Somatic Psychotherapy

Therapeutic interventions for anxiety, depression, anger management, mood disorders and the whole gamut of DSM 5 disorders, in essence, should be  multifaceted.  Since the human being is a complex process, psychotherapy is enjoined upon a deep inquiry into our fight and flight responses, our childhood history, our subconscious minds, our lifestyles, our diets, our social relationships,  our dreams, our movement patterns  and our energy levels. In short, to work with anxiety and depression or any DSM 5 disorder effectively, the therapist should take a holistic approach  that engages the subtle and gross aspects of the self.  So where would one start in this jungle?

The body. The body is what  holds the various strands of our life experience together. Working any psychological issue demands a deep delving into the mystery of the body. Since the body is the subconscious and storehouse of repressed memories, thoughts, emotions and experiences. The body is pregnant with implicit meaning. Life literally inscribes and imprints  itself on our bodies through our posture, our gestures, the tone of our voice, the quality of our eye contact and the grip of our handshake.

The  body is the temple of our consciousness, the ground of our experience and the barometer of our felt sense. We know ourselves and the world through our bodies. We experience pleasure and pain through our bodies. Since its inception,  somatic psychotherapy has emphasised the import of the body mind connection. Today we are reaching even more subtler understandings of the interconnected nature of the psyche soma in the world of psychotherapy, where Cognitive Behaviour therapy and other talk therapies are acknowledged to not be as effective as body oriented modalities. Ground breaking discoveries in contemporary  medical research regarding the enteric nervous system, the gut -brain connection,  polyvagal theory and psychoneuroimmunology  have underscored that we have more information coming from the body to the brain then from the brain to the body. Bearing this in mind, any psychotherapeutic modality that does not take  the body into account is limited in its efficaciousness.

I teach all my clients how to settle, ground, feel and reconnect with their bodies and to bring psychological awareness to their muscles. Somatic awareness in combination with Dialectical Behaviour and Cognitive Behavioural techniques along with insights from Existential, Psychodynamic and Transpersonal psychology influence my therapeutic repertoire. Ultimately,  I believe that psychotherapy in itself is an art form  at the end of the day and  is not a one trick  pony phenomenon. Different individuals have different needs as one size does not fit all. Having said that,  I have found, in keeping with current understandings of the body-mind, that  for most clients, the first place to begin is by  engaging the physiology of our bodies so as to facilitate the unleashing of  the power of the unconscious. Working with the body is a powerful phenomenon that facilities the client in their own healing process. Ultimately, when  clients can begin to  feel their bodies more they  get more insight into their  histories and experiences and in turn improve their cognitive, behavioural and relational outcomes.

 


Refining mental health

Mental Health today is a very expansive concept and there are a plethora of ways to work with the mind ranging from psychotherapy to mantra meditation to herbs to mindfulness ,pranayama and yoga to exercise to nutrition to hypnosis to entheogens to reiki  to quantum healing  to dance therapy to sound therapy etc etc etc…. the list goes on.

Its therefore no surprise if  we get overwhelmed and fall into something called decision fatigue where we don’t know the best way forward for us. Also within the list above there are many nuances and sub types of all the methods listed….for instance in therapy we have somatic therapy, dialectical behaviour therapy, psychoanalysis, Hakomi…under yoga we have power yoga, Ashtanga yoga, Iyengar yoga, the choices and types are ever growing . . .there are thousands of medicinal herbs and substances that are being marketed from açai berries to moringa powder as well as numerous schools and modalities of meditation  from Vipasana to Kala chakra empowerments . . . . so what’s the best thing for us?

Often taking care of the Self requires a multifactorial, holistic approach which stimulates us on a mental, emotional, physical and spiritual levels. So one would need to work with oneself in a balanced and disciplined way that is intelligible to one’s own psychophysiological constitution. What I mean is the right type of exercise, the right type of meditation, right type of food, right amount of rest etc. for oneself . .  Otherwise our efforts are counterproductive and we have limited results. As we say in Ayurveda that one can eat like a king, but digest like a beggar if one’s gut flora  or digestive fire, known as  Agni  is not working properly.  What is meant by this is that one can avail of the best groceries, trainers, yoga studios but if its the wrong type of practise for us in whatever field, we will not be able to contain it in our bodymind and will not receive the benefits from it. So if a very skinny person decided to do an intense cardiovascular work out then it would be extremely destructive for their nervous, endocrine and immune systems . . . similarly if someone who intellectualises and rationalises defensively undertook solely CBT they would not learn to recognise, feel and work with their emotions in the body. Hence it is extremely important to see what suits us . . . so this leads us to exploring our Prakriti or constitution. I now mandatorily conduct Prakriti analyses with my clients  in order to complement  their therapeutic process by giving them the sui generis  nutritional, lifestyle and self care advise that is customised coherently for their unique needs.


Managing Intense Emotions with DBT

Sometimes life feels very difficult, almost unbearable and we are left desolate and helpless. Dealing with the intensity of one’s emotions can be challenging and this might lead one to take extreme measures by over consuming alcohol and drugs, having a lot of sex, self harming, having suicidal ideation and loosing our boundaries with other people, to the point of one’s own self destruction. In such instances, we cannot handle the sensations and feeling that are coursing though the bodymind and we don’t want to feel them.  Our nervous system is fraught with arousal and we do not have the necessary psychological skills to self soothe and self regulate. We attempt to  drown out or change the feelings we experience be it anger, jealousy, sadness  or frustration, often with very unproductive and temporary methods.  Yet, while tragically these coping strategies bring us limited relief, the underlying problem continues to be with us, haunting us and goading us to continue in our self destruction.

Often cases of trauma constrain an individual’s  ability to tolerate distress and the  DSM V psychological disorders known as Borderline personality disorder, Bipolar disorder and other Mood disorders that show a constraint in managing  grief or rage effectively  have traumatic experiences underlying  them. In such instances, it is extremely important to get the right  psychotherapeutic support where the therapeutic work does not remain at the level of talk only. It is important to be able to tolerate emotions by feeling them in the body and being mindful of our experience where we can balance our emotions with our thoughts, our mind with our body, our internal world with the external world and ourselves in relation to others.  Dialectical Behaviour Therapy  (DBT) is a therapeutic modality to work with intense emotions and  low levels of affect tolerance to enhance mood management, prevent self harm and promote well being. DBT was founded by Marsha Linehan and is, at its a core, a set of self soothing and self regulating skills that help individuals gain their equilibrium in the most trying of circumstances. It is  noninvasive and medication free, premised on refining an individual’s self awareness, reframing thought processes and birthing new wholesome behaviours.

DBT is a progression from Cognitive Behaviour Therapy where the contemplative side of the individual is engaged through integrating a mindfulness practice along  with cognitive and behavioural therapeutic practices. In its essence,  DBT consists of 4 dominant skills- distress tolerance, mindfulness, emotional regulation and interpersonal effectiveness. It teaches one to live in the present moment while moving through very disturbing and difficult emotional states. DBT  primes individuals to draw on their higher minds and radically accept circumstances they cannot change while not feeling victimised by them. My clients who have persevered with DBT show remarkable progress in managing the stresses and contingencies of their life, it is not that they do not feel sad or angry or hurt anymore but they have the ability to make space for these emotions and utilise their energies in ways that are productive and beneficial as opposed to ways that are self destructive and malefic for themselves.


Drives, archetypes and sub personalities

As human beings seeking a therapeutic process we often believe that  our cognitions  and behaviours  or the way we think and act in the world is what has been causing us disquiet. However, this is only part of the story – we are, unbeknownst, to us,  informed by subtler subconscious processes that colour how we feel, interact and take in the world. In other words, the way we think and act is influenced by unconscious processes or habits that we are not really aware of. These processes govern us and run us and through the practise of these unreflective habitual behaviours  we constantly hit dead ends  we seek psychotherapy.

These unconscious processes can be said to be linked to energies that are felt in our bodies. Freudians refer to them as drives, Jungians as archetypes while those following Assagioli referred to them as subpersonalites. They can all loosely be understood as forces within us that organise our sense of self, other, time and space and mould our personalities, predisposing us to think, feel, behave and sense in particular ways. Often, these drives disrupt the peace in our minds and we are seeking external objects or experiences to gratify us,

 


Psychotherapy and Counselling

I am often asked the difference between psychotherapy and counselling. While these words are used interchangeably, there is a difference between them and it is vital to be cognisant of the distinction. Counselling generally implies a short term,  very specific and targeted facilitation. There are many types of  counsellors and varied topic-centred types of counselling, such as: marital counselling, drug and alcohol counselling, career counselling, health counselling etc. The list can go on . .  what is important to know is that counselling designates a facilitation around very narrow criteria’s restricted to the theme the counselling is pivoted around.

So a marital counsellor will focus primarily on marital issues, and will have restricted therapeutic skills  in other areas of mental health, such as trauma work, attachment issues or chronic pain. Tangential issues that could come up in the context of a marriage, that go beyond the nominal marital issues, are out of the scope of the counsellor and counselling. For instance, if there are sexual problems in a relationship, due to one of the partners being a survivor of childhood sexual abuse,  it would be hard for a counsellor alone to tackle such a case since childhood sexual abuse elicits deep trauma work. Counsellors are restricted to mostly working on the communication styles of the partners and regulating the behaviours of each member of the couple  in the context of the marriage.

Psychotherapy or rather integral psychotherapy is a more expansive and  holistic method of therapeutic work which integrates a vast panoply of areas from developmental, social, spatial, temporal,   existential, behavioural and transpersonal vectors as they inform the subjectivity of the client. Here childhood misattunements with primary givers are given importance, as well as a range of other factors, some of which could be  medical conditions, cultural conditionings,  learning disabilities, traumas, stress reactions, dreams, fantasies, anxieties, memories, relational patterns, addictions, depression,  tics, phobias etc. that impact the individual. A psychotherapist is trained in one or more modalities that are oriented towards harmonising psyche and soma like integral somatic psychology,  psychoanalysis, analytical psychology, dialectical behaviour therapy, somatic experiencing, hakomi to name a few.

Like there are many different kinds of counselling, there are many divergent types of psychotherapies. It is good to inform oneself about the many kinds of psychotherapies available and then to choose what is most appropriate for oneself. If you are someone who is very into the imagination and has vivid dreams a Jungian analyst might be the right match, if you are oriented towards uncovering unconscious psychological roots of childhood experiences you might want a Freudian or a Kleinian, if you want group work a Bionian, for psychospiritual work a transpersonal psychotherapist, for somatic work a somatic therapist and so on . . .

It is best to know well  your own sui generis therapeutic needs and then to find a psychotherapist or counsellor that will be able to work within your ambit and with your very specific, tailor made  therapeutic goals.


Working with Depression in the Body

Part of being human is to experience difficult emotions such as sadness, depression, anxiety, frustration, disappointment etc. Yet these emotions do not make us feel “good” and so we   have an unconscious tendency of not wanting to feel whatever we are feeling. We might brace, not breathe deeply and develop ways and means to numb ourselves and not feel. Commonly, this is what births addictions that range from food, alcohol, drugs, TV watching to excessive exercise, shopping, sex, and over working to name a few. However, these methods, at best, provide short-term relief, and at worst, create other issues for us, while lodging the disquieting feeling deeper into our psyche-soma, allowing it to eat away at our soul.

These obsessive self-numbing activities are called in psychological terms, “defenses.” In some cases, we are even lauded for being defended against our true experience, especially,  if we wear the mask of productivity as a   “workaholic” or have a great body because we are a “fitness freak.” Yet beneath that veneer, we chronically don’t feel so relaxed and much to our chagrin, nobody realizes our underlying state or empathizes with us.

Most mainstream psychological treatments for depression involve talk therapy, like psychoanalysis, which is known as the speaking cure or laced with some cognitive and behavioral interventions like CBT. While talk therapy, definitely has its relevance, sometimes, it maybe more palliative then corrective. The emotions will arise again and again and don’t really leave our system, unless they are fully felt, digested and processed through. Somatic therapy is a novel way to work towards a more permanent release of distressing emotions by increasing our capacity to really feel and tolerate troubled emotions in the body. In somatic therapy the understanding of what an emotion is expanded to psycho-motor holding patterns, like a permanent ache in the heart at the loss of a loved one or a knot in the throat due to not following one’s true calling, indicating a profound sadness that needs to be alleviated through the very physiology of the person.

These trying emotions are akin to muscular knots that need to be released. We are aware of the discomfort when we have a muscular knot in the neck; we often massage and stretch that part of the body to release the knot. Similarly, emotions metaphorically get knotted up and stuck in the body in half digested ways and need to be energetically discharged. Working with a somatic therapist allows one to truly embody, endure and expel difficult emotions in a self-regulating capacity. As the only way out of a distressing emotion is literally through it.


Depression

Understanding the Dangers of Depression

Our lives are colored by numerous textures of feeling ranging from deep joy to being down in the dumps with many shades of grey in between. It is but natural to feel sad at the death of a loved one, or to be melancholic to be leaving a familiar place or to be upset when we have disagreements with people or get laid off from work.

In fact, there are many instances in life where we feel the blues and this is but natural. However, what is not psychologically healthy is to remain in a perpetual state of dysphoria, which could be described as a “profound state of dis-ease, unhappiness and dissatisfaction,” day in and day out.

According to the DSM V, the following symptoms would help you identify Persistent Depressive Disorder (Dysthymia) in yourself or a loved one:

  1. Depressed mood for most of the day, for more days than not, as indicated by either subjective or observation by others
  2. Poor appetite or overeating
  3. Insomnia or hypersomnia
  4. Low energy or fatigue
  5. Low self esteem
  6. Poor concentration or difficulty making decisions
  7. Feelings of hopelessness

If a person embodies having a “depressed mood for most of the day” day after day with two or more other symptoms one can be said to be clinically depressed. Being clinically depressed, in turn, will have negative consequences on one’s health, well being, relationships, work, productivity and bring down the overall quality of one’s life. Research has shown, that high levels of the stress hormone cortisol have been found in the blood stream of people who identified being depressed, this in turn reduces immune function and makes any pre-existing medical disorder worse or may perhaps even create new ones. What we can gauge from this is that depressed people are more likely to be easily stressed and in turn, people who have a low threshold to stress are more susceptible to becoming depressed.

If an individual is in an intimate relationship or has small children their having depression would impact their loved one’s in very harmful ways. There is a progressive diminishing of real interpersonal contact and closeness since the depressed person is no longer present to anything other than overwhelming feelings of sadness. Spouses of depressed individuals report very low relationship satisfaction as depressions gnaws away at the fabric of intimacy where emotional connection, sexuality and simply having fun together is greatly reduced or becomes non-existent. Studies have also shown that children of depressed people have a higher risk of being depressed themselves, as well as having a vulnerability to addictions and exhibit behavioral disorders.

It is extremely harmful to the self and to one’s loved ones to ignore constant negative ruminations and feelings about one’s life, as they could transition from being pathological to fatal, where individuals driven by disturbing thoughts and emotions could end up taking their life. Another alarming point regarding depression is that it has a propensity to recur once a person has suffered from it before. Depression, in essence, is a thinking dis-ease, which is premised on habitual negative thinking, perceiving and evaluating one’s self and the world. This tendency to think pessimistically, in turn, creates neural pathways in the brain, literally grooves in our psyche, which get easily activated when certain triggers are present. Over a period of time, even small mundane disappointments may set off disproportionate feelings of anguish and hopelessness.

Although, ironically, depression is extremely common, with 20 percent of the population suffering from it at any given time; literally,  one in every five people experiences depression, it remains, unfortunately, ignored, undetected and untreated. While awareness is increasing regarding the importance of mental health globally, in India, historically and perhaps even to some extent today, psychological issues have been ignorantly stigmatized. Individuals are made to feel ashamed of themselves for having life traumas and upheavals and are marginalized for seeking help. Contemporarily, this is a very unfortunate set of circumstances, as historically in ancient India, dukkha was greatly acknowledged by all philosophical traditions as a profound existential state. Especially, highlighted by the ultimate healer and therapist, Gautama Buddha, who stated that “Life is Suffering.”

If you or anyone close to you is depressed it is extremely important that you seek professional psychotherapeutic attention. While exercise, yoga, mantra,  meditation and good nutrition are useful adjuncts and supports, they do not go the whole way in dispelling depression, which is a deep rooted psychological pattern. What the depressed person really needs is a facilitation to cognitively and behaviourally  re-frame and dis-identify with negative thoughts and to  develop the ability to tolerate distress and work through disturbing affects felt in the body.  Depression does not automatically alleviate itself or diminish with family support nor disappear with self-affirmations to be happy, it needs to be confronted and worked through psychosomatically.


Mindfulness and Eating

Conscious Eating: Re-evaluating our responses to food

The context of food in our lives

       As the festive season culminates in the onset of the New Year, we might invariably find ourselves ritualizing these transitions and celebrations with food and wine. Food is a necessity for our life and eating is a quintessentially primal activity whose roots lie deep in our evolutionary past. The ingestion and digestion of food is a nonnegotiable activity that is intimately weaved into the very rhythms of our daily lives and is an important arena of gratification where we relate and bond with others.

Food has been articulated as a life giving force in numerous traditions, from Ayurveda, Chinese Medicine to coeval nutritional science. Moreover, a significant number of the world’s cultures and religions have sacaralised the act of eating. From a biological perspective, our bodies need the right type of food to function properly as diseases and compromised health conditions have been scientifically linked with malnutrition.   Furthermore, individuals suffering from diabetes, cholesterol, heart disease, obesity, neuro-endocrinological disorders, digestive issues, cancer, kidney and liver disease all need regulated diets. In such circumstances, paying attention to the act of eating invariably starts taking on more importance than simply filling one’s stomach with tasty bites and is central to our health and well being.

Hunger: the drive to eat

Getting to know our subjective sense of hunger then becomes an important part in consciously eating. Understanding how we eat, when we eat and why we eat is necessary to correct our unstable relationship to food. Conventionally, hunger is understood as a physiological drive, which underscores an organic void or depletion within us signaled by a fall in blood sugar or a rumble in the stomach, indicating that the body is in need of nutrition. Yet, in a deeper sense hunger is an existential state that drives one consciously and unconsciously to want to eat food and functions on multiple levels from biological to emotional to spiritual.

Today, satisfying the polysemic phenomenon of hunger, in urban metropolitan areas has become increasingly easier due to the 24/7 accessibility we have to food. Over appreciating the value of the instant gratification good food provides us, our post-modern psyche has imbued food with a relevance that goes beyond physiological survival, making it food a principle source of pleasure and comfort We eat sugary, fatty, fried and salty foods not to fill our stomachs only but to help us deal with stress and assuage other disturbing emotions such as depression, loneliness, boredom, anxiety and anger.

Mindless Munching

The experience of stress and the need to de-stress is subliminally played out endlessly in multiple distress- gratifications cycles that seek to balance out an over-activated nervous system, but invariably ends up distorting the natural hunger of the body to a mechanical, unconscious and insatiable deprivation that hijacks the physical response to food. On a more rudimentary level, we “feel bad” so we eat food to “feel good.”

           Eating, as the pursuit of comfort, in a fast paced, hyper stimulated and highly pressured epoch, becomes a coping mechanism to face the numerous demands made on us on a daily basis.  Behaviorally this is more common than not. Have you every sat in front the TV or in the cinema with a tub of popcorn or some other snack and have ploughed through the whole thing in the course of the film? Or been at a cocktail party sipping a drink and chatting with a friend while devouring bowls of nuts and chips? Or polished off a whole bar of chocolate while sitting front of your computer screen trying to make our work deadlines? In such instances we are not realizing how fast or how much we are eating. This is called mindless munching or the act of grinding down edibles with a mind contemplating everything but the food one is eating.

Conscious Eating

An antidote to this would be to mindfully observe and understand our experience of hunger and by that token our relationship to food. By being “mindful,” one pays nonjudgmental attention to the moments when and why one wants to eat, the food one eats and the act of one’s eating. By being focused on how we feed ourselves we can aid a more sophisticated self awareness of ourselves and our subliminal desires and drives that motivate us to eat as well enable a balanced relationship to food and body size. The reasons why we over eat, starve, grow fat, become skinny or on a more severe note become anorexic, bulimic or obese have a lot to do with how we are psycho-emotionally processing our sense of self and the stresses we encounter. Hence it is very imperative to pay attention to the emotional states behind one’s eating habits and working with them if they are disturbed.

For those of us seeking meaningful and healthy ways of being-in-the-world, our relationship to food, (equivalently) along with other quotients of well being, such as spiritual practice, psychological growth, exercise, time spent in nature, nurturing relationships, and aesthetic appreciation, to name a few, is of paramount importance. Below are some guidelines to help restore us to consciously eating:

1)      Before eating do a baseline self- check on your hunger level before eating. Ask yourself where do you feel the hunger? How hungry are you?

2)      Involve all your senses when you eat i.e. really see, smell, taste and feel the food you are eating

3)      Serve yourself moderate helpings of food

4)      Really chew your food and break it down

5)      Eat in a slow fashion to prevent over eating

6)      Don’t skip meals

7)      Avoid all distractions when you are eating

8)      Eat an organic plant based diet as much as possible for yours and the planet’s health

9)      Therapeutically work with yourself or with a mental health professional to reduce your stress, depression, anxiety, anger and boredom levels

 

 


Self Esteem in Romantic Relationships

Low Self Esteem in Romantic Relationships

Often we think that relationships, especially, personal, intimate and romantic one’s, would nurture and nourish us and in turn boost our self-confidence. However, sometimes, this is not the case, if we have inadvertently spiraled off into a destructive or passionless or simply dead and boring relationship quagmire. What drives one to persist in (and with) a painful and unsatisfying set of circumstances, in what was once a romantic relationship that was supposed to give you pleasure and joy? As when we get into a relationship, we are generally not signing up for prolonged physical, emotional and sexual neglect or abuse.

What then could be the motivation to subject oneself to the agony of continuing to be willfully involved with a violent alcoholic or a sex addict or an emotionally unavailable workaholic who just does not have time for you? In other words, what is that kernel within ourselves that enables us to remain, consciously and unconsciously, in self-damaging situations with a dysfunctional partner while staying frozen in a maladaptive relational pattern?

How we embody low self-esteem

On some level, the reason why we choose to persist, and I would reiterate the choice in the matter, is perhaps, on some deep level we believe that we deserve no better, having a low opinion of ourselves and our capacities to be an independent and likable individual. These kinds of negative assumption of ourselves tantamount to a subliminal form of self-hatred. Latently or even manifestly, the voice of one’s inner critic, ensures that we remain embroiled in emotional anguish ad nauseum, while we continue to live our lives as gluttons for punishment as we feel that we deserve to be slapped, cheated on or mistreated because we might be ugly, fat, old, stupid, unattractive, unintelligent etc.

We make excuses about why we cannot leave a painful and harmful dynamic which is anything but romantic because we have a fear of being alone, that we are financially dependent, that we have children with the person who abuses us or that we nurse a fantasy that our partner will change. However, over a period of time, these assumptions show themselves as examples of self-defeating delusions and fears that undermine ourselves. Bluntly put, the foundational core for these emotionally unintelligent assumptions is low or very low self esteem that sabotages us from living a better life and fashions a self-fulfilling prophesy of victimhood. Low self esteem is a requirement to tolerate unpleasant relationships because in some sense one is habituated to being treated badly and may at other times actually be a license for one’s partner to treat one shabbily.

Reasons why we develop low self esteem

Perhaps we grew up with an absent or an emotionally unavailable parent or experienced damaging developmental trauma that destabilized our sense of self or we were simply bullied at school. Admittedly, there might have been pain in our lives but to blame ourselves for bad things that happened to us or to wallow in them indefinitely and play the victim is self-destructive. Often the roots of low self- esteem lie deep in a wounded child within us who feels “not good enough.” As children we feel accepted only to the extent we feel unconditionally loved and supported by our parents. If we felt conditionally accepted or constantly criticized by our caregivers we started believing that we were not adequate and begin to develop an inadequate sense of self.

The persecuted child grows up into a battered adult who stays paralyzed in the face of abuse, retarding her sense of agency or self-efficacy, which is the ability to take control and transform one’s life. The crux of the low self esteem issue is that when we let ourselves remain in a situation that harms and destroys our last remaining shreds of our self, health and well being, it reflects a great deal about how we feel about ourselves and about how we let ourselves be received in the world by others.

Psychophysiological Consequences of Low Self Esteem

Over a period of time, continued low self esteem and sense of victimhood will grind us down both psychologically and physiologically pre-disposing one to suffer from clinical depression, high anxiety, and stress. Chronic low self-esteem may lead onto more severe mood disorders ensuring that one has very low life satisfaction.

Since the mind and body are intimately connected from a psychobiological perspective, prolonged relational stress will wear down our immune system, cardiovascular system, gastrointestinal system, neuroendocrinological system and set us up for potentially harboring carcinogenic cells or auto-immune reactions. Apart from taking serious tolls on our mental and physical health, low self-esteem prevents us from living the life we would want which is a happy well-adjusted life with a partner who loves and cherishes us.

How to work with Low Self-Esteem

If you identify yourself as having low self-esteem, which in turn keeps you, locked in an unhappy romantic situation start doing something about it immediately! It is good to begin to create scenarios and experiences that give you a sense of self worth. Below is a list of activities that help bring up one’s self esteem

1)     Cultivate an attitude of self acceptance and self care

2)     Take some space and time away from your partner

3)     Create independent activities with your friends or start socializing sometimes separately from your partner

4)     Make new concrete life style shifts in your life – – e.g. start exercising, loose weight; become healthy; get a job

5)     Create a new self image by changing your hairstyle and fashion sense

6)     Develop your hobbies

7)     Practice yoga and meditation

8)     Travel alone or take a holiday with friends

9)     Create new social outlets such as joining a book club or a NGO or even a dance class

All the above suggestions are to allow and curate a sense of self- confidence and enjoyment where you feel good about yourself and validated and appreciated by other people. However, despite trying all the above suggestions, you do not feel better because of overpowering feelings of helplessness, it is beneficial to speak with a qualified therapist or mental health professional about how you can either emancipate yourself from the relationship or shift your emotional reactions in or to the relationship.

Since low self-esteem is in fact a psychological problem to deconstruct low self esteem one needs to pursue psychotherapeutic interventions that create cognitive and behavioral shifts. By doing psychological work one can trace and ultimately dis-identify with the wounded inner child and discipline the inner critic within one’s thought processes. Where one learns to replace negative thoughts with more self-affirming ones, and where one learns to create boundaries against abuse as a form of self-care.

I, personally, feel a combination of psychotherapeutic work with self-awareness practices works best with my clients with low self-esteem. By supporting them in their mindfulness practice and psychodynamically engaging and challenging their unconscious core beliefs and assumptions about themselves, clients are able to eventually dis-identify with their negative assessments of themselves. Conversely, they generate more self-acceptance and self-compassion for themselves and in turn translate this into wholesome actions in their lives and relationships.

 


Stress

Understanding Stress

 What is stress?

Stress is an ubiquitous and multilayered phenomenon that is an entrenched reality of our daily postmodern lives. In effect, the stress response has played a significant role in the evolution of our nervous system and was crucial for our survival on this planet. As hunter gathers we experienced acute stress when there were life-threatening perils from the environment confronting us for e.g. a wild animal that crossed the path of our foraging ancestors. In such instances, the human body would mobilize itself defensively and activate the autonomic nervous system to a fight, flight or freeze response to meet the demands of the situation.

When an organism is stressed and in either fight of flight mode, there are profound alterations due to the enervation of the sympathetic branch of the autonomic nervous system. Noticeable psychophysiological shifts take place such as an increase in the heart rate, blood pressure, respiration, muscle tension, sweat activity in conjunction with a cascade of neuro-endocrinological alterations. The adrenal-hypothalamus- pituitary axis gets activated and there are rapid secretions of the stress hormone cortisol along with blood moving from the periphery of the body i.e. the limbs to the core i.e. to the heart and lungs.

These psychosomatic shifts allow the organism to speed up the action that needed to be taken, which in most cases was either confrontation or agitated escape. However, in freeze mode, which occurs in profound experiences of trauma, the parasympathetic nervous, system dominates and the body drops in pressure, temperature, and mobility simulating a corpse. From an evolutionary perspective, the freeze mode was useful as on occasion predators may loose interest if the prey is already dead.

According to one of the pioneers in stress research Hans Seyle, upto a certain point stress is beneficial as it helps us take effective action when facing challenging conditions and this can be understood as “eu-stress.” As such, the stress response to a particular point helps us become focused and efficient and enables us to get things done while simultaneously it protects us from negative consequences that might pertain to our survival. Yet there is a certain threshold value to stress and beyond that stress starts becoming “di-stress” and it starts pathologically eroding and wearing and tearing down our cardiac-respiratory, immune, gastrointestinal and muscular-skeleton systems.

Stress becomes di-stress when the stress response is provoked chronically, which is, unfortunately the zeitgeist of our times. Today acute stress is replaced by chronic stress, where a biological threat is now a psychological one. We react to not finding a parking spot before an important meeting in the same way our ancestors reacted to encountering an avalanche near a mountain that might crush them. Our bodies have not caught up with the evolutionary shifts in our life style and so in a nutshell, our bodies are over reacting to the mundane pressures and irritants of every day living.

Due to a revolution in our material culture, life is now becoming faster and faster . . . we have faster computers, faster cars, faster communications and often our bodies lag behind and we have to whip ourselves to keep up our pace, to perform, to meet deadlines and to make money. As a result, our default existential state is that of an incessant low-grade activation of the autonomic nervous system, which keeps the bodymind latently stressed.

In busy urban areas, especially, we are almost all the time normalized to being unconsciously stressed to the point that we do not realize that we are stressed. This psychologically predisposes us to depression, irritation, frustration, mood swings, and angry outbursts, all of which underscore psychoemotional disturbances. Simultaneously we are prone to worsening any pre-existing medical disorder and susceptible to creating the causes and circumstances for diseases to take root in our bodyminds, highlighting psychosomatic over drive. Diabetes, hypertension, colitis, chronic fatigue syndrome, fibromyalgia, eczema and ulcers are a few stress related conditions.

How do we know we are stressed?

          Since stress is an integral part of our lives, learning how to identify when we are stressed and what to do about de-stressing ourselves becomes paramount for our psychophysiological health and well being. Stress is a polyvalent experience and has cognitive, emotional, physiological and behavioral ramifications.

Below is a brief exegesis of some of the symptoms that manifest in us in relation to each category within which our stress response can be observed. It is important to recognize if any of these are being embodied in our own experience in order to assess how stressed one is and moreover, the ways in which we create stress for ourselves through our perceptions. Regarding a demand from the environment as either a threat or a challenge depends very much on our sense of self esteem and feelings of being resourced and resilient.

Cognitive dimensions: ruminating repetitive thoughts that are automatic and pessimistic; negative interpretations of life events; and a predisposition to play the victim.

Emotional dimensions: feelings of anxiety, panic, irritability, agitation, frustration, jitteriness, anger, impatience, overwhelm, being out of control

Physical dimensions: changes in heart rate, blood pressure, respiration, muscle tension, sweat activity, body temperature, fatigue, migraines, stomach aches, palpitations

Behavioral dimensions: lack of exercise, eating excessively, indulging in unhealthy foods, smoking, drinking, abusing drugs, unnecessary shopping

 Some useful guidelines to regulate stress

        While we cannot prevent stress in our lives, we can definitely shift our emotional reactions to stress. In order to modify how we are oriented to overwhelming life events it is quintessential to make life style changes that allow us to slow down and relax. Some suggestions to safe guard ourselves from being chronically stressed are the following:

 1)     Mediation, yoga, tai chi, qui gong

2)     Physical exercise

3)     Spending time in nature

4)     Healthy nutrition

5)     Listening to music and appreciating the arts in general

6)     Meditation and yoga

7)     Enjoying conviviality with family and friends

8)     Going on holiday

9)     Sleeping a full eight hours

10)   Having a massage

11)   Adopting a pet such as dog, cat, hamster, even having an aquarium

12)   Working with a mental health professional to see your patterns of stress, how you perpetuate them and ultimately to dis-identify with them