I was recently reading a blog post and noticed that someone in the comment section asked the question: “What does it mean when we refer to someone as a survivor?” We hear about “survivors” of domestic violence and “survivors” of sexual assault all the time, but what does it mean when we refer to people in this way? I thought this was a good question to explore.

The description provided by the National Crime Victim Law Institute states a survivor is “a person who endures adversity, moves through it, and perseveres, or a person with resiliency who remains undefeated.” I like that definition. Below, I describe how this definition applies to the four stages that trauma survivors might experience as they heal.

Stage 1: Silence

People who experience adverse situations, such as a traumatic event involving actual or threatened danger, face incredible challenges. The initial stage following a traumatic event is often a time of silence for the victim. It’s common for recently victimized people to refuse to talk about what happened. This may be due to a number of things, including stigma, isolation, shame, guilt, confusion, or denial about the event.

A person emerging from trauma may have low self-esteem at first and may feel overwhelmed and disconnected from the rest of the world.

Stage 2: Victimhood

[fat_widget_right]Eventually, the traumatized self may start to long for change as the ongoing suffering interferes with daily life tasks and a need to grow and recover begins to form. As this need grows, it allows the person to begin exploring ways to move through the trauma. According to available research, there is often a tug-of-war taking place within the individual between a need to be safe and protect emotions and a need to grow and confront the traumatic memories.

The person may feel compelled to talk openly with everyone about what happened and the suffering he or she experienced. Some people will likely be more willing than others to listen. For people working their way through the stage of victimization, having someone to listen and support them as they process the event can be critical to their ability to move forward into survivorhood. Many people find support groups helpful during this stage and may seek counseling or other support.

Stage 3: Survivorhood

Once a person processes the traumatic event and continues transitioning away from the victim experience, he or she often begins identifying as a survivor. During this stage, a person has had an opportunity to talk about his or her experience and has gained some sense of clarity. He or she may begin to identify the ways in which he/she persevered and the strengths that helped make moving forward possible. The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.

Reaching the stage of survivorhood doesn’t happen overnight. It may take months or even years to work through the victim stage and reach the point where one feels that the wounds are healing and a sense of relief is possible. Also, the process of healing is not linear. Survivors take one step forward and two steps back sometimes, and moving through it all and persevering may coincide with feeling hopeful one day and damaged and wounded the next. People in the survivor stage tend to spend less and less time feeling wounded as they continue learning new tools and recognizing themselves as resilient.

Stage 4: Thriving and Transcendence

Most people I’ve worked with seem content reaching the stage of survivorhood. They feel like they are managing challenges better and have a greater awareness about themselves and their experiences. Other people, The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.however, have told me they’re not done growing, and some of them have even said they don’t want to be called a survivor.

This group becomes the thriving group, people who transformed their experiences into a meaningful personal narrative and will not be defined by their adversity. They feel healed and safe, and take appropriate risks in seeking connection with others, such as asking a new neighbor out for coffee. They don’t feel the need to tell their stories unless it benefits someone else. “Thrivers” feel motivated to take part in the community and may seek out volunteer opportunities or other ways to help others.

Of course, this is only one model of healing and one definition of what it means to be a survivor. Every person who experiences a distressing event may have his or her own ideas about what it means to pull through a traumatic time or event.

Reference:

Matsakis, A. (2003). The rape recovery handbook: Step-by-step help for survivors of sexual assault. Oakland, CA: New Harbinger.

Being considered a “perfect child” by one’s parents feels fantastic. Basking in the glow from parents’ approval and love can feel safe and special, like one is living in a magical world where everyone is happy and satisfied. These feelings are very seductive. The child is usually not aware that they pay a price in order to maintain the parents’ continued extraordinary approval. That price is the giving up of one’s unique sense of self in order to comply and be the child and then the adult that the parents adore. Being kept on a pedestal distracts from being aware that one has wants and needs that are not defined by one’s loving parents. This interference with developing an individual self can result in difficult and/or empty relationships as one becomes an adult.

Here is Grace’s story. After Grace and I said our goodbyes during our last session, after 5 years of working together in therapy, I began to think about her journey from the pedestal to the development of a unique self. Grace had become a person with her own separate, individual needs, thoughts, and feelings.

Grace came to see me for therapy when she was 28 years old. She was a pretty young woman who described herself as feeling depressed and confused. She told me she was unhappy with herself and her life. She expressed puzzlement about her feelings, as she described herself as having a successful job, good friends, and a wonderful family. She wished she had a steady boyfriend, but she dated and had been in two almost-year-long relationships. Those relationships “just sort of petered out” and she wasn’t sure why. She shrugged and said, “Something seems off about my life. Nothing feels satisfying; I don’t know what I want. I don’t know what’s wrong.”

As Grace and I worked together in therapy, Grace began to describe how she always felt her life was wonderful. She was an only child and was especially close with her mother, who always referred to her as the perfect child. She told me that she felt special to both her mother and father. They idolized her and believed she could do no wrong. In fact, she told me she did no wrong. She was happy to do whatever they asked: set the table, be home on time, practice piano, not hang out with friends they felt were not a good influence. Grace felt her parents knew what was best for her and she complied.

In therapy, Grace began to talk about how it felt to be seen as so perfect by her parents. She told me she really liked it. She felt safe and loved when they would tell their friends what a good daughter she was. They were so proud of her good grades and her outstanding abilities on the piano and flute. When I asked Grace if she had ever felt like skipping piano practice or coming home later than expected, she looked surprised by the questions as if such behavior was unimaginable. Then she responded that she never behaved that way.

One day, Grace came to our session wondering about why she didn’t have any differences with her parents. She noted, for example, that most of her friends went away to college. She went to a local school and lived at home. She had no memory of wanting to go away to school but realized that now she regretted staying home for college. Grace’s sense of regret about her life began to pervade our work. Over time, Grace posed a number of questions to herself and to me.

Grace wondered if she didn’t consider the possibility of going away to school because she knew her parents wanted her to stay home. She wondered if she majored in music because her parents were so thrilled with her music making. She wondered why she went with her parents on vacations rather than taking vacations with her friends in college. One day Grace began to cry in our session. She was remembering her middle school friend Fran, who her parents didn’t like. They told her she should stop seeing Fran when they overheard her use a curse word. In our session, Grace became angry at herself and her parents. “How could I have agreed to such a thing? Fran was my best friend!” I asked Grace why she thought she should go along with her parents. What did she think would happen if she asserted what she wanted? Sobbing, Grace said she didn’t know. Her parents were good people; they loved her, why couldn’t she say what she wanted to them? Then, Grace stopped crying and gasped: “Oh! I would disappoint them.” I asked “What would be so terrible about disappointing them?” Grace looked very sad and was silent for a long time. Then she looked at me, tears returning to her eyes: “I wouldn’t be the perfect child!”

As Grace and I explored what it would mean to give up being the perfect child, it became clear that such an idea was frightening to her. She loved the feeling of making her parents glow when they saw her. She believed she kept them happy as long as she continued to be their good and perfect child. If she stopped being compliant and who they needed her to be, she worried they would become sad and hurt, and she believed this would harm them. She also would feel guilty. Talking about Grace’s concern and need to keep her parents happy led Grace to the realization that she not only wanted to make them happy, but she was worried that if she didn’t keep them happy, they wouldn’t continue to think of her as so amazingly special. Grace began to understand that to give this up felt like she would be losing their love. She was willing to consider, however, that in fact, she probably wouldn’t lose their love, but that maybe it wouldn’t continue to feel that she was quite so amazing.

Feeling less anxious about the idea that her parents would be hurt and that she would not be loved, Grace began to notice that the way she related to the people in her life was similar to the way she related to her parents. She didn’t like to disappoint or make anyone in her life unhappy. She considered whether the people in her life seemed to like her so much because she always went along. She realized that she didn’t express what she wanted if she knew it would conflict with others. One day she excitedly came into our session and said “I think the reason my relationships with men don’t work out for me is that they never really get to know who I am because I never know what I want and I am always avoiding conflict.” She said with a smile, “I am never satisfied because nothing that happens in the relationship is about me!”

Grace’s smile told me a lot. I congratulated her on the discovery she made and our work turned to focus on Grace’s wishes, desires, and needs for herself in the world. While Grace was eager to embark on a journey of discovery to learn more about herself, she was understandably anxious about how this would affect the relationships she was in. Would the people she was close to, her parents, friends, and new boyfriend, still want her in their lives? Would they love her? Would she hurt and disappoint them? Would it feel like love to her if she didn’t feel she was the most special person to the other in the relationship? These were all important and real issues that Grace would have to contend with.

Over the next 2 years, Grace gradually began to learn what she wanted and liked, what she hated, and what thrilled her. She discovered a passion for cooking and went to school to train as a chef. She weathered her parents’ disappointment that she gave up a career as a musician. And she came to believe she had the right to recognize and follow her own dreams. Her parents didn’t glow as much as they did when Grace first came to therapy, but they didn’t stop loving her.

Grace’s friendships changed. Over time and in spite of her anxiety, Grace pushed herself to reveal more of her wants and feelings as she tested the waters and developed more of a voice with her friends. Some welcomed this new Grace and were excited to learn more about her and make room for another voice. Others were not so welcoming to this new assertive Grace, and some friendships didn’t last. Grace’s dating life changed too. She felt more engaged with her boyfriend. She said “Now the relationship is about us because I am more of a whole person.”

When Grace described her new feelings and new ways of relating, she realized that she is much less compliant as a way of being in the world. She no longer felt perfect in her relationships. She knew she had to continue fighting her resistance to keep her needs quiet. Now Grace feels much more authentic with her family and friends.

Grace often smiles at me ruefully and sighs: “I do sometimes miss the feeling of being so special. Now I struggle to express what I want and it’s hard to accept that sometimes my needs aren’t met. But it is worth it. What I didn’t have, that I do have now, is I feel like a person. I usually know what I want and how to get it. I am not so scared that people won’t like me or that I will disappoint someone. In my relationships, I try to talk about what I want and feel. Sometimes it’s hard, like when I have a fight with my boyfriend or when I feel my parents disapprove of my decisions. But now I make decisions. I don’t go along automatically. I like me. How wonderful is that!”

Grace terminated therapy with the ability to continue the process of discovering and growing her unique self. While she was not yet able to assert herself as much as she wished, she was committed to the struggle to tolerate her uncomfortable feelings and risk that others might not always have the feelings she wished they would have.

That is very wonderful!

Related articles:
The Undeveloped Self and the Difficulty of Relationship
The Pink Elephant of Perception
The Fear of Hurting the Other and the Inhibition of Self

One of the most prevalent and harmful misconceptions about eating disorders is that they are all about vanity. Many people believe that sufferers are vain, beauty-obsessed brats that could easily recover if they’d simply stop looking in the mirror and get over their need to be pretty. This isn’t even close to the truth. As someone who has been personally offended by this belief, I wanted to share my story and my thoughts to hopefully shed some light on the vanity myth.

Before anorexia took hold of my life, I believe I had a pretty unusual level of self-esteem when it came to my body and looks. Sure, I had my days when I scowled at my reflection. They often occurred in dance class when I pranced around in my leotard amidst a room of mirrors. With a naturally lean frame and a fast metabolism, I was used to eating what I wanted and easily keeping in shape with my hobbies and lifestyle. I had been called skinny my entire life, and I actually hated it because it was usually said with a derogatory tone. In fact, there were times were I actually felt guilty about being thin and liking the way I looked. How messed up is that? It was so rare among my peers for someone to be satisfied with their looks and to truly love their body that I felt completely awkward and tried my best to always avoid the subject.

In college, after a series of unfortunate, traumatic events, everything changed. Within a few months I went from having good self-esteem and body image to completely loathing my entire being. How did this happen? Nobody had called me fat, I was never teased about my looks, and I didn’t get the sudden urge to pursue a runway career either. No, this wasn’t about beauty. This wasn’t about being thin. It was about becoming trapped in a “perfect storm.”

Eating disorders are about control, fear, anger, punishment, avoidance, rebellion, needs, security; I could go on and on. They don’t instantly develop over night. The circumstances have to be just right, just like the circumstances of nature that contribute to the development of a “perfect storm,” where all the elements of  location, air temperature, wind speed, and direction, levels of condensation, and evaporation. For an eating disorder to develop, it usually takes a vulnerable personality, usually one with heightened emotional sensitivity and perfectionist tendencies. It often involves one or several difficult life changes, like abuse, the death of a loved one, or the start of a new school. Finally, the beauty-obsessed society we live in, the one that values physical appearance more than anything else, creates the recipe for disaster.

To the person with an eating disorder, many of these factors are not apparent. That’s why, when you ask them what they’re feeling, most often the answer is,”Fat.” When you explain to them that fat isn’t a feeling, the next answer is most likely, “I don’t know what I’m feeling.” This discrepancy is where the vanity-myth is born.  The person with the eating disorder focuses on their body in order to avoid focusing on all the deep, dark, seemingly uncontrollable and overwhelming feelings and circumstances that lie beneath the surface. The endless pursuit of beauty becomes the scapegoat for dealing with society.

What is beauty to you? Can you even put it into words? The first definition that appears in my dictionary states that beauty, as a noun, is “a combination of qualities, such as shape, color, or form, that pleases the aesthetic senses.” Following this is the definition for the adjective version: “denoting something intended to make a woman more attractive.” Hmm. More attractive than what? More attractive than she already is?  More like the air-brushed celebrities that you see in magazines?  It is no coincidence that the number of eating disorders is rising drastically. The idea of the perfect body is being forced upon us earlier and earlier in life. While capitalizing on the beauty within, instilling body-appreciation at any size, and drastically altering the size-zero ideal won’t eliminate eating disorders, it is certainly a step in the right direction.

Mandy nuzzled her 3 month old baby happily as she warmed his bottle. It felt so good to breathe in his sweet baby smell and touch his soft delicate skin, his little body curled in a warm embrace into the curve of her neck. Mandy was starting to feel like she had her “sea-legs’ as a new mom and was particularly enamored of the fact that her new baby was sleeping through the night. The rough night-time awakenings were beginning to subside as baby Noah matured and slept for longer periods. She was looking forward to meeting a new mom friend in the park with their babies after she gave Noah a bottle.

Suddenly, in the wink of an eye, the tender moment vanished. Mandy watched the water warm Noah’s bottle on the stove. She  was blind-sided by a  horrific thought, flashing through her mind of the  water morphing into hot lava and scalding her baby boy. Mandy flinched, gasping and clenching tightly onto Noah, quickly backing away from the oven. The thought terrified her, and she could not believe such an image threatened to envelop her mind. Mandy’s entire body tensed as she began to pant, shallow breaths. She didn’t know it at the time, but, she was well on her way to her first panic attack after experiencing an intrusive thought…a hallmark symptom of perinatal depression and/or perinatal OCD.

Experiences like Mandy’s are common in some 20% of all child-bearing women who develop perinatal mood/anxiety disorders (the clinical term for depression/anxiety during pregnancy and up through the first year after having a baby). Some women develop symptoms of anxiety with intrusive thoughts while others may not experience these often debilitating and traumatic images. Others may have more depression symptoms with a smattering of anxiety, panic attacks, and sometimes intrusive thoughts.

PMADs (perinatal mood/anxiety disorders) are the clinical term for a myriad of symptoms under the umbrella of depression and anxiety from conception through the first year following childbirth.  In layman’s terms, perinatal challenges/neurobiochemical imbalances while pregnant and after having a baby often leave women completely stunned, horrified, and traumatized…because  women don’t know what hit them. And no one talks about it.

The reality is that PMADs are very common, and most likely under-reported due to the stigma connected to them. Mothers can be wracked with so much guilt about any of the symptoms, particularly if she has intrusive thoughts, that they are loathe to talk to a specialist to get help or to a family member. Many women report they feel like they are “going crazy” or afraid to be “like that woman on TV who killed her kids.”

I want to underscore the importance of supporting a woman who is experiencing intrusive thoughts to not delay in seeking help, to get help immediately with a trained specialist in perinatal challenges. The differential amongst these particular perinatal struggles is quite delicate. Furthermore, to receive the best care, she must have help from a skilled perinatal psychotherapist who can provide a comprehensive bio-psycho-social assessment and steer her in the appropriate direction for what is ideally a multidisciplinary approach to treatment.

This article is not intended to be a primer on the difference between perinatal intrusive thoughts and hallucinations since such is the subject of a workshop or conference. And, each set of circumstances requires a different course of treatment (both medically and in psychotherapy). Generally speaking, however, when a woman experiences intrusive thoughts, she is grounded in reality and horrified of the images that are occurring, feeling that her body is betraying her. She will often respond with disgust at the images and in turn demonstrate behaviors that lessen her anxiety and protect her baby (for example, Mandy avoided ovens for a time because such objects were a trigger for her). Intrusive thoughts can be part of perinatal depression and will remit with psychotherapy and in many cases, medication management (typically an SSRI), along with a good self-care plan and social supports in place.  Hallucinations, on the other hand, are considered a medical emergency and potentially part of a more rare PMAD, perinatal bipolar disorder or psychosis. In such a case, the woman is not grounded in reality, and hallucinations can cause her to do or say things that she would not normally do and have the potential to be life-threatening to her or the baby. If you suspect that you or a loved one are experiencing hallucinations, call 911 or go to your nearest emergency room immediately. Do not attempt to diagnose.

Fortunately for Mandy, she realized something was amiss in her brain biochemistry and immediately sought help with a trained perinatal psychotherapist. Upon consulting with a psychiatrist specializing in reproductive mental health, she agreed to try an antidepressant (Zoloft) to help her biochemistry restore itself. Mandy’s recovery was swift because she sought help immediately, she received support, non-judgment, validation, psycho-education, as well as cognitive behavioral strategies in psychotherapy to help her diminish the anxiety and intrusive thoughts. She worked with her therapist on a solid self-care plan and put in place the help of a doula (hired caregiver specifically for new parents). Mandy feels empowered now as a new mom, free of intrusive thoughts and filled with pride at the arrival of Noah in her life. She is now on to a full recovery, enjoying her 7 month old son. (Please note: swiftness of recovery times vary with each individual’s unique circumstances).

If you or someone you love appears to have intrusive thoughts after having a baby (or even while pregnant), do not attempt to diagnose her. Do find a trained perinatal specialist to help the woman you care about to get treatment. The good news is that PMADs are treatable and temporary, and with help, women recover fully.

Other useful resources:

• Postpartum Support International—www.postpartum.net – largest non-profit dedicated to PMAD awareness; vast clearinghouse of information on PMADs, down-loadable fact sheets, online support groups for moms and dads, chat with an expert, stellar bibliography of recommended books, latest research findings and trainings in the perinatal world; current legislation in support of PMAD awareness, destigmatization, and treatment; coordinator/volunteers link callers/e-mailers with trained professionals; warmline in English/Spanish
• Postpartum Progress—www.postpartumprogress.com – most widely read blog on perinatal challenges, by Katherine Stone; the reader can subscribe to a daily news feed and a daily affirmation of hope.
• Real Mom Experts - www.realmomexperts.com – website dedicated to supporting women with PMADs, written by perinatal psychotherapists; self-care techniques for moms

Great book on intrusive thoughts:
Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood by Karen Kleiman and Amy Wenzel (2010). –excellent book for new moms dealing with PMADs, also for perinatal professionals

“For years it lay in an iron box buried so deep inside me that I was never sure just what it was. I knew it carried slippery, combustible things more secret than sex and more dangerous than any shadow or ghost. … I saw things I knew no little girl should see. Blood and shattered glass. Piles of skeletons and blackened barbed wire with bits of flesh stuck to it…The iron box contained a special room for my mother and father, warm and moist as a greenhouse. They lived there inside me, rare and separate from other beings. … I knew my parents had crossed over a chasm … The box became a vault, collecting in darkness, always collecting; pictures, words, my parent’s glances, becoming loaded with weight. It sank deeper as I grew older, so packed with undigested things that finally it became impossible to ignore.”
-Helen Epstein, Children of the Holocaust

(more…)

“It feels heavy right here,” Rebecca* said, crying and touching her chest, “like a huge rock is sitting on me. It’s like that old cartoon, where a boulder would fall off a cliff and pin the roadrunner to the ground—it feels like I can’t move.”  Rebecca, a 32 year-old successful marketing professional whose older sister had recently been diagnosed with a psychotic condition, had come to see me last year. She seemed lost in grief. Fluctuating bewilderment, sadness, fear, anger, tenderness, and love were tying knots in every part of her.

I thought that untying some of the knots in her body, with the help of mindfulness practices, might help her begin to lift the boulder.

Growing up, Rebecca’s sister had provided unconditional loving support which protected Rebecca from demanding, neglectful, and painfully critical parents. She had always relied on her sister to guide and comfort her; they had always been best friends. She said that now it felt like she was standing at the edge of the ocean, watching her sister sit on a raft drifting out to sea. She had been crying uncontrollably off and on for days. What made things even harder was that her sister sometimes acted like her old self, then became delusional again. Rebecca’s emotions were rising and crashing along with her sister’s state of mind.

Mindfulness of the Body: Body Scanning and Stretching

The first foundation of mindfulness is mindfulness of the body. It is cultivated with body scanning and movement practices, like yoga and walking meditation, anchored in feeling the sensations of breathing. A body scan involves directing one’s attention to different areas, one at a time, and focusing on the sensations in each place. A scan can begin with feeling the moisture on one’s skin, sensations of warmth or coolness, pressure or tingling. Then we scan the interior of the body, noting muscle tightness or ease near the surface and going deeper, where emotions express themselves as inner physical sensations.

Building brief body scans into a sustained stretch can begin to soften tight muscles—created from strong emotions—and release the mind from thinking for a while.

Prior to entering therapy, Rebecca had taken an 8-week course in Mindfulness-Based Stress Reduction (MBSR) from me. MBSR is based on the work of Jon Kabat-Zinn at the University of Massachusetts, and is taught in hundreds of hospitals, corporations, and schools in the US and around the world. Rebecca had done many body scans as part of the course. She knew how to locate and identify the physical sensations accompanying her emotional states. The following intervention was natural to offer, and easy to do with her.

Untying Knots in the Body

As Rebecca continued to cry, we talked about the benefits of recognizing and allowing her grief. But after 20 minutes of repeated bouts of intense sobbing, she asked me to help her stop. I asked if she would like me to guide her through some breathing and mindful stretching; she immediately said yes. We did a four- or five-minute sequence of stretches, while she remained seated on the couch. I guided her to stretch gently, to her limit, with each pose, holding it for 20+ seconds, and remembering to breathe. While holding each stretch, she scanned, place by place throughout her entire body, for unnecessary tension—inviting it to soften (without insisting) wherever she found it.

“Psychotherapeutic approaches that utilize mindfulness offer well-developed non-verbal exercises that enable the individual to dip into direct sensation beneath the veil of words that may often conceal the mind’s pain. This sensory immersion enables the individual to disengage from those bottom-up enslavements at the root of suffering….” (Siegel, 2007)

“Our poses can strongly influence our emotional states. For instance, because of the expansive inhalation and opening of the chest, backbending, traditionally a stimulating practice, can elevate a low mood. Exhale-intensive poses such as forward bends tend to calm an agitated mind. In any balance practice, both inhale-oriented and exhale-oriented postures are executed in order to create equilibrium in the body and breath and to gain emotional
harmony.” (Gerstein)

Untying Knots in the Mind and Heart

This practice creates a state of non-thinking in the midst of strong feelings. Non-thinking helps release habitual, reactive thought patterns as attention is redirected to the body—what is called the neutral ground of attention. If, in the heat of raw emotion, we give free rein to thinking or emotions, our familiar and deeply grooved cascades of mental and emotional activity take their usual course, often intensifying the emotions, or cordoning them off from awareness. Instead, if we direct ourselves to notice “what am I feeling in my big toe right now?” the cascade slows, or even stops, for a while. Awareness remains intact, and new, more balanced, and less distorted thoughts have a chance to arise.

When she sat up again after her last slow, deep forward bend, Rebecca’s face had softened, her breathing was quiet, and she said “it’s gone, the heaviness is gone.” She said she felt sad, but less afraid and overwhelmed. She began to speak with compassion for herself and her sister, while remaining more relaxed for the duration of the session.

Before ending, we rehearsed the practice again: she brought the feelings back into her awareness on purpose, then, increasingly independently, guided herself through stopping, breathing consciously, body scanning, and stretching/releasing tension.

Rehearsal increased the chances that she would remember to use breathing and stretching in the days ahead. Later, she reported with some relief that she had remembered and been able to stop and practice, and that it had helped sometimes. Directing focus away from thinking, and into the body, gave her a sense of independence in calming herself, and also helped her to use her considerable intelligence to understand her sister’s situation, and to face the frightening challenge of becoming independent of her sister for the first time in her life.

Practices like these are not intended to offer an easy fix for difficult emotions or life experiences. Mindfulness, at its core, involves observing things as they are and not fighting them. One formula used is Pain x Resistance = Suffering (PxR=S). Paradoxically, allowing ourselves to be with our pain, sadness, fear, or anger, frees us to go beyond them for a while. And, according to Daniel Siegel, when practiced enough, “… an intentionally and repeatedly created state can become an effortless trait of our being.”

Is prior training required for this intervention to be effective?

A person must be open to locating and feeling different body sensations. Not having this training is a limiting factor. In my experience, however, the breathing, stretching and scanning practice can lead to a similar shift in people who are receptive, regardless of having prior training in mindfulness.

*Names and identifying information have been changed for privacy

Resources:
Center for Mindfulness—Stress Reduction Program
Jon Kabat-Zinn’s Guided Mindfulness Meditations site

http://drdansiegel.com/

References:

1. Gerstein, Nancy. (n.d.). How Yoga Affects Emotions. OmPlace.com. Retrieved from http://www.omplace.com/articles/Yoga_Emotion.html
2. Siegel, Daniel J., M.D. (2007). Reflections on the Mindful Brain. New York: W. W. Norton & Company
3. Siegel, Daniel J., MD. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration. New York: W. W. Norton & Company

As a Yoruba priest, I frequently make offerings to the Orishas (divine spirits who guide our lives) and my ancestors. The type of offering varies, with the simplest being a white candle, glass of water, white flowers, and a bowl of fruit on my ancestral altar. We Yoruba also make offerings we call “Ebo.” The expression is to “do Ebo” in order to ask for something we want or to give thanks for something we have received.

In this article, I’d like to expand the notion of “doing Ebo” to include those actions/offerings, perhaps not as obvious, that we all take and make in honor of the divine or the ancestors. To illustrate this, I’ll tell a personal story.

For the past year, I’ve been doing extensive research on my family of origin. As far as I can tell, just about all of them have passed on. They were never very forthcoming about family history when they were alive.

One person, however, my paternal uncle, loomed very large in the family constellation. Not much was said about him by my paternal grandmother or my father. To me there was also a great deal of mystery surrounding him. I never knew where he was buried, when and where he died, or who he really was. All I did know was that he had drowned when he was 22, allegedly after getting a cramp while swimming in a lake.

When she was alive, my grandmother continuously eulogized him. I believe she suffered from what can be called pathological mourning, which is when someone experiences a loss so devastating it haunts him/her throughout, and interferes with, his/her life. My father rarely talked about his brother who was clearly the favorite son. I was going to be named after him (but in the end I wasn’t). All I gathered from them was that he was a budding superstar, on his way to law school, brilliant, talented, and full of promise. In other words, a tough act to follow.

Through research and an off-hand conversation with my father’s second wife, I managed to find out where he died and was able to get a copy of his death certificate. The death certificate told me where he was buried. I visited his grave and did an Ebo, which consisted of some simple offerings and prayers. During the visit to the gravesite, I was struck by the powerful impact his death had on my grandmother and father (and, hence, on me). It was an overwhelming and, for me, life-changing experience.

Jump ahead to this past April. I’m taking my dog to a canine internist in West Caldwell, New Jersey. The plan is to continue on to my house, upstate. I ask for directions from the receptionist at the office who tells me to make a right, then take Route 46, which would then get me to Route 23. I follow her directions and take 46 West. I’m driving and driving, sensing that I’m going the wrong way. But thinking, at some point, I was going to be heading in the right direction. Lo and behold, after more than an hour, I see a sign that says Delaware 7 miles, and I know I’m way off track. I keep going hoping to see a highway heading north. Within minutes I see the sign and then drive past Budd Lake—the very lake my uncle drowned in 72 years ago! I don’t stop but clearly feel he has been calling me to that place to remember him, and to bear witness to what had happened to him. I also felt he wanted something from me.

One of my spiritual advisors suggested I go to a local church and have them say a mass for him. Since my ancestors were Jewish, that didn’t feel right. So I went to the local synagogue, near my house, and was told that they were going to have a Yiskor (a ceremony honoring the dead) on May 20, which seemed appropriate.

Start time for the Yiskor was 9:30. Turned out it was also a holiday (the day that God gave the Ten Commandments to Moses). Unbeknownst to me, that was going to be acknowledged first. So as a group we prayed, and prayed, and prayed and finally about 11:30 a.m. we got to the Yiskor. I prayed for my uncle and my family and touched his photo to the Torah. I cried at his loss and prayed for his elevation. I didn’t leave there until after noon. It was the longest time I had ever spent in a synagogue, certainly the longest time I had spent reciting Hebrew prayers (in English, of course).

When it was over, I genuinely felt that I had done an Ebo. The Ebo was not only finding out about the Yiskor, but also spending far more time than I had intended remembering my uncle. I know he appreciated it.

So think about those sacrifices/offerings you have made for others, living and dead, in your life and take comfort that in doing so, you have been blessed accordingly.

In The Use of Scaffolding Map in Narrative Therapy I documented my first meeting with Peter, a boy who’d experienced anger and sadness after he was exposed to domestic violence in his home.

In my second meeting with Peter, we met alone the majority of the time because his father was taking care of the other children in the family. Peter was talkative and engaged in our conversation. I checked in with him, asked how he’d felt since our last meeting, which had taken place one and a half weeks prior. Peter said he didn’t feel angry or sad, and mentioned this was a change for him. I asked what contributed to that change, and he said he decided to “focus on other stuff,” which enabled him to “worry less about things going on around him.” When I asked what other stuff he focused on, he said homework and baking. Then he smiled and told me of his recent success with baking a new type of cookie he’d discovered in a cookbook. The fact that he got the idea to bake them, asked to bake them, made them, and that they were enjoyable to others made him proud of himself. I asked questions and was able to determine that baking these cookies was a new initiative for him. I asked him to give this initiative a name, and he called it being adventurous.

Here commenced a reauthoring conversation that centered around Peter’s adventurousness. I asked Peter about both his actions and identity, as seen through the lens of adventurousness. Peter’s affect was bright and engaged during this conversation. A reauthoring conversation highlights events in a persons life (landscape of action) as well as exploration of the meaning, hopes, values, preferences, lessons, commitments, and importances to that person (the landscape of identity). My aim was to ground this initiative in Peter’s current and past actions, as well as connect this step to his beliefs about his life, his hopes, and preferences for living. This conversation is summarized in the following letter which I wrote to Peter after we had our reauthoring conversation.

Dear Peter,

Sometimes I write letters to the people I see in my counseling practice; it’s a fun way to remind them of the work they are doing. I hope getting this is a nice surprise for you. Do you like getting mail? I always do.

I enjoyed learning about your adventurousness tonight. It was so cool that you came up with that great word while we talked about the butter cookies you made. It seems like you hadn’t thought of yourself as being adventurous until we looked at it, and it was great to track all the other adventurous qualities you’ve had over the years. You have taken steps in this direction for a while now: trying out sailing at camp, picking up that craft/hobbies book at the church fair, and making butter cookies. And something about feeding alligators? It’s so nice to hear that these things made you proud of yourself. These accomplishments are so different from what sad and angry would want you to notice about yourself. Even calm, for that matter. I know you like calm, too, but your adventurousness gets you closer to feeling carefree, and that seems like a place that you would enjoy.

I hope our talk was helpful in getting your adventurous spirit going even more and that you made some great chocolate chip cookies. Maybe you’ll consider new hobbies, too. I’m interested in how you like to have a nice product at the end of your efforts. Maybe we could talk more about that next time. It makes me guess you enjoy seeing and experiencing your accomplishments, perhaps because you feel proud of them? I’m glad to know that you like feeling proud of yourself.

Will you share this letter with anyone? That is totally up to you, but there may be some people in your life that you’d like to read this. Feel free to do that, or just to keep it for yourself. I hope you have a great week exploring your adventurousness and that sad and angry stay away like they have been. If they crop up, that’s okay, but it sounds like you have some new ways to make them stay away.

I’ll talk to you soon, Peter.

Have a great week,

Peggy

The purpose of the reauthoring conversation is to make previously subjugated storylines more present in people’s lives. Often problem storylines (in this case, sad, angry, and stressed) have taken over people’s thinking, and life events are interpreted within the context of these problems. Since reauthoring conversations bring about a new way to see lives, often these conversations require some extra reinforcements. Because Peter had just discovered this place of adventurousness in his life, I chose to send him the therapeutic letter in order to reintroduce and reinforce these ideas with him a few days later.

At the end of our conversation that night, Peter’s father entered the counseling room and I recounted the developments of adventurousness. By having Peter listen to my retelling of his reauthored story, he was able to listen to the entire plotline from a place of distance, which helped it become more real for him. Additionally, I interviewed his father briefly about what he knew of Peter’s adventurousness, and Peter was able to hear these stories (one about playing soccer on his older brother’s soccer team, and one about feeding alligators in Florida), within the context of him being adventurous. The retelling, the interview with his father, and the letter all serve to bolster and reinforce the strength and power of the developing reauthored story.

Peter has continued to embrace and explore his adventurousness. One day after our conversation, he asked if he could make chocolate cookies from scratch, and he did. He has expressed that trying new things and being adventurous has him feeling proud of himself and happy. He says it helps him feel he can be more carefree and less stressed. His father has also commented that he feels like he has “gotten Peter back,” as they have had the opportunity to have fun together, and be silly and carefree.