Relationship Drama – Part I

Wavebreakmedia/stock.adobe.com

Pop culture

I’m not the most caught up when it comes to pop culture but was recently directed to this music video, “Say Something.” It’s a piece re-recorded by Christina Aguilera in 2013. Yes, that’s exactly how not caught up I am. But the thing is, the message of love doesn’t grow old. With Ian Axel on the piano (all of this information courtesy of Google search), we sense the push and pull that’s a part of relationship drama:  

Our need for closeness in relationships

One way to interpret this piece of music is our longing for connection and engagement with a significant other. We’re desperate for our partner to say something, to let us know they’re still here for us. We DON’T want to quit, we DON’T want to leave or say goodbye, but it hurts TOO much to stay and NOT get a response. When we can’t get to our partner, we feel small. We feel pain, a sense of loss and loneliness in the relationship. It may come out as agitation, criticism and overtime, resignation, but really, it’s about feeling deprived, unloved and uncared for. 

Sounds dramatic? It is. To feel safe and close in our intimate relationships is a basic human need. I tear up when I consider well-meaning couples who miss each other in how they communicate love and closeness. It’s sad to see couples continue in an old pattern of relating until it’s too late and they do have to say goodbye. 

If this song speaks to you, I wonder if this could be you? 

Introducing partners in the pursuing position

While there are different ways to be in relationships, a common relationship pattern is one where one partner is pursuing and the other distancing. We all yearn for connection in our relationships and pursuers try to meet that need, you guessed it, by pursuing their partner. 

You might be a pursuing partner if you try to get your partner’s attention and it comes out as: 

• criticizing or complaining

• demanding or accusing

• controlling or close monitoring

On the surface, you might feel:

• frustrated, angry or critical

• confused

• desperate

• anxious

Underneath all that “protest,” you might feel: 

• unloved, undesired or uncared for

• unimportant, not valued, not special

• alone and abandoned

• disconnected

What you really want is: 

• emotional connection

• to be seen and heard

• to be appreciated and loved

If you look at these pointers and you say to yourself, “That sounds about right!” what are you to do?

Your responses are understandable

Know that this is NOT about what you should or shouldn’t do. Rather, your responses make a LOT of sense given the circumstances. You’re trying SO hard to reach your partner and when you don’t get the response you want, you try harder. You do more of the same because that’s all you know how. Overtime, you’re exhausted and you give up. Like the music video, you’re just too burnt out to continue and you don’t know what else to do.

If that's you, I get you. 

Speaking to your underlying fears and needs

If you’re in a safe and secure relationship, you can more easily speak to how an interaction made you feel and what it brings up for you. However, even in the absence of actual violence in the relationship, couples often feel unsafe to show a more vulnerable side of themselves. That’s like me asking you to go out on a limb, and after years of practice, you’ve learned to cope and get by in your relationship without taking such risks. 

But, there’s hope. You don’t have to go at it alone. 

I help build that sense of safety

I can help you and your partner feel more safe in the relationship so you can talk about the difficult stuff. You can learn to more effectively reach for your partner in a way that doesn’t push them away. You can find closeness and connection in your relationship; it’s not too late. 

Let me know when you’re ready for the ride. And stay tune for a post about the pursuing partner.

---

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. When she’s not working or thinking about work, she loves connecting with her husband over sushi, movies and more recently, walks around Seattle. Their last stroll was in the Quad admiring full bloom cherry blossoms. They were definitely not alone.

How to Overcome Barriers by Cultivating 1:1 Relationships

Remi Walle/unsplash.com

My new pet peeve

So I go to yoga about two times a week, preferably three. I love the studio; love the teachers. It’s a great community there. It’s like 83 degrees inside and people sweat bullets, or more like puddles. I’m fine with feeling my own sweat and wiping it but I discovered a new pet peeve: I don’t like stepping on other people’s sweat. There’s something about my bare feet touching someone else’s bodily fluids that makes me cringe. The mood lighting does not help as I navigate my way around the studio after class. 

How I’ve coped

As with most pet peeves, we find a way to cope with them or to otherwise avoid them. I’d scoot around the studio after class, using what little lighting there is to side-step shiny liquid reflections. If I’ve landed on a puddle, my towel is just a reach away. This was my coping strategy, until one day, my world was turned around. 

Sweat has a name

It was a usual Wednesday evening class with teacher Aaron and he asked us to do something out of the ordinary. After some power vinyasa routine where we were dripping wet, he asked us to find a partner to do this strap exercise. It looks difficult enough: you’re doing some backbend with your leg behind you strapped to your hands overhead. Your partner is spotting you. “Bob” and I were the only ones without partners and I jumped to my feet to join him.

We met in the middle of a matless area and started doing the pose with me spotting him. He talked about not being very flexible and fell over. Fa-thud! I’m not a very good spotter, am I?! Someone then recommended that we do it on a mat and we walked over to his mat. He had a towel spread over it and it was soaking wet. “Bob” was noticeably embarrassed. He started wiping the outskirts of the mat where his sweat puddles formed. He might have apologized for how damp his towel was, but I don’t remember.

None of that mattered. I was about to spot him again so he could do his backbend, hopefully without falling. And I had a few turns and realized the pose was easier than it looked. We chit chatted for a bit while waiting for Aaron to gather us in. We shook hands, shared our names and I eventually went back to my mat. 

Why wasn’t I bothered?

My feet were damp and I wiped them off but I didn’t feel the usual disgust. Why? It could be that I was distracted by the pose or engaged with “Bob.” In retrospect, I think it had more to do with the fact that sweat has a name and it belonged to “Bob” and he was kind and personable. “Bob’s sweat” didn’t bother me because “Bob” is a human being I have come to know, for all of ten-minutes. It’s no longer a nameless sweaty pile on the floor that I tip toe around. 

Perhaps it is a bit of a stretch to say that “Bob” and I have formed a friendship, but he sure is no stranger. He wasn’t in class this past week; otherwise I would’ve waved. The human-to-human connection changed the way I feel about something I used to dread. While I can’t say I’m now free to glide through the yoga studio in the dark without holding back, I am a step closer to that direction because of “Bob”. 

So why am I telling you this story? 

Relationships break barriers

When I think about my experience, that human touch made a difference for me. It’s after all easier to stay on our “mats” or “pair up” with people we already know and feel comfortable with. But we then miss out on opportunities to get to know an “other,” someone different than you; someone different than me. When we do take that time, what might happen? What beliefs might be challenged? What relationship might come of that? 

At the core of who we are, we’re human beings who breathe, sleep, eat, pee, poop and yes, sweat. We all feel glad, sad, mad, fear, disgust, shame/guilt, surprise, and interest. We are all a brother, a sister, a daughter, a son, a friend to someone, somewhere. Our humanity is our common denominator. And, we can be each other’s guide through the discomforts of life if we allow each other in. 

If you ever need help leaving your “mat,” you know where to find me. 

---

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She mostly helps unhappy couples and breast cancer patients. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

A Roadmap Through Emotionally Focused Couples Therapy (EFCT)

Natalie Fox/unsplash.com

Reprinted by permission from the ICEEFT Newsletter: The EFT Community News, 9th ISSUE, Spring 2011. Written by Pat LaDouceur, PhD, LMFT and Veronica Kallos-Lilly, PhD, R.Psych.

Sometimes couples wonder “where they are” in the therapy process. We wanted to create a guide to Emotionally Focused Couples Therapy that would help couples see their gains, understand the rough spots, and know what to look forward to. The following is one such roadmap:

STAGE 1 – UNDERSTAND YOUR STRENGTHS AND THE PATTERNS THAT KEEP YOU STUCK

• Step 1: Set goals for counseling. Understand some of the ways your relationship history affects your relationship now.
• Step 2: Discover and describe the negative patterns of interaction you get stuck in. You and your therapist will track your interactions with your partner and identify where and how your communication breaks down.
• Step 3: Emotions are stirred up in your relationship, especially when you get stuck in these negative cycles of interaction. Emotions also drive the cycle. You may first be aware of anger, frustration, anxiety, numbness or even withdrawal. Notice inside what other feelings are beneath these initial feelings, such as hurt, sadness or fear. Begin to share these “underneath” feelings with your partner. It is OK if this process feels “bumpy” – it helps diffuse the cycle sometimes, but not always.
• Step 4: Describe your cycle and recognize what the triggers are. Understand how the things that you do to protect yourself and your relationship affect and may even threaten your partner. Notice how you co-create the cycle: “we’re doing that thing again…the more I go after you, the more you withdraw because you’re feeling hurt…” Slow down your conversations so that you can tap into the feelings that are beneath the surface. Catch your own thoughts (“She doesn’t care”; “I don’t matter”) before acting on them. You might notice that you can hold back your knee-jerk reactions to avoid the cycle. You might not know yet how to pull each other close and you might be afraid the “old way” will come back. However, when you discover that this negative cycle is the source of unhappiness in your relationship, you realize that your partner is not the enemy. You can then work together to gain control over this negative cycle and that already feels infinitely better.

STAGE 2 – CREATE A NEW, INTIMATE RELATIONSHIP BOND; CHANGE YOUR COMMUNICATION PATTERNS

• Step 5: Both of you are now able to talk calmly about your feelings that get triggered by the negative cycle, including things you might not have been able to say before. With less friction and more compassion between you, there is safety to explore your experience more deeply. We all have doubts about ourselves at times and may also have fears about depending on others. You may struggle with personal fears or insecurities in this relationship. You may have had life experiences that make it difficult to trust others to be there for you. With the help of your therapist, you can take turns and begin to share these “raw spots” with your partner. As you take these risks, your partner begins to truly see and understand where you are coming from, which creates empathy.
• Step 6: This step involves staying engaged and listening to your partner’s disclosures. Your partner may share feelings that take you by surprise. You may feel disoriented or even hurt that you have not heard your partner share so personally like this before. It is OK to experience a mixture of emotions. Start by trying to understand at an emotional level what your partner is saying, without needing to change his/her experience or take responsibility for it yourself. Stay open to the possibility of experiencing and understanding your partner in a new way. Allow yourself to be moved by your partner’s new disclosures.
• Step 7: Explore what helps you feel deeply connected, what is most important for you in this relationship. In this stage of therapy your therapist helps you find ways to ask for your needs in the relationship in a way that is both caring and direct. You can lean into and reach for your partner and he/she is able to reach back in a loving way. You have found a new way to relate when one of you feels stressed, hurt or insecure. The bond between you shifts, becoming closer and more intimate. You can check out your perceptions and talk about feelings. You can listen with an open heart, be curious about one another and offer reassurance when needed. Both of you have a felt sense of “being there” for each other.

STAGE 3 – USE NEW COMMUNICATION PATTERNS TO SOLVE PROBLEMS AND MAINTAIN INTIMACY

• Step 8: Revisit old problems or decisions that have been put on hold (e.g., parenting, finances, sex, family issues, health concerns, etc.) while staying emotionally connected. They don’t seem as loaded now that you feel heard, valued, close and secure. Focus on staying accessible, responsive, and engaged while talking about practical issues. Together, you can face any of life’s challenges more easily.
• Step 9: Congratulations! You have reshaped your relationship. Or perhaps this is the first time in your relationship that you have felt a profound bond with one another. You have worked hard to get here, so it’s important to celebrate it and put safeguards in place to protect it. Create rituals together that privilege your relationship. Find ways of keeping this new way of relating strong.

Emotionally Focused Couples Therapy has helped many couples build stronger, more rewarding relationships.

Are YOU ready to take this next step in YOUR relationship? Give me a call!

---

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She mostly helps unhappy couples and breast cancer patients. She's going through intensive training in Emotionally Focused Couples Therapy and gets regular consultation in her work with couples. While she's serious about helping her couples feel close and connected, she does laugh a lot. If that's not already obvious. 

Why Valentine’s Day is not Always Happy for Couples and What you can Do about it

Melomene/stock.adobe.com

Ordinary Tuesday

It was an ordinary Tuesday when I finished up with my last client. “You must be in a hurry to get home” and I was like, “No, you’re good.” I was still wrapping up my case notes when my husband sent me an emoji rose. Husband is not the romantic type and I was like, “What’s with the rose?” I was then reminded that today was Valentine’s Day. Husband implied that he brought home dinner and I was more excited about that! As I was leaving the building, I realized how unusually dead the office was. Valentine’s Day must be a thing.

Who took the happy out of Valentine’s Day?

If you’ve read one of my earlier posts, you’d know how deeply I feel about this “Show-love-to-your-partner-or-you’re-screwed” Day. This day is supposed to be happy. It is a celebration of love; often a narrow definition of love. For couples, this set date that comes on the 14th of every February is a reminder of where your relationship is, which is not always where you’d want it to be.

Situations change, patterns do not

Regardless of whether you had an amazing time with your partner, it was like any other day, or you had the hardest time, this Valentine’s Day is a reflection of where you already are in your relationship. A commercialized day filled with the expectation of card, sweets, expensive jewelry or flower exchange will not unearth a long standing pattern in your relationship. I often say to my clients, “Situations change, patterns do not,” unless you intentionally and consistently work at undoing the pattern. The situation could be a move, a vacation, an extravagant gift, _______________________. How you relate is still how you relate.

If your Valentine’s Day was indeed unhappy, what to do about that?

What makes for happy and close relationships?

As you can tell, I’m biased against any one day in the calendar deciding for us how we ought to be. If it’s a value or a desire we have, I believe we should strive for it everyday. If having a close, loving relationship with your partner is something you long for, consider how you can relate differently:

1. Speak to your perceptions – How you see your partner will affect how you feel and how you respond. If you think your partner doesn’t care about you, you might see the dirty dishes as proof, whereas if you think your partner got sidetracked, used pots and pans don’t rub you the same way.

2. Dig into your feelings – Anger is usually the emotion that bubbles onto the surface. What’s buried underneath are usually more vulnerable emotions such as hurt, humiliation, fear, and rejection. These deeper emotions, when shared, usually bring out a more tender part in our partner.

3. Clarify your intentions – Sometimes your intentions do not come out as perceived. When that happens, it’s important to clarify where you were coming from. “Wow, I was late in picking you up and you thought I didn’t care that your bladder was about to explode! If I had known you needed to go pee, I would’ve stepped on it!” (Officers reading this, I’m not encouraging speed limit violation. This is about the comfort we feel when we realize our partner is willing to go out of their way for us).

4. Notice and own your vulnerabilities – Are you sensitive to anger because your grew up in a home with an explosive parent? Is it hard when your husband shuts down because your previous partner frequently walked off without an explanation? Have you learned to keep stress to yourself, only to lash out when you’re at your wits end because you haven’t learned to cope any other way? These are examples of sensitivities that partners bring to the relationship. It helps to be aware of them.

5. Share your vulnerabilities with your partner – Let your partner know that particular words and behaviors are triggering for you, NOT because your partner is your enemy, but because we all come with a history. Ironically, we’re often attracted to partners who remind us of our family growing up. Awesome or not; it’s familiar to us.

6. Acknowledge your needs and wants in the relationship – The reason you get worked up in your relationship is because your partner matters to you. If you’re only doing life with a roommate, there’s less at stake. The weight of this relationship has you longing from your partner love, closeness, comfort, appreciation, and acceptance. It’s okay to ask for these things from your intimate partner.

7. Bring it all together – As you share your perceptions, deeper feelings, intentions, vulnerabilities, and relationship needs, let your partner have a turn. After all, it takes two to make love work.

Daily loving

Let’s not wait until the next event, the next anniversary, the next “situation” to show your partner she matters, you love her, and you have her back. You can practice daily loving as a part of living daily. If you need help nurturing a close, loving relationship with your partner, let me know!

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples and breast cancer patients. When she’s not working or thinking about work, she loves hanging out with her husband. On an ordinary day when they’re both working long hours from home, she likes to go give him a hug and a kiss and tell him, quite literally, “I’m here to connect with you.” 

The Great Divide. I’m not having it.

maria_savenko/stock.adobe.com

Way to start the New Year’s

I woke up on Sat Jan 28, 2017 to the start of Jan 1, 2017 on the Chinese lunar calendar. I happened to be in Vancouver, BC, Canada for a two-day training prior to the festivities and stayed with my folks. I had a rather slow morning and came downstairs to my Mama’s homemade CNY brunch. My aunt came over, my sister and niece have spent the night and all was well until I got a text from my husband.

He was asking when I’d be home. Later in the eve, I conveyed, not knowing what’s the hurry. He then mentioned some executive order that Trump has signed that morning. I looked it up and it was f*cking unbelievable.

I am a Hong Kong-born Canadian citizen green card holder living in America and I was shocked. I cannot imagine what it is like for refugees and Muslim brothers and sisters around the world.

I felt very uneasy and after a late lunch, left for the border. For the first time, I didn’t know what to expect. While Canada and the US are allies and I have all my documentation, a “Muslim ban” from selective Muslim-majority countries has me wondering what’s next.

Back on US soil

The border was uneventful, as if nothing has happened. I almost wish that something was different because this is NOT okay. I’m now back on US soil. And for the first time in my 15.5 years of living in the US, I felt different, like I don’t belong here. My countries of origin and naturalization aren’t even on the blacklist. I’m not even Muslim. But to exclude immigrants and non-citizens is to exclude me and to exclude people like me. I realize to make America great again is make America white again.

Pulling away

During my 2-hour drive home, I became increasingly aware of my “other-ness”. I feel threatened by the future possibility of not being welcomed in this country. I find myself emotionally pulling away from my white community. I picture the faces of these people I have come to know and like, and already, I feel further from them.

Suddenly, I realize what was happening. There is a great divide in our country and around the world and to pull away is to concede. In Trump’s promotion of all people white, male, straight, Christian, middle and upper class, able bodied and Euro American, he is shutting down those who don’t fit the bill.

I’m not having it.

Leaning into America

When I realized this, I made a conscious decision to lean in, instead of pull away. It helped that when I got home, my husband, who is 4th-generation Japanese American, hugged me for a long time. It helped that protests rose up at airports and city streets around the country as we stand with each other. It helped that I connected with my community the next day and saw how they were also affected by this news.

It helped that this is not the end; rather, the beginning.

We CAN find safety and shelter in each other. Notice where this was filmed:

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

Creating Deep and Lasting Changes in your Marriage

ZoomTeam/stock.adobe.com

Shallow change

Last fall, husband and I had a chance to visit Kauai. We were there with family and we also got some time to ourselves. With little hesitation, we rented snorkel gear and stand up paddle boards on the first day. We ended up doing little of both because of the strong waves. Nonetheless, it didn’t stop us from trying.

We drove to Poipu Beach Park which is on the south end of the island. We saw some amazing sea creatures, but something else was bothering me: my goggles. It kept leaking water in. I’d be in the water for no more than 30 seconds and my astonishment would be put out by the gradual overflowing of salt water that threatened my eyes and I’d have to re-surface. My husband came and checked on me a few times and I kept trying to make it work: I tightened my goggles, I breathed in to suck the goggles to my face, I tried to remove every trace of hair that might have been in the way. Some of you reading this can come up with yet a 4th way I could’ve tried to make it work, but by now, my forehead was turning purple and I wasn’t having any fun. The changes I was making were not working.

Deeper change

We finally decided to cut the trip short and went back to Snorkel Bob’s to exchange for a new pair of goggles. The next day, we headed to Salt Pond Park. In the back of my mind, I couldn’t help but to wonder, “Are my goggles going to work?” I took a moment to adjust to the water temperature and dove in. I was expecting water to slowly fill up. Nothing. I paddled around for a bit longer and ta-da! My goggles were water proof, as goggles should be! We enjoyed the rest of our snorkeling experience and saw for the first time, trumpetfish!

Shallow changes in intimate relationships

So why am I telling you this story? I believe that we often try to make shallow changes in our intimate relationships, changes we call “first order change” in family systems theory. First order change is when patterns of interactions are changed at the surface level and they usually involve changes in behaviors. Let’s say you and your partner are not getting along. Well, you should learn to communicate better, use “I” statements, carve out time to go on date nights or address a fair share of household chores.

Now don’t get me wrong, I’m all for these changes, except I don’t believe that’s really the problem. These surface level changes will improve things momentarily, probably for longer than 30 seconds. But they don’t change the fact that something more is likely going on that’s causing the “leak” in your relationship. These problems might be surfacing because of deeper underlying issues in your marriage.

Deeper changes in couple relationships

So what is this deeper change and how is it possible? Yes, you guessed it: it’s called “second order change.” Second order change is when your relationship itself changes based on feedback from each other and hopefully, for the better. Underlying rules and beliefs about the relationship is called into question and altered. Let’s come back to your relationship.

Where you’re stuck in your relationship

Same problem: you’re not getting along. Your partner is super defensive when you bring something up and ends up hiding out at work. You become more frustrated every time you approach him and all he hears is your anger. You want to feel loved, accepted, important, and connected and it’s not happening. Your partner feels criticized, misunderstood, like he can’t do anything right. He also feels scared about rocking the boat, because he doesn’t want to make things worse. His feelings of inadequacy makes him withdraw even more. Sounds familiar? Are you tell me that this is just a communication problem and you can fix it by throwing solutions at it?

Want to feel close and connected with your partner?

The thing is, deeper changes lie in each of you recognizing that you have a part to play in the dance. As one of you pursues, often times out of desperation seen as anger, the other gets defensive and withdraws, often due to feelings of incompetence and shame. It’s not as simple as asking you to stop pursuing and the other to stop running away. After all, you have reasons for why you do what you do. Rather, it’s about recognizing that this dance is not working and it’s time to put on a different set of music. We’d still go snorkeling, but let’s switch out the goggles.

Emotionally Focused Couples Therapy (EFCT)

Emotionally Focused Couples Therapy (EFCT) is a heavily research-based model for the treatment of couples. It gets at the underlying needs for couples to feel close, desired, and accepted in their intimate relationship. It focuses on how each partner influences the other and whatever rules or beliefs you had about your relationship will naturally shift as you experience your partner in new ways.

This is hard work and it’s not for the faint of heart. Let me know when you’re ready to trade in your goggles. I'll be here. 

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she loves to go play with her husband! Her favorite sea creature while snorkeling in Hawaii will always be the Humuhumunukunukuapua’a. 

The Guide to Surviving Breast Cancer Screening and Diagnostic MRI

Sergey/stock.adobe.com

Last month, I wrote about the guide to surviving mammograms. When your breasts* are temporarily smashed, to the point where you didn’t think they could be flattened any further, there is nothing fun about that. Breast cancer patients tend to talk about surviving cancer and not about getting through these imaging appointments. Today, I’d like to touch on ways to survive a diagnostic breast MRI, which is sometimes used in breast screening to supplement a mammogram.

Breast Magnetic Resonance Imaging (MRI)

Breast MRI uses powerful magnets to generate detailed pictures of your boobies. You’re to lie tummy down, hands over your head on a moveable flat table, with your boobs hanging into an opening. After you’ve been situated as comfortably as possible on this hard, narrow table, you, along with the table, will slide into a large cylinder-shaped tube. This procedure will last approximately 18 minutes, during which you’ll hear a constant sound of jack hammer, with some breaks in between. You’re to hold completely still to insure accuracy. Once inside the tube, you’ll feel alone in a tight space.

You might be given the choice of music to occupy your mind, but the music would have to be really loud to drown out the construction noise. Near the beginning of the scan, a contrast material will be injected into your arm through an IV to help outline breast tissue details. The technologist will speak to you through a speaker if any communication is to be had. These 18 minutes can feel like forever. How can you survive it?

Do’s and don’ts during a breast MRI

DO ask a friend or family member to come along. Even just knowing that your loved one is near can be comforting.

DON’T be afraid to ask questions or interrupt the process if something is really bothering you. The technologist can help you adjust your position or let you take a break as needed.

DO focus on your breathing. Notice the natural rising and falling of your body as you lay there. Come back to your breath over and over again.

DON’T scratch an itch or move around. If you pay close enough attention, you will feel some level of discomfort. Unless you're in pain or you're super uncomfortable, know that these feelings will pass.

DO close your eyes if it can help forget that you’re in a tube. Instead, imagine you’re in open space.

DON’T tense up your muscles. Notice when you feel tension in your body, from your face, arms, shoulders, torso, gluts to your legs. Invite relaxation into those muscles and let your body fall heavy on the table.

DO hum or speak softly to yourself. You can hardly hear yourself but you can feel what you’re saying. Soothe yourself with your own voice.

DON’T say to yourself, “I can’t wait for this to be over!” This will likely lead to further impatience and frustration. Your scan will take as long as it takes.

D0 think about what you plan to do to reward yourself after you leave the clinic. Perhaps it is a, “Jenny, you did it!” or a mocha waiting for you down the street.

DON’T try to calculate how long it has been. Chances are, it hasn’t been as long as you think.

Bonus tip on surviving a breast MRI: self-touch

No, I’m not asking you to think kinky thoughts as you lay inside an enclosed tube. Rather, remember your arms overhead? Your hands could be touching each other. In fact, before the machine starts, bring your hands to touch, one on top of the other. Feel the warmth of your hand, the texture of your skin. Notice what it is like to be touched, to be cared for, to be comforted, by you. Much like the touch of a loved one can help lower your cortisol level, so here you are, lowering your own stress level because you’re loving you.

Loving yourself through cancer

It’s hard enough going through cancer, your body does NOT need another, “Hurry up and get this over with!” moment. Instead, consider how you can love yourself through it all. If you need help getting through cancer care and life thereafter, let me know!

*Breasts are used in plural form with full awareness and respect that this might not be true for everyone

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she has found yoga to be a wonderful practice to nurture present moment, self-love and self-compassion. She has grown pretty fond of her toes recently. She says hi to them every time she passes them by.  

There is Hope – Trauma Therapies that Re-wire the Human Brain

Tatiana Shepeleva/stock.adobe.com

The word “trauma” on Google

When I google searched “trauma” the first definition that came up was “a deeply distressing or disturbing experience”. The word “trauma” is synonymous with “shock, upheaval, stress, pain, anguish, suffering, agony, misery” and the list goes on. The word has a Greek origin which literally means “wound”. When I pause to reflect on what these words actually mean, my heart becomes heavy.

Posttraumatic Stress Disorder re-triggered

I must say that while I’ve processed the trauma of my aunt’s death, watching an episode of Sherlock Holmes this past weekend was enough to trigger memories of her. I didn’t expect it; it just happened. Then I think about the many people who have been through a traumatic event and have not learned to process it and integrate it as a part of their life story. After all, it doesn’t take much to be triggered with the never ending information on social media, and to hide from triggers is to hide from life itself. If that’s your experience, I grieve with you. But, let’s not stay there.

A recap on CBT modalities for treating trauma

Last month, I wrote about Cognitive Behavioral Therapies (CBT) for the treatment of PTSD. CBT is about changing the way you think and feel about a traumatic experience. There is often an exposure component where you recall what happened in the safety of the therapist’s office and you learn to put the trauma behind you. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE) were amongst the treatments covered.

Trauma therapies that re-wire the brain

Today, I’m excited to call upon additional experts in the Seattle area to talk about other forms of PTSD treatment. They eloquently speak to modalities that use brain activation and body-mind integration to re-wire the brain and change the relationship you have with the traumatic event.

Without further ado, I give you Lorencita Villegas and Laura Moon Williams!

Eye Movement Desensitization and Reprocessing (EMDR)

Lorencita Villegas, LMHC, NCC is a certified EMDR psychotherapist. She writes, “Eye Movement Desensitization and Reprocessing (EMDR) is a therapy modality that helps process traumatic or disturbing life experiences or memories. It follows an eight-phase protocol where I’d ask you to recall the memory and the negative thoughts associated with it, as well as the positive thoughts you’d rather have about yourself. The goal is to replace the negative cognitions with the positive, and allow the trauma to move.

Trauma moves by allowing the brain to create new pathways that are more adaptive. To allow movement we will use eye movements (or other bilateral stimulation) to activate your brain. EMDR allows you to access your intellectual and emotional processes on your own, unlike talk therapy where the clinician would help interpret them.

It is important to note that EMDR will not change the memory of the particular event, but will change the thoughts and physical reactions associated with it. For example, a person who experienced a car accident may go from experiencing high levels of stress to having a more adaptive thought such as, “I can control my driving.” EMDR has been recognized by the World Health Organization and the Veterans Affair as a leading treatment for Posttraumatic Stress Disorder.“

Lifespan Integration Therapy (LI)

Laura Moon Williams, MA, LMHCA is a Lifespan Integration (LI) therapist. This is how she explains LI, “Those who have had a traumatic experience(s) often feel stuck reliving the event through intrusive memories, flashbacks, dreams or physical and emotional responses to reminders/triggers of the traumatic event. These PTSD symptoms occur because the person doesn’t fully and truly know that the traumatic event is over; the body-mind system is stuck in the experience and continues to respond to its current environment as if the event had just happened.

Lifespan Integration provides a safe, therapeutic way of re-experiencing the event and demonstrating that it is over, without re-traumatizing. This is done by viewing multiple timelines, beginning with the event and continuing with everyday memories that bring you into the present moment. Seeing what happened in the days, weeks, months, or years following the event proves to the body that the event is over and allows the traumatic experience to be integrated into one’s larger story. People are often surprised by how quickly they experience relief from PTSD symptoms with Lifespan Integration.“

There is hope for you

If you struggle with symptoms of posttraumatic stress disorder, you don’t have to go about it alone. PTSD affects you when you’re waking or sleeping, when you’re alone or in the company of others, when you’re at work or at play. It doesn’t have to be this way! Lorencita and Laura are here to help you put trauma in its place. Reach out to them! Lorencita is here and Laura is here.

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. She understands that she cannot be known for too many things, but yes, she also loves helping amazing but struggling people recover from trauma using CBT approaches. When she’s not seeing clients, she’s about working on her business and building relationships within the therapist community. 

There is Hope – Cognitive Behavioral Therapies for Treating Trauma

Sunset Girl/unsplash.com

Trauma is prevalent in our society. Turn on the TV or go on any social media and there’s no shortage of natural disasters, accidents and injuries, abuse, threats of violence, violence itself, and sudden deaths. Sadly, this does not include traumatic events that have happened to you or to those you know. In my previous post, I gave an overview on trauma. In this post and next, I’ll be covering treatments for trauma.

Evidence-based treatments for Posttraumatic Stress Disorder (PTSD)

In the field of psychotherapy, “evidence-based treatments” are treatment modalities that have been proven by scientific research to be effective for treating a particular set of symptoms. In the case of PTSD, a subset of Cognitive Behavioral Therapies (CBT) have shown to significantly decrease PTSD symptoms and related conditions, and these benefits are sustained well after treatment is over. I’ll be writing about two types of CBT approaches that I practice at my Redmond office. I’ll also be calling on trauma experts in the larger Seattle community to comment on other approaches that they specialize in.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is designed to help children, adolescents and their families recover from trauma and related symptoms. Over the course of 12-16 sessions, children and their caregivers will learn about the particular trauma the child has experienced, common trauma symptoms, as well as the roadmap for treatment. Caregivers will also get support around parenting and learn ways to manage the child’s emotional and behavioral difficulties related to the trauma. Children will develop and practice relaxation techniques, ways to regulate their emotions, and skills to begin thinking about their trauma differently. They will also be asked to tell/write about their trauma experience in a safe environment, share it with a special person and learn ways to safely navigate the world going forward. At the end of treatment, many kids feel really empowered and their caregivers proud! And, the tools gained from treatment can be easily adapted to cope with other life stressors.

Cognitive Processing Therapy (CPT)

First developed for use with veterans who have experienced PTSD symptoms, Cognitive Processing Therapy (CPT) has been shown effective in treating other types of trauma. As in traditional CBT, CPT sees a strong connection between your thoughts, feelings, actions, and body sensations. And, to the extent that you have some unhelpful ways of seeing the world before and/or after the traumatic event, those beliefs will keep you “stuck in non-recovery”. When you’re “stuck,” you tend to be hard on yourself and others, mistrustful of the world, and feel numbed out and angry. The ultimate goals of CPT are to help you: 1) accept the reality that the traumatic event happened, 2) fully experience the emotions about the event in a safe environment, and 3) develop more balanced, realistic views about the event, yourself, and others. Clients who have completed 12-20 sessions of CPT have shown a decrease in PTSD and trauma-related symptoms such as depression, anxiety, shame or guilt. They have also reported feeling more present in their everyday life.

Now, calling my first expert! *Drumroll*

Prolonged Exposure Therapy (PE)

For years, Caitlin Vincent, MS, LMFT, CDP provided therapy at the King County Sexual Assault Resource Center. She writes, “I find people struggle most with the re-experiencing symptoms of PTSD (flashbacks, nightmares, intrusive memories and strong physical and emotional reactions when reminded of their experience). They often say that they feel haunted and raw, like the event just happened, even if it didn't. Prolonged Exposure (PE) is a form of therapy that is especially helpful for alleviating these symptoms of PTSD by safely revisiting painful memories in detail, from start to finish, in a process called Imaginal Exposure. Just as a once-scary movie becomes less shocking if you watch it several times, this process can allow someone to regain more control over their minds and bodies. By facing these memories thoroughly and directly, and then talking about the thoughts and feelings that arise, people can start to put the experience behind them, because finally allowing the brain to process the memory relieves its instinct to replay details over and over. PE is best for someone who has a clear and identifiable 'worst' traumatic incident that they can refer to and focus on, but can easily also be used for multiple traumas.”

There is hope for you

If you suffer from trauma symptoms and these CBT approaches to treatment resonate with you, there is hope. Yes, it is scary. Caitlin and I hear you. We’ve been there with countless clients and have walked them through this painful and frightening journey into hope and recovery. We'd want to do the same for you. Let us know how we can help. I’m here and Caitlin is here.

Up ahead

Stay tune for other evidence-based approaches to treating trauma that I cannot even begin to describe! I’ll leave it to the experts.

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. She understands that she cannot be known for too many things, but yes, she loves helping amazing but struggling people recover from trauma as well. When she’s not working or thinking about work, she’s eating or thinking about food. 

How to be with the 2016 US Election Results

Ezio Gutzemberg/stock.adobe.com

Unexpected results

Wow! What a week and it’s not over yet. Tuesday seems like eons ago. The election results shocked the whole world, leaving some celebrating, others protesting. On the one hand, as an immigrant and a woman of color, I hear and identify with the concerned voices of my fellow brothers and sisters as they face an amplified fear to the already prevalent racism, xenophobia, islamophobia, homophobia and sexism in our society. On the other hand, republican voters speak to the hopelessness and oppression they felt under the Obama administration. Each has a story to tell.

Narrowing the great divide

Our country is facing unprecedented polarization. That leaves a “we” versus “them” mentality with little room to hear the other. Whether you are a distraught Clinton voter who has taken to the streets, a victorious Trump supporter beaming with pride or a secretive Republican supporter afraid to come out of the closet, here are some ways to be post election.

1. Come together – be with those who share your viewpoint. Find company. Look around you and know that you’re not alone.
2. Express yourself – silence is dangerous. Speak to your hopes, fears, frustration and disappointment. Use words, art, music, anything.
3. Let your feelings come and go, come again and go again – if you’re experiencing shock, denial, anguish, sadness, fear, anxiety, anger, joy, thrill or whatever else, acknowledge them. Pushing away unpleasant feelings will only make them stronger; prolonging pleasant feelings will make you miss out on the here and now.
4. Revisit your values – remind yourself what you’re about and how you want life to be for you, your family, your neighbors, your community, the environment, animal life, and human kind.
5. Know your impact – your beliefs and thoughts carried out in words and actions will affect another. Your choices have consequences, positive or negative. Imagine the effect of those same choices when done to YOUR father, mother, brother, sister, son, daughter, best friend and those your love.
6. Listen closely – you come with your worldviews, life experiences and biases as you encounter another’s worldviews, life experiences and biases. Listen and understand another’s perspective even though that has and might never be your reality.
7. Stand up for justice – give voice to those who are silenced or are afraid to speak up. Stand with those who are treated less than because of their race, gender, sexual orientation, age, religion, class, abilities, looks or ethnicity. Pause to reflect on what each of these even mean. 
8. Teach the next generation – when your children, grandchildren, nieces and nephews inherit this earth, what do you want them to know about caring for ourselves and each other?
9. See our humanity – we are first human beings BEFORE our differences divided us. Strip us to the core, we have the same needs for safety, love and connection:

I might not know your story, but let me hear it. 

---

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond therapy practice in WA. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.