Living with the Fear of Cancer Recurrence

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In my last post, I talked about the complex feelings of cancer diagnosis and treatment. I wanted a separate post to specifically target the fear around cancer recurrence.

Whether you’re still going through cancer treatment or it has been years since you were treated, the fear of cancer coming back is very real. You’re attuned to every ache and pain in your body and instead of thinking that these discomforts stem from sore muscles or the beginning of a cold, you think cancer. Perhaps you secure message your doctor’s office for reassurance or you talk yourself down from feeling anxious. Nonetheless, the thought of cancer is ever looming.

Anxiety about cancer recurrence is normal

While most cancer patients who initially reported depression at the time of diagnosis experienced little to no depressive symptoms 10-years post treatment, the anxiety stemming from cancer is still there. After all, to have a cancer history is to face realities that cannot be fully changed or influenced. Sure, you might decide to eat healthier, stay physically active, manage stress better and maintain supportive relationships around you. While these are all good lifestyle habits to have and nurture, nothing you do can guarantee a cancer-free future.

What to do with healthy anxiety

First of all, if you feel something unusual during a breast exam (and the best time to do a breast exam is at day seven of your menstrual cycle), please do contact your oncology clinic. Similarly, if your body is exhibiting symptoms you don’t recognize or common symptoms are lingering, it is wise to seek medical advice. It is important to listen to your body and care for it; otherwise to ignore these symptoms is to deny that something is wrong. Burying your head in the sand only increases the likelihood of you getting your ass kicked.

What is constant anxiety

There is a difference between caring for your body and smothering it. You know your anxiety is in the driver’s seat when you’re constantly thinking about cancer, Googling every body discomfort known to man, and seeing your providers above and beyond normal follow-up appointments. You might be very rigid about the lifestyle choices you make. For example, you can’t miss a day at the gym, there is little to no flexibility in your dietary choices (unrelated to allergies), or you get easily agitated when you perceive that others are critical of how you’re managing your cancer. In other words, your world evolves around your cancer.

What to do with constant anxiety

Your body responds with anxiety when there’s a perceived threat. After all, cancer was and still is a huge threat to your existence. Doesn’t it make sense that you be constantly watchful of it? Knowing that, it’s important to realize that fear is your friend, not your foe. It is there to protect you; to preserve you. The key here is to befriend your body and to acknowledge your fear while putting it in the passenger seat.

Anxiety management techniques

What to do with your thoughts

Just because you think something does not mean it’s happening or that it’s true. Try it: think of a pot of gold. Think super, uber hard. What happened? Did you get rich from conjuring up images of gold? If you did, please come to my office and have those same thoughts. Okay, so you know I’m being facetious here. What I mean is that when your mind thinks something, that’s all it’s doing: a string of words came and went. You can entertain these words and attach a lot of meaning to them, or you can let them come and let them go.

Put simply, thoughts are either helpful or unhelpful. Helpful thoughts can be, "How do I make the most of what I have?" or "These things are meaningful to me and I'm going to do them!" When these thoughts come, listen to them and act accordingly. These thoughts are serving you. 

On the other hand, with thoughts like, "I can't enjoy my life because of my cancer!" or "Cancer is just going to come back; I know it!" acknowledge them and let them go. Like the pot of gold, just because you think it does not mean anything. In learning to have a different relationship with your thoughts, you’re essentially saying, “I hear you thoughts and I won’t be minding you so much. Here, why don’t you sit in the back? I’m still the one driving.”

What to do with your feelings

Similarly, when feelings of anxiety come, let them be there. Don’t push them away; they will only come back stronger. Acknowledge them; sit with them; talk to someone about them. While these feelings are scary, you can make space for them. What do they feel like? Does your heart pound? Do you get sweaty palms? Is your stomach churning? Know that these sensations will pass. As you ride through the waves of these feelings and body sensations, you can still be in the driver's seat, making the most out of life. 

Staying present

The fear of cancer recurrence has you looking into the future. It is thus hard to focus on the present and what’s going on right now. What have you been missing out on? Is it the changing colors of the leaves? Conversations with your loved ones where you’re only half listening? Finished a meal and you don't remember what you ate? When you find your mind focused repeatedly on your worries, acknowledge your mind, and come back to the present moment. Right now is the only moment you can do something about. Don’t miss out.

Need more?

Often times it helps to have someone come alongside you as you learn how to put cancer in the passenger seat. At the very least, because you’ll still have follow-up diagnostic tests and exams, you know the thoughts of cancer recurring are not going away. However, it doesn’t have to dictate your life. Let me know how I can help!

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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 could 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 work, she loves spending time with her hubby, eating good food and more recently, watching Harry Potter. 

“I was Diagnosed with Breast Cancer. What am I to Feel?”

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October is Breast Cancer Awareness Month. I’m putting on hold my blog post on trauma to address the emotional needs facing breast cancer patients. Granted, cancer patients often talk about their experience of cancer to be traumatic, even though many do not meet full criteria of Post-traumatic Stress Disorder.

To hear that, “You’ve got cancer” is enough to unravel any brave soul. The urgency of the news leaves little room for reflection, for contemplation. You’re scheduled with the surgeon, followed by the radiation oncologist and likely the oncologist. Some medical facilities fit all three appointments into a four-hour meeting; others schedule them one at a time. Either way, your head is full and it’s hard to digest information about the stage, tumor size and grade, if it’s hormone dependent and whatever else you’re supposed to know.

All this knowledge; all these next steps, but how are you feelin’?

Facing a loss

Being diagnosed and treated for breast cancer is to face your own mortality. Your vision for what your life would be like is called into question. You thought you would live to hike the Annapurna Circuit, see your kids graduate and hold your grandkids in your arms. All these plans are now up in the air. Even if you were told the type of cancer you have is highly treatable, you’re starting to envision a very different future.

The pendulum through the messiness of grief

Being diagnosed with cancer or other chronic illness is to grieve a loss. Sure, you’re used to your body having some aches and pains, but you’re definitely not as healthy as you had thought. Thus, it makes sense that women going through breast cancer would face different stages of grief in no linear fashion.

Denial

Also known as non-acceptance, denial happens because you’re in shock and overwhelmed by the news of cancer. “Were those really my test results? Did the doctor make a mistake?” You might weep and you might also feel numb. You might wake up in the middle of the night wondering if it was all a dream. It is common for you to feel out of touch with the rest of the world because quite frankly, you would much prefer a life without cancer, thank you very much.

Bargaining

Your mind races through choices that could have detoured cancer. “What if I had lived a healthier lifestyle? What if I had gotten a second opinion? What if I had reconciled that relationship rather than let it eat at me all these years?” There are no answers to these questions but it doesn’t stop you from asking them. Conscious or not, when you consider how you could’ve affected the outcome, it’s a way to take back the control you feel like you’ve lost. Similarly, you might bargain with God or a higher power to give you another chance at a life without cancer. Or, at least not now, though there really isn’t a good time.

Depression

While not all breast cancer patients meet criteria for clinical depression, sadness is very much a part of the grieving process. When you think about how your body is sick, the possible side effects of treatment and how cancer might affect your quality and quantity of life, you understandably would feel sad. Women have often talked about treatment leaving them feeling “disfigured” or “damaged.” This might lead to feelings of shame and negative self-worth and the tendency to isolate and push people away.

Anger

“Why is this happening? Why me? What have I done to deserve this?” are some of the questions that breast cancer patients might ask. Implied in these questions is a sense of unjust, that this shouldn’t be happening. Sometimes, you might feel anger towards yourself, if you think you could’ve somehow prevented cancer. Other times, you might be angry at God or a higher power from “allowing it to happen,” or at your healthcare providers for not doing more to help. Unfortunately, your loved ones might get the blunt of your anger, simply because they’re the closest to you.

Acceptance

If denial is synonymous with non-acceptance, then acceptance is to face the reality of what is: “You have cancer.” It’s hard to read those words and to face them head on, but to keep on denying that fact is to say, “Cancer has you.” To accept something does not mean you have to like it, or that you approve of it; it only means you’re not fighting the reality of cancer diagnosis, treatment and prognosis. You’re more willing to look it in the eye, and say, “Okay, let’s do this.”

The actual stages of grief

The five stages of grief originally coined by Elisabeth Kübler-Ross is actually in the order of denial, anger, bargaining, depression and acceptance. I mixed up the order to show that there really isn’t a right or wrong way to go through grief because mourning a loss is meant to be messy.

You could be accepting the side effects of chemo one moment and then be very angry that you missed the toilet and barfed all over the floor the next. You could have a good cry and feel at peace, and the next crying episode could make you very angry at God. You might want to cancel your MRI and be in denial about what your doctors would want to say to you and the next day, invite a friend to come along to your imaging appointment.

It’s okay

The Kübler-Ross model likely does not encompass the emotional complexity of your cancer journey. Nonetheless, your cancer experience is your experience. It is okay to feel the way you do; all of your feelings are valid and normal. Allow yourself to go to these places; it’s a part of the healing process.

If you need help navigating through the messiness of these feelings, I’m here.

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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 could 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 work, she loves spending time with her hubby, eating good food and more recently, watching Harry Potter. 

An Overview on Trauma

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My trauma story

In June of 2014, my maternal aunt passed away. It was very sudden and traumatic. I still remember the call I got from mom and her words, verbatim, though spoken in Cantonese, “Ning has passed away.” It seemed very surreal, and I still remember I was in the kitchen, holding my phone, in shock.

What followed was an hour phone call with mom as she told the story and we wept together. Actually, I wasn't sure if it has been an hour because time took on a different dimension. My husband didn't know what to do. Though mom and I spoke in Cantonese, he was able to make out the content of what we were talking about. He just sat next to me and held me as I held the phone, and my mom.

My body's response to trauma

As mentioned in an earlier post, my body tends to hold stress and tension. In the days following, my body locked up and I felt very tensed. I went for my one and only massage with a gift certificate I have received years ago. It provided temporary relief. I went through waves of normal work and home life, followed by strong emotions and uncontrollable sobbing when a co-worker asked me how I was doing.

I stayed up in the middle of the night, recounting what happened, hearing my mom's voice, remembering the last encounter with my aunt. I was more sensitive to others' stories about the death of their loved ones, however they might have passed. I had a strong desire for people to stay alive. Above it all, I was angry that the sun was still shining, that life kept going for the rest of the world.

I know I needed to let go of this pain, this hurt and I finally went on a very long bike ride on my day off. I wasn't in bike-shape, but that didn't matter. It was also one of the hotter days in Seattle; 88-degrees outside. While I filled up on water at every juncture, I was still low at the end of the day. However, nothing compared to the flying feeling I experienced while on petals. It was as if the breeze took with it my burden, my tension, and leaving with me memories of my aunt. That was just the beginning of my healing process.

Trauma definition

The truth is, one in two people will experience trauma in their lifetime. That's 50%. And with the never-ending breaking news, I can only imagine that statistic going up.

Trauma is an emotional response to stressful and dangerous events that happened to you or other people. Examples of traumatic events include:

• living through natural disasters
• experiencing serious accident or injury
• being a victim of crime, violence or abuse
• witnessing someone else as a victim of crime, violence or abuse
• going through a scary medical procedure
• someone close to you dying suddenly

Trauma symptoms

Trauma symptoms are best described in four clusters:

1. Re-experiencing: as you go about your day, you might experience intrusive thoughts about what happened. These thoughts take you back to the event as if you're re-living it. At night, you might dream about what happened. Sometimes you can pinpoint what triggered these memories; other times they come out of no where. You're likely to experience these symptoms at night, and when you're relax and less occupied.

2. Arousal: memories of the trauma often bring strong emotions and physical sensations. Examples of arousal symptoms include trouble falling or staying asleep, anger and irritability, and difficulty concentrating. You might also have feelings of being on guard, like you're constantly watching over your shoulder, and being easily startled.

3. Unhelpful mood and cognitions: as a result of the traumatic event, you might experience a lot of shame and guilt and blame yourself or others for what has happened. You might report feeling sad or hopeless, becoming less engaged in life and feeling cut-off from the rest of the world. It is also possible for you to have trouble remembering key aspects of what happened.

4. Avoidance: because memories of the trauma are so hard to bear, there's a tendency to push away any thoughts, places, activities, people, facts or associations related to the trauma. You might avoid media content that reminds you of the event. You might actively try to avoid thinking about the trauma or feeling your feelings about what happened. Sometimes, avoidance strategies include the use of drugs and alcohol, staying busy, being promiscuous, or making other choices that provide temporal relief.

Diagnosis of Posttraumatic Stress Disorder (PTSD)

While most traumatic symptoms surface within three months of the event, sometimes they remain dormant for a long time. It is normal to experience these stress reactions following a traumatic event and for some of us, these symptoms naturally dissipate. For others, these symptoms linger for at least a month and can affect home, work and social life. If that's you, it is important to meet with a mental health professional to determine whether you meet criteria for Posttraumatic Stress Disorder (PTSD).

Hope for trauma survivors

The initial symptoms I experienced following the death of my aunt were a normal trauma response. While I recovered naturally, I know that many people who have experienced trauma have not, and I want to help. If that's you, there is hope. PTSD is treatable. Trauma treatment is hard work but the results are evident and sustained overtime. In my next posts, I'll talk about the different ways of treating PTSD: Cognitive Behavioral approaches and mind-body integration.

In the meantime, let me know if you need help.

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She helps distressed couples and breast cancer patients. She has also seen a lot of improvement in her work with trauma clients. Since that initial massage, she has had many more massages. She realizes that when she is stressed and tensed, it feels good to be touched and cared for. She hopes you'll also find ways to care for you.

Do We Go Further in Relationships or Do I Go Faster on my Own?

I've been coming across this African proverb often within the Emotionally Focused Therapy community, “Alone I go faster. Together we go further.” I can really see this playing out during my trip to Orlando.

Husband and I were there for eight days, mostly play mixed in with some work. We visited Epcot, Magic Kingdom, Universal Studios, Typhoon Lagoon and Disney Springs. We played like kids, except our bodies don't do what they used to do.

During rides

You see, near the end of our trip, we wrote a journal account of where we've been and what we did. There was an underlying theme: we went on this 3-D simulator ride and husband got sick. We rested. We then went on this next ride, and husband got sick again. I clearly remember at the end of Harry Potter and Escape from Gringotts and husband turning to me, saying, “I need a break.” The lighting made it difficult to see whether he looked pale or not.

Now, am I bummed that we didn't get to go on as many rides as I'd like? Absolutely. The thunder storm was also a contributing factor. And, did I stretch husband and still took him on more rides than he would've liked? Absolutely. Meanwhile, all around me, I was reminded me how I could go faster on my own: wait times will be less for single riders. However, it wouldn't be nearly as fun without him next to me.

Here's why.

What I haven't told you is that I'm a screamer. I get startled easily and I let everyone know when I'm startled. Hence, while my husband might get sick, I'm the one who gets scared and I'm usually reaching for his hand at some point. And, the reason why I get to enjoy these rides is because I feel less scared when I have a hand to hold. As Jim Coan's research might tell us, while a stranger's hand is better than no hand, nothing compares to a lover's grip.

Throughout the day

Rides aside, I can see how having the company of each other helped us last the whole day for five straight days:

“Hon, can you hold this?”

“I have Tylenol.”

“You're about to go into this store for the 3rd time.” (Gift shops span the whole block with multiple entries.)

“We'll be eating at this award-winning theme park restaurant!”

“Let's go to Africa at the end because that's where the safari is. Nemo the Musical is in Dinoland.”

Not to mention on my own, I would've spent a lot of time getting lost.

With a friend

Husband and I often joke that when we go on vacation, I have pictures of him at Disney World or he has pictures of me in front of the Universal Studios rotating globe, but seldom is there a picture of us together. Technology supposedly solved this problem for us with the invention of the selfie stick. However, every picture has an extended arm, a background that's compromised, or the selfie stick just doesn't work very well for a DSLR.

Now what if we were not ONE couple but went with another friend or friends? Assuming we'll spend some time together, we can take each other's pictures.

In the meantime, I help strangers take pictures against the backdrop of Expedition Everest and we can usually get a picture in return. Sure it takes more time, but it helps to document that we were indeed in Orlando, together.

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She helps distressed couples and breast cancer thrivers. When she's not working hard, she's playing hard. Her favorite Orlando theme park was Epcot and her favorite rides were Harry Potter and the Forbidden Journey, Expedition Everest, Soarin' and Despicable Me: Minion Mayhem. Nemo the Musical was also quite amazing!

The Subtle Communication in Relationships and Why it Matters so Much

We got this, right?

I'm on Orlando grounds writing this. Having written about a happily ever after wedding, it seems timely that my husband and I have been here for this past week, hanging out at Disney World and its rival, Universal Studios. Having traveled together, we've gotten into a groove. But every time we go somewhere new, there's a subtle shift in our routine.

This time, it involves a water bottle.

It's hot and humid in Orlando and we try to stay hydrated. This translates to me having to pee often. Usually, there's a water fountain by the bathroom and that's also the time when I'd have my husband do re-fills so we can save time.

I thought we have this routine down, until three days in, I again handed him the bottle before I slipped into the bathroom in a hurry. I came out to the same water level. “Husband?!” I joked, as I looked down at my water bottle. He was puzzled. He thought I had wanted him to hold onto it and that was it.

What was going on in my head

Now, I could've interpreted this many different ways:

“Husband doesn't care about me”

“Husband was distracted by the attractions at the Animal Kingdom”

“I didn't say so; hence, he didn't know”

“Why do I need to spell it out? Shouldn't he know by now?”

And depending on how close, connected and accepting I feel towards him, my interpretation, and hence my response, would differ.

Imagine if we've been fighting at the “happiest place on earth”, I'll be more prone to see this as further evidence of his insensitivity. And given we're on good terms, and I know he cares and loves me, I can joke about it.

We cannot NOT communicate

We're constantly communicating to and with our partner. Whether it's a handing over of a water bottle, a shrug, a turning away, or a leaning in. We cannot NOT communicate. And depending on the state of our relationship, a simple withdrawing of the hand can have huge implications.

“You don't care about me.”

“I don't matter to you.”

“You don't want to hold my hand.”

“Here we go again!”

“What's the matter with you?”

“I can't make you happy!”

It's tiring when we're stuck at seeing ourselves and our partners in this way. There is a reason why this happens. It's because our attachment to our partner is not too different than an infant's attachment to his/her caregiver.

Longing for connection with our partner

Psychologist Sue Johnson, co-founder of Emotionally Focused Therapy, speaks about a dance that we get into with our partners. To summarize, here are the rough steps:

• we invite connection with our partner by reaching for them. We're basically asking, “Are you there for me? Are we still connected?”
• if we don't see a response, we protest and push for one. “It's too frightening to see that we're disconnected and so out comes Anger from Inside Out.”
• If there continues to be a lack of response, or the protesting becomes too much, we turn away or shut down as a way of coping. “It hurts too much to feel rejected, or I feel too threatened when I'm attacked. I need to hide out to protect myself.”
• as a step up from protest and push, we melt down and frantically demand from our partner as a last resort. “Hello, anybody home?! Don't withdraw from me; this hurts too much!!!”
• in a secure relationship, we find a way to turn back to each other and reconnect. “You're really important to me and to be reassured and comforted by you is all that I really need.”

Along with developmental psychologist Edward Tronick, Johnson made a short clip demonstrating how we've been doing this dance since infancy:

Here's an earlier blog that explains this experiment further (How to Talk to your Partner about your Problems and Why this Works). 

Back to the water bottle

To the extent that I know my husband and I were still connected and he didn't perceive my teasing as criticism, we averted the full dance. That is not to say that we won't ever go back to moments of painful disconnection; rather, we'll find a way to each other again.

I love how Johnson quoted Walt Whitman at the end, “We were together, I forget the rest.”

Need help?

Navigating this dance is hard work. Need some coaching help? Give me a call!

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She loves helping distressed couples learn to connect in a safe and secure way. When she's not working hard, she's playing hard. Her favorite Orlando theme park was Epcot and her favorite rides were Harry Potter and the Forbidden Journey, Expedition Everest, Soarin' and Despicable Me: Minion Mayhem. Nemo the Musical was also quite amazing!

Have you Forgotten your Happily Ever After?

Conscious coupling

I recently came back from my cousin's wedding. It was a gorgeous day, cloudy and 70's outside. Inside a beautiful gazebo, we witnessed the story of two people who met at work, started dating, and will continue to work together and go home together. Their vows spoke perfection: a promise to care and hold each other. The bride couldn't keep a dry eye. Outside, they topped it off with a popsicle vendor. I had a raspberry coconut. Amazing!

At the reception, it was Disney themed. Happily ever after. We sat at the Beauty and the Beast table and wrote in a card that they will read at their 10th year anniversary. I don't remember what I wrote but I meant every word of it.

Are you sure about this?

Cousin, I believe in a strong, happy marriage so keep working at it. Otherwise, I do tend to be skeptical at weddings as I question whether people really know what they're getting themselves into. Cuz picture this: at a certain time in your life, sometimes before your brain fully develops, you make a lifelong decision to commit to ONE other person. Does that sound crazy or what? And yet, people all around the world are sharing vows as I type this.

Why is it so hard?

When the adrenaline is gone, the toilet seat is up, and you realized you married your mom/dad, things are rough. Throw in the stress of raising kids, an uneven distribution of household chores, and conflict with in-laws and you have it made. What about disagreement in how you manage finances and the use of substances, food or gambling to cope with stress?

When have you ever seen Disney couples fight? All you see is the kiss that ends the tale. Is happily ever after even possible?

Be prepared to work hard

I want to say yes, but be prepared to work your butt off. Relationships are hard work. You're either building up your partner or you're tearing them down; drawing them close or pushing them away. As psychiatrist Robert Waldinger might add, “Relationships are messy, complicated, and the hard work of attending to family and friends are not sexy, but lifelong.” Happily ever after is in the daily grind of doing the small things that would create safety and security for your partner to come close and for them to do the same for you.

Are you ready?

Often times by the time couples come into my office, they've forgotten the vows said years ago. How I so want the DeLorean time machine from BTTF so I can witness their wedding, their longing for each other til death do them apart. And sometimes, I have the privilege of catching glimpses of that hope, the love once shared, but we have to dig through the mud to get there.

Patterns of relating take years to form but possibly only months to unravel and rebuild. Would it be worth it to devote an hour a week to deepen a connection that will last a lifetime? Emotionally Focused Therapy (EFT) has shown such results! Compared to a 35% success rate with other forms of couple therapy, 86% of couples "report feeling happier in their relationships" with EFT. 

If happily ever after is what you're striving for, give me a call!

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She loves helping distressed couples learn to connect in a safe and secure way. She enjoys the Seattle summers and last week, went SUPing with her husband on Lake WA. At one point he tied his ankle bracelet to her paddle board. Let's just say it was a bad idea. 

Want to Live Happier, Longer, Healthier? Here's how

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The Grant Study

Robert Waldinger, the 4th and current director of the Harvard study of adult development tracked the lives of a group of men for 75 years. The goal of the study was to identify the factors that predict healthy aging. The study compared Harvard graduates with a group of disadvantaged youths in Boston. They studied their medical records, which included blood work and brain scans. They also interviewed their children and captured on camera interactions with their spouses. What they learned was profound. Contrary to the belief that wealth, success, or fame will bring us happiness, “Good relationships keep us happier and healthier, period”.

Here are some lessons learned from Waldinger's study:

1. Social connections are vital to our health and well-being. Conversely, loneliness kills us. Men in the study who reported feeling lonely faced earlier declines in health and brain functioning.
2. It matters NOT the number of friends on FB or followers on Instagram and Pinterest; what's more important is the quality of our close relationships. High conflict relationships is a good predictor of poor health, whereas safe, secure relationships is a protective factor for our physical, and I would argue, mental and emotional health.
3. Good relationships keep the brain sharper and for longer. Being in a securely attached relationship at old age is a buffer against memory loss. While our relationships will not be smooth all the time, the ability to be able to count on the other can help us weather through the storms of life.

Here's Waldinger's study on Ted Talk: 

Old news

The thing is, there is nothing new under the sun. In 1988, sociologist James House studied a group of residents in MI and found that people who were social connected lived longer. With subsequent studies, House concluded that social isolation is as dangerous to our health as obesity and smoking.

In 2002, professor James Coyne noted that for men and women with congestive heart failure, a good marriage gives a person the will, “to fight their way back to health”. In fact, the quality of these patients' relationship was a good predictor for which patients will be alive four years later.

In 2006, Louise Hawkley and her colleagues published an article confirming that aging Americans who are lonely are at greater risk for increased blood pressure. And the list goes on.

Then and now

The sad thing is, Waldinger noted that at any given moment, 20% of Americans will report feeling lonely. That's no small number.

And my mind wanders to how we used to live in caves and were a part of a tribe. The men hunted and gathered and the women cleaned, cooked and cared for the kids. Imagine if one of the men woke up one day and said, “Hey buddies, not feelin' it. I think I'm just gonna stay in my cave...” It's either that he has to get up anyway because his buddies won't let him have it, or he and his family go hungry and their genes never made it.

The last I checked, the vast majority of Americans no longer live in communities. We're more mobile, moving half way across the country or across the world, away from our natural supports. We work more hours, sleep less and we are careful with the time that we do have. Who is worthy of our time? Often, that's reduced to our immediate family. And of the (fewer) relationships that we do have, we put more eggs in those baskets. Those relationships matter more to us because they are it.

In comes Emotionally Focused Therapy

Sue Johnson, the co-founder of Emotionally Focused Therapy (EFT), argues that we often look to our partners to satisfy the emotional connection that people from generations ago got from a whole village. When we have such high expectations of our adult love relationships, so much is at stake.

In fact, Waldinger's findings would not surprise Johnson. She was the one who pointed to the wealth of research noted above. I have heard her argue for why James Bond would be a hot mess if he were to come into my therapy office because we are NOT meant to be unattached and self-sufficient. We are made for close, secure attachment with our significant other.

Waldinger acknowledged the "What": accounting for the presence of physical pain in men in their 80's, those in a satisfied relationship stayed happy. One of Johnson's friends, neuroscientist Jim Coan, explained the "Why": the perception of pain is curved by being in a supportive, happy relationship.

Going forward

My pledge to you is similar to that of Waldinger's: go seek out a friend and connect offline. Go mend a broken relationship. Be open to new friendships. Make small steps toward expanding your social connections.

If you long to be close and securely attached to your partner, I'm here!

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She's a Licensed and Marriage Therapist and she loves helping distressed couples learn to connect in a safe and secure way. When she's not meeting with clients, she loves working on her business and expanding her reach to help more hurting people. And when she's not working, she has been frequenting various farmers' market and feasting on summer fruits.

How to Talk to your Partner about your Problems and Why this Works

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How I talked to my partner

A few years ago, there was an incident that made me feel disconnected in my marriage to my husband. It bothered me enough that I brought it up the same day. At first, my husband's response made me feel like it was a joke. When I pressed further about how much it impacted me, he took it seriously and said that it wouldn't happen again. My husband is a good guy and I believed him. I still believe him, but there was something unsettling about how that conversation ended. 

How are you talking to your partner?

I bet you I'm not the only person to dread difficult conversations with my partner. Ever brought up a heavy topic and realized how hard it is to drudge through it? Or, it doesn't go well and you end up on a tangent about unresolved issues? Things get shoved under the rug, but never really resolved and the next time you argue, it's the same old, same old?

That's because these conversations are hard. It's easier to put a bandaid on it; only it's a temporary fix. You might have read about using “I statements,” balancing every 1 negative statement with 5 positive statements, or not attacking your partner. While these may be good communication skills to have, when you're emotionally charged, all those tools go out the window.

What to do instead

I remember as a kid carrying this card around that reads, “If you want to know how to keep an idiot busy for hours, turn this card over” and of course it says the same on the back. The thing is, when something doesn't work, you should really try doing differently.

Borrowing from the tradition of Emotionally Focused Therapy, here is what to do instead:

• speak to your emotions - “I'm angry that you made me look like a fool in front of our friends.”
• speak to how you perceived yourself - “That made me feel like I wasn't important in your eyes.”
• speak to how you perceived your partner - “I thought you did it on purpose.”
• speak to your deeper emotions about your relationship longing - “When that happened, I felt hurt and unloved.”
• speak to your relationship need - “What I really want is to know that I still mattered to you and that I can trust you to have my back like I have yours.”
• speak to what you need as a repair - “I can really use a hug right now.”

Now granted, this is meant to be a 2-way conversation and I've only given you one-side of the dialog. Considering that your partner is loving and supportive, hearing about your deeper needs would usually move them closer to you. And, if this sounds foreign, it is. But, this gets at the root of the matter, rather than staying focused on the content of what happened. Content changes, like hats, but at the core is whether two individuals feel like they're available, engaged and responsive to each others' needs.

Why this works

Emotionally Focused Therapy views adult love relationships from an attachment lens. Consider this Still Face Experiment video and how a baby reacts to a present, then distant mother:

(Please note there is a similar, longer video about babies' attachment to their fathers.)

Sue Johnson, the co-developer of EFT argues that intimate relationships mirror that of an infant-mother relationship. With almost three decades of research behind her, Sue notes that as adults:

• we desire to maintain closeness with our partner
• we need assurance from our partner when we're upset
• we feel distressed when we experience distance from or a loss of connection with our partner
• when we feel like our partner has our back, we feel more confident exploring the world
• when we feel secure in our relationship, we could reach out and connect easily
• if that secure bond with our partner is threatened, we get anxious, angry and controlling or we avoid contact altogether

All of these responses and patterns are mirrored in the above video. 

Can you see how unless you speak to the threatened bond between you and your partner, the argument will just play itself out in similar ways the next time?

What it looked like for me

So I went back to my husband a couple of years ago and told him how that particular issue continued to bother me. He was a little agitated at first and then surprised that it remained an unresolved issue. “I thought we've talked about this?!” He again reassured me that it wouldn't happen again and that I could trust him and him me. For reasons I couldn't pinpoint at first, his response was still dissatisfying.

Two months ago, I went back to him, yet again after an intensive EFT training. That conversation was heart-palpitating, armpit-sweating, and tears-flowing and I wanted to talk about everything else but that. But trust me, it was well worth it. I told my husband that this incident three years ago continued to bother me because I felt disconnected and hurt and that it threatened our relationship. I told him that I do trust him but I also needed to know that he loved me.

Husband was agitated, but softened up when he heard that I felt hurt. He's in disbelief that I wouldn't bring this up again a 4th time, but reassured me that he loved me and apologized that his actions hurt me.

I can understand why my husband would be in disbelief, but what he didn't see was a healing that happened with that repair. I felt lighter and closer to him. No further conversation is needed because that sense of safety and security is restored and deepened. What's more, when we feel safe and secure in our relationship, we can be vulnerable to share our deepest fears and longings. That same evening, my husband turned around and shared situations where he felt left out and I've since been mindful of how to better include him. Vulnerability begets vulnerability and it brings us closer together.

Need help?

That sense of connection, safety and closeness is not built overnight. It takes two people who want it and are willing to work on it. See me as a coach. I'm here when you're ready.

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She loves helping committed couples who have grown apart find each other again. She's recognizing that during difficult conversations with her husband, she'd rather talk about the pretty skies or the crawling spider than the issue at hand. Yet, she's learning to stick with it. Seeing the fruits of that, she'd want to help you do the same. 

Is Pokémon Go Ruining your Relationship? Here's what You can Do about it

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What's happening?

You don't need me to tell you that Pokémon Go came out this weekend and our country went mad. There was an epic number of people on city streets, all staring down at phones. In the overlapping worlds of virtual and real realities, people are capturing wild Pokémons and training them to fight in “gyms”.

Pros to Pokémon Go

There have certainly been some benefits to this social phenomena, with pockets of strangers turning into allies, crossing age divides, and strategizing around game secrets. It's likely boosting our economy, with businesses more frequented and phone chargers in greater demand. I also see it as an opportunity for people to leave the house and get fresh air. And, it encourages exercise: the greater the distance you go, the more items you can lock in.

Thrillest even joked about Pokémon Go being the new dating app:

And one person did get a date, while families talked about Pokémon Go giving them something to do together and connecting them.  

Cons to Pokémon Go

On the flip side, it didn't take long for there to be multiple concerns for public safety. There were numerous trespasses in parks and yards, and armed robberies of players preoccupied on their phones in broad daylight or lured to secluded places at night.

Playing Pokémon Go has caused both major car accidents and minor cuts and bruises. Road signs are encouraging people, “Don't Pokemon and Drive. ”The City of Miami Police posted a video educating parents on the potential dangers.

I can only imagine the list growing as we speak.

What about relationships?

The Huffington Post and Buzzfeed captured tweets of distressed individuals in relationships where Pokémon Go has taken precedence. The words “divorce” and “Pokémon Go” were lumped together, and had some asking for marriage counselors.

New York Mag showed similar tweets of men neglecting their relationships, and a dad catching a Pokémon while his wife is in labor.

Sure, some of these posts might be exaggerated, but Pokémon Go is causing rifts in relationships, regardless of whether lovers are competing or only one partner is hooked on the game.

What can you do about it?

First of all, if you're an individual playing and looking for tips on how to play responsibly, the LA County Sheriff's Department can speak more eloquently to that. 

However, if your relationship is impacted, here's my advice to you, in rough steps:

• without jumping to end the relationship, have a sit down talk with your partner, phones on silent.
• validate that this is an epic game that has America (and other parts of the world) going cuckoo and Nintendo stockholders really happy.
• talk about how his tardiness or her lack of concern for your relationship is impacting you. “When you're an hour late coming home because you stopped by the park to catch Pokémons, that left me feeling really hurt.” 
• speak to your needs of wanting to feel like you're important, loved, or that he's available to you. “It feels like Pokémon Go matters more than me and I want to count on you to be there for me.”
• if both of you are playing, or both of you are in agreement for one to keep playing, talk about boundaries around that. “No trespassing to neighbor's yard at 2am,” or “set a timer on your phone to get off because it's time to pick me up.”
• lastly, if the conversation above is too difficult and you truly need a marriage counselor, I'm here!

Note: There will be no Pokémon Go in my office.

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She's a Licensed and Marriage Therapist and she loves helping committed couples who have grown apart find each other again. Should her husband decide to download the Pokémon Go app, she might have something to say about that. Her favorite Pokémon creature from way back when is Psyduck.

Marriage Problems after Baby? 11+1 Tips to Stay Connected to your Partner

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Cover your eyes if you don't want to read this: It's not looking good after kids

Are you having marriage problems now that your baby is born? You're not alone. My husband recently shared with me the CNN article about the steep decline in marital satisfaction following parenthood. I remember reading such research back in grad school, so it was definitely old news. However, it got me thinking whether the decline has to be this drastic.

Ready for your marriage to go down the toilet?

True, parenting is a major life transition, and this complicated by the fact that you don't know who's coming out on the other side and how their temperament might fit with yours, or not. Sleepless nights, little time to yourself, and a disruption to everything you've ever known. Is there still time and energy to connect with your partner?

I want to say yes!

Here are 11+1 tips to stay connected to your partner after baby:

1. Use humor – if this is your first child, in all likelihood, a lot of things ring true in Brian Gordon's comic about parenthood. Laugh at yourself and with each other. Is it an interesting finding in baby poop that wasn't well digested? Your mismatched socks? Your partner's overgrown beard? Take time to laugh. Don't take yourselves too seriously.
2. Admire your partner as a co-parent – this will be your first time witnessing your partner as a father/mother. How are they different with the baby? The same? Can you take a moment to watch the two interact from a distance? How does this make you appreciate your partner all the more?
3. Make use of every moment – is it the first few minutes of your partner walking through the door or when you pass by each other in the hall? Share a touch, a kiss, a something that lets each other know you're still there. These brief moments of connection can go a long way.
4. Do the little things – aside from sharing a moment in between feedings, what were the little things you used to do for each other, to show that the other mattered? Is it a quick text with Emoticons, picking up his preferred brand of toothpaste, or making coffee in the morning? When you're tired and your patience is thin, knowing that you're remembered keeps you going.
5. Hire a sitter – take a break, go out, or do nothing. Time away from your kid and chores makes you a better parent, a better partner. If you must use this time to run errands, remember to grab yourself a little treat.
6. Set up date nights early on – while it can no longer be every Friday, unless you have a plan, months can go by without the comfort and familiarity of time together. Go out for a movie, a nice dinner, a stroll in your neighborhood. While it may seem like you have left someone important at home, taking the time to connect with your partner can make co-parenting more enjoyable.
7. Focus on each other during date nights – if you're not careful, topics around your kid's music lessons, her playdate with Sally or even how you've organized the baby's drawers can quickly seep into your date night. Set a rule to minimize business talk during your night out. How is the other person doing? What's happening at work? What did you used to talk about before the baby came along? Revisit that.
8. Take turns baby sitting - “me time” and time with friends are still important, even though you're pooped and your priorities have shifted. Put it on the calendar that the 2nd Tuesday is your coffee night and the 4th Thursday is bball with his buddies. When you encourage personal interests outside of the home as new parents, you're cognizant of each others' needs as individuals. That's another way of giving to each other.
9. Keep the conversation going – parenting brings out the worse in all of us. Things that work one day no longer works the next because the kid changes on you. Keep talking about expectations around roles, chores, and responsibilities. Be willing to adapt to the needs and preferences of the kid, and each other.
10. Visit each other at work with the child – you don't have to wait until Bring Your Kids to Work Day. Set an intention that the visit is as much about seeing your kid and showing him around as it is about meeting with your partner midday.
11. Involve your child – there are ways to be mindful of your partner while you're with your child. You can talk to them early on about mom's favorite food, dad's favorite color, and let the child pick up something at the store for the other parent. That's hopefully sending the message, “I love you and I'm teaching our child ways to love you too.”

And here's a bonus and my all time favorite:

1. Use terms of endearment – it often pains me to hear partners be called, “mommy” or “daddy” following the birth of a child. What happened to “Babe,” “Honey,” “Wifey” or “Apple Streusel”? Okay, maybe not “Apple Streusel,” but you get the idea. As much as possible, call your partner the names they were once known for. It's a reminder that you were partners before you were parents.

Another bonus: if this is not your first rodeo, here's an earlier post about connecting with your child around bringing home a second baby.

Mitigating the loss

While I won't argue against 30 years of studies that show time and time again a decline in relationship satisfaction following children, I do believe there are ways to soften the blow. Let me know how I can help!

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond counseling practice in WA. She loves helping individuals and couples grow through life transitions, parenthood being one of them. She's usually overjoyed when her husband brings home the occasional dinner. She's a firm believer that we tend to remember the sweet little things.