So, after all the thinking, considering, avoiding, and then making plans in the process of change, the time comes when you are ready to take Action.  Stage 4 of the Transtheoretical Model is all about that first plunge into actual behavior change and beginning the journey to accomplish your goals.  But as many people find in Stage 4, finally taking the leap may come with some surprises, and this week’s post is about how to help you begin your actual change with the highest chance of continued success.  

Often the build up to change is so filled with anxiety that finally doing something may actually bring a bit of relief.  For so long you may have avoided a change, constantly living with the fear it would be too difficult to maintain and/or that you wouldn’t be able to do it at all.  Often people find that when they do make the change, it feels pretty good.  For example, many people who want to quit smoking or drinking feel tremendous anxiety about what a nicotine or alcohol free life will be like.  They imagine all sorts of scenarios involving attempts in the past that had gone awry.  The anticipation of how bad it will be is itself really uncomfortable.  So by the time they actually have their first taste of smoke free or alcohol free living it feels better to actually face it than to worry about it.

One strategy that may be useful is to pick a start date.  Quite often people moving into the Action Stage are too nervous to commit. Fearing failure, they try to ease into it, by saying things like, “tomorrow I’m going to try to go the whole day without a cigarette.”  Human nature being what it is, we leave ourselves too much wiggle room for the ambivalence we have been fending off to sneak back in.  After a few days of “trying” but not fully committing, we unfortunately prove to ourselves that we can’t do it.  So picking a start date is a very important psychological step to cementing our commitment and calling in all the coping when we reach that milestone.  A start date provides the structure to your plan and signals that the beginning of your new way of being has completely begun. 

Once you take the action toward your goal, reward yourself and congratulate yourself.  Reinforcement and support are extremely important in maintaining the confidence and motivation required in a change.  Use the people who you had identified as support people and let them know what is helpful. The Action Stage typically involves making some kind of public commitment to your change.  People may notice you doing things differently or you may have to announce it.  Declining an offer of a drink,  dessert, or a cigarette can feel uncomfortable at first.  You may find yourself awkwardly explaining or even in the role of needing to make an excuse for suddenly being different than other people, especially in your social circle.  It’s important not to feel you have to justify yourself or make others feel better.  Each of us are entitled to make our own choices and your change is not a comment on other people’s habits.  

Depending on the goals you set in the Contemplation Stage and the plans you made in the Preparation Stage, the Action Stage can be either a series of small steps or one big life change.  It may feel strange or even empty to be living without a habit or way of life that you have done for so long.  And while the initial success may be exciting, it may take time to see the long term desired results.  It is natural to have a period of grieving and a transition time to adjust to a new normal.  Identifying effective ways of coping with stress are crucial during this action phase. Of course the better prepared you were with your plan, the easier it tends to be, but you will inevitably encounter circumstances you had not prepared for.  Don’t be afraid to continue to ask for help and to problem solve and tweek your plan as needed.  Sometimes we need a little extra help to break through a barrier or to face an unexpected road block.  

Repetition is one way to help in the early stage of Action.  Doing the same thing each day tends to help make any change a new habit more quickly.  Reviewing your list of motivations each morning and your successes each evening is a good way to keep in touch with your goals and what you may need to help support yourself.  

Often the fear of failure keeps us from wanting to tell people we are making a change.  But by not telling anyone, you rob yourself of their support. And you will need it.  Because at some point during the Action Stage, the realization will  kick in that not only do you have to do this new change today, but you may in fact have to keep doing it every day.  And this, my friend will tend to bring a bit of shock and fatigue and even regret.  But have no fear, my dear change agents in action, this will be a perfect sign that you are moving into the next stage…Maintenance. A sure indicator you are creating success!

Action: Taking steps toward change but hasn’t stabilized in the process 

Primary Task:  Help implement change strategies and learn to eliminate potential relapse

So, you’ve gone through the process of deliberation and have decided change is needed and/or desired.  Now that the scale has tipped toward making change, the topic of this post is how to get ready.  Stage 3, or the Preparation Stage, is all about the plan.  It’s easy to underestimate the importance of this stage, as it tends to be the quickest of the stages, as Preparers are on the verge of and are motivated for change.  But having the right strategy for change is so important for success and if not done well, can undermine your efforts and quickly zap both your confidence and motivation.

While Preparers still experience ambivalence, the quality of this is more along the lines of not whether change is needed, but if it will be possible.  Preparers are eager, but wrestle with fears and self doubt.  They tend to start making small changes to prepare for the bigger change and can be excited or discouraged based on how these smaller steps go. For example, they may switch to lower fat foods if the goal is weight loss, or begin smoking an hour later in the morning if being nicotine free is the change desired.  The important outcome of this stage is to make a realistic plan.  Commitment to change without a good long term game plan can undermine your efforts and lead to disappointment and frustration.

In the Preparation Stage it helps to gather information both externally and internally.  Externally, doing a good search for structures and strategies that can guide you is a great idea.  For example, if weight loss or eating healthier is your goal, you can find a lot of information about different options such as Whole 30, Weight Watchers, or Intermittent Fasting.  You can also look for groups or communities that will be a good source of information and ongoing support and encouragement.  It’s good to find resources not only to help in the transition of change, but also thinking ahead to maintaining the change.  For example Nicotine Anonymous is a great resource for quitting smoking and has a wide range of meeting times and locations.  Or finding a local hiking club if your goal is to get more active.

But don’t get lost in the planning, Preparers.  It can be overwhelming to research all the possibilities and options.  This is where the internal preparation is so important, asking yourself what plan seems best suited for your lifestyle and personality.  To be successful at change, you need a realistic assessment of the difficulty of the desired change and the strategy you are going to use to make it.  It helps to look at past efforts and where they were derailed as well as potential barriers that might get in your way.  For example, increasing exercise in the winter in cold climates during a pandemic will be especially difficult, with gyms closed and storms on the way.  This may be a good time to ask for help in creative problem solving, either from trusted people or a professional who may have ideas and experience you have not considered.  

During this stage, journaling is a great tool.  It gives you a chance to reflect and play with ideas.  Some questions that are helpful to explore:

What possible obstacles or conflicts may arise?

What mindsets, habits, or behaviors might sabotage your efforts?

How will achieving your desired change affect others in your life (family, friends)?

Are there any sacrifices you will need to make? Are you ready to make them?

How will your life need to change in order for you to achieve your end result?

Is the end result aligned with your core values and beliefs?

Asking yourself these important questions before you begin a significant life change can save you time, effort, and heartache, and allow you to make any necessary adjustments ahead of time.  In addition, it’s a good time to take stock of your assets.  It can help build your confidence to see that you already have a number of things in your favor that can be called on when needed.  Make a list of your resources, such as money you can invest in your change, skills you already have, people in your life who can support you, or any other special skills, training, or experience you can draw on.  For most of us, we may also find we have some missing pieces in our arsenal of assets.  Preparation is a great time to also assess the assets you will need and begin to build them.  You may need to adopt new mindsets, obtain training to have a new skill, create a physical space for your endeavor and a calendar of time commitment in your schedule.  Planning for how to be prepared is about breaking down your big change into its component pieces.

Finally, once you have created your multi step plan, you need to create a Plan B…or C…or D.   No matter how well you prepare there will always be obstacles and bumps in the road.   Of course you can’t anticipate everything, but having an overall strategy can help you ride through any setback.  For example, if you get off course, who can guide you?  If the people in your life are not supportive and they resist your change, how can you address it?  A good part of the preparation for change is to accept that it will not be a straight journey toward your destintion, but an uneven series of hills and valleys, lefts and rights, and frustrating detours.  Anticipating this will help keep you from being upended by any particular unexpected pothole!

Stage 3 Preparation:  Commitment to change is achieved, but still considering what to do and how  Primary Task– Identify the best strategy for you and create a plan

While my last post focused on the Pre-Contemplation phase of change (Stage 1), when you tend to avoid and deny the need for change, a shift into Stage 2, Contemplation,  is achieved when you gain an awareness and acceptance of this need.  But now that you’re considering the change, the pros and cons are in constant consideration.   The hallmark of Contemplation is ambivalence, a back and forth of conflicting emotions regarding whether or not it’s worth taking action toward the change you now accept should be made.  Like riding a swing, Contemplators go back and forth and back and forth, spending a lot of energy, but not actually going anywhere just yet. 

Contemplators are more aware of the personal consequences of a bad habit and are able to think about the possibilities of change.  They may be more open to seeing the negative aspects of their behavior and the positives that would come with a change, yet, they doubt if the long term benefits will be worth the cost.  As the desire for change gets more real, so does the awareness of what may get in the way.  The good news is that Contemplators increasingly are open to information about their specific problem, such as reading books or going to websites, and are more open to discussing and reflecting on their conflicting thoughts and feelings.

The challenge to Contemplators is getting stuck in “all talk and no action.”  How many times have we made a plan, talked with our friends about it over and over again, but never put the plan into action?  We get stuck in the ambivalence, wanting change but not having the confidence or motivation quite up to breaking the impasse.  Contemplation can be thought of as the thinking phase, where we think and think about doing something.  For some people the thinking may lead to eventual doing, but for some people, thinking is as far as they may ever get.

This can be frustrating, both within ourselves and with others.  When you’re with a Contemplator, it’s natural to want to push them into action.  Enough already, we want to tell them, or tell ourselves: “Stop talking and do something!”  In order to support someone in Contemplation, it’s best not to become judgmental, but to ask questions that aim to build confidence and highlight the benefits.  For example it may be good to ask about why change is desired, what is preventing change, and what could help them make a small step in the direction of the change.  In Contemplation, supporting a person in gathering more information, exploring answers to any questions, and tipping the balance toward the benefits of change vs the cost is most helpful.  Supporting  a Contemplator look at change as a process of gaining something, emotional, mental, or physical, rather than giving up something may encourage them to move them past their ambivalence.

Riding the back and forth of whether or not to make a change is uncomfortable.   And yet, at this point, it may feel more comfortable than taking the risk of actual change.  As I look at journals about my News Year’s Resolutions over the past years, I can clearly see my own pattern of Contemplation.  In just reading them I want to strangle the part of me that blabs on and on about all I’m going to do, clearly not doing it, as there it is again in next year’s goals. At some point I hope to get up enough speed with my efforts to launch myself off the swing!  But until I do, at least I have a fancy name for my process.  I’m not doing nothing…I’m Contemplating.

Stage 2: Contemplation – Sees the possibility of change but is amivalent and uncertain. Primary Task:  Resolving ambivalence, choosing change.

In my last post I made a case for change as a process. I outlined the Transtheoretical Model’s Stages Of Change which describes the evolution of “readiness thinking” that is necessary to put change into action. This week I’m starting with Stage 1, Precontemplation, and highlighting what the characteristics of this stage are and how to help yourself or someone you care about with the particular tasks of this stage. In Precontemplation, just as it sounds, change is not even in the realm of possibility yet. People in this stage have no plans for change, even if they wish for it. In other words, Precontemplation is the very beginning. But just like a seed hidden in the ground during winter, although you can’t see it yet, the potential for a flower is there.

In Precontemplation, a person completely lacks motivation or confidence (or both) to change. People may not be fully aware of the potential benefits of a change, or they may be demoralized from failures in the past. Generally, the hallmark of this stage is a general lack of awareness and/or an annoyance or avoidance of the need for change. According to Dr. Prochaska, who developed the model, “In Precontemplation, people underestimate the benefits of changing and overestimate the costs or cons. But they’re not particularly concious of that, so it’s not a focused rational decision making process.”

So how do I know if I’m in this stage if it’s not conscious?  Chances are you’re a Precontemplator if you’ve heard plenty of times from your partner, your doctor, your friends, or your own conscience that you should make a change.  And when these people, including yourself, try to talk to you about it, you tune out, shut down, withdraw, or change the subject.  You may even find yourself annoyed and wishing they would mind their own business.  Precontemplators often are represented by the four “Rs.”  Reluctant precontemplators lack knowledge or inertia to consider change.  The impact of the problem hasn’t become fully conscious.  Rebellious precontemplators have a heavy investment in their current behavior and in making their own decisions.  They’re resistant to being told what to do.  Resigned precontemplators have given up hope about the possibility of change and are overwhelmed, perhaps having failed before.  And finally, rationalizing precontemplators have all the answers. They have plenty of reasons why they have no problem and or why the problem is a problem for others but not for them.

Supporting a person to move through Precontemplation involves mostly increasing their tolerance for awareness (it’s painful to think you need to change!).  Therefore, it’s so important to approach the issue in a way that is as collaborative as possible, showing love and compassion, even within yourself.  Often out of frustration, we lecture, nag, or confront in a way that may actually increase resistance.  Often it’s out of shame and embarrassment that a person avoids a topic and becomes irritated when the subject is even mentioned.  It’s important to remember that we can’t make anyone change and that the best way to support change is to allow the person to take responsibility in whatever way they feel possible.  Oftentimes it takes a scary test result, a major life event (such as the birth of a child, the death of a loved one) or a health crisis that opens the door for people to get motivated.  

It’s also important to remember that even just thinking about change is in fact a change in and of itself and is the first necessary step.  According to Dr. Lickerman at the University of Chicago, “thinking about making a change is what gets people used to the idea of actually making it.”  Some tools for addressing the Precontemplative dilemma are to ask permission to address the topic with someone and be flexible to what is a good time and place for the discussion.  It’s also good to acknowledge and commend the person to being open to the conversation and be a good listener.  It’s usually more helpful to ask questions than to provide answers.  Check in with the person during the conversation and when you are finished, be open to feedback.  Watch for body language that indicates someone is overwhelmed and/or feeling shame.  

Power struggles can be strong barriers to change, even within yourself.  Compassion and curiosity are truly the best tools you can acquire for the process of change.  Remember, the seeds of change need nurturing. You can’t make a flower bloom by demanding that it does or assuming it doesn’t love you if it doesn’t.  

Stage 1: Precontemplation – Not yet considering change or unwilling or unable to change. Primary Task:  Raising Awareness

“Good riddance to 2020!” so many of us said this past New Year’s eve.  Unfortunately, when we woke up in 2021, little had actually changed.  But our expression is a good sign that we have hope that things can be better and carry within us the belief that it will.  I remind myself that for most significant things, change is slow and actually happens in small steps, little by little, day by day, week by week.  It got me thinking back to one of my very first posts about change being a process.  I thought now might be a good time, at the start of this much anticipated new year, to look more closely at one of the most popular models of how change happens and what we can do to support it.  Over the next few posts I will review each stage of change, starting with today’s overview of the change process.

Nature provides such wonderful examples of change as a process.  A caterpillar turning into a butterfly or the changing of the colors of the leaves remind us of slow transformation that usually involves a complex series of small changes.  But caterpillars don’t worry whether life as a butterfly will be better than life as a caterpillar, and trees don’t have to decide if they want to keep their leaves this year.  As thinking beings we have the capacity for refection, and thus bear responsibility to make choices in how we live.  Therefore, our thought processes are a major focus of understanding the change process and form the lens through which readiness for change is evaluated.

Also called the Stages of Change Model, the Transtheoretical Model was first developed by Prochaska and DiClemente in the late 70’s while studying smokers who were successful in quitting.  The researchers found that people quit smoking when they were ready to do so (surprise!).  They focused their model on the decision making that occurs in the process of becoming ready to change and assumes that people don’t change behaviors quickly and decisively, even if it may appear so to others.  Rather, change, especially of habitual behavior, occurs continuously through a cyclical process.  In order to help support change, understanding the stage of change in which a person is currently in helps to match the intervention to the period of time in which it should be most effective.  For example, giving someone the nicotine patch is not going to be very effective if they’re still wondering if it’s worth the effort to quit smoking.  Conversely, when someone’s in nicotine withdrawal, listing pros and cons of smoking may not be good timing, either (and bears a risk of getting clobbered).

One thought process that proves to be extremely helpful in the change process is motivation.  In order to make sacrifices or endure the discomfort of change that usually happens, either physically or emotionally, we have to have a significant level of motivation and desire for the change.  But motivation is not enough, it turns out.  We also have to have confidence and skill.  We need to know how we will make the change, so that when we apply our motivation, we can succeed.  If we don’t believe we’ll be successful, it’s hard to keep up our effort.  If we don’t have the skill, we’ll lose the confidence.  As you can see, it is indeed a cycle and a complex emotional and mental feedback loop to make and maintain change!

Understanding the level of readiness for any change is so important in keeping perspective about the change process.  Whether it’s on a very personal level of a change within yourself, or for a person you care about, or our society at large, change necessarily involves risk.  By having a better understanding of where things are currently for any change, it helps to identify more specifically what we can do to move it along most successfully.  Reminding myself that change is a process that takes time and sequential steps, moving forward and at times backward, helps me keep up my confidence and motivation.  And Lord knows we need both of these to get 2021 off to the good start we’ve been hoping for.

As we head into the New Year (finally!) we typically set goals for weight loss, financial status, and career aspirations.  With a year so full of losses and loneliness, I think it’s especially important to be attending to the well being of our moods and mental health and providing ourselves with the care we deserve. So for my last post in this strange and challenging year of 2020, I hope you’ll take the time to watch to an inspiring video first posted to The NY Times Op Ed on December 7th (link provided below).  After watching this video, I hope you’ll give equal attention to setting some mental health goals for 2021. 

Alexi Pappas is an elite athlete.  After the 2016 Olympics, she experienced a severe major depressive episode.  She felt alone and lost.  Even though she had powered through injuries and setbacks her entire running career, she found she was not well equipped or supported in facing her mental health injury.  This brave woman shares how she began to approach her mental health with the same amount of resources and attitude of healing as her physical health.  

According to the Center for Disease Control and Prevention (CDC) approximately 1 in 5 adults in the US or 43.8 million people experience mental illness in a given year and 1 in 5 youth ages 13-18 will experience a mental health disorder at some point.  Suicide is the 10th leading cause of death in the US and is the only one in the top ten on the rise.  Among those 10 to 24 years of age, suicide is the third leading cause of death.  Mental illness occurs indiscriminately across race, gender, ethnicity, sexual orientation, or culture.

With the uncertainties and stresses of 2020, I am sure these numbers will rise, unfortunately.  One silver lining this year has been an effort to publicly reduce the stigma of mental illness and encourage people to speak up.  One such noted effort is the “I’m Listening” campaign, where celebrities including musicians and athletes have opened up and shared about their struggles with anxiety and depression (see Radio.com) and stressed the importance of both talking about your experiences and the benefits of being heard by someone.  

So as you make your list of goals for the New Year, please include some goals for your mind as well as your body.  This can be a great year to try a new meditation app (Insight Timer or Calm), educate yourself (read books like Ambiguous Loss, The Anxiety and Phobia Workbook, The Body Keeps the Score) and/or even reach out to see a therapist (we are only a phone call away, especially while we work via telehealth!)  But the main goal I encourage for you to set this year, to be done with people you love and trust, is to talk about how you are feeling and ask someone else how they are doing.  Whenever we share what feels like a dark secret, we most always feel a little better by bringing it to the light.  Remember, you are not alone!!!

Please watch this beautiful account of growth and healing:

https://www.nytimes.com/video/opinion/100000007372207/alexi-pappas-depression.html?campaign_id=9&emc=edit_nn_20201207&instance_id=24780&nl=the-morning&regi_id=83086246&segment_id=46245&te=1&user_id=2d09d4cb91922563a691ccabdbe83abc

Some resources:

Text Line (741-741) Text to Talk 24/7 crisis counselors

The American Foundation for Suicide Prevention 1-888-333-2377

Depression and Bipolar Support Alliance  1-800-826-3632

Psychology Today : Website for Therapist Referral

Substance Abuse and Mental Health Services Administration (SAMHSA) 1-800-662-4357

The Trevor Project (LGBTQ 24/7 hotline) 1-866-488-7386

In my first year of graduate school we learned a technique for anxious and obsessive thinking called “thought stopping.”  Basically it involved putting a rubber band around your wrist and every time you had the negative thought, you would snap the rubber band and say “stop!”  Yes, I had the same reaction you’re probably having:  Is this the best we can do to help people already in pain?  Fortunately, psychologists have come a long way in understanding the complex relationship between our thoughts and feelings and have developed some kinder techniques to address negative thinking.  And this past week, several of the people I work with inspired me with their creativity and reminded me of the power of self compassion in thought redirection.

What we’ve come to find in research and in practical experience is that trying to NOT have a thought is not possible.  We really don’t have much control of what pops into our heads.  And reactive thoughts are commonly old tapes of things we’ve long ago internalized, often from bad experiences, such as “I need to be perfect or else…,” “I won’t be loved if…”, or “bad things will happen if…”  Thoughts like these are our minds’ way of anticipating what may go wrong and trying to gain a sense of control to protect us.  Fighting against these thoughts is counterproductive,in that by trying to not have thoughts,.they seem to only take on greater power.  

What we can do when we have these unpleasant thoughts is use the mindfulness technique of acceptance and self compassion.  We can allow the thoughts to happen and then redirect our thoughts toward kinder responses.  For example, a man I work with had not been able to drive due to panic attacks.  He felt his heartbeat and his mind race with all the bad things that could happen were he to make an error in judgment.  The more he tried to stop himself from thinking about it, the more tense he became.  Over the last few weeks he’s been able to develop a compassionate response to his anxious thinking by telling himself, “It’s just a really uncomfortable situation because I am a caring person who wants to be safe.”  In this way he reduced the intensity of his anxiety and redirected his mind away from the panicky feelings and on to his strengths of being a responsible driver.  Another man I work with would wake up to scary thoughts of feeling hopeless and afraid since losing his job during the pandemic.  His mind would take over with “what ifs” that led him to the point of feeling depressed and lethargic.  In working on it, he recognized that he was a very visual person and found it helpful to imagine throwing a bucket of bleach on his thoughts and whitewashing them away.  By giving his mind a “love bath,” he was clearing out the thoughts that were bringing him down and making space for new ideas.

Often people find it hard to be compassionate with themselves, especially when their negative thoughts involve guilt or blame.  At these times, it’s helpful to step back and embrace your thoughts for the underlying intentions.  For example, if you’re angry at yourself and ruminating about what you said to your child even after apologizing, remind yourself that you were acting out of love and caring, even if it came out the wrong way.  Or if you are having thoughts about mistakes you will make on the job or how you will disappoint your co-workers, remind yourself that these thoughts are just fears because you are actually a great worker who wants to do a good job.  

It’s interesting to see how people can become so stuck when thinking of how to talk to themselves in caring ways, but as soon as I ask them what they would say to a friend in the same situation, they become quite insightful.  Somehow when talking to a friend we don’t hold the same rigid views or perfectionistic standards.  So as a last resort, if people can’t think of anything nice to say to themselves, I encourage them to think of the most loving person they know, and think about what they would say to them in that moment.  Hopefully over time this kinder, gentler voice becomes internalized.  Because when you’re being your own worst enemy, it’s the exact time you also need to be your very own BFF. 

Every year at this time I share how Thanksgiving is my favorite holiday and then reflect on some aspect of gratitude (the NY GIants had a bye this week-couldn’t lose!).  But with all of the craziness of 2020 and the layers of losses we’re experiencing, it seems a little preachy right now to be encouraging people to make gratitude lists and to look on the bright side of what you do have.  But ironically, it is through the pain of loss that we can really experience gratitude.  It can, indeed, be a silver lining and a way of finding hope and comfort in dark times.

Both my clinical sense and the research I’ve read strongly suggest that a deeply experienced grief process often leads to a heightened sense of appreciation both for what was lost and for what is left behind. In one study of people who had lost a parent, 79% said that the loss had increased their sense of appreciation for life and relationships.  In addition, these people had lower levels of depression and a greater level of well being.  And just as I have experienced in the 25 years since my sister died, there are times of deep melancholy even now.  But along the way in being cracked open there is also a sense of deeper connection to how precious and fleeting life is and for what truly matters.

With this pandemic leading to so many deaths as well as the loss of experiences and opportunities, I think if we can allow ourselves to feel the grief, it is possible that if can bring a greater appreciation for the times when we can be together, when we can hug one another freely, and can travel and wander without hesitation.  Grief is a very complex process and it comes in waves as it unfolds a bundle of feelings including memories for what was, dreams for what could be, and regrets for what can never be. In allowing ourselves to acknowledge these layers, we can more deeply connect to what’s important to us.

I am very moved by a Facebook page started by a woman, Kelly Buckley,  who was struggling after the death of her son, Stephen  She wondered how she would go on and how she could help her other son.  She started with a small  step of finding one tiny thing to be grateful for each day. Let me share with you her words as my gift to you this Thanksgiving:  As the days, weeks and months passed, our list of tiny blessings continued to grow, bringing flickers of light and hope along with it. We found we couldn’t just limit it to one little thing any longer. Blessings were sprouting up all over the place. Butterflies, belly laughs with snorts included, fresh strawberries, naps, a letter from Stephen’s friend, birds, chats with my son or a moment of normalcy with my husband. It did not change the pain of the loss. But it did alleviate some of the suffering. I started to see that all these one little things were actually the big things that really gave meaning to my life. This path of gratitude was healing me, and tethering me to the present moment as I grieved. And in the present moment, I was okay.

Kelly refers to her Facebook group as Just One Little Thing and her members are “JOLTers.”  It began in 2011 and has over 120,000 members from over 50 countries speaking over 40 languages.

Please have a safe and festive holiday no matter where you are, who you are with, or how you celebrate.  Giving thanks does not require any other people to be present, a cooked turkey or pumpkin pie, or even a zoom account.  You just need an open heart.

While election results were being counted, a woman I work with in therapy remarked that it was “time to focus on my own problems again.”  Indeed, there does seem to be a collective exhale that we all need to take after such a long campaign and election process. But her comment got me thinking about what each of us considers our “own problems” and the relationship we hold between the personal and the political.  

For so many years I’ve been honored to hear the most intimate details of people’s personal problems as they engage with me as their therapist.   People come for help in taking personal responsibility for what is happening in their lives.  But often what is happening is beyond their control to fix and their problems reflect trends and commonalities, traumas and societal and institutional ills.  Because they can’t seem to get a foothold to “pull themselves up by the bootstraps,” they are left feeling that they did something wrong. For example, working at a health center many of the people seek our services after a health crisis.  They can’t work the way they used to and go through a series of cascading and devastating losses, including esteem and identity and the various manifestations of financial hardship, such as losing their home and the freedoms they once had when they had more resources.  In trying to cope with their new situation, they suddenly come into contact with a host of governmental agencies, including the disability system, low income housing, and possibly even food stamps.   Worn down and feeling dependent, these people often fall into depression and are vulnerable to addiction, given both physical and emotional pain and the loss of a sense of purpose.  This only fuels their identity as damaged people who have little to contribute and who feel disempowered from participating in the political process -the very process that creates the systems they now for the first time really understand.

I have mentioned in previous blogs the trend I’ve seen over the last 20 years of the majority of people seeking psychological services for depression shifting to the majority of people coming in for anxiety.  I have seen suicidal thinking in adolescents and children rise dramatically and the age at which it begins get lower and lower.  These are not individual problems, but reflect trends in society, perhaps related to the role of social media and the widening income gap that creates feelings of helplessness, stress, negative social comparison, and a sense of failure.   These cultural and political trends are reflected in the daily struggles of each and every one of us, yet we are but one person in a society that seems to be moving so rapidly in a direction we can’t seem to keep up with.

And the truth is, for the woman I saw this week who is ready to get back to her own problems, a change in President is most likely not going to make as much difference in her life as recognizing her own patterns and addressing her own choices in relationships and coping behavior.  Her day to day emotions will be far more affected by the moments of joy we can help her to find and the sense of calm she can achieve by quieting her inner critic with mindfulness. And maybe even medication is the answer, because sometimes we are so stuck, we no longer have the energy or capacity to cope. And yet, while I help people take control in the ways that seem most beneficial, I can’t help but sometimes feel I am enabling a society that is harming its people.  

There are reasons bigger than our personal responsibility that influence us.  Oppression, grief, trauma, and even good fortune are most often things we cannot control.  We often say in our therapy group Seeking Safety, for people who have experienced trauma, that while you are not responsible for your trauma, you can take responsibility for how you respond to it.  But then, who is responsible for the trauma?  

I believe unequivocally that we are responsible for our choices.  But I also believe we are responsible for each other.  And perhaps this is where the rubber meets the road for me, where the personal and the political intersect.  We all carry a responsibility for the society we live in that has the power to create or destroy opportunity, equality, and decency.  And for each of us in our roles as parent, friend, teacher, business owner, civil servant, or President, we need to ask ourselves how we each personally contribute and influence the maintenance of our society.  To ignore the larger trends and not speak out when justice is denied or compassion is lacking is self indulgent.  But it is also self indulgent to do nothing to empower ourselves, denying  our own inner strength and resourcefulness that can contribute to the greater good.  

A Presidential election offers an opportunity to exercise our democratic right to select a leader who represents what we want our society to be. We select a leader to enact the will of the people.  But we sometimes forget that this is a will we personally own every single day of our lives and in every interaction we have.  It’s not just an every four year right, but an everyday opportunity.

(Note: I have found throughout my career that non-profits have been tasked with picking up the pieces of society’s ills. But they rely on the generosity of people willing to do the hard work with little resources and the constant solicitaton of those willing to contribute. Yet they hold a lot of the pain and stress caused by governing that does not protect the vulnerabilty of many citizens).

I voted last week and boy did it feel good!  So good, in fact, I wanted to keep the little “I Voted” sticker on for days and grab another one to wear on election day.  The afterglow is still with me even now.  It just feels like such a relief to finally have a chance to do something for change and to express my opinion about what has been going on the last four years. 

Realistically, my vote matters very little.  I live in California that tends to vote heavily blue and my one vote among so many millions is not going to be the deciding factor.  Even knowing this, though, it still feels like I, personally, finally had my say!  This got me thinking about the psychological benefits of voting.  It turns out, according to the American Psychological Association and other political scientists, there is a measurable mental health benefit to voting.

Voting does in fact make you happy!  Studies show people who vote have higher levels of happiness, likely because it makes you feel a part of a larger group.  It ties you to your community and brings people together for a cause bigger than themselves.  Voting is tied to a feeling of inner peace, largely related to having engaged in a pro-social activity.  And most significantly, according to research, voting benefits mental health as it empowers people, giving you a voice in changing what is important to you. 

“When you believe you are doing something that could make your life better, that’s where the most psychological benefits come in,” says Lynn Sanders, a political science professor at the University of Virginia.  The act of voting transforms into an act of protest and an opportunity to stand up for what you believe in.  Even if your candidate loses, having voted helps you cope better with the results.  Marc Zimmerman, a researcher in voting behavior, finds that even if you don’t end up with your desired results, having participated makes you feel good.  “We find people are happier with the outcome and they feel more in control of their lives if they voted, rather than feeling things don’t matter.”  Even though the positive benefits of voting are better if your candidate or issues win, there are still positive psychological effects in that you were able to make your opinion known.

Research also shows the benefit for kids in watching their parents vote.  Children become more involved in the issues and are more likely to engage in critical thinking when parents share their participation in the political process, even if the kids are too young to vote.  They, too, feel a sense of increased control and empowerment when they believe their interests are being represented by their parents’ vote.

I have been so moved by the reports and images of people waiting in line for so many hours to vote (also appalled that this is happening in our country).  It gives me hope that people care and want to be active in shaping our country.  And selfishly, I must admit, in experiencing this great feeling, it makes me want to get and stay even more involved.  Being politically engaged and active is something I could and should do all year round.  This joy is cheaper than a vacation, less calories than ice cream, and lasts longer than a cocktail buzz.  It also makes me feel grateful and humbled that I live in a country and a time where I have this right and privilege at all.   So, please, do yourself a favor.     If you haven’t already, make sure you vote.  You’ll be happier because you did.