Tag: In Person Counseling

Are you depressed?

by Nathan Chua

No, you’re not.  You are called by a name, and I don’t think your parents or guardians would name you, “Depressed!”  Yes, this is kind of a play on words, but it can also serve as a reminder to you that your depression doesn’t define you.  I have met a good number of clients who have come to me saying that they have been diagnosed with major depression and subsequently medicated for something they are supposed to have that causes the depression…some sort of brain disease.  It no longer surprises me when clients come to me and say that they had a chat with their provider for 15 minutes and voila, they are labeled as being stricken by something that is called major depressive disorder or MDD!  Sad to say you’re broken and you need some fixin’!  

These conclusions are made in the service of a manual that says someone has a problem with depression when it lasts for a couple of weeks or more, plus a few other criteria listed.  Most people who get such a diagnosis often end up feeling like they have very little control over their choices regarding how they want to spend their time.  Much of their time from thereon will be focused entirely on getting rid of this depression.  They begin to adjust their lives and expectations about their lives and their relationships around a diagnosis.  People have to be careful about my feelings.  They shouldn’t say anything that can trigger my depression or sense of self-worth.  All of a sudden a mask is worn throughout their remaining existence.  

A few words about our sadness:

I have recently shared this thought experiment about our sad feelings.  It speaks about how understandable our negative feelings are.  If you were in a funeral wake to visit the friends and loved ones of the departed, wouldn’t you be surprised if anyone came in without at least a tinge of sadness in their face?  If you lost someone you cared for, would you think you’re abnormal for feeling sad?  Wouldn’t you once in a while even after years following the death of a loved one, still feel a sadness that comes with a reminder of the person who once meant so much to you?  Wouldn’t that be about just being a person who has feelings?  And yet we have a system or a culture that says you only have a couple of weeks to get over your sadness.  

The loop:

I remember an expert sharing that depression as we interpret it today, is not about the presence of sadness, but the unwillingness to feel sadness.  The loop happens when you and I try to get rid of our feelings of sadness.  This can come in many different forms.  We may try to distract ourselves, opt out of activities we enjoy, ruminate about the guilt and the what ifs, and some of us even take substances.  The sad news is unless you have a major brain injury or you are close to that age when you get hit by Alzheimer’s, you will experience sadness sooner or later.  No amount of avoiding can help you on your way to being unable to feel.  Take it from me, there are times I wake up feeling sad for no particular reason at all.  That’s just the case about feelings.  They visit us once in a while and they come and go of their own accord.

In short, the loop kind of looks like this, you don’t only feel sad, but also feel sad that you are sad.     

It’s not what you are, it’s something you have:

You are not a walking depression.  You can just observe.  Take a full day without any medication and see if you will feel sad 24 hours non stop.  Chances are you will find that your sadness only visits you in spurts.  And when it is a longer spurt, chances are you are trying to suppress it.  The problem with that strategy is that the more you try to forget about your sadness, the more you remember.  Because trying to forget something only reminds you of what you have to forget!

The meaning behind the sadness:

Finally, this article won’t be complete without some kind of redemption.  If our sadness were meaningless then I would be first to recommend that all of us should find ways to escape it.  For example, if you were being physically or verbally abused by a partner or a guardian, this is needless pain that all of us can and should avoid.  But the kind of sadness I speak about here does stand for something.  Our sadness means we have lost something or someone of great value to us.  We have sad feelings for a reason.  We are sad for the loss of a loved one because…we loved them!  If our sadness stood for something as life-changing and powerful as love, then why should we be ashamed of it?  

I remember an author and psychologist mention that we have tears come out of our eyes because they were meant to be seen.  I often say this to my clients, your tears today tell me something about you that any form of running away from or medicating your way out of your sadness cannot.  They tell me something about you that makes me feel connected to you.  You’re just as human as I am. 

So next time you lose someone or something that matters to you, take a moment and look at the other side of the coin.  This moment is precious because your sad feelings tell you you have lost someone precious.  And for you to feel the pain of the loss, is the essence of why it is both difficult and a privilege to be part of the human species.                   

Two Shrinks Over Drinks! With Lou Lasprugato

Hi Friends!

I am excited to share a new series with you! I call this one, “Shrinks Over Drinks!” And this episode will be called, “Two Shrinks Over Drinks!”

Have you ever wondered how it feels like to eavesdrop on a couple of shrinks having a casual conversation? Well, welcome to our world! Hope it doesn’t turn into a rude awakening! But seriously, this was a wonderful conversation with a fellow ACT therapist. Hope you enjoy your eavesdropping!

In this video, I feature a conversation with Lou Lasprugato who is an internationally recognized trainer and behavioral health provider. He’s a licensed Marriage and Family Therapist, with private practices in both California and Virginia (United States), and Peer-Reviewed Trainer in Acceptance and Commitment Therapy (ACT) with the Association for Contextual Behavioral Science, for which he also serves as chair of the Training Committee.

Here’s how Lou describes the video:

“I was delighted to have been hosted by Nathaniel Chua for his new podcast series entitled “Shrinks over Drinks” where we touched upon various ACT-related/informed topics, including eclectic vs integrative approach, clinical implications of functional contextualism, rule-governed behavior, couples therapy, ACT-flavored movies, our ACT origin stories, love, humanity, and more!”

For more information about Lou and his work please visit: www.loulasprugato.com!

We will talk about a number of exciting and interesting stuff like, what movies remind you of ACT and what’s love got to do with our work and many more!

For more information about One Life Only Counseling Services, please go to www.onelifeonly.net!

Fourteen Years of:  “Just Call Me Nathan.”

by Nathan Chua

One thing I dislike is titles.  I have always been uneasy with titles unless they were used in settings where it is necessary to set limits, respectful, honorific or makes it easier to identify the people being referred to.  The counseling room has never been a place where I thought titles were necessary.  One thing that I don’t want to impart to any of the people I see. is for them to view me as someone who’s got it all together somehow.  I don’t want them to think that I have some kind of panacea that will answer all of life’s problems.  I love the way one ACT (Acceptance and Commitment Therapy) expert put it, and I will paraphrase it here.  I often use this metaphor to describe the kind of relationship I will have with my clients.  I am not ahead of them nor am I on top of them looking down.  We are just two people climbing up our own mountains that are facing each other.  My job is to see what’s ahead of you as you climb yours and give you signals when I see what’s coming your way.  

Which brings me to the point that I want to make in this article.  What on earth are we doing counseling for?  If you have had this question come across your mind before, don’t be alarmed.  I have asked myself the same question many times before.  Through more than a decade’s work, I have hypothesized about this.  As a healer, I thought that my job was to relieve symptoms.  As a humanist, I thought that it was to find acceptance and purpose.  As a psychodynamic counselor, I thought my job was to come to terms with the past.  Today however, as a behaviorist, I have come to see that counseling is about being able to handle our difficult thoughts and feelings in a more effective way.

To date, I still find behaviorism to hold the most promise in helping alleviate human suffering and promoting successful living.  Please remember that successful living in this context is not about having the most financial success or the happiest existence.  Successful living is about helping people live up to their greatest potential.  This is not in the service of any temporary exuberant feelings nor is it about having great wealth, but about having a life that’s meaningful to the unique aspirations of every individual.  

What I find hopeful in behaviorism is the goals that it establishes that are based on scientific evidence.  A metaphor that ACT therapists use to describe the process is like learning to speak a new language.  If we spend a long enough time using a new language, we will start to get used to it and eventually not go back to using our old language.  Nonetheless, learning that new language does not mean that we completely forget the old one.  

In less metaphorical language, it simply means trying out new or different ways of behaving in the face of life’s problems.  There is an old ACT saying among therapists which goes like, I don’t have tricks to change how a client feels, but I have tricks to help a client live the life they want even with those difficult thoughts and feelings.  Here are some examples of how this can be manifest in a life:  

  • If you react to painful experiences by griping and ranting, then maybe try sitting with the pain with compassion and find out why it pains you.  Maybe it tells you that you care about something that is life-giving and loving.
  • If you react to painful experiences in relationships by running away, then maybe try to learn new ways of staying put and communicating more effectively to let the other person know how important they are to you.
  • If you react to painful experiences by distractions like drugs, alcohol, binge watching, or even working, then maybe try to see if you’re missing out on the more important goals or relationships you had in mind before the challenges came.  

I don’t know if there’s better science out there.  I would like to find out.  For now, it’s been quite the adventure of a search for what best serves the lives of those I see.   If there is one thing that I am slowly losing while learning ACT, it’s my ego.  Good riddance!  I am just your fellow sojourner my friends, and that’s why I’d appreciate it if you’d just call me, Nathan.   

Thank you for fourteen years. Your shared lives have made mine sweeter and more worthwhile.  

Pain vs. Suffering Video!

Pain vs. Suffering

by Nathan Chua

There’s an old aphorism that goes, “Pain is inevitable, suffering is optional,” credited to Japanese writer, Haruki Murakami.*  Have you seen a kid who was disappointed by a parent or primary caretaker who wasn’t as appreciative of a pyramid of blocks it created, and then proceeds to wipe out the masterpiece with one quick stroke of an arm?  I do remember myself doing so but can’t remember what my creation was.  If we look closely, we as adults sometimes revert to this way of coping with the inevitable hard feelings or the pain we get in situations at home, at work, and at random moments in our days. 

I am here borrowing a series of questions you might ask yourself when faced with a challenging moment in these situations.  This can help you see if you may be causing more pain on top of what is already an emotionally difficult moment.  I borrowed this from a book written by experts in functional analytic psychotherapy.**

  • In that situation, can you notice what it is that you do in reaction to it?  
  • If another person is involved, what do they do in response to your reaction?
  • What do you think it is that you do that aggravates or contributes to the problem?
  • Did the way you reacted show up in other places or with other people?
  • What is immediately rewarding about what you do?
  • What is it costing you in the short term?
  • What do you foresee will happen if you continue doing what you’re doing in the long run?
  • What would happen if you stopped doing what you’re doing now?  What would you have to be willing to accept?
  • Is there a purpose important enough for you to accept or face that?

In your relationships with your partner or your family:

When people in close relationships fight, there’s usually a reason for such behaviors.  Very often life’s stressors provide enough of a catalyst for differences and emotional sensitivities to be highlighted.  Couples and parents often believe that their partners or children need to be exactly just like them.  There is a tendency to believe that what is evident to one should be evident to the other.  There is nothing wrong with these thoughts for that is a typical function of our minds.  We compare and find out what should or should not be the same.  However, in your attempts to change the other, what results do you notice you get?  And if you didn’t do this, maybe you would have to accept that you and your kid or your spouse are different from you.  Now is there a purpose here for which you would be willing to accept that?        

In your relationships at work

Just like in other areas in your life, change happens at work.  Let’s take for example your boss.  We all hope that we have only one boss who happens to like us and the way we work, usually for life!  Unfortunately, that is not, most of the time, under our control.  Many decisions from within the hierarchical structure are handed down from above.  So ask yourself the questions posed above.  Let’s say you end up consuming hours contemplating how bad things have been since your company had a change of management.  You may notice that there are short term costs involved in this behavior, like procrastinating on your work tasks.  In the long term, such a habit can only lead up to you losing your job or getting bad marks on your performance.  Would you be willing to accept the fact that companies change and at times your boss will frustrate or be different from you?  What would be reason enough for you to accept this reality?  Is it the family that you love and care about who depend on your job to sustain their needs or even lifestyles?  Is it that long wished for vacation that you planned to spend with loved ones?          

At random moments    

You and I know that driving in a megapolis like Metro Manila can be rather challenging.  Anger and frustration are easy to come by when you have to contend with multiple threats to your peaceful drive home.  When you yell and scream inside your vehicle while your kids and partner are with you, what do you notice are the payoffs and both short and long term negative consequences?  Has it gotten in the way of an otherwise happy ride home?  Would you have to accept that at times driving in an overcrowded city can be challenging?  Is your drive home important enough of a reason for you to hold your peace?  

There you go my friends.  Hope these examples will give you a snippet of what you can learn from what the experts have painstakingly worked to provide us with, which is the knowledge that we are not free from life’s pains, but we are free to choose how we respond to them.  Will we follow old rules of thumb that have both long and short term costs to what otherwise are things we most cherish about our jobs and relationships?  Or will we stop and take a step back and see from a distance what we can do differently to avert the costs and live well in the moment?

*https://www.goodreads.com/quotes/613585-pain-is-inevitable-suffering-is-optional-say-you-re-running-and

**FAP Made Simple by Holman, Kanter, Tsai, Kohlenberg

How to be successful in conflict, Video!

How to be successful in conflict

by Nathan Chua

I have heard it said before that couples who don’t fight, don’t talk either.  The same thing can be said about families and friends.  We can be so averse to conflict that we often opt out of talking about them.  I often hear couples demand that their partners should have as similar wants as they do.  My partner should already know what I want and asking for it will make me look pathetic.  In our culture, it is quite common to see couples come to seek therapy due to the long periods where there have been so many bottled up emotions.  In this article, I will share with you some things you can try to help you prevent conflicts that can either drive you apart because of a major fight, or make you imperceptibly drift apart.    

Tune in to your feelings 

In contrast to what most of us might believe, conflict can actually be healthy in close relationships.  It’s really how we handle them that can make a difference.  One way to avoid escalating conflicts is for us to tune in to the deeper feelings that are hidden in our efforts to protect ourselves from exposing our vulnerabilities.  In many challenging situations, we are often unaware that we have mixed emotions.  A good example to use is when we lose someone in death.  Most of us believe that the only legitimate emotion that we should feel is sadness.  Yes, that is true.  Sadness would most likely be first on our list.  But some of us end up unable to accept the grieving process believing that we are somehow defective for having other feelings like guilt, anger, or even relief at the idea that the burden of caretaking has been lifted out of us.  

In relationships, it is legitimate to feel anger or irritation with our loved ones. Tuning into ourselves involves discovering the other feelings that we might be missing.  Are there other feelings involved here? 

See for yourself if showing just one side of you to your partners is helping you come to a resolution.  If not, maybe it is time to let your partners see those other sides of you. 

For some, the angry side is what the loved ones want to see.  Maybe our indifferent attitude has made them think that they don’t matter.  At least seeing our anger tells them they matter.     

In case you lose it 

Then there might be times when you just couldn’t help but go back to your old ways of handling the situation.  You very well know that you’ve gone away from what you would like to be in the situation.  Listen to your senses, if it doesn’t feel like you like yourself in those situations, then waste as little time as possible and make amends.  Begin an open and honest conversation about it.  

One thing I help couples to realize in the counseling room is that the work they do does not guarantee that they will never make mistakes.  It is impossible to expect near perfection.  They can accept that these are tendencies that the relationship will probably evoke in each of them when there are major challenges and changes.  Couples and relatives can ask themselves one thing to recover from such ill-fated arguments.  Has anything changed in what they value?  Have their deepest aspirations for themselves in their relationships become different?  Chances are they have not.  Their values remain the same.  

I recall one of Dr. Steven Hayes’ analogy of how we are in times of challenges.  He reminds us of what we were like as toddlers.  Toddlers fall down countless times experiencing, at times, excruciatingly painful wounds just to learn how to walk.  Well, we’ve all been toddlers before.  We can remind ourselves that before we had language, we kept on standing up when we fell.  There were no rules that told us what we can or cannot do.  The only thing we instinctively did was to stand up again and walk toward what matters to us.

Say you’re sorry and do it over again.  We are all a work in progress.  Perfection is not what we were built for.  And that’s why we are all called simply, to be human.