Writing about mental health from a feminist counselling perspective
June is Migraine and Headache Awareness Month here in Canada, an opportunity to raise awareness through education and research on the nature and impact of headache and migraine disorders, as well as support and advocate for people living with this type of chronic pain. For those of you who might not know, I have a personal history in dealing with migraines. I’ve always had them but, a few years ago, chronic stress and burnout led to daily, high intensity migraines that wouldn’t go away. Since then, things have improved for me, but as a chronic pain condition, this is something I have to live with. Here are 4 things I’ve been doing to navigate migraines in the last year:
1. Neurologist care
I’ve been getting by pretty well with the support of my GP, but back in September we decided that if I’m going to try one of the injectable migraine treatments, I really needed to talk to someone who was an expert in the area. In Edmonton, this is Dr. Michael Knash, a neurologist who specializes in migraine and headache. He was able to assist immediately with finding the right dose and sharing with me some options for getting medication coverage.
One thing that I was surprised to learn is that not all neurologists have the same training or expertise, so it's important to find one who specifically works with migraine. You can watch this video from the Pain Society of Alberta where he talks about options for treating your migraine attacks at home.
2. Therapist support
Fortunately, my existing therapist has experience working with migraine . I’m so grateful that she’s able to have direct conversations with me about therapy, pain, and when I’m holding unrealistic expectations about what my relationship with chronic pain should be.
She also reminded me that stress is a part of life, and if my plan included never being stressed, it wasn’t going to work. We’re both big advocates that migraine treatments should work despite the daily stressors of living in Alberta, being a parent, and being a therapist. Her reminder to me was that treatment of chronic pain is a gendered issue and that I needed to go back to my doctor if my current medication was no longer working. This was also a reminder that what works for a while in terms of treatment may not always work, and if severity or frequency of pain increases, it’s a good idea to revisit medications and treatment plans.
3. Guided visualizations
I continued to use the guided visualizations from Curable Health. Curable is an online program and app that provides professional help to people living with persistent or chronic pain. They use a biopsychosocial approach that addresses pain from multiple angles (psychical, psychological, and emotional) to provide science-backed lessons and techniques.
My favorite is the control room visualization, where you turn down the volume on pain and shut off the alarm. Most of my clients know I’m a big fan of using imagination work to assist healing, because through imagination, we create a new physiological response and allow our lower brain to take in alarm-reducing cues. That’s what Curable’s visualizations help me do.
4. A sustainable work schedule
Making our work schedule sustainable seems to be a huge conversation in the psychology circles I’m in right now, and I’d love to share what sustainable looks like to me. First, it’s individual, and second, it changes over time.
I used to work longer hours 4 days a week. Now I’m doing fewer hours per day on a 5 days a week schedule. At different points over the years, my capacity has changed, and what works best for me to be present and engaged has changed. One of the key strategies I’m using is not filling my schedule to capacity. A full schedule for me would be 6 clients per day. But I know that this leaves zero room for inevitable parts of life and this job, including days when I’m in pain and room for urgent appointments or reports. So I only leave 5 spots open on my online calendar, and I book the 6th by my discretion. That way I can really have a look at what the day and week looks like to help me decide if it’s within my capacity or not. I also book regular time off each month and a longer period at the end of the year to fully put responsibilities away and focus on recharging.
If you too live with chronic or persistent pain: what are some of the things that help you navigate it?
In my experience of working with shame, I’ve found that when people are first learning about it, they generally ask about how shame manifests in the body. The reason is that they’re hoping for guidance so they can begin to better identify it in themselves.
It’s such a great question because it invites a sense of curiosity and mindfulness to the experience of shame. And I’ve often said that curiosity is a great antidote to shame.
Identifying how shame shows up in your body
Before we start learning to identify how shame shows up in our bodies, we need to understand that every nervous system is different. This is something that became clear in my experience.
In my work with clients, I integrate the Somatic Experiencing approach, based on the work of Dr. Peter Levine. This is a body-oriented therapeutic model that seeks to help the nervous system get unstuck from the fight, flight, or freeze response that is activated during a traumatic or stressful situation. In this approach, we learn to ask people where they experience a sensation rather than telling them where they should be experiencing it.
So, to get started, this is what you can do when you identify that you’re feeling shame. Explore what your body feels like in that moment. Ask yourself if you might be feeling heat, tightness, closed, small, or stuck, for example. If you’re just starting to learn about identifying sensations, I have a blog post that you might want to check out. In it, you’ll find a list of words describing different body sensations: you can try them out and see if any fits.
When you identify a sensation, can you discover where in your body you feel it the most? For example, some people feel heat in their face, others might feel their throat tightening, and others might feel sharp pain in their chest. Again, these are just examples. Identifying and acknowledging shame is one of the first steps in shame resilience.
Shame as a freeze state
Shame is an intense, whole-body freeze response to a situation. This is why it’s common that people will identify body sensations that relate to feeling frozen.
When exploring your own sensations, you might have used the words frozen, stuck, fuzzy, or numb, for example. People sometimes feel so overwhelmed by shame that they become disconnected from themselves. Because of the freeze, it may be hard to find words or move into action.
This is something that can be worked on in 1:1 therapy using Somatic Experiencing techniques. But I also believe that we can learn to identify shame as it’s happening and take a step back from it by building our resilience. The way I teach my clients how to do this is by using 6 scientifically-backed tools: 1) Connection; 2) Recognizing shame; 3) Self-compassion; 4) Self-talk; 5) Accepting your limits; and 6) Contentment. If shame resilience is something you’re interested in, I invite you to check out my online course Shame Resilience Skills.
One of my strongest convictions is that the body sends us signals about what does and doesn’t feel good inside. If you’ve known me for a while, you’ll be familiar with my motto of “listen to your body”. However, many of us have been taught to override these signals in order to feel safe and connected with others. In this post, I want to tell you more about experiential psychology and mindfulness, and how I use them in my practice to help people better listen to their bodies to understand their boundaries.
It’s hard to speak our needs when we know that it would shake up existing patterns in our families, relationships, or workplaces, so we adapt by disconnecting. I always view this adaptation as a strength that helps us survive our situation. And yet, I know it comes at a cost. Becoming disconnected can make it hard to speak for or even know what we really need. In order to help us rediscover a relationship with our bodies, I have found that experiential exercises can help us learn about boundaries from a felt sense.
The concept of “felt sense” was originally developed by philosopher Eugene Gendlin as part of his Focusing approach. It refers to the awareness of a bodily sensation that is difficult to articulate clearly. Through psychotherapy, it’s possible to increase this awareness to improve the connection between mind and body.
One of my favorite exercises to do in a group or 1:1 session is the string exercise. I originally learned it from a colleague and have been adapting it since then.
With twine, yarn, or any other materials that appeal to you, place a boundary around yourself. You may create a boundary that is thick, thin, tight around yourself, or giving you lots of space. If you’re in a group, think about your distance from the other people in the room. Notice how it feels. Make adjustments if needed and pay attention to your bodily reaction. Notice also where you are within the circle (i.e., what’s it like to be close to the edge vs with plenty of space between you and the string?).
When you’ve adjusted the string to a comfortable position, ask yourself: how do you know it’s right? In other words, what’s the sensation inside that tells you so? Some people might notice comfort, ease, or a feeling of protection. Take the time to connect with this felt sense inside.
Optional: imagine yourself in a different situation, such as at work or with family. Letting your body be your guide, recreate your boundary with this situation in mind. Adjust until it feels right. Once again, ask yourself: what are the sensations you experience that tell you it’s right?
Here, you may begin to notice that your sense of what feels “right” can shift in different situations. If you repeat this exercise over time, you may also notice that your boundaries can shift over time. This is because our boundaries aren’t fixed – they’re contextual and responsive, based on our circumstances, capacity, culture, recent experiences, and so much more. It’s why I believe in the practice of listening to ourselves, and continuing to check in with our needs over time.
Additional Experiential Exercises
When we’re first trying to reconnect with our body, having a variety of exercises to help explore our felt sense can be helpful. In addition to this, I have noticed that a curious approach and a willingness to experiment helps.
In my Somatic Experiencing training, I learned a boundary exercise involving walking toward another person and listening to our body responses as people move toward us and away.
In S.A.F.E. EMDR they also teach a boundaries exercise using a scarf held between the therapist and client. The client is invited to notice the right amount of distance, tension, and so on, and importantly, what tells us that it feels right.
All of these exercises can offer us a chance to mindfully notice the boundary-related body clues that have been within us all along. Try them out on your own, or ask your therapist about it if you're interested in exploring this possibility.
One of my hopes as we go forward into 2022 is that we can all find more peace with food and our bodies. I know fat bias and stigma make this incredibly challenging, but there are everyday things we can do to let go of shame-fueled beliefs around our bodies and embrace body acceptance. Some of this involves saying goodbye to things that make us feel worse about it (i.e., curating our social media feeds) and some of it involves surrounding ourselves with what supports us to feel better.
If you’re aiming to have a more compassionate relationship with food and your body, here are some resources that may support you in journey:
1) Maintenance Phase is an excellent podcast hosted by journalist Michael Hobbes and activist Aubrey Gordon. They debunk popular nutrition advice, health fads, and wellness scams. Aubrey also has a book out, What We Don’t Talk About When We Talk About Fat, where she explores fat activism as a way of fighting for social justice.
2) The F*ck It Diet is a book by Caroline Dooner where she explains how dieting makes us more fixated on food, and lays out a pathway to move away from the restrict/purge cycle. If you’ve worked with me before, you know one of my life mottos is “listen to your body”. This includes learning to listen to our hunger and fullness cues, trusting in our body’s wisdom, and getting out of the pattern of constant restriction.
3) For those who are hoping for a more personalized approach, you might appreciate reaching out to a HAES dietician like Selene Yan of Embodied RD. I recently connected with her and love the somatic wisdom she brings to her work with clients – it’s very much in alignment with the type of work I do and I think many of you will appreciate it too.
4) In this blog post, I share a series of strategies you might turn to when you feel shame about food, as well as some reminders of the things that never help. The most powerful way of dealing with shame in the long-term is by building up our resilience to it. If that’s something you often struggle with, I have an online course called Shame Resilience Skills where I share 6 concrete tools you can use everyday to complement healing.
More resources to support you
I initially sent out this brief list on my newsletter, and in response I received some extra resources that some folks consider fundamental reading, especially around the origins of anti-fat beliefs and racism.
5) In Fearing the Black Body, sociologist Dr. Sabrina Strings explores the origins of fatphobia and the cult of thinness through history as linked to Western white supremacy.
6) Belly of the Beast by Da’Shaun Harrison is another book that takes a contemporary look at the intersections of race, police violence, gender identity, fatness, and health, specifically in the USA.
7) When talking about body acceptance, we can’t forget to mention the Health at Every Size (HAES) philosophy, supported by ASDAH (Association for Size Diversity and Health). The HAES pledge has three components: 1. Respect (celebrates body diversity; honors differences in size, age, race, ethnicity, gender, dis/ability, sexual orientation, religion, class, and other human attributes); 2. Critical Awareness (challenges scientific and cultural assumptions; values body knowledge and people’s lived experiences); 3. Compassionate Self-care (finding the joy in moving one’s body and being physically active; eating in a flexible and attuned manner that values pleasure and honors internal cues of hunger, satiety, and appetite, while respecting the social conditions that frame eating options.) Individuals can take the pledge to show their commitment, and be signed on to their database so people looking for their services can find them.
8) Megan Jayne Crabbe has what looks like a great newsletter on mental health, social media, bodies, relationships, feminism and healing. I've been following her IG account for years now and enjoy her compassionate and thoughtful approach to body acceptance.
9) In the Food Psych podcast, Christy Harrison brings a different guest every week to talk about their relationship with food, the harm of diet culture, experiences of recovery, fat acceptance, and more. Christy also has a book out on the topic, Anti-Diet.
10) Roxane Gay’s book Hunger: A memoir of (my) body is an intimate look into the author’s relationship to food, weight, and her body in connection with her experience as a survivor of sexual trauma, but it also explores learning to take care of yourself.
Were you familiar with any of these resources? What did you think of them? Do you have any other favourites? I’d love to read your thoughts in the comments!
*This post was edited on March 15, 2022.
After 10+ years as Feminist Counsellor Edmonton, I’m moving on to a new brand identity: Embodied Psychology. You’ll now see the new logo and brand everywhere I am online, including my website and social media. I’ve been thinking about this change for a while, and I believe the new name better represents who I am now as a somatic, relational, experiential, and feminist psychologist.
Although I perform counselling as part of my work, the word psychologist better represents the whole of what I do within session and on a weekly basis. And while I’m based in Edmonton, I see clients throughout Alberta, and my aim through my writing and courses is to reach more people worldwide.
About Embodied Psychology
In the last few years, most of the work I’ve been doing has been related to listening to our bodies, being present with what is, and finding peace in the present moment.
I want us all to be deeply connected to ourselves, and I know there’s a lot that gets in the way of this. Most of us have been taught about hustling, pleasing, control, and boundaries in ways that don’t serve us. At work, we’re treated like machines. Outside of work, there doesn’t always seem to be space for the fullness of our humanity. Directly and indirectly, we’re taught to disconnect from our feelings and our needs in order to survive.
As we work to move away from the shame-invoking and toxic messages that were passed onto us about who we were supposed to be, I think it helps to have something to move toward.
This is where embodiment comes in. To me, it’s a practice that involves slowly and safely finding ways to turn inward again and start listening. To be with our experience with compassion rather than judgment. It involves being present, playful, and curious in our lives, rather than driven by the need to always be productive or pleasing.
Being embodied involves slowing down. Taking care of the parts inside of us that are still on high alert and making peace with the adaptations we’ve made to get this far.
The New Logo
As I encourage my clients to practice embodiment, I’ve also been practicing it alongside them.
When it came to creating a logo, the images that came to my mind in relation to the times I felt most embodied all involved nature. Some of the images were quite simple and everyday: I remembered many times during the summer where I sat outside between sessions, allowing the sun to warm my face, and all the lunchtime walks I went on in the last year. I also thought a lot about the trips I took to the mountains, where I’d hike, sit by the lake, or go out on the paddleboard.
Being in the mountains has given me a sense of coming home to myself, and it’s this I hoped to capture most.
Last month I had the pleasure of attending the College of Alberta Psychologist’s Annual General Meeting (AGM), where the topic was "The Psychology of Pain" (and yes, I was actually excited to attend… I’m a typical psychology nerd who loves conferences, workshops, and has a stack of partially read self-help books on my desk). I wanted to share some of the highlights for those of you who live with pain, work with people who live with pain, or both!
If you don’t fall into any of these categories, you might still appreciate this information as someone who cares about pain as a feminist issue. Increasingly, psychology is recognizing the social disparities that lead to the development and also treatment of chronic pain. The full Health Canada report also discusses pain disparities in relation to sexual orientation and gender, incarcerated populations, and veterans. It’s important to understand this disparity and what we can do to relieve the burden of the chronic pain that 1 in 4 Canadians over the age of 15 is estimated to be living with.
Injustice and our experiences of pain
The first speaker at AGM was really interesting because he discussed how feelings of injustice play a role in our experiences of pain. Specifically, he talked about a study where people who had experienced whiplash injury were asked to name the sources of their injustice. What stood out is that they identified clinicians and insurers as the perpetrators of injustice even more so than “the other driver”. This is a big deal.
When people come into our office, the last thing we want to do is add to their sense of injury. And yet, sometimes we do. Strategies used in an attempt to reassure our clients (i.e., “the pain won’t always be this bad”) can misfire and actually be experienced as invalidating. Premature focus on the positive is another misstep that can be perceived as dismissing of the client's feelings. People who have experienced difficult or unfair events are often, first and foremost, looking for validation.
I love this takeaway because it’s a reminder to all of us as clinicians or helpers: one of the biggest and most powerful things we can do to help with pain is to show up with empathy and align ourselves as an ally.
The impact of sleep on pain
Another takeaway for me was the reminder about the impact of sleep on pain. As Psychologist Melanie Noel pointed out, they’re now finding that the link between sleep and pain is not as bidirectional as people once assumed. Sleep issues drive the pain. What this means is that addressing sleep can make a huge difference in resolving symptoms of pain.
Fortunately, there’s an incredibly effective form of therapy out there called Cognitive Behaviour Therapy for Insomnia (CBT-i). I know that a recommendation for a CBT-based technique from a somatic-relational therapist may be surprising, and yet I really found it helpful for this specific issue. So, if you’re curious, it may be worth checking out. You can do so through a therapist who’s trained it in, or a resource like The Insomnia Workbook by Stephanie Silberman.
Treating sexual pain
Dr. Lauren Walker also spoke about sexual pain, an issue I too have seen in my practice. The stigma around sexual pain can mean that many people experiencing it don’t receive adequate support, nor even know that help is available.
The good news is that there are lots of professionals who can help, including physicians, pelvic floor physiotherapists, and psychologists. Of course, not all professionals are trained in the treatment of sexual pain, so you’ll want to look for someone who is, or get a referral. In Edmonton, Pine Health and Zenith Wellness are just a few of the options for physiotherapy. If you’re looking for other specialized referrals in Edmonton, don't hesitate to ask me.
Resources for chronic pain
There are so many resources on chronic pain now that you can really find a community of support. A few Instagram accounts specific to migraine that I like include Migraine Canada and Migraine World Summit.
As I’ve mentioned previously, I’ve found the Curable app’s mix of psychoeducation, meditation, and writing exercises to be incredibly helpful. You can also find them on Instagram.
At the AGM, they also highlighted the Pain Society of Alberta’s “World Pain Summit” 2021. It’s happening virtually on October 15-17 and it looks amazing. Featured keynote speakers include Dr. Kristen Neff and Dr. Gabor Mate. This event is free to those with lived experience of chronic pain (unless you’re also a healthcare provider).
If you’ve ever had your pain discounted, I hope you can start to feel heard and understood.
In Canada, June is an opportunity to celebrate and learn about Indigenous history. At the same time, though, we're coping with a profound national grief. Some people are coming to terms with the truly devastating realities our Indigenous communities have faced and continue to face for the first time, while others have expressed that they are saddened but not surprised by the ongoing news. The mass graves found at the sites of former residential “schools” are painful reminders of not just a historical trauma but also the current and ongoing impacts of intergenerational trauma, cultural genocide, and persisting systemic racism. Instead of celebrating Canada Day this Thursday, here are 3 calls to action to honour Indigenous peoples.
Before we dive in, for any Indigenous community members who have been affected by this news, please know that there are resources available to support you, as listed on SACE’s website.
Hearing the truth
Some of you who are not part of the Indigenous community have already been wondering how you might be able to respond to surfacing events. Personally, I appreciate SACE’s sentiment that “Reconciliation must start with truth”. We can all make a commitment to hearing the truth with humility and compassion.
Following this, we can become familiar with the calls to action of The Truth and Reconciliation Commission and the calls for justice found in the Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.
As we all move through this challenging time and more people reconcile with the truth, I imagine that waves of grief may arise, though experienced differently for everyone. It may be helpful to keep Susan Silk’s “Ring Theory” in mind. From my perspective, it reminds us that we’ll all be impacted by the stories we’ve been hearing to varying degrees. Our job is to ensure that we’re gaining the support we need from those in our own circle or further away from the trauma, and sending support toward the centre of those most impacted by the event.
Source: Illustration by Wes Bausmith
While reading or listening to stories of trauma, I also think it’s important to consider how we can do so in a way that allows us to stay in a seat of empathy and presence. Often, people begin with an aim to stay informed but end up dissociated because they’ve become dysregulated by imagining the traumatic events. You may relate to the idea of “putting yourself in someone else’s shoes” in order to understand what they’ve gone through.
It turns out that imagining what it would be like to experience someone else’s trauma not only puts us at risk for vicarious trauma, it also isn’t very effective. If you’re reading or listening to a lot about trauma right now, I invite you to try something else instead: stay curious. I’ll be sharing more about this idea in an upcoming course I have on vicarious trauma, so please watch for that.
Ensuring appropriate healthcare access
Finally, for those who are healthcare professionals, there are a number of things we can do to ensure appropriate healthcare access. Start by checking out this article on How We Can Support Indigenous Peoples’ Wellness. I also have found it helpful to learn about the ideas around decolonizing mental health. It aligns really well with a feminist counselling perspective where we try to understand the historical and present context people are dealing with in order to understand why they might be struggling and offer trauma-informed support that aims not to pathologize.
A few years ago, I had the pleasure of attending a workshop led by Karlee Fellner where, in addition to talking about decolonization, she focused on “Indigenizing Psychology”. On her website, she offers a definition for both terms:
“decolonizing involves breaking down colonial ideologies & how they manifest, looking to Indigenous counter-stories of survivance & relationality instead. Indigenizing centres Indigenous ways of knowing, using local knowledges, traditions, and languages to address the interests of particular communities. together, these processes contribute to Indigenous self-determination and healing”.
I hope these brief ideas have been helpful. If you’re looking for more, please keep listening - both inside yourself and to the many voices in our Indigenous communities as well.
In a post last month, I shared with you some reasons why you might find therapy useful for dealing with some aspects of the coronavirus crisis, like shame reactions to feeling judged, pandemic-related anxiety, and information overwhelm that can lead to feeling hesitant about medical advice. If you’re still unsure about starting therapy, here are three more ways psychologists can help during a pandemic.
Many of you have shared with me the feeling of stagnation you've been experiencing this past year, or feeling ‘blah’. Handily, a number of you have also sent me this incredibly popular New York Times article on “languishing” that finally put a name to this experience so many people have been having. If you haven't read it yet, it may be worth your while, but here’s a summary. Languishing can be placed in the middle of the mental health spectrum between depression (ill-being) and flourishing (well-being): it’s the absence of well-being. You might experience a lack of excitement or joy, a sense of emptiness, difficulty to focus on work or to feel motivated, but you’re not having symptoms of mental illness—however, research suggests that languishing might be a risk factor for experiencing them later in life.
Languishing is different both from burnout and depression. In this short column my colleague Tami-Lee Duncan did for Edmonton AM, she describes how you might be able to distinguish languishing from major depression, and what you can do if you've been feeling this way.
I know for many people I spoke to, having a name for the experience was enough to bring some relief. We know this as psychologists—naming our emotions and contextualizing them helps us feel better, even when we can't change our situation. This is why bringing up this feeling in therapy can be immensely useful, and help move you once again towards flourishing.
Intimate partner violence
Since the onset of the pandemic, increased social isolation and less access to resources mean that people who typically experience intimate partner violence (IPV) are even more at risk for abuse. Psychologists recognize this increase in violence against women as a "shadow pandemic", although some initiatives point out that this narrative can impact the way we think about sexual and gender-based violence (SGBV) as something that is hidden, or that is only related to the pandemic, and the responses to it.
If you have experienced or currently experience IPV or SGBV, therapy can be a safe space for you to work through it and the various issues that can come up related to that, such as depression, anxiety, low self-esteem, challenges in new relationships, financial autonomy, and more. Psychologists can also help you identify signs in your relationship that might point to an abusive dynamic, and direct you to other resources you can turn to. Most importantly, they should be able to offer empathetic, non-judgemental listening.
I recently came across these wonderful resources from the Centre of Excellence for Women’s Health that frontline workers and service organizations can use to ensure they're responding in a trauma-informed way. If you're a frontline worker hoping to increase your knowledge on IPV or trauma, you may also be interested in the manual I wrote last year for the United Cultures of Canada Association.
If you’re a COVID-19 frontline worker or first responder, you may need extra support to stabilize the nervous system during times of immediate crisis and distress in order to do your job. Your psychologist can find specific strategies that work for you and walk you through them, so that you can have these tools whenever you need them.
One of those strategies is the SE Crisis Stabilization and Safety Aid toolkit, SCOPE: Slow down, Connect to body, Orient, Pendulate, Engage.
These simple interventions take less than five minutes to do, and you can print out the toolkit to keep it with you everywhere (check the link for the printable PDF version).
Remember that if you are a health care provider or first responder living in Alberta and you’d like to access support specifically for coping with the COVID-19 pandemic, the Disaster Response Network offers 1-3 pro-bono sessions for those who need it.
Let me ask you a question: Have you thought about seeking therapy recently? A sentiment I’ve sometimes heard out there in the general public during the past year is “I can’t change the situation, so what’s the point of talking to someone about it?” If you can relate to that, and you’re wondering how psychologists can help you during a pandemic, please keep reading.
Counselling is not solely reserved as a space for solving problems or changing our circumstances. It can also be a space for seeking comfort, finding new ways of coping, healing emotional wounds, building emotional resilience, getting out of old patterns, feeling seen and understood, and seeing new perspectives. I also want to assure you that therapy isn’t “just talking”. Psychologists and other licensed clinicians are specially trained to do work that goes beyond having a conversation in the way that you would have with a friend. Here are a few of the ways psychologists can help during a pandemic:
Shame reactions to judgment
People have been asking me how to make sense of the increased criticism and judgment they’re seeing within their own communities right now. I think it partly has to do with shame. When we feel judged about our actions, shame reactions can arise. As Nathanson originally described, these shame reactions include self-criticism, withdrawal, denial, and blame.
Let’s imagine a situation where someone feels judged because they decided to send their child to school and a close friend chose not to. Perhaps the friend said something that was ambiguous, and could be seen as judgmental. The person feeling judged might isolate from that friend, numb by drinking more than usual or keeping overly busy, criticize themselves (“I’m obviously failing as a parent, I can’t do anything right”) or blame and criticize the friend (“This is their fault for making me feel this way. What, do they expect me to just stop working?”). The blame can sometimes extend to other people in attempts to separate ourselves from those who are the “real” problem (e.g., “At least I’m not like _______, who is obviously doing the wrong thing”). Psychologists can help you identify your reactions to shame and incorporate compassion-based practices.
Naturally, this is a time of heightened levels of anxiety for all of us. Some people might also be experiencing what’s known as “death anxiety”:
“We are living in a time of extreme insecurity and multiple threats to our existence [...]. Within a few months in 2020 we went from a world in which death was something in the indefinite future for many of us, to a world in which not only our own death but the deaths of millions became an imminent possibility.
A rational response would be to come together and fight for our collective survival. So why are so many people choosing divisiveness instead? Sheldon Solomon, a professor of psychology at Skidmore College in Saratoga Springs, New York, offers an answer: when reminded of the fact that we die, we double down on our existing beliefs and circle the wagons, regarding anyone outside our cultural group with suspicion.”
Without ignoring the real causes of concern, there are still things we can do to reduce our overall anxiety and panic so that we can be more present and grounded in the moment. I find it’s important to acknowledge how our current stressors have contributed to the way we’re feeling, then take a moment to ask ourselves what might help bring us comfort with the experience of anxiety. Sometimes it might help to have a plan, distract ourselves, and move our bodies, or try out some grounding exercises.
Vaccine hesitancy and the spread of misinformation
The pandemic has brought to the forefront another phenomenon we might not even had heard about before: an infodemic. This saturation of false or misleading information, as we’ve seen, creates confusion and mistrust in authorities, which can be disastrous for public health. However, this also has an impact on a personal level: we might be affected by this confusion ourselves and not know who to trust, or we might struggle with the beliefs held by someone we care about.
Well, psychology has something to say about this! I was really glad to get this article in my inbox from the Psychologists' Association of Alberta last month. I'm looking forward to learning more about how the spread of misinformation happens and the ways we can better help people in our community sort through how to debunk myths so they can make more informed decisions about their health.
Another really interesting article from a psychology perspective is this one published in Forbes. This is a good read if you’re curious about how vaccine hesitancy might relate to the mental blind spots we all have and how we can avoid them. It’s also worth looking at this piece about the influence of US media in our perceptions and beliefs about the pandemic. Maybe it’s a good time to start curating our follows on social media!
When you’re feeling hesitant about any medical information or advice, you might consider asking yourself if there’s a source of trustworthy information you can turn to during this difficult time (e.g., your family doctor, a pharmacist, or an evidence-based source of information online). Here are some non-partisan sites dedicated to combating misinformation that you might be interested in consulting: Science Up First, AFP Canada Fact Check, FactsCan, Snopes, and the app Project Fib for Chrome, which detects fake news on your Facebook feed!
In addition to all the above, psychologists can also help with a ton of other pandemic-related issues like coping with loneliness, relationship issues, dealing with trauma and vicarious trauma, grief, figuring out new boundaries, and so much more.
For those of you who are residents of Alberta and seeking help specifically related to the COVID-19 pandemic, you might try accessing the Disaster Response Network: “Our Disaster Response Network members are offering pro-bono psychological services with priority for health care providers and first responders traumatized by recent events. This is not a crisis line or a referral service but pro-bono support by volunteer psychologists of 1-3 sessions for those in need.”
So far I’ve given you some strategies on how to deal with our shame around productivity and parenting. This time, we’re going to see what to do when you feel shame about food.
It’s very important to know and to remind yourself that there’s no such thing as good foods and bad foods. As most dieticians and psychologists who work with disordered eating will attest to, labeling food as good and bad puts a moralistic value on it that shouldn’t be there. I have a philosophy in my house—one I picked up over years of listening to body trust and intuitive eating experts—that all food is good food. That means ice-cream is good, pancakes are good, avocados are good, chocolate is good. It’s all good.
Maybe you’ve seen this image before, but I find it so useful to help remind you the real differences between good and bad food:
Let’s take one example of food-related shame I sometimes hear. People who are struggling with shame can feel bad about the type of food they ate (let’s say it was extra dessert) or the amount they ate (especially if it was more than they planned). I’ve found that the most common responses when people experience food shame is either to attack themselves or to numb their feelings with more food.
I’ve found a couple ways to interrupt this. If you’re criticizing your food choices, keep in mind that feeling shame is only going to make you feel more stuck. Here’s something very interesting I’ve learned: every time you tell yourself that you shouldn’t eat something, this creates restriction. And the more we restrict? The more we binge. So it’s never really “eating too much” that’s the problem. The issue is in creating restrictive diets and shaming your body when it gets hungry. Caroline Dooner explains all about this and more in her book The F*ck It Diet, if you want to read more on this topic.
If you’re the type to numb out with food instead, you might try practicing mindfulness. Creating a pause between the impulse and the action may give you a moment to notice the emotions that are driving the behavior. If you notice you’re feeling ashamed, you can take care of the shame (through self-compassion, connection, or a number of other shame resilience skills you may already be practicing). If you’re feeling angry, or sad, you can take the time to take care of that too. You might also still choose to eat--the point is slowing down the whole process so that more and more options become available for taking care of painful feelings.
In my last post, I discussed the feeling of shame around productivity and how it generally comes up from this idea that we need to earn our sense of worthiness, of feeling we’re good enough. To continue this series, today I want to talk to you about what to do when you feel shame about your parenting.
You’re going to hear me say it every time, folks. The first step to getting out of a shame spiral is recognizing that you’re in one. So how might you know that you’re experiencing shame about parenting? Let’s say in this case that you accidentally snapped at your kid, and you’re wishing you hadn’t. Maybe the self-critic is showing through, and it’s beating you up for letting your irritation show. Or you could find that the irritation grows, and the blame turns toward your child (e.g., “They’re being such little monsters! Why can’t they ever listen to me?”) or your co-parent (“They only act this way because you’re so lenient with them!”). Some people might instead withdraw, concerned that if they let someone else know what’s going on, they’ll be judged even further. And other people might deny or brush off their behavior because it’s embarrassing to admit to (e.g., “It wasn’t so bad”). These are common reactions to shame and they’re often our best cue that we’re caught up in it.
When you recognize a shame spiral in the midst of it happening, it’s a good time to pause, take a step out of whatever room you’re in, and go find a quiet space to attend to your feelings. Yes, that’s right. I’m giving you permission to close your bedroom door, or lock yourself in the bathroom for a few minutes, or go on a walk, or whatever you need to do in order to have a few moments of compassionate space to yourself. Even if you have a crying baby or child in the other room and all you can manage is to take a few breaths. It’s going to help you, your child, and your relationship with them if you can take just 10 seconds to start making your way out of the shame spiral.
I’m always a fan of using self-soothing and self-compassion strategies first, and looking at things from a cognitive perspective later. So please, I encourage you to do what you need in the moment to bring kindness to yourself in the difficult situation you’re experiencing.
After that, it might help to remind yourself that we don’t need to be perfect parents in order to have good, healthy relationships with our children. I love how Diane Poole Heller puts it:
“The perfect parent does not exist, nor does it need to. According to developmental psychologist Edward Tronick, even exceptional parents are only 20-30 percent attuned to their children, but even this amount of attunement can lead to Secure Attachment if parents are willing to repair the ruptures that occur between them and their children.”
I love sharing this information with clients. 30%? I think most of the parents I know are aiming for 90% and then feeling terrible when something inevitably gets messed up. I love understanding that we can repair when things go wrong. This is also where shame resilience comes in. The more we see ourselves as bad parents and stay caught in shame, the harder it becomes to do anything about our mistakes. If you can see yourself as someone who’s doing the best they can, and who might make mistakes sometimes along the way, then you’ll also be better able to take actions to fix those mistakes. In this way, we can start to separate our actions (which may not always be perfect, even when we’re trying our best) from our identity as a person.
I talk a lot about shame and how to deal with it--in fact, in case you’re new here, I have an online course called Shame Resilience Skills. This will be the first of a series of posts where I will discuss shame specifically in relation to different things that can come up in our lives. So, to start, let’s talk about what to do when you feel shame about your productivity.
The first step to reducing shame in any situation is always to recognize it. Say to yourself “I am in a shame spiral about productivity”, or “I am getting caught up in all the messages about my productivity being tied into my worth”. Remind yourself that this is shame talking.
If you’re ready to explore shame about productivity in greater depth, you might want to ask yourself where you first learned that you needed to do more in order to feel good enough. A lot of the time, the way that this works begins with an experience where something bad happens in our lives. For example, we are bullied, or a parent is neglectful, or we experience another type of hardship. But the child brain doesn’t know how to make sense of these difficult events and, at a young age, is very, very egocentric. What this means is that a child believes everything happens to them because of their own doing. So if something bad happens, a child believes it must have been because of something they did or didn’t do. A child’s understanding of why abuse or neglect happened might be “It’s because I’m not good enough”. They’re not able to see the bigger picture of why a parent would be neglectful or someone would be abusive toward them and realize that it has nothing to do with them. Instead, they accept the idea that it’s because they are not good enough as a fact.
Because feeling not good enough is so uncomfortable, we as children will do what it takes to get away from this feeling. If we truly believe at our core that we’re not good enough, then what makes sense in order to cope with that? Children try to “be better” in ways like increasing their productivity and achievements at school, or by being more likeable and pleasing in their families and in their relationships. They do everything they can in order to earn a sense of worthiness. What the child doesn’t realize is that they never had to earn it to begin with.
This is your reminder now – you don’t have to earn your worthiness. It’s okay to put down your projects, close your laptop, and rest for the day.
In my last post, I talked about scarcity as one of two main barriers that usually get in the way of setting and sticking to our own boundaries, in order to respect our needs. Today I want to talk about a second obstacle: guilt.
Healthy guilt shows up in our lives when we’ve done something out of line with our values and, typically, it helps us get back on track. But most of the time, what we’re actually dealing with is toxic guilt. Toxic guilt stems from a belief that everyone else should come before us. So, I want to invite you to start by asking yourself this: did you do something out of line with your values? If the answer is no, then it’s toxic guilt you’re dealing with, and it’s not serving you. Remind yourself that you’ve done nothing wrong, even if it feels that way.
On that note, we can reframe that “guilty” feeling we get by naming it for what it really is. If you catch yourself saying “I know this is the right thing to do, but I feel so guilty”, try this trick of language: replace the word “guilty” with “sad”, and see if it fits. For example, “I know that I need to end this relationship, and I feel so sad.” Is sadness the emotion that you were really trying to name? If so, I hear you. It’s sad and heartbreaking, and I know we all find ourselves wishing it wasn’t part of life – but it is. It’s an important and necessary part of life to end relationships when they’re no longer working. At the same time, it also makes sense that you’d be grieving that.
As another example, we can try it in difficult situations that call on our humanity. Instead of saying “I know I can’t realistically afford to lend my brother this money, and I feel so guilty”, rephrase it to this: “I know I can’t realistically afford to lend my brother this money, and I feel so sad”. Again, you can try out the words and then notice how it feels inside.
It’s absolutely normal for sadness and grief to arise when we love someone and are also watching them struggle. We often wish the people we care about in our lives didn’t have to struggle, or that we’d be able to take away their pain for them. We wish we lived in a world where people didn’t have to struggle for basic needs, and there’s a deep and touching sadness that shows up in all of us when we confront the unfairness of this truth. Yet, there’s something different and powerful that happens when we can let go of the individual trapping of “guilt” and allow ourselves to feel the depth of communal grief underneath. When we allow ourselves to feel grief, we can experience empathy and compassion. When we get stuck in toxic guilt, we instead experience pity and eventual resentment.
How to say no without guilt in one simple step
Since we’re on the topic of guilt, I want to share one more thing with you today. Now, I don’t want to be flippant because I know it’s way harder than it looks from the outside. At the same time, what if I were to tell you that there really is one simple step to saying no without guilt? I actually have a way to do this! You’ll have to forgive me, though, because it’s simple, but not easy. Here it is:
You have to say no with guilt a bunch of times first. Do it with kindness, do it with integrity, but do it. And hold on to the truth that you’re still a good person. Time and time again, I hear from people that the more they practice saying no, the less guilt they feel. They start to see that they can remain compassionate, connected, and generous while still being able to have human limits.
Are you looking for a deeper dive into letting go of guilt? I have an entire section on exactly that in my Big-Hearted Boundaries online course. Big-Hearted Boundaries offers you 8 practical steps to prevent burnout and create sustainable caring. The way we can do this is by making whole-body decisions that are in line with our values, setting boundaries accordingly, and working through the shame and guilt of saying no to the things we don’t want in our life – which makes room to say yes to what’s important to us. If this sounds like something you could use, make sure to check out the full course curriculum and register here.
Sometimes, we might consciously know what steps we should take to care for ourselves, but still feel like we can’t follow through. It’s not that we’re unaware that going to bed will probably serve us better than staying up all night answering emails. Or that taking a 5-minute break will give us the energy we need to keep going on a project. So, what really gets in the way of respecting our own needs and the boundaries we’ve set?
I ask people about this any chance I get, and there are a couple of answers that get repeated again and again. Based on that, I’ve identified two major obstacles to respecting our boundaries. In today’s post I wanted to address one of those barriers: scarcity.
Our beliefs about scarcity are revealed in sayings like “I don’t have enough time, energy, or money to take care of myself”. If this sounds like something you’ve said before, I want to start off by acknowledging that there are absolutely real barriers to contend with. With the realities of income disparity, not everyone is in the position to sign up for a gym membership, buy organic food, go on vacation, or many of the other typical self-care strategies that tend to get suggested or thought of. I know plenty of young parents who are short on time, and plenty of single-income contract workers who are short on cash. From a feminist counseling perspective, it’s so important to acknowledge that those shortages disproportionately affect women, people of color, queer communities, and people with disabilities, to name a few.
We also have to work with a narrative that we’re not allowed to retreat and restore. Especially in hard times, many of us have been made to feel that we’re not allowed to be cared for. Many people I work with have a sense that other people have it worse than they do, and therefore they shouldn’t prioritize themselves.
Self-care is not conditional
When we find ourselves low on resources, we absolutely have to get creative about the ways in which we can respect our own needs while still respecting our limited time, energy, and money. And that’s not easy. Many people are probably tired of hearing the phrase “get creative” because that’s all they’ve ever had to do. It’s a struggle that folks who haven’t ever had to deal with scarcity may have a hard time understanding.
At the same time, I want to also (gently!) suggest that the magical time when we have “enough” time, energy, and money will never come. I keep hearing this idea of “I’ll take care of myself once things slow down” or “I’ll keep working like this until I save up enough to go on vacation”. But then, I watch people push themselves, and push themselves, and they never seem to get to that place of “enough”. Even when they reach their original goals, the bar just keeps getting raised. “I can’t slow down now, I’m finally ahead!”
Without choosing to make yourself a priority in your life, that won’t happen. Everything else will continue to come first. We can put our lives on hold waiting for the time to feel right. We end up waiting for the universe to slow things down and to feel like there’s finally space for ourselves. From my experience, the time just continues to get eaten up by other things. The bills continue to arrive. The people around us continue to struggle.
Most people seem to treat the idea of self-nourishment as an extra they can add on to their week only if everything else goes well. My perspective is that taking care of our needs isn’t something you reward yourself with once you’ve done enough. Taking care of yourself and respecting your boundaries is an integral part of life on this planet. And so, we need to make choices even with limited resources.
How do we do this? We can start with saying “This is a priority for me. My needs are important. I’m worth looking after”. Even just this – acknowledging your own needs and holding them as important – is a huge step. I’ve seen that alone open up all sorts of new avenues for people.
Jamila Reddy is a wellness advocate and coach who echoes this sentiment. I love how she reminds us that it’s okay to rest:
“When I give myself permission to have whatever I need to feel grounded and energized (without guilt or shame), the ripple effect of goodness extends far beyond my imagination.
Remember that you are inherently worthy of having all that you need to be and feel your best. You were BORN being deserving of rest, ease, joy, and wellness — you don’t have to earn it.”
How can we make ourselves a priority despite scarcity?
Putting yourself as a priority doesn’t have to be big, time-consuming, or expensive. Prioritizing your needs and turning toward yourself can mean paying your bills, trying to eat something every day, taking care of personal hygiene, drinking some water, dressing for the weather, going outside, moving your body, connecting with a spiritual practice, expressing your feelings, and so much more.
Another way the myth of scarcity shows up is when we say to ourselves “I’ll do it later”. The answer to that is simple – no, you won’t. So do it now.
Here’s something you should know: making yourself a priority is likely to give you energy. Within that framework, you don’t actually need to have the energy to do it. You don’t need to feel like doing it. You just need to do it.
To wrap this up, I leave you with some questions you may use for a writing exercise:
In my next post, I will tell you about the second barrier to respecting our boundaries, so keep an eye out for it!
One of the biggest sources of emotional resentment is being in a caregiving role and not knowing how to say no when we need to. It’s incredibly important to learn how to set (and stick with!) our boundaries.
I hear so many people talk about how tough it is to set boundaries, especially when it’s with someone you care deeply about. If you love someone who is struggling with mental health issues, you can probably relate to feeling the gamut of emotions: tired, annoyed, overwhelmed, fed up, sad, ashamed, and alone. You might feel responsible for the person’s behaviors, or guilty when there’s tension in the relationship. You might feel like you’ve been a caregiver for a long time, so you’re trying to figure out how to support the person you care about without becoming the therapist yourself.
If you’ve been aware of your more uncomfortable feelings and you recognize that you’re on the path to burnout, you might have already recognized your need to step back. So what happens if, when you finally set boundaries, you get pushback?
How to deal with pushback when you set boundaries
First, let me just say, I can just imagine how tough that is. I think most of us imagine our ideal scenarios when we go to set boundaries for the first time. “The person will totally understand! They will accept my boundary and we’ll move forward! It will be a one-time conversation!” Unfortunately, I’ve come to realize that the ideal scenario is often not how it plays out, even with people who love us and want what’s best for us. It can take time to adjust to new situations, even for people who want to and are willing to work with us.
But let’s put our curious hats on and find out a little bit more about the type of pushback you’re on the receiving end of:
Sticking with the boundary you set after you receive pushback is uncomfortable, especially for people who are used to pleasing others. If you think the person you’re caring for can grow with you, then I might encourage you to focus on trying to tolerate the discomfort of sticking with it. Many people slide back into giving all they have at the first sign of discomfort in a relationship because they’re concerned that the other person won’t be able to handle it, when in reality what they’re seeing is that the other person is taking time to adjust. It’s okay to give reminders of what you’re willing and able to provide – you can even do this in a way that is compassionate to both you and the other person. You may also need to show through your behaviors that you’re committed to following through on the boundaries you’ve set out.
If, on the other hand, you’re dealing with someone who simply isn’t willing to accept that you have needs of your own, then you might need to take a different tack. Beyond setting and sticking with your boundaries, you might be dealing with the grief of realizing the relationship can never be as reciprocal as you’d hoped. You might be working on how to cope with guilt-tripping, or learning how to take a further step back from a relationship that’s no longer serving you. Remember that it’s okay to leave relationships you’ve outgrown. You’re allowed to do what’s best for you.
*Originally posted on PsychCentral as an expanded version of an earlier post.
A few months ago I was facing some tension with an acquaintance (caused entirely by his unwillingness to hear my very reasonable “no” to his request), when I caught myself in a dangerous thought.
The stress of having tension between us was really getting to me, and I found myself thinking, “maybe I should just compromise after all, to make it easier”.
In other words, maybe I should just say yes to his request, in order to escape the tension and stress that had resultantly arisen. And then, here comes the epiphany. I was about to say yes simply for the fact that someone I barely knew had guilt-tripped me about saying no. That wasn’t compromising. That was conceding.
My mind was blown. And I started to wonder - have I been using the wrong definition of compromise for my entire life? My thoughts started racing, and I actually had to look up the definition of compromise on the spot (or, Siri looked it up for me). As it turns out, a compromise is when both sides give a little in order to find a mutually acceptable arrangement. There is nothing – absolutely nothing – I would have gained from giving into this situation.
Conceding, which is what I was doing, involves losing so that the other person can win. It means to surrender or yield something to another. The first truth about conceding in the situation I just described is that it would have had zero benefit to me.
But was that a good enough reason to say no?
Many of us who’ve been socialized as female are taught to believe that other people’s needs and desires are more important than ours. We’re taught that our role is to keep things running smoothly, and make sure to do everything in our power to reduce tension.
For many women I work with, this means being the one to silently give up our own wants and desires, or never name them in the first place. Directly or indirectly, we might have been taught that talking about what we want is selfish, rude, or (*gasp!*) unladylike. And while some of us might not consciously think about it this way, those deep-seated beliefs often play out in our most important relationships. For example, in any intimate relationships, have you ever….
Of course, we all have experiences at times in our lives where we give up some of what we desire for the greater good of the relationship, or because it fits a larger, long-term goal. (In other words – compromise!) The difficulty is when we consistently concede within a relationship context that isn’t give and take. As women, we often do so because we’ve been socialized to think everyone else should come first. We’ve been taught to feel guilty when we say no, and made to feel as though just because we can do someone a favor, we should.
I’ve gotten to a place in my life where I’ve recognized it’s okay to ask for what I need, and it’s okay to say no. I’m not going around creating unnecessary tension, but I’m not going to go out of my way and do myself a disservice just to make someone else happy.
Now, some people might be thinking, in the example I started with, I might not gain anything materially, but perhaps I would gain some goodwill with this person, and in the future they’ll be more likely to go out of their way to help me. It’s a nice thought, but it turns out to be rooted entirely in wishful thinking.
In my own life, this wishful thinking has mostly shown up in my relationships with men, both close to me and not so close. I remember as a teen and young woman giving a lot to relationships with men, with the very naïve belief that everything I gave would eventually be returned in kind, and that we were all working toward a reciprocal connection. It turned out what they really wanted was for me to keep giving in the way I was giving without question.
I think a lot of us can get caught up in the wishful thinking that eventually all our giving will be returned in kind. So let me reiterate something from above about the scenario I first described – he was guilt-tripping me for saying no. I was now dealing with tension and stress because I said no. Does that sound like the kind of person who is going to be appreciative if I make a sacrifice? Who is going to want to be generous in the future? I can tell you from experience both in my own life and in the lives of my clients, it isn’t. I’ve made sacrifices before, in the hopes of building a relationship of goodwill and reciprocity. It doesn’t work unless both people are willing to be generous, and make compromises that are mutually beneficial.
So the next time you catch yourself thinking of making a “compromise”, ask yourself, is there mutual give and take here? Is this a relationship of reciprocity? Or am I just giving in because I’ve been taught that other people’s needs are more important than mine?
Sometimes people find themselves dealing with low mood, inability to get motivated, irritability, and a feeling like they can’t get anything done at work. If this has ever happened to you, you might wonder “Is this depression or is it burnout? Are they the same thing?” They share some of the same symptoms including exhaustion, difficulty sleeping, withdrawal from social activities, concentration problems, irritability, and low mood, so it’s not surprising it can be hard to differentiate the two.
I thought it might be helpful to write about some of the similarities and differences. Before I begin, I’d like to remind you that if you’re experiencing mental health symptoms, you should consult with your family doctor, psychologist, or other licensed mental health professional for individualized assessment and advice. Although I love sharing ideas through my writing, I can only offer so much nuance through a general blog. This is very different from ongoing and personalized care with someone who knows your situation and knows you.
So, how are they different?
As a feminist psychologist, I work hard with clients to look at the context that leads to our mental health struggles. For both depression and burnout, I see these issues as largely impacted by the context we’re living in. One difference would be in the types of experiences and situations that most often put us at risk.
When clients are dealing with depression, we might explore some of the current or past experiences that could be contributing to it. For example, childhood neglect, trauma, loneliness and isolation, and shaming experiences could be seen as contributing factors. Johann Hari has an incredible book called “Lost Connections” on the contextual factors that contribute to depression. In it, he identifies disconnection as the primary source of depression. Specifically, he talks about disconnection from meaningful work, disconnection from others, disconnection from meaningful values, disconnection from status, disconnection from nature, disconnection from a secure and hopeful future. He also writes about childhood trauma, changes in the brain, and genetic factors. This falls in line with the widely accepted biopsychosocial model, which suggests that some people have risk factors such as genetic predisposition, and it also ascertains that there are many factors both in our histories, current personal circumstances, and the more global context that can lead a person to experiencing depression.
Unlike depression, which can be related to many factors, burnout is primarily related to our work. In fact, it’s defined this way. As of 2019, burnout was recognized by the World Health Organization (WHO) and included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon (WHO, 2019). Burnout differs from other mental health disorders because it is tied directly into a person’s relationship with their work.
What we can do about burnout
Because burnout is defined this way, it means that people who are experiencing burnout and are able to take a break or extended leave from work will likely start to feel better. Of course, it takes time to recover, and we need to be patient with ourselves through the recovery process. But, largely, removing yourself from the situation that has made you feel unwell will start to bring relief. Working through depression, on the other hand, isn’t as straightforward as leaving a job or taking a break.
If you think you might be experiencing burnout, you could ask yourself some of the following questions:
I’d also encourage you to watch my mini course on How to Prevent Burnout, because I share the definition of burnout, the workplace-related causes of it, and some ideas of what you can do to prevent it (other than just quitting your job!)
Footnote: Hari’s book, in my opinion, can come across as a bit anti-medication. I wanted to note that this is not my stance, and I don’t want to further stigmatize or shame the pathways that work for people. I’m supportive of what works best for my clients, which sometimes involves medication, and sometimes does not.
In my work, two of the biggest themes I talk about a lot are burnout and shame resilience—I even have an online workshop on How to prevent burnout and my most recent one is about Shame Resilience Skills. If you've been following me for a while, you might already know this. What you might not know yet, though, is that there’s an overlap between the two.
Here’s what I've noticed: at the root of overworking (which eventually leads to burnout) often lies a sense of shame. We might feel that our worthiness is directly connected to our productivity—either because we've been told so or been made to feel so in indirect ways.
In trying to get away from the uncomfortable experience of shame, many of us strive to be perfect. We might make demands to ourselves to appease that voice: "I'll just achieve more at work, I’ll be pleasing in my relationship, I’ll give more in my community…" But, at some point, we reach our limits. We’re only human, so we get exhausted, our bodies break down, and resentment settles in.
I often have clients who come to me with the goal of getting better at being perfect. Although this is an impossible standard, they’re beating themselves up for not continually being able to meet it. Instead of giving them strategies to “get more motivated” and just get on with achieving more than they possibly can, what I do is work with them on the root feeling of shame. Why? Because I believe that they are good and worthy just as they are, without having to do anything more, and I want to help them feel that way.
What can we actually control?
This push to be perfect doesn’t always come from inside ourselves, though. Many times we’re actually made to feel guilty or ashamed of our choices by other people, even if they don’t mean to, like when someone tells you “Wow, you’re leaving early!” or “I wish I could do that but I have a lot more work to do!” Unfortunately, as many of my clients have found, if you’re waiting for someone else to change, you might be waiting a long time. This is why, instead of waiting for other people to realize what they’re doing and change their ways, I focus on behaviours that we ourselves can do differently.
Another thing we can get really caught up in is trying to get someone else’s permission or acceptance of our boundary, to convince people that we have the right to our own boundaries. It’s important to learn that we can simply do what we need to do for ourselves and let other people deal with their own discomfort around it.
Setting the boundary and then sticking with it when we get pushback will feel uncomfortable for us, too: here’s where accepting our feelings and practicing self-compassion can be really useful. We might have to remind ourselves that you can be a good person, even if other people are disappointed, or that other people don’t have to understand your boundaries in order to respect them. This is the heart of burnout prevention and shame resilience.
From my perspective, self-compassion boils down to being as kind to yourself as you would be to a friend. Over the years I've had a lot of people ask me about whether they could forgo compassion and just get things done by motivating themselves through shame and grit. My short answer is, I tried that method. As I’ve previously shared, it led to an entire year of intense daily pain. That was over years ago and I still have chronic pain issues, so life will never quite be the same. Fortunately, I've found ways to cope with it that don't involve telling myself what I "should" be doing.⠀
Oh, and the other answer involves that there's good research to back up my very individual story (thanks Kristen Neff!) about how shame isn't motivating – self-compassion is the way forward.
When I talk to clients about self-compassion, I often talk about acceptance. In this post, I wanted to touch on acceptance in three specific areas: acceptance of mistakes, acceptance of our limits, and acceptance of our feelings.
Accepting that we make mistakes
We hold ourselves to such impossible standards sometimes. And hey, I get it. If we can just be perfect, then we’ll never have to feel the horrible feeling of shame, right? So we aim for perfection, try never to make a mistake, and then hold our breath. Unfortunately, perfection is a plane of existence that doesn’t exist.⠀
From my perspective, not only is making mistakes allowed, but we can end up growing and transforming because of them. It’s part of what helps us move through life and learn about ourselves and our world. When we make a mistake, I feel like there’s SO MUCH we can do with it. Getting stuck in shame is not the only way. We can actually learn, repair, forgive ourselves, and do a ton of amazing healing work after we mess up.
I know forgiving ourselves might be a hard one, so here's my thought: we all make mistakes. After all, we're all human. We can learn to be accountable. We can learn to take responsibility for our part. We can learn to take a step back from shame and forgive ourselves, remembering that our mistakes (or the things we didn't know then) don't have to define who we are.
Accepting our feelings
Accepting our feelings has been an especially significant theme in the last year because many of us have been feeling uncomfortable emotions and probably also wishing we weren’t going through so much stress, anxiety, and pain. Isn’t that human? To be wanting to move away from the hard parts, and also to be feeling a lot of it right now.
However, when we try to get away from the difficulty, we deny our reality. And that reality doesn’t go away. We might temporarily push it down, but to what effect? The most long-lasting impact I see is what Tara Brach would describe as shooting ourselves with the second arrow. Not only are we still feeling the initial anxiety that was there – we’re now also feeling the shame of it too (“what’s wrong with me that I just can’t get through this?”). We’re left with twice as much pain, or more often more than we initially started with.
Now don’t get me wrong. If I could magically get rid of my fear of public speaking, or airplanes, I would! But since I can’t wave that wand, I’ve found there’s a better option: acceptance. Leading up to those events, I can take of those fears and anxieties rather than ignore them or try to muscle my way through the pain. Most of us know by now that pain gets worse when we try to suppress it, so I think it’s time to try something different. When we’re more self-compassionate and can accept what we’re experiencing as human, we do a way better job of taking care of the physical sensations, emotions, and thoughts that go along with everyday life, and the whole thing gets easier to cope with and less intense over time.
Accepting that you have limits
You may have noticed by now that acceptance is a tough one because we're working to accept things we'd rather not. Like the fact that we do, in fact, have limits and can't do it all. Or like how we wish we had more time and energy for the things and people we love and, at the same time, our body is breaking down, making it impossible to give any more without great detriment to our health. ⠀
At the risk of sounding repetitive, you are human. Even if sometimes you don’t want to be constrained by those limitations. Even if you think you should be "better by now" or "able to handle more". Fighting it isn’t working anymore. Pretending it’s not there isn’t working anymore. Work on accepting that, just like every other human on this planet, you have limits too.
If you’re curious to learn more, please feel free to check out my new online Shame Resilience Skills course. I go over more of the elements of acceptance and my favorite ways of bringing about more self-compassion into your daily life.
As Brian Mahan described, shame is predominantly a physiological wound. We have a physiological response to shaming experiences; a holding pattern or stuckness that can emerge. Even for people who might know on a cognitive level that they have nothing to feel ashamed of, deep in our bodies we feel unworthy, bad, or wrong.
This knowledge can guide us to how we can heal shame. It's not just a matter of having new cognitive information: it's the physiology that we need to heal. So, if we can work with our imagination in the present, then the lower brain is going to take all the information as if it was real, as if it was happening now, and we’re going to have a physiological response to it. If we can have a physiological experience of compassion, softness, or being protected... well, it's an entirely new pathway.
Said another way, the lower brain is collecting information from the higher brain and middle brain as well as our five senses. It does not have the capacity to differentiate between reality and perception. This is why imagination is such a powerful way of working with shame. Through imagination, we have a new physiological response. Imagining something compassionate, protective or kind happening for our younger self can have an effect on our brain that’s quite similar as if it had actually happened for us.
In my work I've been helping clients revisit the original shaming incidents through imagination. By doing so, we can help the child part of them have a new experience of feeling understood, safe or welcome. For example, through imagination we might help the wounded child understand that they did nothing wrong.
This is important because, when we're children and something goes wrong (e.g. parents get divorced, we experience neglect, someone is cruel to us, etc.), our child-brain understanding of why that happened is because "something is wrong with me". We feel the pain and we can't see that it might have been our parent that caused the pain (because our parent is perfect, in our minds), so it must be us. We take "something is wrong with me" as absolute truth, and it becomes a powerful coherent narrative because then it explains (or seems to explain) everything else difficult that follows. If later we're bullied at school, or if we experience body-shaming in the culture, or if we struggle in friendships, it all feels like it's because "something is wrong with me". And we never question it. It just feels true, because we adopted it SO EARLY ON, before we had the capacity to think critically or examine things from other perspectives.
Using imagination to help give the young child the kindness, support, and unconditional love they needed back then allows us to free ourselves from toxic shame. This way of working is very much in line with what I learned from the hakomi therapy community: that we heal not by having new information, but by having new experiences.
Nicole Perry is a Registered Psychologist and writer with a private practice in Edmonton. Her approach is collaborative and feminist at its heart. She specializes in healing trauma, building shame resilience, and setting boundaries.
About the Blog
This space will provide information, stories, and answers to big questions about some of my favorite topics - boundaries, burnout, trauma, self compassion, and shame resilience - all from a feminist counselling perspective. It's also a space I'm exploring and refining new ideas.
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