“Will my partner change?” Here’s my answer to this common question!

A common question many therapists get is, “Is he/she going to change? Is my romantic partner going to change?” I’ve been asked this question by both men and women, but recently I've noticed it coming a lot from women with male partners, wondering if the man in their life is going to eventually stop behaviors that are unhealthy or unhelpful to the relationship. One client recently asked me, “Am I foolish for believing that maybe he might change? Am I foolish for having that faith in him?”

The answer is no, you are not foolish for believing that people are capable of profound changes. Maybe that's just part of me being a clinical psychologist - I believe people are capable of change, big change in fact, in their life. However, here's the thing: Change requires effort. We know this because it’s one of the key rules of neuroplasticity (meaning, brain change). To change your brain, and to change your life, requires sustained effort, and a lot of times it's hard to do this. Change often requires a struggle, so it can be a difficult thing. So, what you must do is ask yourself, “What prompts someone to be willing to put forth the tremendous amount of effort that’s required to make lasting change?”

I think a lot of times the answer to this is that people change their behavior when it stops working well for them, or starts costing them something. Maybe it’s making them suffer or lose something important to them. That distress is what is often required for change, and is the same distress that leads people to seek therapy. If you notice that your partner keeps doing the same things over and over, and you really want them to change but they refuse to, the reason is likely that their behavior is still working for them in some way. Until that changes, they probably won’t!

Ultimately, we can only change ourselves, not others. However, one thing that you can do is to take steps to better understand the unhelpful dynamic you’re stuck in. For instance, when your partner engages in the hurtful behavior, how do you respond? Is there any way that you might be accidentally reinforcing that behavior? If the behavior sometimes stops, what might cause it to stop?

Here's a classic example of a way in which someone may unwittingly reinforce a behavior that they don’t like. I had one client come to me with the main complaint that she feels like she “does it all” around the house. She lamented that she does everything around the house, all of the housework, all of the laundry, and all of the cooking, all while working a full-time job. I asked this client to describe how this happens – how the dynamic flows – and she responded that she always asks her partner. When I asked her how it plays out, she said, “I tell him that I need help and give him a list of what needs to be done, but he doesn’t do any of it.” The next question I had for her was, “What happens next?” The client then admitted that due to feeling stressed and angry, she often ends up doing it herself, thinking that it’ll be faster if she just takes over.

What is happening in this situation is that the client, unintentionally of course, is reinforcing the unhelpful behavior of her partner not helping around the house. That’s just one example, and it’s not always the case that people do things to reinforce problematic behaviors, but it is something you can check in with yourself about when you find yourself stuck in an unhelpful or unhealthy relationship cycle. And if you are unintentionally reinforcing the dynamic, remember, you’re the one person who can change you!

For the original vlog this post was based on, go here! 

My Therapist Keeps Telling Me To Breathe…. Why?

If you’re like a lot of people who’ve been to therapy, you’ve probably heard your therapist tell you to breathe. The recommendation might have been in passing, or perhaps they even taught you some specific diaphragmatic breathing exercises to practice at home. Either way, you may have asked yourself why this seems to be a thing. Why emphasize something you’re already doing? I’m breathing right now, and I bet you are too. I breathed yesterday, and the day before that, and I’ll breathe every day from now until I die.

When I’ve brought up breathing to clients, I’ve seen the initial, “I’m paying you for this?” look more than once. But breathing the right way is really good for you and might just help you reduce some of the symptoms that brought you to therapy in the first place. Let me explain.

Take Home Point 1: Normal breathing and diaphragmatic breathing are NOT the same thing.

This is critical to understand. Diaphragmatic breathing is when you fill your whole diaphragm with air, breathing fully in, and fully out. This is different from what most of our breathing tends to look like day to day, which is usually “chest breathing.” Chest breathing is faster and much more shallow, and does not utilize our entire diaphragm. Chest breathing can be associated with a heightened stress response, increased toxins in the body, and less oxygen in the brain, and is usually not very healthy. However, it’s what we’re all used to, and to create more healthy breathing habits takes training.

Take Home Point 2: In order to reduce your anxiety you must breathe through the diaphragm. All other breathing is pointless (other than it keeps you alive).

The error a lot of people make when practicing breathing exercises is that they don’t actually breathe through the diaphragm. Maybe it’s because they don’t know how to, or perhaps they erroneously think they are (but actually aren’t). For most people, there seems to be a lack of understanding regarding how important this actually is, so I want to emphasize this. If you are not breathing through your diaphragm during a mindful breathing exercise, you’re wasting your time.

Take Home Point 3: Breathing through the diaphragm activates the vagus nerve; vagus nerve activation is what reduces your anxiety.

When you breathe through your diaphragm, something amazing happens: You activate your vagus nerve, which tells your brain to stop producing anxious feelings and start relaxing. Here’s a depiction of the vagus nerve – it’s the bright yellow band running from the brain to the organs.

 

So here’s what happens when you breathe through the diaphragm:

1.     You inhale fully, expanding your diaphragm.

2.     As your diaphragm fills with air, the diaphragmatic wall pushes downward, like a balloon that is filling up.

3.     When the diaphragmatic wall drops, it begins to squish your internal organs a liitle bit.

4.     Wrapped around your internal organs is the vagus nerve, so as the organs are getting slightly compressed, so is the vagus nerve.

5.     When the vagus nerve is pressed, such as when you breathe through your diaphragm, it activates!

6.     After activating, the vagus nerve sends a signal upward, through the spine to the brain, telling the brain to stop the stress response and activate the relaxation response.

7.     The brain can then reduce the stress response and everything associated with it (fast heart rate, that nervous jittery/buzzing sensation, foggy thinking) and replace it with the relaxation response!

This whole process takes about 45 seconds. That’s right – we can literally calm down and reclaim a sense of control over our emotions, thanks to how our bodies are naturally built, in less than a minute. Amazing, right? So, the next time you’re told to breathe, consider trying it, but make sure you’re breathing through the diaphragm!

If you aren’t sure whether what you’re doing is diaphragmatic breathing, and want to ensure you’re breathing optimally, click HERE to request my free mini-guide, “Diaphragmatic Breathing 101: Five Ways To Breathe Well.” It contains five breathing strategies that take the guesswork out of diaphragmatic breathing.

Suffer from Low Self-Esteem? Consider a Feminist Therapist

A very common reason clients begin psychotherapy is to improve low self-esteem. While low self-esteem isn’t in mental health providers’ diagnostic “bible” of mental disorders (called the DSM-5), self-esteem issues can wreak havoc in multiple domains of a person’s life and are connected to a variety of other conditions such as anxiety, depression, and posttraumatic stress disorder. And while men sometimes suffer from low self-esteem, this affliction disproportionately affects women.

So what do you do if you’re suffering from low self-esteem?

The short answer is to seek professional help, but keep in mind that not all therapists are alike, and there are many theoretical orientations from which mental health providers work. Here’s a somewhat more specific answer: Consider a feminist therapist.

What is a Feminist Therapy?

Feminist therapy is a bit difficult to define because it does not prescribe specific methods be used, and it does not have a single founder or champion. Rather, feminist therapy is based on a core set of feminist values and adheres to four main tenets. Specific methods and techniques, in turn, are derived from these feminist assumptions.

Core Values of Feminist Therapy

Feminist therapy is based on the following values (Rawlings & Carter, 1977):

  1. Pathology is conceptualized as social and external, as opposed to personal and internal. Thus, women’s low self-esteem is believed to be driven by past (and often current) oppression and repeated disempowering experiences.
  2. The assumption that pathology is externally-based does not exonerate the client from responsibility. While the cause of the pathology may be largely external, the solutions, and resulting individual and social change, begin from within.
  3. Rather than encouraging women to simply adjust to social conditions, usually by modifying themselves, the focus is on social and political change. This shift toward social change can be a difficult one, as women are frequently taught to accommodate others and to modify themselves.
  4. Other women are not the enemy, and neither are men. Rather, an oppressive, patriarchal system is assumed to be the catalyst for many of society’s problems, as well as for several mental health issues.
  5. Women should work to become psychologically and economically independent. This helps women to become more empowered and to avoid becoming trapped in coercive or abusive relationships.
  6. Relationships should be equal in personal power. The minimization of relationship power differentials reduces women’s chances of being mistreated, manipulated, or coerced.
  7. Rigid gender roles should be challenged and eliminated. Instead of blindly adopting traditional gender roles, women are encouraged to actively define their roles and to design their lives in a way that fits with their own personal values.

Core Tenets of Feminist Therapy

In addition to the values described above, feminist therapists tend to adhere to the following core tenets of feminist therapy (Worell & Remer, 2003):

  • Privileging women’s experiences: Historically, psychological theory and professional practice has centered on men’s lived experiences and realities, while women’s experiences have been largely marginalized. To privilege women’s experiences the feminist therapist considers both women’s and men’s experiences equally, and the commonality of women’s experiences is validated (Sturdivant, 1980).
  • Egalitarian relationships: The creation of a completely equal relationship between mental health providers and clients is not believed to be possible, however, in feminist therapy the inherent power differential is minimized and treatment planning is collaborative. Power differential reduction can be accomplished through the identification of therapist and client roles and responsibilities, therapist transparency regarding methods used and what they intend to accomplish, and the assumption that the client is the expert on themselves, while the therapist is the expert on psychotherapeutic approaches (Brown & Brodsky, 1992).
  • Personal is Political: During the self-reflective and consciousness-raising Women’s Movement groups of the 1960s, it was discovered that many women experienced similar problems and symptoms. These women had previously assumed their issues to be unique, but these groups revealed certain women’s issues to be common, and strongly influenced by the social and political context in which women live (Morgan, 1970).
  • Empowerment: Empowering women to actively make positive changes is a central tenet of feminist therapy because it helps to address the myriad of problems created as a result of women’s subjugation, limited power, and maltreatment (such as sexual harassment and sexual assault). The result of empowerment is that women become able to identify and use their own strengths, and to facilitate individual, social, and perhaps even political change.

Given all of this, how exactly can feminist therapy improve self-esteem?

Self-esteem is defined as “confidence in one’s own judgment, abilities, power, etc.”  Those who experience low self-esteem often have difficulty making decisions, excessively worry about what others think, doubt their abilities and potential for success, experience disempowerment, and/or often feel as though they are not as good as others. Feminist therapy can help with these issues in a variety of ways!

First, feminist therapists can help clients to better balance responsibility and power in their lives, whether it be by reducing responsibility for things out of the client’s control (which leads to feelings of anxiety and helplessness) or increasing the power the client experiences by emphasizing natural strengths and encouraging assertiveness and positive action (whether it be individual, social, or political). Also, by focusing on clients’ strengths and helping them step out of their comfort zone to take small, manageable risks, clients can begin to experience small successes and moments of increased confidence. Through empowerment-building exercises such as these and others, clients can grow to fully enjoy the courage and strength they have always possessed, become more decisive and independent, and trust in their ability to handle difficulties that come their way. These shifts allow clients to become proactive instead of reactive, hopeful instead of hopeless, and empowered instead of disempowered. They can also bring the client’s own voice to the forefront of decision-making so that decisions are no longer fear-based, but value-based.

If you believe a feminist therapist might be helpful for your low self-esteem, one option is to peruse Psychology Today and contact a mental health provider who specializes in self-esteem issues. When first speaking with them, inquire about their “therapeutic orientation” (which is essentially the therapist’s beliefs about how mental health issues develop and how to best resolve them), and ask whether they utilize feminist principles in their work. Also, remember that the most important factors when choosing a therapist are whether you can really connect with and open up to them. Choose someone who is a good fit for YOU. In doing this, you’ll have taken the first step toward self-empowerment!

This article was originally posted on Psychology Today on March 16, 2016.