It started with a therapy student.

I was feeling energized while in a mentoring session with a graduate student at my alma mater. She expressed her ambition to eventually find herself as a therapist in private practice. Her questions were insightful, and her energy was infectious.  

I have enjoyed my work as a psychotherapist in solo private practice for over 10 years. In the past year, I have been reconfiguring my simple solo private practice into a complex group practice. I am enjoying the clinical aspect, continuing my own work as a therapist, as well as hiring and supervising early career therapists.  

But learning the accounting and legal aspects of running a business like this has been steep,  and for me, doesn’t come naturally. Truthfully, it has been outright humbling. I’ve been forced to recognize how little I know about family and medical leave insurance, unemployment insurance, employer sponsored health insurance, and payroll taxes. I’ve had to acknowledge the need to educate myself on these things, enough to find and hire professionals to support me in these areas. 

And what about marketing?  

I have barely scratched the surface on this new world. All of these things are running through my head when I was asked this question:  

“How did you set yourself up for success?”  

My mind rewound back to when I was a graduate student, followed by the years working in nonprofits and hospitals while earning my clinical hours towards my license.  

How did I set myself up for success? I’m not even sure what that means. “I suppose,” I said slowly, “I didn’t…”  

When you take any kind of professional or personal risk, there really isn’t an insurance, or “assurance”, that you will be successful. There are plenty of coaches and consultants who can guide you, at least in the professional realm; but, I made a lot of clumsy moves along the way, learning along the way. Some of them were quite costly in terms of time and finances.  

Some of my choices, I realize in hindsight, appeared a bit unpolished. For instance, I  built my own first website before there was Wix or SquareSpace. It was a Yahoo Small Business website, and I called it Yogalena Therapeutics. What even is that??  

I chuckle to myself now when I think about it. But I was PROUD of it then.  

Was that going to set me up for success? Were people googling words like “Yogalena” and “Therapeutics” in their search for a psychotherapist who loves yoga? 

What does it mean to be successful?

In our never-ending quest for success, there really isn’t a recipe. You take a step in the direction in which you are either energetically driven, or even just a little curious. And then make your move. Sometimes you don’t necessarily know what your next move beyond that will be.  

 We refer to this as the proverbial “leap of faith.”  

The thing that often stops us the most from pursuing the thing that we most desire is the fear that we aren’t “set up for success,” so why even bother trying?  

 That is your anxiety talking. Your anxiety wants to keep you stuck, spinning your wheels, wishing you could get past your fears and “level up.” Much of the work of therapy is identifying these fears, and then taking small steps in the direction of your goals.  

 Of course you need to lay a foundation for any professional goals you have. You must do the work, and recognize that learning never stops. But worry less about doing so perfectly, or you will likely never start. 

An evolving concept.

In the end, I told my interviewer that there is no formula for success. There is only continuing education, vision, inspiration, creativity, and energy. There will also be setbacks, anxiety, fears, and yes, some losses. There may even be some failures, which sometimes require time to heal. Then you can reevaluate before determining next steps. 

But please, I implored her, do not let that stop you! If you want to be successful at something, first, decide what type of success you are looking for. What does success mean to you? Is there a financial benchmark, or a professional milestone of accomplishment that means you are successful? Then, not fearlessly, but in spite of your fears, go in that direction.  

Keep in mind, the mark of “success” is always moving. You may reach one milestone and find you already have your next milestone in your sights. Celebrate the victories before moving on to that next level of success. And remember, there is no “there, there.” Few people arrive at their personal pinnacle and think to themselves, “Ok, I did it! I’m successful!” And then stop.

My hope for you is that you will enjoy your wins along the way, and continue setting your sights on the next peak to climb. Rather than setting yourself up for success, set your goals and continue moving towards them. And find some time to enjoy the ride! 

People who can be described as “Type A” come in all forms and disciplines. If you tend toward Type A characteristics, chances are you already know that about yourself, as may those around you. You are driven, motivated, energized, and enthusiastic. You may already be quite accomplished, but there are always new challenges awaiting you, and the prospect of preparation and execution in tackling them is thrilling.

That is the good news. The bad news is that Type A people are often overwhelmed with the stress of urgency. They feel rushed, tend towards workaholism and competitiveness, lack adequate sleep or downtime, and don’t participate enough in other activities necessary for rest and recuperation.

A Closer Look at the Type A Personality

Most people think of high-profile celebrities, such as reality stars, journalists, business people, and artists as classic Type A personalities. But did you know that Type A people come from all walks of life? The tendency to be driven and tirelessly ambitious knows no discrimination across cultures, occupations, and socioeconomic status.

Is being Type A a necessity for success? I would say no. But people who are Type A often have a lot of energy and drive to put into whatever task presents itself. They are highly motivated to accomplish goals and succeed, often as efficiently and quickly as possible, so they can move on to the next challenge.

When Your Mind Is Motivated, but Your Body Can’t Keep Up

What happens when your ambition exceeds your physical capabilities?

Maybe you have a Type A mind in a body that lacks the same vigor. This is a rather common occurrence, but it leaves many people feeling frustrated. It is especially discouraging if there was a time of life when you did have the energy and physical capacity to drive your body as fast as you wanted.

Often, I see people in my practice whose bodies decided it was time to slow down while their minds did not experience a similar awakening. Having a body that is less tolerant of stress can be a natural reaction to being pushed through countless deadlines, nights of inadequate sleep, few vacations, too much caffeine and sugar to stimulate the body’s energy, and too little time to eat nutritious food.

How to Nurture an Energized Mind and a Tired Body

If this sounds even a little like you, there are steps you can take to manage your Type A tendencies to achieve your goals while honoring your body’s needs to minimize stress or harm.

1. Make your Type A personality traits work for your health.

Schedule regular bodywork, exercise that is not too strenuous, and a regular bedtime. Use your drive and motivation to tend to your body. If shopping and cooking healthy food is not your thing, consider some of the many food delivery services that do all of the shopping and prep for you.

Having a body that is less tolerant of stress can be a natural reaction to being pushed through countless deadlines, nights of inadequate sleep, few vacations, too much caffeine and sugar to stimulate the body’s energy, and too little time to eat nutritious food.

Think about caring for your body as one of your many tasks. See how you can fold self-care and optimal health into your naturally hard-driving inclinations.

2. Make bedtime a priority.

Few things are more critical to optimal physical and emotional well-being than sleep. If your sleep is not adequate in time or quality, that will affect everything else you do throughout the day. You may be too tired to exercise, unable to attend to your hunger cues effectively, and unable to concentrate or function without excess sugar or caffeine.

3. Keep moving, but slow it down.

In Yiddish, there is a word called shpilkes. People who have shpilkes are those who have a lot of “get-up-and-go.” They don’t want to stop moving and are always ready to take on the next thing once a task is completed (and maybe even before that).

That may be true of your Type A mind, and you do not have to give that up. It is possible to continue being productive and inspired despite a tired body. Non-strenuous activity can be particularly beneficial when you feel very tired or sluggish. Of course, it doesn’t hurt to take a rest day or week, or even a little time off during the day to eat your food, take a walk, visit with a friend, or to self-reflect. But generally, even when you feel very tired, and despite your obligations, keep it moving. Just slow it down.

4. Be kind to yourself.

It is normal to feel frustrated with yourself when your body will not comply with all you are demanding of it. Those are the times it is most essential for you to encourage your body and your Self.

You may naturally feel the urge to criticize yourself, especially if you find you are unable to complete tasks and meet work demands. But altering your focus to pay attention to what you are doing well can help shift your energy in a more positive direction.

5. Journal, talk to someone regularly about your feelings, or speak with a therapist.

Voicing irritation, urgency about reaching your goals, and disappointments in your body’s limits may help take the “teeth” out of your frustration. When you express your emotions, verbally or in writing, you may be more likely to slow down the hamster wheel of thoughts racing through your mind.

Speaking with a therapist or counselor about this frustration can also help you reconcile your capabilities with your ambitions. Therapists are there to support you in reaching your goals and can help you incorporate healthy habits into your daily routine.

You will also be able to reflect on your responses, an activity which may reveal that your stress responses are not always necessary. You can still accomplish your goals at a pace that is more productive for your body once you ease any resentment towards yourself.

It is possible to thrive with a Type A mind and a body that needs more care to function at full capacity. The key is in honoring your body’s needs. This may mean taking more time than you would prefer to care for your physical self, but in return, you may be rewarded with higher levels of functioning and energy and much-needed rest for your mind. The payoff is often well worth the effort.

Advice is cheap.

Advice puts the onus on the listener and not the speaker.

Advice is often a quick fix—a mere Band-Aid on a wound that needs more persistent care.

I can usually detect someone’s frustration when, as their therapist, I pointedly do not offer advice. One of the skills therapists learn early in their training is one of the hardest, for both the therapist and the person in therapy: sitting in silence. But drawing out more information from people is a psychotherapist’s most useful tool. After all, your therapist is a trained listener, not advice-giver.

That does not mean your therapist is merely looking at you and listening while you talk. Any skilled therapist will be listening acutely for specific signals, which they then use to guide the direction of the conversation over time.

In general, your therapist is listening for three things:

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1. What You Really Want

Nobody knows you better than you. That is why advice so often fails to help you move in the direction you want to go. Ultimately, you have the answers to your questions, though they may be buried under the expectations, hopes, and dreams of others.

It is actually pretty rare that people ask us what we really, truly want. We spend so much of our energy and efforts trying to meet the needs and desires of others. This is true for concerns large and small. It has to do with how we spend our weekends, what we eat for dinner, the career paths we choose, whom we marry and when, whether or not we have children.

In a variety of ways, your therapist is asking you, “What do you really want?”

Answering that question can bring about changes you may never have expected—some joyful, some scary. But in the end, the answer comes from you and nobody else. The essence of your answers are what will guide you closer to the life you want.

2. Change Talk

Speaking of changes, I am rarely surprised when I hear someone hint at something in their lives they wish would change. When I reflect that desire back to them, people often respond as if it is the first time they had thought about it.

Your therapist is listening for your change talk. It usually starts with a tentative, “Maybe I could …” or “I wonder what would happen if …” or “I’ve always thought it would be interesting to …”

Your therapist is listening for your change talk. It usually starts with a tentative, “Maybe I could …” or “I wonder what would happen if …” or “I’ve always thought it would be interesting to …”

When I dive deeper upon hearing something like that, usually those sorts of statements are brushed off as a pipe dream. Your therapist intervening to examine change-talk statements may require you to face some of your deepest fears. This could be a fear of failure, fear that it is too late to try something new, fear that you are lacking in the talent, charm, or financial means necessary to follow this line of thinking. The reasons I hear why people cannot take even the smallest steps toward their dreams are usually more creative, varied, and unpredictable than I could imagine.

That is the point of intervention for you and your therapist. Change talk is where the work of therapy begins.

3. Your Self-Regard

Many people are shocked when they finally recognize how hard they are on themselves. Over time, we develop core negative beliefs about ourselves which we mistakenly believe to be the truth.

Your therapist is listening for those types of statements. Don’t be surprised if your therapist picks up on a core negative belief about yourself and challenges it. Such beliefs, that we are not “enough” in some way, seep into our subconscious so much that we do not even realize how critically we speak to ourselves.

Confronting those beliefs are some of the most demanding aspects of therapy. But it is possible, even likely, that if you think you are not enough, your therapist does not think of you the way you do, and they will reflect that belief to help you develop a more positive (and realistic) self-regard.

So while your therapist may guide your conversation in certain directions, it is not to offer you advice. It is so you can both learn more about what you truly want. And, eventually, so you can both learn what steps you think are most appropriate to take.

Shall we get started?

It is a simple question, but one that can cause more inner turmoil than most of us realize.

“How are you feeling?”

For countless people living with a longer-term or chronic illness, that seemingly innocent question can be loaded with emotions.

As a psychotherapist specializing in living with chronic conditions, I hear countless people wonder aloud if people really want the truth. Or they worry that the truth, some variation of “not so good,” will be followed by awkward silence or unwanted advice.

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Part of the issue can also be that when you do not feel well, the people who love you are not “okay.” In that sense, if you are the one struggling with a condition, then you are also in the position of providing reassurance to loved ones that you are okay and therefore they are too.

These kinds of stressors are not helpful.

Many people with health conditions would rather scrap the topic altogether, so they grit their teeth into a forced smile and say, “I feel good! Fine!” Then everyone can get on to a different topic.

If you are living with a chronic condition, how do you respond to people who ask how you are feeling?

One of the most important things you can learn when you are experiencing a chronic condition is how to communicate about it. Deciding on a couple of go-to tools, phrases, and responses to questions can go a long way to helping you manage your stress around the condition.

1. When people ask how you are feeling, offer up a number on a scale of 1 to 10.

For instance, you can say, “Today I’m a 4. Hopefully tomorrow will be better.” And leave it at that.

In doing this, you are letting people know you are not feeling great, which can be helpful information for them. It also protects you from having to divulge specific symptoms.

2. Draw clear boundaries around how much information you will give ahead of time.

If it is someone with whom you are in regular contact, you can let them know of some general symptoms you experience such as pain, fatigue, headaches, etc. But you can decide you are not going to discuss particulars.

Having the conversation sooner rather than later, and preferably at a time when you are feeling relatively okay, will go a long way to fending off a tendency to respond in an aggressive or possibly hurtful way when you are having symptoms.

3. Cut unwanted advice off at the pass.

When you are experiencing a persistent condition, you will inevitably encounter people who know someone (who knew someone) who had just what you have, and they will know exactly what you should do.

Listen carefully for the beginnings of advice coming your way, and if it is not something you are interested in, kindly let that person know with some variation of, “Thank you for the idea, but I’ve got all the help I need right now.”

After all, people just want to help. And the truth is, if you don’t feel well, others may feel uncomfortable too, and they may feel compelled to help you “fix” it.

Of course, some people will be interested in hearing any kind of new ideas to try. But what I hear most often from the people I work with is they are already engaged with physicians, specialists, and very likely some integrative or complementary practitioners. They don’t want any more advice.

Listen carefully for the beginnings of advice coming your way, and if it is not something you are interested in, kindly let that person know with some variation of, “Thank you for the idea, but I’ve got all the help I need right now.” If they continue with their advice, just repeat.

4. Ask for you what you need, and be clear about what you do not need.

This is important for everyone with chronic conditions, and especially necessary when your condition is not visible. The people who care about you are not mind-readers. You may look like you feel great when you are buckling under pain, fear, and discomfort.

Make informing those around you of your needs a priority, especially if you are feeling symptomatic. If you need to, reschedule the dinner party, plan a date night that does not require too much energy, or send the kids to a friend’s house for a few hours.

Maybe you do not need an elaborate meal, a bouquet of flowers, or a great show of affection. Simple whole foods and a bath before bed might be all you require. The trick is to pay attention to your instincts and let those around you in on the plan.

Ask yourself what information you are willing to share and what you are willing to accept. Have some answers to the familiar and often-asked questions ready so you can get on with your day and not get mired in the details.

When I was in high school, my best friend’s mom made no secret of her worries about us driving, going to parties, meeting new teens she didn’t know, and staying out late. But she felt confident in our ability to navigate the temptations of risky teenage behavior because, in her words, “You have good friends.”

She was right to assert that our solid, trusting relationships with each other were protective, certainly for our physical safety. But as a therapist, I can see now that another aspect of our bonds played a significant and lifelong role in our emotional safety as well. We encouraged one another to take some risks and scale our actions back when necessary; we showed up for one another when we were needed and supported each other when we were down.

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The life lessons of those years, and in many cases the friendships, have withstood the trials of distance, careers, children, marriages, and, yes, other friendships. Whether you have enjoyed positive friendships in your life or not, it is never too late to examine if and in what way your friendships, or your friendship, are lacking and could use attention. While it may seem glaringly obvious that we need trustworthy and reliable friends in order to thrive, here are six common types of friendships that can undermine your efforts to enjoy those friendly bonds and negatively impact your emotional well-being:

1. The Toxic Friendship

Friendships go through ups and downs, as any relationship does in life. Sometimes we find ourselves in situations where we feel a certain tension or friction in a friendship. That is normal, and through time and solid communication you can often work through those uncomfortable periods.

But that’s different from a friendship that consistently leaves you in a negative state. If you regularly hang out with a friend or group of friends and notice you do not feel energized either in their presence or once you leave them, that is a sign you may need to examine the friendship and your role in the dynamic.

2. The Slippery Friendship

We have all had these friends, and maybe you have even been that person sometimes. It’s natural to suggest to someone you like, “Hey, let’s get together sometime!” But the slippery friend is tough to pin down for an actual date. You may have a plan for Friday night, but on Friday afternoon they bail on you because something more interesting came up.

If you make a plan with someone and they repeatedly cancel at the last minute or make no effort to reschedule, that may be revealing about the nature and quality of the friendship.

3. The Ghost Friendship

Some friends may be good day-to-day buddies, some are terrific in a crisis, and some you don’t see often because of time or distance but know you can count on them to show up for you if and when you need them. Unfortunately, we don’t often know in which camp our friends belong until that moment arises.

It can be hurtful when you reach out to someone expecting them to respond and they are silent. It doesn’t necessarily mean they can’t be a good friend, but it may mean you need to either have a talk with them or consider reevaluating to what extent you can rely on them.

4. The Self-Loathing Friendship

As inherently social beings, we can’t help but be influenced by those around us. So if you surround yourself with the company of people with positive outlooks, you may be more likely to regard yourself positively.

The same holds true of the opposite. If you are spending your time and energy with people who don’t like themselves—or, just as bad, who don’t like other people—you may tend to like yourself less. If you are frequently around someone who talks negatively about others, leaving you feeling less happy with yourself, you may be caught up in a self-loathing friendship loop.

5. The Wet-Blanket Friendship

When you are hedging on a risky move in life that could pay off but also may have a disappointing result, such as considering a career change or taking a big step for your health or finances that feels scary but exciting, sometimes our unconscious defense to protect ourselves from that risk is to reach for our nearest wet-blanket friend.

This is the person who will tell you all the things that could go wrong and why you shouldn’t bother, leaving you feeling deflated and your parade drenched in rain. You don’t need to shun your wet-blanket friend, but you should be aware that your friend is stuck, and would rather have your company in Stuckville than see you move forward without them.

6. The Placating Friendship

On the flip side of the wet-blanket friendship is the placating one. While you don’t want your friendships to constantly kill your life buzz and shoot down your ideas, you also need people in your life who are going to tell you the truth as they see it.

While you don’t want your friendships to constantly kill your life buzz and shoot down your ideas, you also need people in your life who are going to tell you the truth as they see it.

As long as the feedback is kind, sensitive, and truly in your best interest, you can still come away feeling good about your decisions or the options ahead of you. If you sense that your friend would not meet you with nothing-but-the-truth sincerity, it’s good to ask yourself what role that friendship is playing in your life, and adjust how much sway that person’s feedback has on you accordingly.

Healthy friendship seems like a simple transaction, but the reality can be complicated, especially as we grow and our emotional needs change over the course of our lives. There will be times when we cannot be the best friends we could or should have been to those we care about. But it is important to keep in mind what is most important about friendships, especially if you are feeling like the “friend” area of your life is lacking. Friends should be reliable, trusting, caring, and honest.

And when you do click with a good friend, remember the wise words of William Shakespeare: “Those friends thou hast, and their adoption tried, Grapple them unto thy soul with hoops of steel.”