Blog – Page 3

January 24, 2017 By Susan O'Grady 10 Comments

How to Be Sad

There’s a plethora of information about happiness.

My literature search on this subject yielded over 13,000 scholarly research articles and over one thousand books. Advice about how to be happy floods the internet daily with simplistic listicles and click-bait articles that make it all seem so easy.

But their advice, like telling a sad person to think about all the reasons they shouldn’t be sad, or a depressed person to just get up and exercise, doesn’t work. Thinking about the good things in life can sometimes ameliorate sad feelings, but usually, trying to grasp at happiness when in the grip of a depressed mood leads to failure. And while the research on exercise’s positive effect on depression is robust and persuasive, depressed people lack the drive to work out: that’s what depression means.

These suggestions, though well-meant, amount to telling depressed persons to snap out of it—or it’s their fault. This shames the sufferer, making things worse. And the resulting family strife doesn’t help. Well-intentioned spouses and parents who believe that snapping out of it actually is within a depressed person’s power will eventually succumb to exasperation and resignation.

A recent New York Times article gives suggestions for eliminating negative thinking, and paraphrases Rick Hanson, author of Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence: ” it might be helpful to ask yourself if you are accomplishing anything by dwelling on your negative thoughts.”

Depressed people have negative thoughts. Understandable. When we’re depressed, we’re likely to feel hopeless, inadequate, and a failure. While practicing controlled breathing and mindfulness even with your eyes open, as the article suggests, will help, how do we get to the point of making these actions regular parts of daily life? When sadness overwhelms, it is often impossible to follow well-meaning suggestions with regularity. Like New Years’ resolutions, these techniques fade quickly.

When Sadness is Normal

Sometimes sadness is normal. Experiencing a range of feelings in reaction to painful life events is understandable; these life stressors would make most of us depressed. When psychologists see a client for a first appointment, we assess mood, its duration, and the severity of distress. Is the client’s symptoms within normal limits given the precipitant for entering therapy, e.g., a marital crisis, job loss, or death of a family member? We would say a client’s feelings are “within normal limits” when they come to therapy with sadness after losing a loved one.

In my own practice, a former client returned to treatment recently because his wife had just died. He spoke of his inability to shake the feelings of loss and sadness. It had only been four weeks, and he asked me if it is normal to feel depressed, and the question that inevitably follows: how long it will last? It’s okay to feel sad—but to someone grieving, the feelings can be so intense that time stands still. Four weeks can feel like four years.

It’s hard to feel deep emotional distress, of course. Indeed, because suffering is part of the human condition, we’ve devised a vast repertoire of ways to avoid experiencing our painful emotions and worrisome thoughts, including self-medicating by substance use, distraction by Facebook and other media outlets, and much more. Americans account for two-thirds of the global market for antidepressants, which also happen to be the most commonly prescribed drugs in the United States. These drugs can play a vital role in helping many people cope with chronic depression, but all too often these medications are over prescribed or prescribed without looking at inner sources of depression.

When Positive Thinking and Life Coaching Make it Worse

Or, life coaches with little training in mood disorders are prescribing positive thinking the way many physicians prescribe mood stabilizers, but even positive thinking strategies are ways to avoid painful feelings. I have seen the disastrous results of life coaches who work remotely from home, charging enormous amounts of money to people desperate for help. Sadly, these coaches have not laid eyes on the people they propose to help. They are unable to see the dangerous weight loss or weight gain or pick up the nuanced suicidal non-verbal communications.

One client I saw judged himself to be a failure after his six-month life-coaching sessions because he was unable to feel better or do the things the coach was suggesting. When I saw him after his failed coaching experience, he was in a deep depression, his sadness palpable. I asked if he was suicidal and he admitted that he was—something his coach had never asked about. Alerting his partner and suggesting hospitalization was imperative. Alarmingly, he had already seen three different psychiatrists and obtained antidepressants from each, and not one of them had inquired about suicidality.

Another example from my practice is that of a woman who saw a life coach because she hated her job. They talked about the need to follow her bliss and sever ties with her employer. She took this advice, quit her job, and when her unemployment ended, she was unable to find another job. Despondent, she came to therapy to help sort out her feelings about her life and to find a way to understand why she was unhappy at her former job. She needed to understand her role in how she was sabotaging herself. She took the long road to what ultimately brought her fullness and acceptance of life and work.

Accepting Suffering as Unavoidable

Suffering can’t be avoided. (In Buddhism, it’s the first Noble Truth.) But allowing ourselves to express sadness and to accept deep pain will eventually allow these feelings to dissipate; blocking emotions only deepens problems. Also, giving ourselves time to settle into feeling allows us to recognize that they ebb and flow. Through this, we can accept that while old age and death are inevitable, and feeling sad is part of living, suffering is impermanent. By being able to sit with emotions and not get caught up in either rumination or anxious fretting, we develop a steadiness of mind. Meditation works by settling our turbulent thoughts and emotions so that we can titrate them into tolerable moments.

What works

When sadness becomes major depression, positive thinking (and related approaches, such as life coaching) are like putting a Band-Aid on a gushing wound. Facing our pain, learning to bear our suffering, and then doing the deep inner work of understanding our role in our troubles is a way out. It is often slow and filled with obstacles. Here are some steps in the process:

Become aware of subtle emotions as you experience them. By becoming aware of emotions as you feel them, rather than pushing them away, you will be better able to use them to employ coping strategies.

When emotions become intense, know that feelings don’t stay that way forever. All emotions are transient. Practices such as regular meditation help us not just to become aware of feeling but also not to indulge them.

Remember that subtle change is hard to see. A broken bone mends slowly; in the early stages, healing is hardly noticeable on an X-ray.

Look deeply at ourselves and the role we play in our mood. Doing so opens what is within, leading to understanding and insight.

Take into account what precipitates depression. Learning to tolerate understandable sadness and some depression helps normalize what we are experiencing. All emotions have a role to play in living well; we must accept and not disown our most difficult feelings.

January 9, 2017 By Susan O'Grady 7 Comments

Psychologists Need Self-Care Too

Who Helps the Helper?

Self-care and Professional Ethics

Most psychologists get into this profession because we get deep satisfaction from helping people. But who helps the helpers?

What about us, anyway? We sit for hour after hour, year after year, listening to our patients’ troubles. We help them make sense of what brings them to our office. We help them deepen their understanding of themselves, working with them to bring meaning and healing. But as psychologists, our training is not very conducive to our taking care of ourselves. The doctorate alone requires years of study, often at great expense, to say nothing of the 3,000 hours of unpaid or poorly pay internships, post-docs, and fellowships. It doesn’t end there; paying back debt and building a practice all take a toll on our self-care.

And of course, while dealing with these stresses, we must be effective and ethical therapists, even when clients may be testing our limits, perplexing us, or causing us worry.

A therapist’s most valuable tool is the therapist’s own self. We need to model a healthy self to our patients, and this is where self-care comes in. In fact, self-care is an ethical obligation to maintain our competence as psychologists. Caring for ourselves as well as others is an inherently integrated and reciprocal process. When we “more readily realize the false demarcations between ourselves and our clients, self-care becomes both an ethical imperative, and a humanistic one.”

So as a therapist, don’t forget to ask “What about me?” Issues that can challenge self-care include:

Balancing our own and clients’ needs
Countertransference reactions such as envy or erotic feelings
Confidentiality

For example, let’s take envy, a problem that can loom large in this time of widening income inequality or for any therapist working with wealthier patients. No one likes to admit to these feelings, but denial is never a good strategy.

And this can especially be a problem if we feel stalled in our own lives. We’re in the trenches; meanwhile, we’re helping others live fuller lives. They write books, get fit, flourish. Good for them—but here we sit, with unfinished books, unexercised bodies, unexplored possibilities.

Here’s an example from practice. I had a patient with a lucrative professional job who came to me for anxiety. His wife was leading one of my dream lives, an unlived life: owning, showing, and riding horses. I thought “Damn, she is lucky.” I felt impatient with his problems and had to stop myself from telling him his wife should get a job. Because we have lots of training in recognizing when our reactions are countertransference, I was able to see my envy at the moment so as not to let it interfere with my client’s process.

Or again, I authorized a patient’s disability leave. He got four months of paid time off, lost 20 pounds, got a personal trainer, went on a luxurious retreat, and returned looking 15 years younger. Good for him again, but I was seeing 30 patients a week and couldn’t help contrasting my responsibilities with his fortune. For those of us in private practice, taking time off is tricky. We lose income, and our clients may have a hard time without the continuity of their therapy.

When our patients improve and surpass us, how do we deal with that? That’s our goal, after all, to help them attain full lives and be the best selves they can. It’s not their fault we haven’t achieved the same goals. We must move forward in our own lives if we’re going to maintain ethical principles and standards.

Another challenge can be secrecy. Keeping patients’ secrets is an ethical imperative, but not always easy. A very famous person came to me for something highly scandalous, something I was dying to tell—but even married to a psychologist, I could only mention broad strokes, no name, and no juicy details. It’d be a great story to tell at parties, but I have to keep all such secrets locked in a vault. It’s a peculiar situation to know more about the inner world of a very famous person than anyone else and not be able to tell a soul, but as an ethical psychologist, I can’t.

Heal Thyself, Know Thyself

The arduous, never-ending self-scrutiny and inner work required by our profession is like no other. Gaining deep intimacy with our clients requires us to be just as deeply familiar with our own feelings. As therapists, we’re already familiar with the value of therapeutic lifestyle changes in areas like exercise, nutrition, rest and relaxation, maintaining good relationships, and service to others. We recommend these to our clients, so we should also practice them ourselves, along with helpful interventions like apps to help monitor diet, movement, and sleep. To that list, we should add personal therapy and development for ourselves, not just clients.

This is because our work depends on the personal/professional therapeutic bond. In turn, this largely reflects and depends on the therapist’s interpersonal skills and capacities, which must be developed in the therapist’s personal growth. The link between ethics and self-care is professional competence, which is necessary to protect our patients. Clients’ experiences of the therapeutic relationship—the respective interpersonal capacities of the client and therapist—are among the strongest predictors of outcome in psychotherapy. Those of us who are reluctant to practice self-care techniques should remember that we are decreasing our competence as therapists.

More information on these principles can be found in the American Psychological Association’s “Ethical Principles of Psychologists and Code of Conduct.”

Taking care of ourselves

When we say we’re not taking care of ourselves, what does that mean? Examples include overbooking or double-booking clients and working late; taking no breaks; being distracted, impatient, or bored; giving clients the same exercise as last week; talking about your problems instead of the client’s; or falling asleep. As you can see, these actions affect clients as well as ourselves. If we’re not getting our needs met, we may look to our clients to meet them, a violation of their boundaries.

Occupational hazards

In our jobs, occupational hazards include isolation, demands on body and psyche, frustration, and never-ending self-scrutiny. Burnout, compassion fatigue, secondary traumatic stress, suicidal patients or our own suicidal feelings, depression, anxiety, boredom, conflicts with co-workers, practice logistics, insurance company hassle, money problems, personal losses—these can all add to professional stress. To cope, we need inner strength, self-soothing skills, and awareness of our own strengths and vulnerabilities.

Even when we’re well aware of the damages we’ve suffered, we can fall into the mistake of projecting all such woundedness onto patients, and claiming the role of healer—and healed—for ourselves. Self-knowledge helps prevent this trap. It’s also important to seek peer support through professional groups and other networks, social support from friends, and develop coping methods like cultivating humor and a positive attitude.

Occupational Privileges

As psychologists, we live a life of service. We are always growing and our work protects us from stagnation. As Irvin Yalom states in his book The Gift of Therapy, we daily transcend our personal wishes and turn our gaze toward the needs and growth of the other. We take pleasure in the growth of our patients and also in the ripple effect–the salutary influence our patients have upon those whom they though in life. Viewed the right way, the very stresses of our job help prevent stagnation. Continual growth and self-examination help us to see the world, ourselves, and our patients for what they are, making us better able to help—which is what brought us into this field in the first place.

The result of my exploration on this topic is that I am taking a sabbatical during the month of January. I plan to write, read, and spend more time deepening my self-care.

References

In pursuit of wellness: The self-care imperative. Barnett, J. E., Baker, E. K., Elman, N. S., & Schoener, G. R. (2007). Professional Psychology: Research and Practice, 38(6), 603–612. http://doi.org/10.1037/0735-7028.38.6.603

What Therapists Don’t Talk About and Why: Understanding taboos that hurt us and our clients. Kenneth S. Pope, PhD, Janet L. Sonne, PhD, and Beverly Greene, PhD Second Edition, APA Books, second edition, 2006.

Ethics, self-care and well-being for psychologists: Reenvisioning the stress-distress continuum. Wise, E. H., Hersh, M. A., & Gibson, C. M. (2012). Professional Psychology: Research and Practice, 43(5), 487–494. http://doi.org/10.1037/a0029446

Ethical principles of psychologists and code of conduct. The American Psychologist, 57(12), 1060–1073. http://doi.org/10.1037/0003-066X.57.12.1060

September 19, 2016 By Susan O'Grady 1 Comment

How to Keep Your Marriage Healthy While Coping with Chronic Illness

Most marriages will be confronted with challenges. How we cope, make meaning from, and find benefit in challenges affects our overall satisfaction in our marriage. One of these biggest challenges marriages face is health

In Sickness and In Health Till Death do us part

We take our marriage vows in innocence and with deeply felt sincerity. That’s probably a very good thing, because the reality of coping with a chronic, debilitating illness such as a stroke, Parkinson’s disease (PD), or dementia, makes many question or regret their vows to stay together in sickness and in health.

When our love is new, we don’t vow to love honor and cherish until. And usually, we don’t intend to leave when our partner becomes ill—but we may feel like it at times.

When One Partner Becomes a Caregiver

In the United States, spouses are first in line to take on caregiving responsibilities (Pinquart and Sorensen, 2011.) We are living longer than ever before, so the likelihood that one partner will become a caregiver is high. Studies have shown that the caregiver burden when a spouse has a chronic illness negatively affects the non-ill partner both physically and mentally: more depression, more financial and physical strain, and lower levels of well-being.

Take PD, for example. PD is a chronic debilitating illness characterized by complex motor and non-motor symptoms. When PD is first diagnosed and during much of the illness, the non-PD partner provides most of the informal caregiving. Roles and division of labor often shift, with the caregiving spouse taking over such tasks as scheduling and driving to medical appointments, assuming the banking and paying bills, and so forth. Chores increasingly fall on one partner, making it difficult to find time for the non-PD partner to practice their own self-care or see friends.

Research on marital satisfaction and quality of life shows that social support is a key factor in coping with illness, yet sadly, couples often become more isolated, withdrawing due to an increase in interpersonal distress, shame, or apathy. The need to cut back on work-life or retire abruptly brings another set of challenges, such as loss of work identity, fading ties with coworkers, more dependence on family, and decreased income.

My Illness or Your Illness: Attending to the relationship

Chronic illness needs to be seen not only as an individual challenge but as a relationship challenge as well. Anger at the unfairness of life when newly diagnosed is entirely normal, for example, especially if the implications of the disease process are fully understood. Wanting to blame someone is understandable, but with an illness such as PD, it’s important to ascribe the difficulties to the disease, not the person.

Studies have looked at how dyadic coping—a process by which a couple works together to cope with the stressors that one or both face—might be one way of improving health and in turn, the quality of the marriage. Couples who see the illness as a relationship issue rather than an individual issue will be more satisfied with their relationship than couples that don’t.

Coping together: We-ness in marriage

One clue to how couples see the relationship is their pronouns. These seemingly innocuous parts of our everyday speech give us an important window into the inner workings of relationship. If one member of a couple comes into my office and is talking at his/her partner, using pronouns such as I, me, my, you, your, this shows a greater sense of independence and distance in relationship. Using words like we, us, our, implies a shared identification between spouses, more intimacy, and more emotional investment in their relationship.

Self and Partner Soothing

We-ness is also associated with more positive and fewer negative feelings, and with lower autonomic nervous system arousal—the fight or flight response. When one partner is anxious or distressed, we can calm them down by using we-ness words. This produces a soothing or emotion-regulating effect on the other spouse. I have seen this many times in my office when counseling couples. For example, when Joyce was becoming agitated about how she would cope with Al’s PD, Al reached over and gently stroked her arm, saying ”We’ll deal with this together.” This had an immediate impact on Joyce’s anxiety.

That simple act can make a big difference. We refer to these as emotion-regulating behaviors. Couples can help each other cope with anger, frustration, and fear and minimize the damage to the marriage. In couples therapy, we help partners understand the importance of self-soothing during difficult times and the value of providing that to their partner when needed.

Benefit Finding: Glorifying the struggle

When couples come to therapy, I assess their strengths and the areas that need work. Asking such questions as “Looking back over the years, what moments stand out as really hard times in your marriage? Why do you think you stayed together? How did you get through these difficult times?” Or, “How would you say your marriage is different from when you first got married?” With such questions, I am looking for growth as a couple and for a sense of how they cope. Are they a team? Or do they point fingers and accuse their partner of messing things up?

By developing a shared narrative, and finding meaning in how we strengthen our bond (or we-ness), we can improve our marriage and how we cope with problems. Couples who view their struggles as hard, but worth it, demonstrate hopefulness and togetherness. Yet when one partner feels out of control of the events that they face, they may slip into passive endurance, believing there is nothing they can do about a problem. They struggle to survive instead of growing closer through the challenges. These marriages are less likely to be happy and more likely to end in divorce.

But for couples that find meaning and growth in difficult times, they “glorify the struggle” and will have a better chance of staying together through hard times. Hope and commitment toward growth as a couple are elevated over disillusionment and negative perspective. I don’t want to be dismissive of the real, hard problems such couples face or expect them to have a Pollyanna, rose-colored-glasses approach. We can acknowledge the pain and suffering we face, but at the same time, try to find something in our experience that helps us learn something new, to grow from it.

By viewing the inevitable problems that arise in marriage as “our problems” rather than blaming our partner, we strengthen our bond. Moreover, when we work as a team rather than in parallel, we are less likely to complain criticize, or be defensive. This has a valuable outcome: we naturally reduce each other’s tension or physiological arousal. When we are relaxed when confronted with problems or conflicts, we are more likely to find ways to manage them—in sickness and in health.

August 16, 2016 By Susan O'Grady Leave a Comment

Expressing Fondness and Admiration for a Strong Foundation

Sound relationship House w copyright-1 Healthy relationships are built on a strong foundation. In Northern California, where I live, houses are constructed on a solid footing to protect them in an earthquake. If a home is built on soft soil without proper engineering, strong seismic waves will cause a lot of damage. One way that a building is secured is by using lead-rubber bearings, which contain a solid lead core wrapped in alternating layers of rubber and steel. This combination of material is both strong and flexible, reducing damage.

Similarly, a relationship that has a strong but flexible foundation will withstand the slipping and sliding that accompany big life events, such as an illness, job loss, affair, or the birth of a first child. We need a core of strong support, but we also need elasticity for our relationships to flourish.

When a relationship is new, we tap into a powerful current of affection and attraction that makes it natural and easy to express appreciation for the other’s positive attributes. Meanwhile, we’re less attuned to the negative—but undesirable traits will be revealed in due time. What then?

The more we feel appreciated and respected by our partners, the happier our relationships are. I often tell clients who come to me for couples’ therapy that “It doesn’t count if it doesn’t come out of your mouth.“ In other words, you may think your partner is beautiful, or funny, or brilliant—but if you don’t say so, your partner doesn’t know.

The Magic Ratio: Five positive interactions to one negative

As with any skill, it takes continued practice to nurture a relationship past its first blush. The research of Dr. John Gottman shows us that we can create a strong foundation by keeping a balance of five positive interactions to one negative.

More-damaging negative interactions are weighted more heavily than others. Whining, for example, is a negative of one point, while disgust is rated at negative 3, and contempt at minus 4 points. Contempt is the worst because it conveys a huge disrespect for your partner as a person. It’s hard to recover positive feelings when contempt is prevalent in the relationship. As with all negativity, the antidote to contempt is genuine fondness and respect.

So how do you cultivate more-positive interactions when life can be so challenging, our partners sometimes so annoying, and irritation comes easier than appreciation? That’s where the flexible stability comes in. For example, when Ken and Josie came to therapy, they had developed the habit of harping at each other for little things. Josie would come home after a long day and see that Ken had left his stuff all over the living room. She’d gripe, and in response, he’d grouse at her for something she did or didn’t do. These negative interactions became so habitual that Ken and Josie were almost unaware of the pattern. But they were very aware of their unhappiness in the marriage.

In therapy, we focused on learning to express fondness and appreciation—not as rote words of thanks or praise, but from practicing mindfulness, attention, and remembering. In mindful relationships, we stop running from task to task on autopilot. Instead, we slow down enough to scan our environments and pay attention to what’s good about our partners, rather than fine-tuning our list of grievances.

Here’s an example from child-raising. We’re attuned to catching children in bad behavior, but it’s actually very important to catch them doing something right.

When my daughter was in middle school, she’d come downstairs as I was reading at the kitchen table. Often, I’d automatically ask her to empty the dishwasher or some other household task. One day when she came into the kitchen she said, “Mom, if every time you see me here you ask me to do something, I’m going to quit coming into the room!”

I let out a hearty laugh. In that instant, I saw myself through her eyes and realized the power of Pavlov’s classic description of conditioned responses. If I didn’t want to condition my daughter to stay out of the kitchen, I’d have to change my ways.

Similarly, in long-term relationships, try to catch your partner’s good deeds instead of simply noticing the irritations. In the case of Ken and Josie, they were able to recall the qualities that attracted them to each other and made a point of expressing their positive feelings regularly. By expressing more appreciation they noticed they were complaining less.

It feels good both to give and to receive heartfelt compliments. But they don’t have to be huge—even just a simple thank-you for doing the laundry counts. In fact, noticing and acknowledging those daily, routine things our partners do goes a long way to shoring up the foundation of our relationship house. Although it may feel awkward at first, positive interactions become automatic with attention and practice.

What are positive things you can do?

Find good things about your partner. This rewards what they’re doing right, and daily practice becomes ingrained in the brain and will therefore likely continue and reinforces continued positive interaction. It’s almost magic.

Express appreciation. For example, say thank you for stopping at the market or for taking out the trash. Even if these tasks arise from a couple’s division of labor, it’s still important to acknowledge them.

Pay attention. For example, listen to the way your partner tells a story about his/her day and respond with sincere interest, Don’t rush to change the subject to your own day or allow yourself to become distracted by phones, TV, or other attention snags.

Express affection. Physical affection tends to diminish as a relationship matures, but it doesn’t have to. We know that happy couples give and receive lots of affection through gestures like holding hands, stroking an arm or cheek, winking, and even just smiling. While these may seem obvious and simple actions, they’re often absent among couples who come to therapy—not a good sign. Getting back to affection requires letting go a bit, being relaxed, and trusting that your partner will be responsive and not pull back.

August 2, 2016 By Susan O'Grady 4 Comments

Suffering, Compassion, and a Skate Ramp

Last summer my neighbor’s son built a huge skate ramp right next to our property line. (We’re on different streets, so I’d never met him or his family.) First sawing, then drills, and eventually it was finished. I was glad for the wild Toyon bushes that grew high along a chain-link fence, blocking the view—but they didn’t block the noise. In use, a wooden skate ramp has a distinctive mechanical rhythmic sound. It’s similar to the poinging back-and-forth of a tennis match, but is contiguous and unvarying, except for sudden yelps from the kid or his friends.

My work as a psychotherapist is focused and can be intense. Quiet time in my garden is where I replenish by slipping into reverie and stillness. I love the silence, punctuated only by bird song and breeze-tossed tree branches. But now all I could hear, from morning to dusk, was the skate ramp. I tried to counter my disgruntlement by reminding myself ”At least it’s not a meth lab, and I could be glad he’s getting healthy outdoor exercise instead of playing violent video games and watching TV all day.” But in truth, my first thought when occasionally I heard a thud followed by silence was ”Yes! A broken ankle.” I did also think ”Oh no, he could be seriously hurt.” But then the skating would start up again, shattering my peace and sending me back inside, grumbling to myself.

It’s true that in many ways, mine was a problem of privilege. I was just irritated by a noisy nuisance, while some people are living in refugee camps or dodging bullets in their own neighborhoods. Many people have no quiet, private, beautiful place whose silence can be invaded. But most everyone can relate to feeling dominated by difficult or negative emotions like helplessness and anger.

Finding Another View: Opening a window

This summer, though, something happened to help me accept the noisy interruption of my peace. When a Monterey pine succumbed to bark beetles, the tree guys removed some of the Toyon bushes, opening the way to roll giant slices of the dead tree to the driveway. For the first time, I had a window to view of the skate ramp. The opening allowed me to see a shadow dance, the blur of back-and-forth movement, that accompanied the rhythmic skating sound. Actually seeing the annoying kid had the interesting effect of making me less annoyed. Suddenly he was a person, a kid in a baseball hat having fun, not just a maddening, repetitive sound.

I felt compassion; I wasn’t trying to feel compassion, talking myself into it, as I had before. Catching glimpses of the kid trullunking on his skate ramp allowed me to view it differently. I can now sit in my backyard and know that the neighbor kid is doing what he enjoys. I can occupy that space literally alongside him. It becomes background sound, along with the birdsong and an occasional leaf blower. And it also nice to notice when it stops.

How does my experience relate to suffering and compassion? Because it’s only when we can see the humanity of others and acknowledge our own uncomfortable thoughts that we can transform them. When I couldn’t see what annoyed me, all I could do was feel passive and irritated. Once the view was clear, I saw the source of my feelings and could accept it. A kid having fun. On a skate ramp in his backyard, which happens to abut my backyard. We all have hedges that obscure our view and block compassionate response.

In psychotherapy, and in mindfulness-based therapies, we learn to see that our emotional suffering and problems in life are not only caused by external circumstances but by the way we react to them. When our minds are dominated by difficult or negative emotions, we feel out of control. We employ defense mechanisms like withdrawal, projection, and demonizing the other. In contrast, meditation and practicing mindfulness is helpful because we cultivate the capacity to watch what is arising in our mind.

We sit with feelings and thoughts, noting but not getting caught up in them as we refocus on breathing and sitting. Witnessing our thoughts and feelings and allowing them to move on, rather than reacting unreflectively, gives us more emotional control, more choices about how to respond with our better, less overwhelmed selves. Meditation provides a window to compassion, something like the window through the hedges. We may begin to see that things are not so bad.

W.H. Auden’s poem “As I Walked Out One Evening” contrasts the idealistic hopes of lovers with the quelling voice of Time, which recommends looking in the mirror—accepting things as they are—and the healing that comes from putting aside illusion:

‘O stand, stand at the window

As the tears scald and start;

You shall love your crooked neighbour

With your crooked heart.’

With my crooked heart, I do.

How to Be Sad