleitner & Gunderson, 2007)
  • mindfulness (Surrey, 2005; Surrey & Jordan, 2005)
  • relational psychotherapy (Jordan, 2010; Walker & Rosen, 2004)
  • education (Schwartz & Holloway, 2014)
  • mentoring (Gunderson et al, 2015; Spencer, Jordan, & Sazama, 2004)
  • empowerment of girls (Covington, 2008; Jordan, 2016)
  • friendships (Miller & Stiver, 1997)
  • neurobiology of relationship (Banks, 2016)
  • couples (Jordan & Carlson, 2013)
  • resilience in girls (Jordan, 2013)
  • clinical outcome (Oakley et al, 2013)
  • chapter representations in college psychology texts (Engler, 2003; Frager & Fadiman, 2012)
  • summary of research on RCT’s usefulness in the field of counseling (Comstock, 2008; Duffy & Trepal, 2016).

Many more references to RCT can be found in the forthcoming APA 2nd edition of Relational-Cultural Therapy (Jordan, in press).

In terms of power analyses, RCT suggests that power over models severely restrict the development of mutuality. When people exercise power over, they seek to maintain the status quo, the imbalance of power that affords them considerable privilege in a stratified society. “Power with” and “power for” models provide healthier social arrangements in which all people matter, all people contribute to one another and the relationship and all people grow as a result of their interactions. In empowerment, we participate and value the growth of the less powerful person. The goal is mutual benefit and movement toward a greater sense of the power of connection.

Women talking by a campfire

RCT views isolation as one of the core factors in psychological suffering and dysfunction. Re-establishing meaningful connection with others fuels healthy development. As the client experiences empathic responsiveness with the therapist, she feels understood and she also feels less alone. She begins to entertain the possibility of healing and feeling that she matters. Strategies of disconnection begin to shift and the client begins to take small, appropriate risks in bringing vulnerability to relationships. This vulnerability is essential to being open and affected by our relationships with others and hence being able to grow in connection.



Banks, A. (2016). Wired to connect. New York: Tarcher/Penguin.

Comstock, D. L., Hammer, T. R., Strentzsch, J., Cannon, K., Parsons, J., & Salazar II, G. (2008). Relational-Cultural theory: A framework for bridging relational, multicultural and social justice competencies. Journal of Counseling and Development 86(3), 279-287.

Comstock, D. (Ed.). (2005). Diversity and development: Critical contexts that shape our lives and relationships. Belmont, CA: Brooks/Cole.

Covington, S. (2008). Women and addiction: A trauma informed approach. Journal of Psychoactive Drugs, 5(3), 377- 385.

Duffey, T., & Haberstroh, S. (2014). Developmental relational counseling: Applications for counseling men. Journal of Counseling and Development, 92(1), 104-113.

Duffy, T., & Trepal, H. (2016). Introduction to the special section on Relational-Cultural theory. Journal of Counseling and Development. 94, 379-382.

Eisenberger, N., & Lieberman, M. (2004). Why rejection hurts: A common neural alarm system for physical and social pain. Trends in Cognitive Sciences. 8, 294-300.

Englar-Carlson, M., Stevens, M., & Scholtz, R. (2010). Psychotherapy with men. New York: Springer.

Engler, B. (2003). Personality theories: An introduction ( 6th ed) . Boston: Houghton Mifflin.

Fedele, N. (2004). Relationships in groups: Connection, resonance and paradox. In J Jordan, M Walker &L Hartling (Eds.), The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute (pp. 194-219) New York: Guilford Press.

Fletcher, J. (1999). Disappearing acts: Gender, power and relational practice at work. Cambridge, MA: MIT Press.

Frager, R., & Fadiman, J. (Eds.). (2012). Personality and personal growth. New York: Addison Wesley Longman.

Frey, M. (2013). Relational-Cultural therapy: Theory, research and application to counseling competencies. Professional Psychology Research and Practice. 44(3), 177-185.

Gahleitner, S., & Gunderson, C. (Eds.). (2009). Gender, Trauma und Sucht: Neues aus Forschung, Diagnostik und Praxis. Kröning: Asanger Verlag.

Gahleitner, S., & Gunderson, C. (Eds.), (2007). Frauen, Trauma, Sucht: Neue Forschungsergebnisse und Praxiserfahrungen. Kröning: Asanger Verlag.

Gunderson, C. (2012). Human trafficking: The trafficking of women in Northern Germany for the purpose of sexual exploitation. A systemic overview of community based responses and challenges. Münster, Germany: LIT Verlag

Gunderson, C., Müller, A., & Teichert, G. (2013). Zwangsprostitution und Menschenhandel/Sex slavery and human trafficking. Münster, Germany: LIT Verlag

Jordan, J. (in press). Relational-Cultural therapy. (2nd ed.) Washington DC: American Psychological Association.

Jordan, J. (2013). Relational resilience in girls. In S. Goldstein and R. Brooks (Eds.), Handbook of resilience in children (2nd ed.) pp. 73- 86. New York: Springer Science and Business Medico. Jordan, J. (2010). Relational-Cultural Therapy. Washington, DC American Psychological Association.

Jordan, J., Kaplan, A., Miller, J., Stiver, I., & Surrey, J. (1991). Women’s growth in connection. New York: Guilford.

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

Lombardi, K. ( 2011). The mama’s boy myth. New York: Penguin.

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

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

Norcross, J. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patient. New York: Oxford University Press.

Oakley, A., Addison, S.C., Piran, N., Johnston, G., Damianakis, M., Curry, J., …(2013). Outcome study of brief relational-cultural therapy in a women’s mental health center. Psychotherapy Research, 23(2), 137-151.

Schwartz, H. (2014). “ I become part of the learning process”: Mentoring episodes and individualized attention in graduate education. Mentoring and Tutoring: Partnership in Learning, 22(1), 3855.

Sparks, E. (1999). Against the odds: Resistance and resilience in African American welfare mothers. Work in Progress, No 81. Wellesley,MA: Stone Center Working Paper Series.

Spencer, R., Jordan, J., & Sazama, J. (2004). Growth –promoting relationships between youth and adults: A focus group study. Families in Society, 7(3), 354-363.

Surrey, J. (2005). Relational psychotherapy, relational mindfulness. In C. Germer, R. Siegel, & P. Fulton (Eds.), Mindfulness and psychotherapy, (pp. 91-110). New York: Guilford Press.

Surrey, J., & Jordan, J. (2013). The wisdom of connection. In C. Germer, R. Siegel (Eds.), Wisdom and compassion in psychotherapy: Deepening mindfulness in clinical practice. (pp. 163-175). New York: Guilford Press.

Tantillo, M., & Sanftner, J. (2010). Measuring perceived mutuality in women with eating disorders: The development of the Connection-disconnection scale. Journal of Nursing Measurement, 18(2), 100- 119.

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

Reducing Bedtime Anxiety: Steps, Worksheets, and Activities

Worn out from the holidays? Having trouble sleeping?

Bedtime Anxiety

Bedtime Anxiety woman trying to sleep

Excerpted from Coping with Sleep Issues
By Ester Leutenberg and John Liptak, EdD

What keeps you awake when you want to be sleeping?

Bedtime anxiety keeps everyone awake at times. Below is a set of steps that you can use at bedtime to dramatically reduce your feelings of anxiety and begin to effectively cope with them. These steps are designed to help you cope with anxiety from its onset. Think of something you are anxious about, describe it, and then try these six steps to conquer anxiety before bed time.

  • STEP 1 = Reduce physical tension by taking a deep breath and holding it for five seconds. Do this ten more times. How did that feel?
  • STEP 2 = Stay in the present by bringing your thoughts to the here-and-now (as if the future does not exist!). How did that feel?
  • STEP 3 = Start the calming process by forming a mental image of a calm place. Close your eyes and picture yourself in this calm place. Use your senses of smell, touch, taste and hearing to make the image real. How did that feel?
  • STEP 4 = Continue calming your body and achieve a sense of deep relaxation. Start at the bottom of your feet and begin relaxing all of your muscles until you reach the top of your head. How did that feel?
  • STEP 5 = Realistically assess the accuracy and rationality of your thoughts. STOP any negative statements and replace them with positive statements. How did that feel?
  • STEP 6 = Repeat several positive affirmations that will help you to stay in the present moment. Affirmations might include statements such as “My thinking is peace-filled.”

Click here for a printable version of Bedtime Steps to Reduce Bedtime Anxiety

The truth is that there is no actual stress or anxiety in the world; it’s your thoughts that create these false beliefs. You can’t package stress, touch it, or see it. There are only people engaged in stressful thinking. ~Wayne Dyer

Activities to Reduce Bedtime Anxiety

There are many ways to reduce anxiety before it spirals into a heightened, debilitating state. These distractions allow you to get out of your own head and focus on things outside of yourself.

  • Physical Exercise Early in the Day (jogging, walking, etc.)
  • Enjoyable, Nourishing Activities (hobbies, family activities, etc.)
  • Creative Expression (garden, scrapbook, journal, etc.)
  • Relaxing Activities (Yoga, meditation, etc.)

Click here for a printable version of Activities to Reduce Bedtime Anxiety.

Man with sleep problems rubbing eyeMy Negative Thoughts and Feelings

Consider all of the negative thoughts and feelings you are experiencing today. How do you think the above negative thoughts and feelings will affect your sleep?

Emotional Pain

Negative thoughts and emotional pain get in the way of a solid bedtime sleep. To relieve emotional pain, you need to deal with it!

Explore the various reasons that you are experiencing your emotional pain. (Example: feeling guilty about something you did or did not do.) What is on your mind?

  • Step 1: Acknowledge your feelings.
  • Step 2: Accept what happened.
  • Step 3: Feel it.
  • Step 4: Don’t mask it.
  • Step 5: Learn from it
  • Step 6: Overcome it.

Use these six steps when you are emotionally troubled.

Click here for a printable version of Emotional Pain.

Creative Arts Can Help with Bedtime Anxiety!

Woman paintingThe creative arts can help you in this process! Create a poem, write a song, create a short story, or draw something that describes what you’re feeling and going through. Remember, this is for you and only you to read or see. Don’t worry about rhymes or meter, sentence structure, or how professional your art is. Do it for yourself, and yourself alone. Try going through this process a few hours before going to sleep.

Click here for a printable version of Creative Arts.

Regretful Feelings: True or Not True?

It’s often hard to know whether feelings about incidents one regrets are based on truth, or what one believes to be true. Evaluate your level of responsibility for what really happened.

  • What situation do you regret feel guilt, sad, embarrassed, ashamed, angry, or afraid?
  • Who else was involved?
  • How much control did you have over the situation?
  • Were you really responsible?
  • What could you have done differently?
  • How can you forgive yourself and let it go?

Click here for a printable version of Regretful Feelings: True or Not True?

Distractions from Dwelling on Mistakes

All people make mistakes! It’s time to move on from the emotional pain of having made a mistake. Distract yourself from thinking about the mistake by forgetting it and letting it go.

  • What recreation-time experiences that bring you pleasure?
  • What activities do you like to do that bring you a sense of deep relaxation?
  • What activities do you enjoy that bring you a sense of accomplishment?
  • What activities do you enjoy so much that you actually lose awareness of time?
  • What activities do you feel passionate about, activities that bring you meaning and a sense of purpose when helping others?

When lying in bed trying to go to sleep, distract yourself from negative thoughts by thinking about these activities.

Click here for a printable version of Distractions from Dwelling on Mistakes.


The word affirmation comes from the Latin affirmare, originally meaning “to make steady, or to strengthen.” Affirmations help purify our thoughts and restructure the dynamic of our brains so that we truly begin to think anything is possible. Which affirmations resonate with you? Write them down and keep them in places that you look at it often, on your night stand, mirror, refrigerator, dashboard, etc.

  • I will not struggle. I am peace filled.
  • I forgive myself!
  • I am setting myself free.
  • I choose peace of mind.
  • I am living in the present.
  • I connect with the calm of this present moment.
  • Tomorrow I will enjoy each and every moment.
  • I am relaxing, clearing my mind, and going to sleep.

Repeat one affirmation of your choice as you are going to sleep.

Click here for a printable version of Affirmations.

Spiritual Moments – Developing Spirituality in Children

Spiritual Moments

Excerpted from Nurturing Spiritual Development in Children by Understanding Our Own Spirituality

By Ester R.A. Leutenberg and Deborah L. Schein, PhD


Nurturing Spiritual Development in Children by Understanding Our Own Spirituality

Caregivers should be aware of the importance of spirituality and to realize that spiritual development can be nurtured at very young ages.

In this blog the term caregiver refers to biological, adoptive, step or foster parents; family members; child-care educators; day-care workers and nannies; and other people who are in the position of being responsible for the care of young children.

A caregiver can begin instilling spirituality even before a child is born. Singing and other sounds are felt as vibrations and possibly as sounds by a fetus in the womb. During this time frame, an infant is most vulnerable to the environment. A baby absorbs and adapts to time, place, region, and local norms and culture. The spiritual embryonic phase begins here and continues throughout one’s lifetime.

Spiritual development is vital for all caregivers. There are aspects of spiritual development that are common to all people. The intent of the authors is to provide opportunities to evoke and strengthen each caregiver’s spiritual development, and ultimately, influence the spiritual development of the children to whom the adults are giving care. Readers will find information about various aspects of spiritual development. Caregivers are encouraged to spend time in reflection and journal writing. This will provide opportunities to evoke and strengthen the spiritual development that will enhance the spiritual development of the children the adults are nurturing.

Truisms – Young Children and Spiritual Development

  • Spirituality is an innate human trait.
  • This innate trait must be nurtured in order to flourish.
  • All children require love and attachment at the beginning of life to awaken this innate spirituality, so that it can be nurtured and developed.
  • All children need interesting and beautiful spaces in which to experience life. This space can be as big as a park, and as small as a corner of a room.
  • Young children are extremely competent learners because they have absorbent minds with exceptional ability to learn culture, language, and nuances from the environment and the people in that environment.
  • Spiritual development plays an important role in promoting learning and growth for all children, and is inter-related with all other domains of development.
  • Children will develop spirituality far more easily when the adults in their lives are spiritually grounded.

Important definitions to keep in mind:

Complex disposition is reflected in how one acts toward others by caring, kindness, empathy, and reverence.
Basic disposition is the internal feeling triggered by moments of wonderment, awe, joy, or inner peace.

Spiritual Moments Happen Every Day

Spiritual Moments at Machu PichuI was co-writing a book about spirituality and on the way to a restaurant with friends, I asked the husband if he was religious, spiritual, spiritual and religious, or none of them. He gave me a confused look, and said, “What is spirituality?” I told him that it is different for everyone. I said, “For me, when I look at the mountains beyond my backyard, I have a sense of wonderment, of being a small part of the universe. It swells my heart.” His response was, “I have no idea what you are talking about.” We enjoyed our dinner, saying no more about it.

Driving home, he said he had been thinking. When he was at Machu Picchu, atop the Andes Mountains in Peru, he recalled an unbelievable feeling of awe. He reflected at that time upon his wonderment of the world. In the twenty-five minutes it took us to drive home, he told a half a dozen other stories like that. His wife’s mouth was wide open. She, in fifty years of marriage, had never heard these stories. That one question opened him up to reflect and to recognize his spiritual moments and to consider his own spirituality.

~ Ester R.A. Leutenberg

Spiritual Moments in Time

Spiritual moments in time are quiet, calm moments with extended time for children to play and explore – these moments are most felt when children live their lives within a set routine and within environments that provide order. Such environments invite children to predict, know, and feel secure within a day, a week, or more.

Think about moments that have given you feelings of peace and contentment; moments when you felt as if time was simply stretched out before you and you had no need to hurry.

  • What are you doing in these reflective moments?
  • What ties these reflective moments together?

Click here to for a printable worksheet.  

Spiritual Moments in Space

Spiritual moments in space describe young children’s play environments that are aesthetically pleasing and a beautiful space where real objects, real experiences, and rich language are intentionally provided. This type of environment is often filled with moments of wonder, awe, joy, and inner peace that can fill each child’s basic disposition.

  • What would you consider to be a beautiful learning space. What qualities would that space need?

Click here to for a printable worksheet.

Spiritual Moments in Relationships

Children with pet dogMost children enjoy interactive relationships that are not stagnant, but that change in ways that stimulate their senses, intellect, and inner person. Such moments can help children to strengthen their will to self-regulate, be mindful, and take on responsibilities such as caring for a plant or garden, a pet, or helping to keep a room clean and organized.

We all have special people in our lives.

  • Think about the special people who were important to you as a young child. What made them so important to you?
  • Who are the special people in your life now and what makes them so important to you?
  • Describe how the qualities of the important people in your life, from your childhood to now, are the same or how they have changed.

Click here to for a printable worksheet.

Spiritual Moments in and with Nature

Many research studies have been conducted on nature’s impact on human development. Kindness, respect, empathy, harmony, and being welcoming to others, are just a few of the benefits children engage in as they experience the natural world. As they explore the outdoors with nature, nature is also brought indoors for close-up exploration. Spiritual life begins with a sense of wonder, and one of the first windows leading to wonder is the natural world. In general, nature is an amazing source for wonder, awe, joy, inner-peace, and relationships. It eventually provides an environment for the emergence of big questions.

Go for a walk outdoors and look for moments that touch you spiritually.

  • Why do you think this is happening?
  • Try to put words to your feelings.

Click here to for a printable worksheet.

Spiritual moments under a large treeSpiritual Moments with Big Questions

Big questions are capable of taking one beyond oneself. When one engages in big questions, one is able to feel one’s own place within the universe. If one believes in transcendence, then a big question can take the person to that place. If one does not, the big question can provide feelings of humility, smallness, and a feeling of a place within the vastness of the universe.

Young children are capable of big questions, also. You can see the question in a child’s body posture, eyes, and expression. Through exploration of the world a myriad of questions come alive for a child. It is through big questions that a child is capable of seeing that the world exists way beyond oneself.

We all have big questions about life and how we see ourselves in the big picture!

People often have big questions involving these aspects of life:

  • Spiritual Moments
  • Caregiver Love
  • Self-Awareness
  • Mindfulness and Mindsight
  • Disposition
  • Wonder
  • Kindness
  • Openness and Imagination
  • Gratitude
  • Breath and Presence
  • The Big Picture: Spiritual Development

Although children may not be able to completely articulate their big questions, they hold curiosities and questions about how life works.

Examples might be:

  • Where does the sunlight come from?
  • Why does light go away at night?
  • Where do my shadows come from?
  • Who creates a rainbow?
  • An example of a big question from an adult might be:
  • What happens to a person when the person dies?

A Big Question can lead you to explore spirituality from a personal perspective.

  • What is one of YOUR big questions about life in general
  • that in some way involves one or more of the items listed on the prior page?
  • Why is this big question important to you?

Click here to for a printable worksheet.

The Relationship of Rituals and Spiritual Moments

Spiritual Moments boy prayingA ritual is a ceremony or regular occurrence consisting of a series of actions performed according to a prescribed order and a set time. Some common rituals are saying good morning to someone when waking up, or singing a song to a child before going to bed. One’s life is filled with rituals that strengthen one’s spirituality.

  • What are some rituals that were shared with you as a child?
  • At the time, how did you feel about those rituals?
  • How did it make you feel to participate in those rituals?
  • How do rituals strengthen your spirituality?
  • What are some of the rituals you share with a child in your life?

Click here to for a printable worksheet.

Spiritual Moments: Thought-Provoking Quotations

Spiritual moments happen every day. All you need to do is to know how and when to recognize them.

~ Ester R.A. Leutenberg

Spiritual moments are created in relationships with others, in awareness and appreciation of self, in and with nature, and in dialogue with big questions capable of taking one beyond oneself.

~ Deborah L. Schein

Click here to for a printable worksheet.

Spiritual Moments

Ideas, Activities, and Moments for All Caregivers to Share with Children

Spiritual moments can sometimes happen by chance. More often, though, they need to be created by establishing nourishing connections. Here are some ways to provide spiritual moments for the children you know, and for yourself as well. Such moments can strengthen the spiritual development of everyone. • Answer questions in a patient, thoughtful way.

  • Ask the child to tell you a story. Then, ask questions about it.
  • Breathe slowly with a young child, putting each of your hands on each other’s heart.
  • Clean up toys together.
  • Create time in the day to simply be with the child.
  • Dance together.
  • Discuss the importance of friendship.
  • Encourage quiet time.
  • Enjoy reading with a child.
  • Find a caterpillar and wonder together where it came from and what it will become.
  • Find a spider’s web and talk about it.
  • Keep play spaces decluttered and organized, but expect them to get messed up.
  • Laugh together.
  • Limit saying No when you can – offer Yes or Yes, but, and don’t be afraid to say no when it is truly needed.
  • Look at the brown on a banana and together, wonder why it’s there.
  • Notice and discuss the wag of a dog’s tail.
  • Offer children time to play alone or with other children without any interruptions.
    • Do not interfere.
    • Do not show the child what to do.
    • Do not suggest to the child to do something different than what the child has chosen to do.
    • Do not talk.
  • Pay attention to the environment, make it beautiful and inviting.
  • Play together.
  • See a shooting star, watch the moon, clouds, sunrise, or sunset.
  • Show appreciation and respect when a child repeats something over and over again.
  • Sing together.
  • Stop and smell the roses.
  • Support a child’s right to have open time to play.
  • Take time to answer children’s questions.
  • Talk about things for which to be grateful.
  • Together, look at the shadows cast by the sun.
  • Walk together.
  • Watch and discuss a worm squiggling on the ground.
  • When hearing a siren, say aloud, “We are wishing good thoughts to the person in the ambulance.”

Click here to for a printable worksheet.

Coping Styles: More and Less Skillful Defense Mechanisms and Means

Coping Styles

The following material is excerpted from

Mindfulness for Emerging Adults: Finding balance, belonging, focus, and meaning in the digital age.

By Donna Torney MA, LMHC, RYT

The identity project: Encouraging mature coping styles

Early psychoanalytic thinkers defined common defense mechanisms, more frequently known as coping styles, that help individuals regulate emotions and reach goals. These defense mechanisms are often categorized as unhealthy, immature, and mature. The Harvard Men’s Study found a strong correlation between the use of mature defense mechanisms and triumphing over adversity in adult life. Buddhists and yogis may use the terms skillful or unskillful means, or mindfully healthy and unexamined unhealthy coping behaviors. Here’s a partial list of defenses and coping styles classified as less skillful means and more skillful means along with an example of how they may show up in emerging adult life. As you read through the coping styles, can you remember using some of the less skillful coping styles? Is there a defense mechanism you still use that keeps you feeling isolated?

Coping Styles Young Man AloneLess skillful means

When the less skillful defense mechanisms are in use, we usually feel as though we have no control over our environment. These coping mechanisms are often semi-consciously employed. In an attempt to gain control, we might resort to these defenses. Unfortunately, they often create more chaos.

Less Skillful Defense Mechanism Example
Aggression/Anger An overly stressed and frustrated individual responds by punching a wall or person.
Denial Ignoring the consequences of a dangerous behavior like unprotected sex, or binge drinking.
Displacement Taking out frustrations from work on a family member.
Somatization Mental stress and anxiety are ignored, but manifest as physical symptoms.
Dissociation Mentally removing oneself from a stressful situation losing connection with people or physical surroundings.
Wishful thinking/fantasy Adopting an unrealistic view of a situation rather than facing disappointment.

More skillful means

As we gain more life experience, we often learn more skillful coping mechanisms that help us feel more in control and capable of achieving independence and connectedness. At times we need mentors to help us move toward more skillful coping styles. A person who is using denial and ignoring the consequences of heavy drinking might start to consider the more skillful means of moderation. Someone who is ignoring mental stress but experiencing physical symptoms might identify with a friend who takes daily walks to manage stress and can start building his own awareness of the connection between mind and body.

More Skillful Defense Mechanism Example
Moderation A young adult who is struggling with spending too much time playing video games with friends decides to set a weekly time limit.
Patience/Acceptance Instead of bringing frustrations from work into the home, a roommate decides to talk to her trainer at work.
Identification Instead of letting unmanaged stress cause physical symptoms, a person in recovery identifies with the story of an ex-heroin addict who takes up running.
Sublimation/Altruism Rather than feeling sad about not having a significant other, two single friends sign up to volunteer at a local charity.
Humor Realizing that final exams are causing stress and low mood, a group of friends decides to watch a comedy on Netflix.
Anticipation Foregoing a weekly dinner out to save for an upcoming vacation.
Suppression Instead of lashing out and becoming consumed with a recent break-up a young musician waits until after an important performance to process the difficult emotions.

Click here for printable version of the charts above.

Coping Styles Friends TogetherNormalizing the circling back process and filling in developmental gaps

Many emerging adults are looking for help in finding intimate, meaningful relationships with friends and romantic partners. However, coping styles often lag behind chronological age. Most emerging adults don’t spend a lot of time consciously thinking about their coping styles. In fact, in traditional psychoanalytic theory defense mechanisms are thought to be subconscious.

We are at a critical point of human evolution and cultural identity. We can look at the industrial revolution and imagine what it was like to be a young adult raised on a farm trying to make the transition to a more urban way of life. We can look at the Sixties and imagine what it was like for an emerging adult trying to make good decisions during a time of radical social change. We are again facing a sea change. The current knowledge-based, digital age is radically changing the way we live and think about ourselves in the world, not to mention the way we take care of our basic needs. There are many benefits to this new way of life, but as with any big cultural change, wise application of innovation can make the difference between a thoughtless, joyless existence and a life well-lived. Building balance, belonging, focus, and meaning early in life and facing direct experience with clarity will lead to healthy decision-making and healthy identity development for the individual and society. Speaking with elders and looking back at past innovation and our adaptation to innovation will help us make wise choices with the newest wave of technology.

Voice of an Emerging Adult
Jake: Focusing and belonging

I thought I was doing a good job taking care of myself but my boss’s comments at the end of my review were kind of a wakeup call. This time when I walk into her office I hope she notices that my clothes don’t smell and I took a shower. I thought she was judging when she first brought it up, but I could tell she was just worried that I wasn’t taking care of the basics, like scheduling in time to do laundry and eat. It’s just so hard to focus lately.

The fights with Becca are getting worse. I have a stomachache almost all the time lately. I’m so jealous of any guy she talks to. Last night our fight was so bad that I hurt my fist by punching a wall. I hope I can still play at the show tonight.

I don’t know what my problem is. I’ve been on my own since I was nineteen. I’m twenty-seven now. I always thought of myself as being super independent. So why am I so obsessive and crazy about my girlfriend? Sure, Becca and I are splitting expenses and it would be hard to live on my own. But at this point I’m ready to couch surf again. I know how to get by on almost nothing. That’s how I was able to quit my job and tour with the band last year.

It’s been a good thing to stop drinking and stay away from drugs. Last week my co-worker had me try some deep breathing exercises. They helped a little. We also talked about how much I used to like to mountain bike. I realized I’m hardly ever outside anymore. I’m trying to think of a way to get back into enjoying time on my own.

I’m still having a hard time sticking to my goals. Part of me wants to apply to the community college for sound engineering. Part of me just wants to take off and do another tour, even though we hardly break– even financially when we are on the road and the basics – like healthy food – take a hit.

Jake is typical of the many emerging adults looking for help in finding intimate, meaningful relationships with friends and romantic partners. However, Jake’s coping style was lagging behind his chronological age. Most emerging adults don’t spend a lot of time consciously thinking about their coping styles, in fact in traditional psychoanalytic theory, defense mechanisms are thought to be subconscious. The contemplative exercises in Center Points will help emerging adults become more conscious of unhealthy coping styles and move toward more skillful means of managing stress.

Voice of a Mentor
Words from Jake’s grandfather:

Imagine what it was like to be young 65 years ago. It’s hard for me to watch Jake struggle. But when I was his age I was already a manager at the paper mill, was married, and Jake’s dad was on the way! It wasn’t easy but I can remember feeling proud. We had a good group of neighbors – some stayed our neighbors for fifty years! We didn’t get our first television until 1960. It seems every time Jake visits me he has a new gadget! Sometimes I get frustrated with Jake. Those tattoos! And I thought his dad was wild! I consider myself a modern thinker. Hell, I have a tattoo from the Navy. It was just  our way of bonding. Even an old guy like me can see all the changes. I read the papers. I can see how hard it is for Jake’s generation. I can also see how my wife may have been frustrated with being a housewife, raising three kids without access to a car every day. But it seems like Jake and his friends have fewer opportunities. We could buy a house on one income and easily pay it off on my manager’s salary. Not so for Jake and his friends.

A flexible identity

Identity formation is a life-long process. A healthy, flexible identity can serve as a resting place, a place where we can practice direct experience with pleasure, or at least with less discomfort. There are aspects of Buddhism and yoga that foster healthy human development. Combining these aspects with newer theories in Western psychology such as positive psychology and modern neuroscience make these ancient practices accessible and practical for use in everyday young adult living.

The rules of finding intimacy have changed drastically due to online dating and digital overload. The idea that someone looks good on paper but is completely different in person is a real challenge for young adults. Furthermore, in the digital age, emerging adults are bombarded with images, many unrealistic, about what a healthy, happy relationship should look like.

Voices of Emerging Adults
Tracey – Balancing outside expectations with personal goals, and formulating a genuine identity.

I thought once Peter and I got engaged and I had a good first job that I would feel more confident. But lately I’ve been so anxious. That’s why I decided to call Donna. I stayed home from work last Monday because I was overwhelmed with the wedding plans. I am trying to manage what my parents expect and what I really want. I just can’t keep letting my emotions get the best of me!

I’ve also been kind of hiding from my friends. I don’t understand why I can’t let go of other people’s standards and just live my own life. I have a great job and I just got a small raise. I’m just about the only one of my friends who can pay for an apartment and pay for my student loans. Why can’t I just relax?

Donna told me that I was sitting as still as a statue in our first session. The deep breathing has helped me relax a little and sleep better. I’ve stopped missing work but now I’m having doubts about Peter, which is really freaking me out!

I know everyone thinks we are the perfect couple. From the outside, everything looks ideal. We’ve been dating since sophomore year, and we are great friends. I really am a relationship person. I can’t deal with the thought of going back to online dating. Plus almost all my friends are getting married now.

Donna asked me to do a couple of exercises to help me think about my strengths, and things I value. I realized that I never work on my art anymore! I used to love going to museums and taking art classes. In fact I was hoping I could add more design work into my job description.

It’s just that Peter doesn’t like art that much, and I really don’t like doing things by myself. Like I said, I’m a very social person. I guess I really have been using this relationship to hide from my anxiety about being alone. Ugh! I can see now that the anxiety won’t go away if I keep running away from it and trying to make everyone happy.

Craving/grasping and aversion/avoidance:

Mindfulness for Emerging AdultsEmerging adults’ anxiety often increases at the same rate as the emerging craving to be able to express one’s true self. When a young adult has reached a point of discomfort then he or she is more willing to explore coping styles. Without an honest exploration of true identity and personal values we are all susceptible to getting caught up in what Buddhists and yogis identify as the suffering of clinging to ideas at one extreme, and the unhappiness of avoidance of experience on the other.

Every generation of emerging adults has faced its own particular flavor of clinging and avoidance. For those reaching adulthood in the digital age clinging might show up as unhappily and hypervigilantly checking Facebook for status updates, or clinging to media-driven ideas of work, friendship, and family. Avoidance can manifest as a rigid and anxious stance against new ideas that might prevent exploring reasonable opportunities.

Click here for Breathing for Balance exercise.

Click here for Mood Mapping exercise.

Understanding PTSD as we Honor Veterans

Saturday, November 11 is Veteran’s Day. As we pause in our busy schedules to thank those who have served our country, we must remember that many returning from deployment come back suffering from Post-Traumatic Stress Disorder or PTSD. Let’s take a few moments to review our understanding of this often devastating condition. The following information was excerpted from Veterans: Surviving and Thriving after Trauma by Ester R.A. Leutenberg & Carol Butler, MS Ed, RN, C.

Exposure to combat, witnessing death and destruction, and other trauma can lead to common reactions that resolve soon. When reactions persist over time they become PTSD symptoms. Many veterans have an array of post-traumatic stress symptoms. These symptoms may not rise to the level of a formal diagnosis. Nevertheless, they may significantly hinder the joy and quality of daily living and need to be addressed. They can include:

  • Anxiety, the fight or flight reaction, freezing with fear, being jumpy and watchful
  • Sadness or depression, crying, lack of interest or enjoyment, self-isolation, fatigue
  • Guilt and shame: The serviceperson feels they could have done more; they feel guilty because they survived when others did not
  • Irritable and angry about being treated unfairly, low levels of patience, overreacting
  • Behavior changes, increased substance use, reckless driving, self-neglect

Symptoms of PTSD for the person who experienced or witnessed an event involving actual or threatened death or serious injury and responded with intense fear, helplessness or horror, include the following:

  • Re-experiencing or reliving the event with the same terror, images, thoughts, perceptions; dissociative flashbacks, nightmares, illusions, hallucinations
  • Intense psychological distress reaction to triggers which are internal or external cues that resemble an aspect of the trauma
  • Avoiding reminders – people, places, things such as crowds, cars if their convoy was attacked, fireworks, keeping too busy, and not addressing related thoughts and feelings, and not talking about traumatic experiences
  • Numbness, feeling shut-down, detached or estranged from others, not feeling affection or joy, inability to recall aspects of the trauma, diminished interest in formerly significant activities, harboring a sense of foreshortened future, not expecting a normal life-span
  • Hyper-arousal, easily startled, poor sleep patterns; irritability or anger outbursts, hyper-vigilance, (on guard)
  • Feeling lost, alone, distrustful, awkward, and afraid most of the time

Veterans are at greater risk if they had earlier trauma such as child abuse, mental illness, a family history of emotional problems, poor support system, limited education, or other recent life changes.

PTSD often leads to self-medicating through substance abuse, employment and relationship problems, hopelessness, depression, despair, shame, aggression and suicidal ideation.

People may not seek help due to the perceived stigma of mental illness, long waits for treatment, denial, or cultural factors such as being stoic versus false a perception of weakness if asking for help.

When family members suggest getting help veterans are urged to follow through to respect their loved one’s concerns.

Denial is a common response yet tough people suffer symptoms, not always combat-related. Victims of abuse, accidents, and natural disasters are at also at risk.

Physical reactions may involve chronic pain, heart palpitations, trouble breathing, profuse perspiring, stomach upsets, and other bodily reactions to anything that reminds the person of the stressful military experience.

How do we open a discussion with a Veteran about the possibility that they may be experiencing PTSD? The following are tips from the U.S. Department of Veterans Affairs, and were retrieved on Nov. 7 from

  • Be respectful and calm during conversations.
  • Be patient ‒ it usually takes more than one conversation before most people accept the idea of seeking care.
  • Don’t argue or attempt to talk a Veteran out of their feelings, thoughts, and/or emotions
  • Allow the Veteran in your life to decide whether or not they want to talk about what they have experienced or what they are currently dealing with. If they don’t, that’s okay. Let them know the door is always open and you’re willing to listenwithout offering advice or suggestions.
  • Do not take the Veteran’s social withdrawal or isolation personally. Be willing to invite them and accept that they may not want to participate. Let them know they are welcome to change their mind.
  • Avoid giving advice unless the Veteran specifically asks for it.
  • Minimize distraction during conversations with the Veteran by turning off phones, TV, radio, etc. Be willing to limit conversations to 10 to 20 minutes at a time, if necessary. Think small steps.
Joseph Ambrose, an 86-year-old World War I veteran, attends the dedication day parade for the Vietnam Veterans Memorial. He is holding the flag that covered the casket of his son, who was killed in the Korean War.

Joseph Ambrose, an 86-year-old World War I veteran, attends the dedication day parade for the Vietnam Veterans Memorial. He is holding the flag that covered the casket of his son, who was killed in the Korean War.

Help your Veteran to feel more comfortable and be aware of potential triggers that may aggravate a Veteran’s heightened alertness, such as loud noises on TV, fireworks, a car back-firing, etc.

  • Remind yourself that it’s not about you. Be patient when a Veteran is struggling with feelings, emotions, stress, and so on.
  • Talk about your feelings and encourage the Veteran to share their feelings about what is going on without forcing the issue.
  • Validate the Veteran’s feelings if they are willing to share them by simply listening, rather than offering advice.
  • Try to build in some enjoyable activities with the Veteran in your life on a regular basis.
  • Encourage sticking to schedules and routines.
  • Don’t force a Veteran into social outings. If they agree to go, plan ahead in case they feel uncomfortable and want to leave.

The U. S. Department of Veterans Affairs also reminds caregivers to take care of themselves. You can’t help your Veteran if you are exhausted.

  • Engage in activities you enjoy that help you tolerate or decrease stress.
  • Educate yourself about mental health problems.
  • Consider getting your own counseling and mental health support.
  • Join a support group or talk to others who are struggling with similar issues.

Thank you to all of those who have served our country in the military: The Marines, Coast Guard, Army, Air Force, Navy, and National Guard. Whether a deployed soldier in Afghanistan or a helper in a flood in Texas or a fire fighter in the West, we owe our appreciation, support, and understanding.

Chronic Sleep Problems Affect 50 To 70 Million Americans

50 to 70 Million Americans Struggle with Chronic Sleep Problems

Excerpted from Coping with Sleep Issues Workbook
By Ester R.A. Leutenberg and John J. Liptak, EdD

Man with sleep problems rubbing eyeMost people, at one time or another, have experienced trouble falling asleep or staying asleep. Inability to sleep occasionally is normal and is often the result of some sort of stress in life. However, when sleep problems become a regular occurrence and begin to affect one’s ability to function in daily life, the person may have developed a sleep disorder.

A lack of adequate sleep may not seem like a big problem, but it can seriously affect one’s performance at school or work, ability to concentrate, ability to control emotions, and ability to handle stress. Lack of sleep is a challenge to one’s own general health and well-being.

Adequate sleep is a great buffer that helps to protect people from everyday stress. Sleep is a vital support for one’s ability to rejuvenate the mind and body.

Any type of sleep deficiency can seriously increase one’s vulnerability to a variety of physical disorders and to a host of negative feelings, emotions, and behaviors such as:

  • anger
  • anxiety
  • frustration
  • irrational thinking
  • irritability
  • sadness

Inadequate sleep can result from two things:

  • A reduction in the amount of sleep one experiences. This occurs when people find that they are not sleeping enough hours each night.
  • A reduction in the quality of sleep one is receiving. This occurs when people find that they are having a hard time falling asleep, often awaken, and then may difficulty going back to sleep. This reduction causes a dramatic break in the sleep cycle.

Click here for a printable handout: What is the Sleep Cycle?

Over the years many folks have written about getting a good night’s sleep. Here are a few. Journal a few lines about each one and how you feel about it. Do you have other favorite quotes about sleep? Jot them down in your journal and write about how you feel about them. It is important to understand your (and your client’s) attitude to sleep problems so you can provide a guide to better sleep that may include anything from easily made changes to routines to participating is a formal sleep study.

Woman with chronic sleep problems

Control what you can control. Don’t lose sleep worrying about things that you don’t have control over, because at the end of the day, you still won’t have control over them.

-Cam Newton

Though sleep is called our best friend, it is a friend who often keeps us waiting.

-Jules Verne

If you have difficulty sleeping or are not getting sleep or sleep of good quality, you need to learn the basics of sleep hygiene, make appropriate changes, and possibly consult a sleep expert.

-Andrew Weil

Sleep is the best meditation.

-The Dalai Lama

My father said there are two kinds of people in the world: givers and takers. The takers may eat better, but the givers sleep better.

-Marlo Thomas

Click here for a printable worksheet on quotes about sleep for your clients.

Possible Causes of Sleep Problems

Some clients feel overwhelmed when they try to analyze why they are having trouble sleeping. There are so many possibilities. This list of suggestions can help them narrow down the choice. For example, this is a list of possible causes of sleep problems.

  • Acid reflux
  • Allergy
  • Anger
  • Anticipation that something might happen
  • Certain medications
  • Anxiety
  • Bedroom cluttered
  • Caregiving responsibilities
  • Disappointments
  • Disease
  • Electronics (tablet, cell phone, games) in bedroom
  • Emotional stress
  • Family issues
  • Fearfulness
  • Friend relationships
  • Frustration
  • Grief
  • Guilt
  • Hot flashes
  • Hurt feelings
  • Indecisive
  • Isolation
  • Jealousy or envy
  • Job issues
  • Medical issues of self or loved one
  • Mental health issues
  • Overwhelmed
  • Partner
  • Phone use in bedroom
  • Physical ailment or pain
  • Regrets
  • Relatives or in-laws
  • Sadness
  • Social life
  • Stimulants
  • Substance abuse
  • Suspicions
  • Time constraints
  • Too warm or cool in the bedroom
  • Trauma
  • Uncomfortable bed and/or pillow

Click here for a printable worksheet version.

Man with chronic sleep problems asleep at the wheelSuggesting small changes that can make a difference is a good start. Some are more difficult to achieve than others. Start with the easier ones and move on from there.

  • Avoid alcohol, nicotine, or caffeine before bedtime
  • Avoid extreme exercises before bedtime
  • Avoid rich and spicy foods before bedtime
  • Be sure the bed, mattress, and temperature are comfortable
  • Do easy stretches before bed
  • Do something mildly stimulating after dinner to avoid falling asleep too early
  • Don’t watch scary television shows before going to sleep
  • Drink enough fluid at night so as not to wake up thirsty, but not so much that you frequently need to go to the bathroom
  • Eat nothing or something light before bedtime
  • Eliminate loud noises
  • Engage in deep breathing exercises
  • Enjoy a pleasant book on tape
  • Get up at the same time each day
  • Go to sleep at the same time each day
  • Have the same sleep routine on weekends
  • If something is on your mind, write it on a paper next to your bed and then fall asleep
  • If you wake up and can’t fall back asleep in 30 minutes, get out of bed until you are tired enough to sleep
  • Consume no caffeine after noon time
  • Keep the bedroom cool
  • Listen to relaxing music
  • Maintain a bedtime routine
  • Make preparations for the next day before going to bed
  • Meditate
  • Nothing in the room but sleep and intimacy
  • Progressive relaxation exercise
  • Read a pleasant book or magazine
  • Save vigorous exercise for during the day
  • Stay away from big meals close to bedtime
  • Take a nap way before bedtime
  • Take a warm bath or shower before bed
  • Take prescribed medications
  • Turn off electronics or technology (other than an alarm clock, turned backwards)
  • Use earplugs to block out noise
  • Use guided imagery
  • Wind down the evening with a favorite hobby, calm music, fun television, or book
  • Write in a journal

Click here for a printable worksheet version.

According to the U.S. Centers for Disease Control, an estimated 50 to 70 million Americans face chronic sleep problems. Sleep deprivation is associated with injuries, chronic conditions such as obesity, mental illnesses, poor quality of life, increased healthcare costs and lost work productivity.

Tired eyeMost adults require seven to nine hours of sleep each night. Getting less than that daily amount can cause a serious sleep deficit over time. While some sleepless nights may be the result of too much caffeine or thinking about something that’s worrying, chronic sleep deprivation is often the result of a sleep disorder such as:

  • Delayed Sleep Phase Disorder is a disorder in which a person’s sleep is delayed by two or more hours beyond the conventional bedtime. This delay in falling asleep causes difficulty in waking up at a desired time.
  • Insomnia is the most common type of sleep disorder. Some of the symptoms of insomnia include difficulty getting to sleep, waking many times during the night, and often waking before it is time to actually get up. Insomnia can affect normal daytime activities. Insomnia is most often caused by stress, anxiety, certain medications, depression and/or inadequate sleep habits.
  • Narcolepsy occurs when people feel excessively sleepy in the daytime. The sleepiness felt with narcolepsy is overwhelming. Some people with narcolepsy have uncontrolled sleepy periods that can occur regardless of what they are doing, while others have constant sleepiness throughout the day. The person has this feeling for a period of time longer than three months, and it is accompanied by a higher than usual percentage of REM sleep.
  • Nightmares are frightening dreams that occur during deep, REM sleep.
  • Periodic Limb Movement Disorder is the movement of hands, arms, feet, and legs during sleep that frequently causes arousals and disturbs the sleep cycles. Whether the person remembers waking or not, the brain often shifts from sleep to wake in a response to the jerking of the limbs causing the sleep cycle to be disrupted and increase excessive daytime sleepiness.
  • Restless Leg Syndrome occurs during wake hours and is often worse in the evenings and before bedtime, which can lead to sleep onset insomnia. This discomfort can come in the form of an urge to move one’s legs and feet to get relief. People find themselves experiencing excessive and rhythmic movements while they are sleeping.
  • Sleep Apnea occurs when soft tissue covers the airway, either partially or completely, causing a cessation of breathing for ten seconds or longer repeatedly through the night. This can cause frequent arousals and disruption of the desired sleep cycle. These disruptions cause those suffering from sleep apnea to be very tired during the day.
  • Sleep Talking is a sleep disorder defined as talking during sleep without being aware of it. Sleep talking can involve complicated dialogues or monologues, complete gibberish, or mumbling. The good news is that for most people it is a rare and short-lived occurrence.
  • Sleep Terror Disorder occurs mostly in children, but can be found in adults. Night terrors are frightful images that appear in a person’s dreams, but are often difficult to remember upon awakening.
  • Sleepwalking is a disorder that causes people to get out of bed and walk while they are sleeping. It usually happens when a person is going from the deep stage of sleep to a lighter stage, or into the wake state. The sleepwalker can’t respond during the event and usually does not remember it.

Clients suffering from serious sleep disorders might be helped by a visit to a sleep center. Contact the American Academy of Sleep Medicine at to find an expert near you.

Coping with Sleep Issues Workbook and Card DeckA book such as Coping with Sleep Issues Workbook from where most of this material has been excerpted can be of invaluable help to you and your clients. It can be found at

Appreciation and Independence: On Gratitude in Young Adulthood –

Can you remember feeling gratitude as a young adult? Maybe you were having the time of your life at a concert. Perhaps you were taking your first solo road trip and came upon a beautiful scenic vista. Maybe you had a community you felt sure of. Or maybe your received a gift to help you make ends meet; one freely given, with no strings attached.

We may instinctively know that gratitude, along with joy, love, awe, humor, and a handful of other positive emotions, adds to our health and well-being. But gratitude can be a hard emotion to access when…

Continue reading

Source: Appreciation and Independence: On Gratitude in Young Adulthood –



Excerpted from Mindfulness for Emerging Adults: Finding balance, belonging, focus, and meaning in the digital age

By Donna Torney MA, LMHC, RYT

Mindfulness has become a household word in popular culture causing some of us to see it as just another fad. But emerging adults can trust in mindfulness practices thanks to the large body of scientific evidence proving the benefits of this once esoteric idea. Recent studies have shown that mindfulness practices can help us manage stress and anxiety, better communicate with friends and co-workers, and build our ability to give and receive love and compassion.

Emerging Adult in a moment of MindfulnessMost researchers define mindfulness to include these two main components:

  1. Mindfulness is the practice of bringing yourself back to the present moment, over and over. Our minds are wired to have a sometimes anxiety-provoking bias toward planning for the future or remembering the past. Mindfulness practices tame this bias.
  2. Mindfulness is reacting to the present moment without judgment. Mindfulness practices help us build the capacity to notice, without self-criticism, when we lose sight of the present moment.

One emerging adult I work with describes mindfulness as the ability to be with one’s current set of circumstances without freaking out. She tells me that mini-mindfulness breaks at her workplace help her notice when she is having an automatic negative reaction to a situation, something that was getting in the way of her success at work. By employing mindfulness she found that she was better able to stay open to present moment experience in a way that helps her feel less threatened by new people and places. This skill, in turn, helps her with making conscious choices about her future and building more successful connections with peers.

Starting in the mid-20th century, in a time when millions of people were healing from the aftermath of two world wars, theories that elaborate on optimum human development began to emerge. These theories expanded on child development to acknowledge that adults continue to grow and evolve psychosocially way beyond the point of reaching full physical maturity. But this perpetual maturing only happens if we are willing to continue learning from life experiences and adapt in healthy ways – a process that demands mindfulness.

Erikson’s stages of psychosocial development

Young man emerging adult on campusErik Erikson’s classic model of psychosocial development has been used as a frame for exploring human growth beyond childhood by many prominent social scientists. Erikson’s model measures timeless developmental struggles and serves as a good frame when thinking about using contemplative exercises to foster positive adult maturity. Erikson went well beyond Freud’s focus on unconscious drives, seeking to legitimize theories of human altruistic potential.

Most scholars of human development see Erickson’s stages as flexible, to be expanded or contracted based on current cultural norms. They are not necessarily completed fully and sequentially. As balance is gained in one area of psychosocial development, it will affect the next area. This is good news! Life presents many twists and turns and often we must abandon straight-forward developmental maturity in order to survive. The beauty of Erikson’s model is that it acknowledges that individuals can circle back and revisit certain developmental processes.

Summary – Erikson’s stages of psychosocial development
Life stage Conflict Resolution or value attained Manifestation in adult life Example
Infancy (0-1 year) Learning basic trust vs. mistrust Hope Appreciation of human interdependence I accept help and trust that it is available.
Early childhood (1-3 years) Autonomy vs. shame and doubt Will Acceptance of the life cycle and impermanence I can manage disappointment
Play age (3-6 years) Initiative vs. guilt Purpose Humor, resiliency, compassion I don’t take myself too seriously; I take time to enjoy life.
School age (6-12 years) Industry vs. inferiority Competence Humility, accepting unfulfilled hopes I have both strengths and weaknesses.
Adolescence (12-19 years) Identity vs. role confusion Fidelity Merging of complex thought and emotions I take both emotions and logic into account.
Early adulthood (20-25 years) Intimacy vs. isolation Love Acceptance of the complexity of long-term relationships, openness, loving-kindness I am willing to work to maintain important relationships.
Adulthood (26-64 years) Generativity vs. stagnation Care Caring for others, empathy and concern My life has more meaning when Icare for my community.
Elderhood (65+ years) Ego integrity vs. despair Wisdom A sense of identity and integrity that tempers physical limitations I feel content and I accept the aging process.


A printable version of this chart can be found here.

The famous Harvard-Grant Study of Adult Development uses many of Erikson’s ideas. The Grant study followed a cohort of men who entered Harvard in the late 1930s, along with other less privileged young men. For over seventy-five years, this study has measured everything from blood pressure, to alcohol intake, to coping styles, and more recently, to brain activity. The study compares these measurements with the participant’s satisfaction and success in work and in relationships. Researchers involved with this longitudinal study are still collecting data and refining its findings on test subjects who are now in their eighth decade of life.

Most scholars of human development see Erickson’s stages as flexible, to be expanded or contracted based on current cultural norms. They are not necessarily completed fully and sequentially. As balance is gained in one area of psychosocial development, it will affect the next area. This is good news! Life presents many twists and turns and often we must abandon straight-forward developmental maturity in order to survive. The beauty of Erikson’s model is that it acknowledges that individuals can circle back and revisit certain developmental processes.

Mindfulness for Emerging Adults Book Release

Because of the current elongated road to adulthood, (see “Are We There Yet”) there is often a blending; some might say a clash, of the adolescent and emerging adult developmental milestones of finding identity and finding intimacy. George Vaillant, long-time director of the Harvard-Grant study, states that we must first master identity before finding true intimacy. Vaillant defines mastery of identity as achieving economic, social, and ideological independence from one’s parents.

Mindfulness for Emerging Adults: Finding balance, belonging, focus, and meaning in the digital age By Donna Torney MA, LMHC, RYT is a new Whole Person Associates book. Now available for order at

WPA Book Release: Mindfulness for Emerging Adults

Book Release

For Immediate Publication

Mindfulness for Emerging Adults Book ReleaseMindfulness for Emerging Adults

Finding balance, belonging, focus and meaning in the digital age.

By Donna Torney, MA, LMHC, RYT
Publisher: Whole Person Associates
Number of pages: 258
Publication Date: September, 2017
Contact Person: Peg Johnson, or Carlene Sippola: 800-247-6789

Duluth, MN – Whole Person Associates proudly announces the publication of Mindfulness for Emerging Adults by Donna Torney, MA, LMHC, RYT.

Mindfulness for Emerging Adults explores the task of becoming an adult in the twenty-first century. Advances in neuroscience underline the imperative to see mindfulness and other contemplative practices as indispensable life skills. These ancient and now rigorously researched practices are more important than ever in our age of accelerated change, media overload, and chronic busyness. The scientific community has now provided unrefuted evidence that these practices create positive change in the mind and body. By exploring and adopting mindfulness and other contemplative practices which the author calls Center Points, emerging adults can forge a path to find authentic identity and healthy personal and community connections, creating a good life in the digital age.

For the emerging adult (somewhere between 19 and 30) the mindfulness skills learned in this book will help take control of stress and manage difficult emotions. Donna leads the reader to become grounded in the present moment and experiencing more ease, contentment, and life satisfaction – a state that positive psychologists refer to as well-being. Throughout the book, highlighted sections entitled Voices of Emerging Adults tell the stories of typical young adult struggles. These stories are a composite of tales Donna hears in her private therapy practice, with details changed to protect privacy. The most common themes are highlighted, such as finding intimacy in a digital world, managing debt, finding a fruitful and worthwhile career path, managing difficult emotions, and practicing self-care. Mindfulness for Emerging Adults will inspire hope in young adults looking for the good life.

This book is written for parents, teachers, counselors or other mentors of young adults as well as the emerging adults themselves.  Highlighted sections entitled Thoughts for Mentors will guide mentors to better relate to young adult challenges. By listening to the voices of modern young adults and comparing their stories to the timeless developmental challenges of past generations, readers will be able to build greater understanding of the perennial journey to adulthood.

“Mindfulness for Emerging Adults is a must read that will capture your attention! This engaging guide is concise yet comprehensive, with intriguing and immediately applicable exercises. Donna Torney masterfully highlights how to weave the time tested, powerful, and evidence-based concepts of mindfulness into today’s rapidly changing, digitally-oriented world. She successfully translates sophisticated scientific constructs and contemplative practices into understandable terms and relevant tactics.”
-Karen Doll, PsyD


About the author:

Donna TorneyDonna Torney is a licensed psychotherapist based in Cambridge, Massachusetts. She uses mindfulness-based cognitive therapy and other mindfulness informed tools to treat teens, emerging adults, and mature adults who are seeking to manage anxiety, depression, trauma, and interpersonal struggles. In addition to her formal training in psychological counseling, Donna has studied with many leaders in the fields of contemplative neuroscience, yoga therapy, and meditation. She is passionate about combining Western psychology with researched contemplative practices to offer a unique approach to therapy and wellness. Donna Torney is available for speaking engagements. She can be reached at

Using Poetry to Explore Thoughts and Feelings

Creating a Healthy Balanced Life WorkbookPoetry exercises excerpted from Creating a Healthy Balanced Life

By Sandra K. Negley, MTRS, CTRS and Ester Leutenberg

Looking for an interesting way to lead your clients as they explore their thoughts and feelings? Something different and introspective? Try poetry.

Poetic Thoughts and Feelings – exploring through poetry

One creative way to explore thoughts and feelings is through the writing of poetry. Don’t worry, this does not mean a person has to be a great poet or writer to have fun with this unique and ancient art form. The key is to be open, enjoy, explore, and look soulfully at one’s deeper thoughts and feelings. Writing poetry can assist a person to focus thoughts, stop circular thinking, and begin to look at life from a different perspective. A variety of creative writing techniques will work with most people and most ages; here are four styles to initiate participants’ creative thinking.

Technique #1

Haiku is a unique ancient Japanese style of writing that uses 17 syllables divided into 3 lines of 5, 7 and 5 syllables.

River inspiring poetryExample:

River flows gently

Water moves sand and rock

Forgiveness begins


Technique #2

Five-line poetry while similar to Haiku is less restrictive and for some allows a more creative exploration.

Title of Topic (1-word) Describe Topic (2 words) Action Occurring (3-words) Feelings—how it makes you feel (4-words) Summary (1-word)



Honesty, acceptance

Evolving through time

Creating more fulfilled experiences



Technique #3

Pass Around Poem

A fun exercise in poetry writing can come from a less threatening approach that lends itself to creative and critical thought. This opens the door for participants to have interesting and inquisitive discussions on the coincidences in life.

Poetry book and notebookInstructions: Distribute one poetry book, a pen, and one piece of paper to each participant. Instruct participants that when you say, “start” they will follow this process:

  1. Close your eyes
  2. Open the book
  3. Place one finger on a spot in the book
  4. Open your eyes
  5. Write a line of poetry from where your finger landed (one line)
  6. Give participants an example

The facilitator gives participants 30 seconds and then says “pass.” Participants will pass their book to the right and repeat the process. The number of lines of the poem will be determined by the number of participants. (Keep in mind some people may need more time than others, waiting can be unsettling and/or break the magic with boredom. Consider facilitating with smaller groups.)


Technique #4

An I Am Poem can be used as an introspective exercise for participants to increase self-awareness while also connecting with other members of the group. The I Am Poem is a creative way to also teach and explore current issues, science, art, and conceptual thoughts. There are two ways to approach this form of writing:

Form One — Instruct the participants that to write this poem only requires one instruction; each line of the poem must start with “I am . . .” The poem can be as long as they choose and reflect as much about themselves as they would like to share. The poem may include such things as gender, ethnicity, interests, family traditions, mottos, memories, or future goals. Encourage participants to be creative in defining who they are and how they express themselves. Remind them that it does not have to rhyme.

Example Format:

I am a woman

I am multidimensional

I am strong and industrious

I am vulnerable and emotional

I am an advocate for individuals with disabilities

I am a listener

I am a mother, grandmother, teacher, friend

I am a woman


Form Two — This poem follows a more directed and structured format. Begin with the I am statement — two characteristics of the person. This statement can be repeated throughout the poem as a line opener and then repeated as the last line of the poem. The writer can have as many stanzas to their poem as they choose. As the facilitator, you can prepare a format for participants or you can list a variety of suggestions and let participants develop their own format.

Example Format:

I am (characteristics of the person)

I wonder (something the person or thing could think or be curious about)

I hear

I see

I dream

I am (If you wish repeat first line of the poem, every 4-5 statements)

I fear

I love

I understand

I hope

I am (end poem with this line)

Additional Suggestions

I care                     I feel                      I want                     I touch

I pretend               I respect                I cry                       I laugh

I worry                   I unfold                  I release               I forgive

I say                        I hope                    I honor

Thrive Behavioral Coping Skills for Teens

Teens ~ Out-of-the-Box Coping SkillsExcerpted from Teens ~ Out-of-the-Box Coping Skills

By Ester R.A. Leutenberg & Carol Butler, MS ED, RN, C

It’s already August. Teens, whether they have been working, getting ready to go away to college, or just hanging about the house, are bored. They grunt in response to questions, don’t want to go anywhere with the family (pa-leeease, Mom!), have their noses in social media of all kinds at all times, and are, in general, no fun to be around.  They need to find some way to cope with the last of summer. We need them to find a way to cope.

Assuming that they already have a firm foundation in the coping skills we teach to our teens, let’s take it a step further and take a look at how teens can thrive by becoming part of a larger cause. We can guide participants to interact with their community by engaging in activities they are passionate about.

I’ve come to believe that each of us has a personal calling that’s unique as a fingerprint – and that the best way to succeed is to discover what you love and then find a way to offer it to others in the form of service, working hard, and also allowing the energy of the universe to lead you.

-Oprah Winfrey

Poems About the Earth

Clean it Up

Clean up the earth,
so it could be a sparkling clean place for us all!
Clean up the earth,
so we can see the gorgeous blue and green on our planet.
The blue and green will shine in our eyes if we clean it up.
So clean it up,
so that we don’t see any garbage ~
any time or any day.
Clean it up
and live in a world of happiness.
The world we live in can be cleaned up and we can be happy!

-By Allie ~ 9 years old from
Ms. Siegelman’s Third Grade Class
Nassakeag Elementary School – Long Island, NY

In the Future, My World …

I will live in a country of my own making.
In the future,
Environmental destruction will be the norm.
No longer can it be said that
My peers and I care about this Earth.

-Excerpt from The Lost Generation by Jonathan Reed

Before the session begins, place a small globe or a picture of the earth in a covered box.

  • At the start of the session, have a volunteer take the picture out of the box and show it to the group.
  • Ask the participants what is represented (our world).
  • Ask what it means to live in one’s own little world. (Caring only about oneself and one’s close associates.)
  • Point out that teens might have a wider view of the world – school, community, etc.


Distribute the handout of Earth Poems. (Click here for printable handout.)

  • Have a volunteer read Jonathan Reed’s poem aloud.
  • Ask the participants what it means to them. Discuss.
  • Have another volunteer read it again, this time from the last line to the first. (Not each word, each line.)
  • Ask the participants what it means now.
  • Why did the poet want us to hear it both ways?
  • Which way do the participants want to see going forward?
  • Can we achieve this?
  • Ask participants for suggestions on how we can achieve a world where environmental destruction will be rare and folks will care for and cherish the earth.


Point out the list of causes on their handout. Ask what other causes might be added to the list.

Animal advocacy Health issues School
Children’s needs Homeless assistance The arts
Community Literacy Veterans
Cultural rights and equality Political issues Violence prevention
Faith-based organizations Safety


  • Ask them to choose a cause and write a poem about it. As they see from the examples, the lines do not have to rhyme, nor does the rhythm need to sound like that of Robert Louis Stevenson. Write their thoughts about an issue important to them and that causes them concern.
  • Have volunteers read their poems aloud. It might help to write one of your own and read it first to break the ice.
  • Discuss what ways there are to use their various abilities to support their chosen cause.
  • Debate the pros and cons of peaceful demonstrations.
  • Identify other ways a message might be conveyed.
  • Discuss how to raise funds to support a cause.
  • Identify the benefits received from volunteering.
  • Help each participant create and share a plan to follow through on advocacy or humanitarian efforts they care about.
  • Discuss the value of volunteering for a charity, faith-based or public service organization? Does it negate your contribution if you benefit as well as your cause?

Enrichment Activities

 Initiate discussion about these questions; possible responses are in italics.
  • How can teens use their artistic or literary skills to promote their causes?
Posters, postings, and pictures on social media, letters to editors, petitions, etc.
  • I what other ways can a message be spread about a particular need?
Songs, movies, television programs, documentaries, stage plays, etc. about the topic.
  • What are the pros and cons of parades and peaceful demonstrations?
Pros – publicity, educate the community. Cons – may be difficult to organize.
  • What are some ways to raise funds?
Sales (baked goods, rummage, etc.), services (cut lawns, wash cars, etc.). Donate the proceeds.
  • What is the value of volunteering for a charity, faith-based or public service organization?
 A natural high from helping others, make like-minded friends, work experience for a resume.
Prompt teens to make plans to follow through on one or more of their ideas. 

Post Traumatic Stress – Grief and Survival Guilt

Grief and Survival Guilt

As veterans make the transition from deployment to civilian life, from military housing to home, from loneliness to being in the heart of their family they often experience grief and survival guilt. Survival Guilt JournalingIf you are doing this exercise with a group, ask them to share what the phrase “shock and awe” means to them both as a military term and as a generic phrase. If you are doing this exercise alone, journal about what the phrase means to you. Remember, journaling is for your eyes only. Don’t worry about your writing style. Just jot down your thoughts as they come to you.

The death of a comrade in arms or the death of anyone close to you often leads to feelings of being overwhelmed, of not having the strength to go on, of feelings of guilt…why am I here and he/she isn’t.

Read the following with your own feelings in mind.

Excerpted from Veterans: Surviving and Thriving after Trauma

By Ester R. A. Leutenberg and Carol Butler, MS Ed, RN, C

Shock and Awe

Shock and Awe is a military doctrine of rapid dominance; the use of overwhelming power and spectacular force to paralyze the enemy’s perception of the battlefield and destroy their will to fight.

  • Shock, disbelief and denial are usually the first reactions to death.
  • Awe involves fear and dread, natural reactions to loss, especially sudden death.
  • You may grieve the loss of your former identity, the loss of innocence after combat, the loss of a dream if you change careers due to emotional or financial problems, and so on.

The grief process is individualized. Stages have been theorized, but people do not go through all the same stages and no specific time frames exist.

Elizabeth Kubler-Ross named five stages of grief:

  1. Denial, a defense mechanism that buffers immediate shock.
  2. Anger, we resent the pain and loss, and then are guilty about being angry.
  3. Bargaining, If only I had been better toward them; or if they are still alive, we tell our Higher Power, if they are saved I promise …
  4. Depression, sadness, about practical concerns and the loss.
  5. Acceptance, new normal, easier after a long illness or advanced age; harder to accept when a soldier dies in the prime of life.

GriefWork ~ Healing from LossGriefWork ~ Healing from Loss lists three markers along the Healing Pathway:

  1. Shock ‒ The reality of the loss has not sunk in.
  2. Disorganization ‒ The reality of the loss is real.
  3. Reorganization ‒ Rebuilding a satisfying life ‒ a New Normal.

Survival Guilt compounds grief among many veterans.

  • Some ask, why wasn’t it me who got hurt or killed.
  • Some take responsibility or blame, it’s my fault.
  • Some think, the dead person deserved to live and I deserved to die.

Survival Guilt can be mitigated if you accept the following statements to be true:

  • Admit to your feelings
  • Realize that survival guilt is common, but not comfortable
  • Seek others who understand, veterans, support groups, family
  • Mourn the loss, possibly having a ceremony or some other way to commemorate the person’s life
  • Act and live as they would have advised; make a contribution, hold a fundraiser, give blood, time, and energy to the causes they believed in

Warning Signals

Some symptoms are dangerous and require professional help. Make note of those symptoms of depression or complicated grief that apply to you.

  1. Thoughts of harming or killing yourself or others.
  2. Inability to trust yourself or others.
  3. Persistent belief that you deserve(d) to die.
  4. Inability to function months after the death; cannot perform at work or school; unable to care for children or household responsibilities.
  5. Severe depression and hopelessness about the future; feeling worthless.
  6. Inability to eat or sleep or take care of personal health and hygiene.
  7. Feelings of extreme guilt, rage or bitterness.
  8. Substance abuse, including taking higher than recommended doses of prescribed medications.
  9. Extreme physical reactions like nausea, aches and pains, lowered immunity.
  10. Very slow thinking, speech, and body movements.
  11. Seeing or hearing things that are not there.
  12. False beliefs that the person still lives; searching for them, or thinking you recognize them in familiar places.
  13. Envy toward others who are not suffering, or not caring about others.

Veterans front cover*Here are two exercises from Veterans: Surviving and Thriving after Trauma that may help those working through grief and survivors guilt:

Carry the Torch

Shock and Awe – Journaling Suggestions

May is Mental Health Awareness Month

Mental Health Awareness

Excerpted from Managing Moods Workbook, by Ester R.A. Leutenberg and John Liptak, PhD

Managing Moods WorkbookMay is Mental Health Awareness Month. It is important that facilitators keep an open mind about mental health issues and the stigma attached to people experiencing these issues. Rather than thinking of people as having a mental disorder or being mentally ill,  Erasing the Stigma of Mental Health Issues through Awareness helps facilitators to diminish the stigma that surrounds people suffering from these issues. Stigmas occur when people are unduly labeled, which sets the stage for discrimination and humiliation.

People who stigmatize and /or stereotype others bring about unfair treatment. This unfair treatment can be very obvious. For example, people make negative comments or laugh. On the other hand, this unfair treatment can be very subtle. For example, people assume that a person with mental health issues is dangerous or violent.

Stigmas affect a large percentage of people throughout the world. Some of the more common stigmas are associated with physical disabilities, mental health conditions, age, body type, gender, sexual orientation, nationality, family, ethnicity, race, religion, financial status, social sub-cultures and conduct. Stigmas set people apart from society and produce feelings of shame and isolation. People who are stigmatized are often considered socially unacceptable and they suffer prejudice, rejection, avoidance and discrimination.

Mental Health Awareness – An Introduction to Stigmas for your Clients

Intense Anxiety - Mental Health AwarenessA stigma is extreme social disapproval of some type of personal characteristic or a belief that is not considered socially acceptable. Fear of judgment and ridicule about mental illness often compels individuals and their families to hide away from society rather than face criticism, shunning, labeling and stereotyping. Instead of seeking treatment, they struggle in silence. Here are some ways you can combat the stereotypes and stigmas that are associated with mental illness.

  • You and your loved ones have choices. You can decide who is to know about your mental illness and what to tell them. You need not feel ashamed or embarrassed.
  • You are not alone. Remember that many other people are coping with a similar situation.
  • Seek help and remember that treatment from medical professionals can help you to have productive careers and live satisfying lives.
  • Be proactive and surround yourself with supportive people – people you can trust. Social isolation is a negative side effect of the stigma linked to mental illness. Isolating yourself and discontinuing enjoyable activities will not help.

Mental Health Awareness Month – Printable Exercises

DE-STIGMA-TIZE with the Facts About Mental Health Issues

Myth: Mental health issues are rare.
Fact: Mental health issues are not rare and affect nearly everyone either directly or indirectly.

Myth: People with mental health issues are unable to lead productive lives.
Fact: Most people with a mental health issue respond to treatment, learn to cope with and manage their problems, and go on to lead productive and fulfilling lives.

Myth: People who have mental health conditions will not get better.
Fact: Once diagnosed, mental health issues are treatable. While they are not always cured, they can be managed effectively. Most people with mental health conditions live productive and positive lives while receiving treatments for their mental health issues. As is the case with any illness, individuals with severe or persistent mental health conditions who respond poorly to available treatments may require more support and may not function as highly as others.

Myth: People with serious mental health issues are violent and unpredictable.
Fact: While some people who suffer from serious mental health issues do commit antisocial acts, mental health issues do not equal criminality or violence – despite the media’s tendency to emphasize a suspected link. People with mental health issues are no more likely to commit violence than anyone in the general public, but they are more likely to be victimized and are more likely to inflict violent behaviors on themselves.

Myth: Mental health issues happen because of bad parenting or personal weakness.
Fact: The main risk factors for mental health issues are not bad parenting or personal weakness but rather genetics, severe and prolonged stress (such as physical or sexual abuse), or other environmental influences (such as birth trauma or head injury).

Myth: Treatments for mental health issues are not usually effective.
Fact: The effectiveness of any treatment depends on a number of factors including the type of mental health issue and the particular needs of the individual. A combination of psychiatric medication and psychotherapy, or social interventions is the most effective way to treat mental health issues.

Myth: Mental health conditions are caused by everyday stressors.
Fact: It may seem that stress is responsible for mental health conditions; however, there is no one clear cause of mental health issues. Rather, it is a result of complex interactions between psychological, biological, genetic, and social factors. Stress, stigma, and lack of support can make it worse on the individual.

Myth: Mental health issues are always hereditary.
Fact: Some mental health issues include a genetic component, which results in a predisposition or vulnerability toward the mental health problems among children and siblings, but environment also plays a key role in the development of certain conditions. If someone in one’s family has a mental health condition, that person will be a higher risk.

Click here for a printable version DE-STIGMA-TIZE with the Facts About Mental Health Awareness Issues