O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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The fullest experience of the adventure of life: Eleanor Roosevelt, Blogging, and Mindfulness

I just returned from Rhinebeck, NY, where I took an intensive professional training course in Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse. The five-day course was developed for health-care professionals who already have experience with mindfulness-based approaches.

Many years ago, I studied Mindfulness-Based Stress Reduction with its developer, Dr. Jon Kabat-Zinn. Since that time, research has continued to demonstrate the effectiveness of mindfulness training in treating many forms of emotional difficulties. Offspring treatments that involve mindfulness as a major component to their treatment protocol include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT).

Taking a course in MBCT  gave me the opportunity to study with one of the major researchers and writers in the field. It was given by Zindel Segal, PhD, and Susan Wood, MSW, LCSW. Dr. Segal is the author of Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, 2002, The Guilford Press.

While the course was valuable and added to my skills in teaching this treatment approach, the highlight of the trip was my excursion to Val-Kill, the unpretentious, comfortable home of Eleanor Roosevelt. Just down the road in Hyde Park, NY, stands the opulent estate of her husband, Franklin Delano Roosevelt. Ms. Roosevelt created her separate home in a style that reflected her sensibilities, not those of her husband. Set among trees and brooks, the house contains simple furniture and cozy, intimate rooms.

I was fascinated to learn that Eleanor Roosevelt was a kind of pioneering blogger extraordinaire. She wrote a daily letter to Americans that came to be called “My Day,” one of the most popular syndicated columns of the time. She wrote her column six days a week, often dictated in any free moment she found. She published over five hundred words per column, at least six days a week for 26 years from 1936-1962. Personal as well as socially relevant, her work communicated her thoughts, joys, and intimate concerns.

As a beginning blogger, I have wondered about my urge to write. In a previous post, I talked about how this form of writing allows me to take my many years as a psychologist and put words to this experience that can go beyond the confines of my confidential private office. Social media has provided a means for anyone to make his or her thoughts and opinions public, taking journaling to a new level—but not an unprecedented one, as I saw by Eleanor’s example.

Pleasant and Unpleasant Events Calendar

I often suggest that my clients journal. Collecting thoughts and feelings by observing them and taking the extra step to write them down allows insights to emerge. In MBCT, one of the first homework exercises is to write a daily note about a pleasant and an unpleasant experience that occurred during the day. By noting the thoughts, feelings, and sensations associated with such experiences, we bring mindful awareness to daily life. This can allow us to experience and appreciate the moment simply as it is, without adding further elaboration in the form of wishing, dreading, or judging. It is often our mental elaboration that triggers rumination, a common symptom in depression. We can begin to realize that even unpleasant events can be tolerated. Bringing awareness to each situation, whether we label it good or bad, is an important step in learning to relate differently to them. This takes practice. And curiosity.

The Fullest Experience of the Adventure of Life

As Eleanor Roosevelt writes in You Learn by Living: Eleven Keys For a More Fulfilling Life, “There is no experience from which you can’t learn something. When you stop learning you stop living in any vital and meaningful sense. And the purpose of life, after all, is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience. . . . The experience can have meaning only if you understand it. You can understand it only if you have arrived at some knowledge of yourself, a knowledge based on a deliberately and usually painfully acquired self-discipline, which teaches you to cast out fear and frees you for the fullest experience of the adventure of life.”

Being attentive to thoughts and writing them down takes discipline. When keeping a journal (or a thought record of daily events, or writing a blog) our life experience is enlarged and enriched. For people struggling with depression, being able to notice even slightly positive things during the day allows them to see that such events are already there for them. For some, it may be noticing the song of a bird, or the stars on a clear night—these simple experiences are always within reach, but for someone who struggles with depression, they go unattended. Writing is a vehicle of self-expression.

References:

Roosevelt, E. (2001). My Day: The best of Eleanor Roosevelt’s acclaimed newspaper columns, 1936-1962. D. Emblidge (Ed.) Cambridge, MA: Da Capo Press.

Roosevelt, E. (2011). You learn by living: Eleven keys for a more fulfilling life. New York: Harper Perennial.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.

 

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The College Transition: Things to Talk About

 College is a rite of passage, a transition into adulthood. It’s a transition for parents, too, who can no longer sleep in the room down the hall with ears half-cocked and one eye open. It’s all the more important, then, for parents to have conversations with their kids about how to deal with the common, normal changes and stresses likely to arise in these early years of living away from home.

As high-school friendships shift and fade, college students must forge new social connections or risk social isolation. Kids who have poor coping and social skills before starting college might seek unhealthy solutions, like partying, playing computer games, or holing up in their dorm rooms with their laptops

If these solutions, healthy or unhealthy, don’t work, college kids often isolate, deny, pretend, and find all sorts of other ways to conceal their loneliness. To be lonely is shameful. Instead, many tend to brood over stressful experiences and feelings, a process called rumination. The lonely, anxious person ruminates on negative thoughts: reliving past injuries, flubs, or missed opportunities; feeling apprehension about social events, and anticipating distressing outcomes.

Anxiety, Rumination, and Depression in College

Rumination and anxiety create a cycle where each promotes and prolongs the other. The effect of this is that a stressful experience (such as, say, being snubbed at a party) does not end when the stressful situation ends, but can continue on in one’s thoughts and moods. So it is not only the exposure to the initial stress but also exposure to the recurring representation of that event in the mind that results in a depressed mood. Over time, this anxious rumination leads to negative self-esteem and depression.

Apart from such dangers, loneliness doesn’t just feel bad; lonely people are at greater risk for poor health. Social support mediates health: It is well known that when someone has close family and friends, they will be encouraged to seek medical attention when needed, and they will take better care of themselves in general.

One simple thing to look at when considering college students, loneliness, anxiety, and stress is the role of sleep. Good sleep is the cornerstone of mental health. Most of the clients I see—college students or otherwise—suffer from some form of sleep disturbance. Difficulties getting to sleep or staying asleep are common in both depression and anxiety. (Oversleeping, too, can be a problem when it’s used to avoid situations that may provoke difficult feelings.)

In the recent issue of Health Psychology, researchers examined the mechanisms that underlie the relationship found between depressed mood and poor sleep quality in college students. They found that found that rumination and anxiety are strongly connected to loneliness and depressed mood as well as poor sleep quality.  The authors conclude that psychotherapists and college counselors need to assess loneliness in kids at school.  It is not enough to look at depression and anxiety.  Parents, teachers, college counselors need to look at sleep quality and social isolation, in addition to symptoms of anxiety and depression.

(Zawadzki, M. J., Graham, J. E., & Gerin, W. (2012, July 23). Rumination and Anxiety Mediate the Effect of Loneliness on Depressed Mood and Sleep Quality in College Students. Health Psychology. )

Of course, the image of a college student pulling an all-nighter, or partying until dawn, is a common one, and it’s true that college-aged kids need less sleep than adults. For vulnerable kids, however, poor sleep can lead to severe psychological problems. And as we’ve seen, college can be a vulnerable experience in itself. Add to this that students trying to solve their sleep problems don’t always choose healthy options. Some college kids I’ve worked with use combinations of stimulants and caffeine to stay awake, and anti-anxiety medications to sleep. This leads to drug dependence, and in vulnerable kids, will cause emotional problems ranging from depression to delusional thinking.

Whether problems are caused by too much social media, partying, or are the result of depression and anxiety, we need to pay attention to how these activities are affecting emotional well-being.  Find time to talk with your college-bound kid about some of these issues.  Enjoy the fun of shopping for dorm room stuff, but don’t neglect the crucial conversations about what to expect during this first year away from home. Some basic topics to discuss could include: how to deal with being lonely, how to contact the college counseling center if they feel anxious or depressed, limiting social media, how to get sleep when distractions inevitably occur, and of course, “call us when you feel down.”

Originally published here.


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Educational Engagement : Learning to Learn

Red Brick, Ivy, and Spiderwebs: Learning to Engage

I spent my first two years as an undergraduate at a red-brick ivy-covered college. I remember very little of those two years, but not because I was partying. I was in a different kind of daze, induced by class sizes of up to 200 and studying for tests that required bloodless rote memorization, devoid of joy. The only professor I remember was my biology teacher, Mr. Jenkins. I was enthralled with his course. It was taught in an enormous lecture hall but did not feel big because Mr. Jenkins was so animated, clearly delighted in his subject.  He walked back and forth on stage in front of a screen displaying his photos of spiderwebs, flora, and fauna. Each intricate web was unique, many glistening with dew in early morning light, evening light, and moonlight. The slides were awe-inspiring.

During the first exam for this class, I sat stunned, tears falling down my cheeks, as I realized that I could not answer most of the questions. I had studied, yet I was unable to finish three-fourths of the test. Noticing my distress, Mr. Jenkins gently touched my arm and asked to see me after the exam.  In his office, he asked me how I studied for the test and I told him about flashcards and notes. That was all. Without chastising me for poor study skills, he showed me more of the beautiful photos he had taken with his son, who had died, he told me.  His kindness and his openness about the loss of his son had a big impact on me.  I realized I wanted more connection with my professors.  I wanted my education to include dialogue and engagement with the subject.

Somehow I had made it to college with no idea how to learn. I wasn’t even burdened with attention deficit disorder (ADD) or some similar diagnosis. What I assumed were good study skills were completely off base. It was an awakening.  I did not know how to memorize and assumed that I was incapable of being successful as a student.

Something in me persevered—I think it had to do with those dewy spider webs. Without consulting my parents or friends, and in a time that pre-dated the now ubiquitous larger web, I discovered an experimental college in the woods.

I entered The Evergreen State College because I wanted to learn without the focus on grades. I found a good fit. The class sizes were under 20 and the professors knew our names, and skied with us on Friday nights. They read our journals and interacted with us at all stages of the course.

I discovered I could learn. It developed imperceptibly at first as I read Montaigne and dialogued with him in my journal. I argued with Nietzsche and ranted at Machiavelli. I empathized with Faust and the urge for power and knowledge that led him to sell his soul. I fell in love with Don Quixote and Sancho Panza. Unlike my first two years of college, the last two are a vivid, still-living memory. While I did not return to the study of biology, I discovered a love of liberal arts.  Active engagement with the reading took organization and skill.  These were not simple books but through discussion and writing, they came alive.

How To Do What You Love

Engagement, I found, is the key to learning. Today’s children face enormous pressure to ace standardized tests and get into only the top colleges. If they have ADD/ADHD or other learning disorders, good medications and therapies exist for them. But do they care about learning? Do they love it? Do they know how to structure their time and work with their minds and hearts in the ongoing process that learning requires? In my practice, I have seen the results when kids fail to engage. They become dependent learners. Apathy and boredom are common.

Paul Graham—programmer, venture capitalist, and essayist—writes in   How to Do What You Love” about the intricate dance of finding meaning in what you do and sticking with difficult tasks. Nothing can be achieved without effort. Engagement is not about taking an easy road. We will serve ourselves and our children well by modeling discipline and love of learning. When my girls were little, we would watch spiders make their slow crawl over the lawn, in awe of their perseverance.  Tiny legs, and impossibly large grass obstacles, yet biology won out as they did want they are designed to do.  When our resident mockingbird would call from the chimney, we would run outside to listen to the concert. These simple experiences would later be woven into a story or a dinner discussion.  Bringing mindfulness to everyday life leads to a plethora of opportunities to find fullness in life, and in learning.

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Appreciating the Absence of Pain

 

You don’t appreciate not having a toothache until you have a toothache.  Sitting in the endodontist’s chair last week, I was asked if my tooth ached.  I paused for a long moment, and then replied, “ache is a very vague term”.  We both laughed.  Pain is difficult to measure.  Equally difficult to measure is joy– elusive and fleeting.

Thich Nhat Hanh used the toothache analogy when he spoke to a group of therapists many years ago. “When you have a toothache, you are enlightened—you know something very important—that not having a toothache is a wonderful thing. “

He further elaborated; “when you do not have a toothache, you don’t seem to enjoy it—peace is there in the present moment, but we find it boring and that is why we look for something more exciting”.   It feels so good when a toothache finally goes away.  If only we could appreciate the absence of that pain all the time.

Not all pain can be resolved by a dental procedure.  We are surrounded by pain in our work.  We see so many varieties of suffering, some themes repeated like a familiar chorus, others particular and unique to a single human being.   Our hearts ache with the daily news from places both remote and in our own backyards.  But when we experience extraordinary pain, we remember how fortunate we were for the time when pain was absent. Most of the time, however, we slug through our days, not noticing the absence of pain.

During the root canal, I listened to a favorite playlist on my iPod.  Steve Jobs had died a few days before.  I could not help but silently thank him for the music that distracted and entertained me, drowning out the sound of the drill.  Like many, I shed tears when I heard the news of the great man’s death. Grief is too strong a word for my feelings.  Rather, I felt a tender softness for the man I never met, for he enhanced my life at almost every turn.  From the podcasts that enrich me, to the MacAirbook that keeps track of my notes and projects, power points and photos, to the iPad that keeps me from double booking my clients (most of the time) and gives me a library full of books, and finally to that most magical of devices, my iPhone—that lets me check the weather, the news, the map, and gives me countless sources of entertainment.

Technology has enhanced our lives.   We have become experts at multitasking.  But it is in the moments of quiet, when our senses are awake, that we can feel the absence of ache.

Autumn has arrived.  October is my favorite month.  It is the month of my birth, but that is not the main reason I love it.  I love the long shadows and the harvest moon.  The light and the darkness meld into one another as the center of day holds until it succumbs and leaves the evenings long, for soup, for hearth, for stories.

And with the arrival of autumn, the holiday season approaches.  Our clients feel the tug of opposing emotions—joy, gratitude, resentment, and disappointment. We listen.   And we try to help integrate their dark and light.

But at the end of the day, we must shed our helping selves for a time, so that we can appreciate the absence of ache.  So that we can enjoy the moments that, when strung together, give us that delicious taste of all that is good in our lives.

“Be hungry, be foolish.”  Mr. Jobs spoke that advice at Stanford after hearing of his cancer diagnosis.    As we head into this holiday season where autumn fades into winter, let’s remember to be hungry for creative urges, for love, and for all that feeds us around the hearth. In our consulting rooms as we listen deeply to our clients as they work with their pain let us be present.

I remind myself to be playful and look for newness even if it seems foolish.  Mindful living is to be in touch with life—in order to enjoy the presence of your non- toothache.

Originally published:  President’s Column October 21, 2011