Personality Drive: A Holistic View

By Metta Sweet Edge, LCSW

It’s becoming increasingly well known and accepted that thoughts, feelings, and physical experiences are interrelated and deeply inform and impact one’s daily life.  For example, a single thought (“I’m running late”) almost instantaneously causes a feeling (such as fear or worry) which triggers a physiological response such as rapid pulse rate and sweaty palms.  A holistic perspective—holding head, heart, and body as equal and interconnected aspects of the human experience—can also add to a deeper discovery and understanding of one’s personality drive.

The teachings of the Enneagram (please refer to the first and second articles on the Enneagram for more information) include distinctions between what are called the “Triads” or “Centers”: Feeling (heart), Thinking (head), Instinctual (gut/physical).  The personality drives fall into each of these as follows:

Heart/Feeling Triad:

• 2 (Helper/Be Loved)
• 3 (Achiever/Performer)
• 4 (Individualist/Be Special)

Head/Thinking Triad:

• 5 (Thinker/Researcher)
• 6 (Loyal Skeptic/ Safety/Security)
• 7 (Enthusiast/Adventurer)

Gut/Instinctual Triad

• 8 (Challenger/Self-Reliant)
• 9 (Peacemaker)
• 1 (Reformer/Be Right)

The three personality drives in each triad/center have a shared “root” emotion/issue that each drive responds to and defends against either by over expression (2s, 5s, 8s), under expression (4s, 7s, 1s), or denied existence (3s, 6s, 9s).

For the Feeling triad (2s, 3s, and 4s): their power lies in ability to feel emotions (2 feel too much of only positive emotions, 4 feel too little positive emotion, and 3s deny their authentic emotions all together).  The root issue of the Feeling triad is shame and hostility:

Root: SHAME and HOSTILITY

• 2s deny hostility and act as an idealized person to compensate for the shame
• 3s deny shame and then try to fill the gap by being what they achieve
• 4s try to fix the shame by shoving hostility down deep never finding it

For the Thinking and Doing triad (5s, 6s, and 7s): their power lies in ability to think and take action (5s think too much and therefore act too little, 7s act too much and think too little, and 6s deny their thoughts and actions value all together).  The root issue of the Thinking and Doing triad is anxiety and dread:

Root: ANXIETY and DREAD

• 5s dread/are afraid of the world and overwhelmed by people, go inside their heads to knowledge/thoughts (source of all power to 5s) so can be free of the anxiety and dread.
• 6s don’t trust their own thinking and doing, so they look outside themselves to the world to handle the anxiety and dread for them so they won’t have to deal with it, to make safe from the anxiety/dread
• 7s run away from the anxiety/dread to lose self in the excitement and adventure of the world

For the Instinctual/Physical triad (8s, 9s, and 1s): their power lies in ability to instinctually, from the gut, take impulsive action (8s are overcome with aggressive “animal” instinct to quickly and blindingly, 1s repress their animal instinct, and 9s deny their gut’s very existence).  The root issue of the Instinctual triad is aggression and resentment:

Root: AGRESSION and RESENTMENT

• 8s express aggression and say “deal with it”
• 9s deny aggression and resentment not wanting to rock the boat
• 1s sublimate aggression into idealism and perfection.  Try to make aggression sublime (not just repressing it, shoving it down and having it come up as righteousness and doing the right thing)

Knowing your personality drive’s place within the triads can be very helpful in discovering not only the root issue that needs healing, but also where the key to your power lies for optimal personal growth.

Resources

There are many resources on the Enneagram, but the ones I work with most are from Riso & Hudson’s Enneagram Institute (www.enneagraminstitute.com) and The Wisdom of the Enneagram, Daniels & Price’s The Essential Enneagram, and Concept Synergy’s Harnessing Your Personality Drive Through Exploring the Enneagram as well as PPV Enneagram: Forging the New Self.

Addiction and the Craving for Wholeness

By Melissa Kulick, Ph.D., RYT

And You? When will you begin that long journey into Yourself?
- Rumi

Happiness is your nature. It is not wrong to desire it.
What is wrong is seeking it outside when it is inside.
- Sri Ramana Maharshi

When children grow up with experiences of trauma or deprivation, it is not uncommon for them to feel an inner emptiness. Confronted with what may be overwhelming negative emotions (sadness, hurt, fear, unworthiness,) and never having had the opportunity to learn healthy “self-soothing,” these individuals adapt by finding or developing more unhealthy coping strategies, including various form of addiction. They learn to search, reach and cling outside themselves to anything that seems to offer some immediate release from their pain.

The word “addiction” comes from the Latin addictus (pp of addictio), meaning an awarding, giving over, devoting or surrendering to. In addiction, we give over to the object of our addiction our power and ability to know we are okay, enough, whole. We actually, unknowingly, surrender our identity.

That being said, it can be argued that we are all addicted in some way. We all have things we can, consciously or not, cling to in order to tell ourselves we are okay in a given moment. We can be addicted to substances (drugs, alcohol, food,) activities (work, shopping, gambling, sex, exercise,) relationships and persons, receiving praise or attention, controlling others, and even to beliefs about ourselves and other internal thought processes (denial, interpreting situations as saying/confirming something negative/shameful about us – as unworthy or stupid.) Yes, we can be addicted to negative thoughts and feelings about ourselves, even addicted to an identity as an addict – as a way of experiencing a known, predictable, solid identity and not having  to confront the fear, confusion, groundlessness of not knowing, and the responsibility that comes with accepting our choicefulness.

All addictions arise from the same place within us and all share a common effect. All addictions are (conscious or unconscious) reactive attempts to temporarily reduce, eliminate, or avoid facing and moving through our pain. The result, however, is that they all block in us our ability to open to receiving that which we are, at heart, truly seeking: knowing that we are enough and loved  for who we are in any given moment; that we are already whole just as we are.

Well-known spiritual teacher Ram Dass describes the experience addictive behaviors afford as a “short rush” allowing us a “taste of heaven” and “home” but not allowing us to remain because we didn’t get there in a right, real way. There is a yearning to come home, but we continually find ourselves thrown out by the negative self-thoughts and feelings we were trying to avoid in the first place, now seemingly reinforced by our ‘bad’ behavior. In our attempt to fill the whole, we feel it only growing.  [For Ram Dass’ full commentary on Attachment and Addiction, go to http://www.youtube.com/watch?v=T3ixRqOauq4.]

Healing is Making Whole

Eminent Swiss psychiatrist Carl Jung, in a letter to Alcoholics Anonymous co-founder Bill Wilson, described the alcoholic’s craving for alcohol as “the equivalent . . . of the spiritual thirst of our being for wholeness.” Continued attempts to satisfy the thirst through addictive behaviors, however, render it ultimately unquenchable. As a common AA saying goes, “For an alcoholic, one drink is too many and a thousand is never enough.” In other writings, Jung stated that it is our darkness, our “shadow” aspects that we are compelled to disown, that have the capacity to be our greatest teachers and tools for growth. He wrote that our felt brokenness results from an alienation from who we are. We heal by embracing, not dividing. Healing is making whole.

If the addict’s perceived self is an empty or fragmented self, how does one create a sense of self based in wholeness and fullness?

My teacher, Swami Jaya Devi Bhagavati, was once asked by a student struggling to understand and reconcile the co-existence of God and war, whether God was absent in war. Swami Jaya Devi’s response was that God was present, but that the awareness of God was absent. Another twelve-step saying is that an addict is “not a bad person getting good, but a sick person getting well.” Addicts are not bad or evil people absent good, they have simply lost or lack awareness of their true goodness, leading them to wage the internal war of addiction.

Learning to practice simple awareness – without reactivity – is therefore a vitally important tool in addressing addiction. We need to learn to sit and be and allow a feeling or sensation without jumping to interpretation that something is (or I am) wrong, bad and/or needs to be changed. Awareness, itself, allows for transformation. We give power to a feeling by resisting it. We have already transformed our relationship to it and its power over us by not reacting to it. It no longer needs to be removed in order for us to be whole and okay.

Most people are familiar with the expression, “Whatever we resist, persists.” It is also and perhaps even more accurate to say that it is not so much that we resist things because they are painful, but that they are painful because we resist them. We can transform our experience of, and relationship to, pain. Simple breath meditation – sitting with our eyes closed and following our breath in and out, bringing our attention back to our breath when we become aware our mind has wandered (because it will) – is one way to begin training ourselves in awareness and focus without judgment. Anything that happens inside of us is okay – anything we think and everything we feel. Nothing we think or feel is evidence of our not being enough. And nothing we have done diminishes our wholeness.

The teachings and practices of yoga can be powerful resources on our journey to wholeness and ‘enoughness.’ Yoga literally means “union” and “wholeness of being.” It is designed to “yoke” the practitioner to her or his deepest Self. Yoga is an “eight-limbed path” toward our highest consciousness, toward true contentment and happiness. One of these limbs, pratyahara, most directly addresses addiction. Pratyahara is the withdrawal of the senses, a turning inward. When we practice pratyahara we stop chasing our external sense experiences and focus our attention inside ourselves, directing our energy internally. We practice coming back to center, to our heart. We come home in a way that allows us to stay.

The physical practices of yoga, the asanas (postures) and pranayama (breathwork), are also valuable in cultivating our experience of wholeness. To “practice yoga while you’re practicing yoga” can be a great challenge. It means to be fully present in our body and breath, neither judging nor forcing ourselves beyond what is true and right for our body in that moment. We are given the opportunity to practice awareness and acceptance and ‘enoughness’ on the mat, then bring this experience off the mat and apply it in our everyday lives.

There are also specific practices in yoga that can help move us toward wholeness. Our bodies are energy bodies, with thousands of energy paths running through it. There are seven main energy centers in our physical body, beginning at the base of our spine and moving up to the crown of our head. The second of these energy centers, or chakras, is located low in our abdomen. Correlated with the sex/reproductive organs in our body, the second chakra is also associated with creativity and the element of water. When in balance, we experience ourselves ‘in the flow.’ When out of balance, we have a tendency toward avoiding, controlling or ignoring our feelings. At its extreme, this imbalance leads to self-denial, self-rejection and self-deprivation. When we are blocked in this way, when this flow of receptivity is dammed, we are unable to connect with that which would truly satisfy us. Our ability to enjoy any activity is in direct proportion to how present and open we are to it in the moment.

The second chakra is considered the seat of duality (separation), unworthiness and of addiction. Its name, Svadisthana, means “sweetness” or “one’s own place or base.” Addicts’ external searching is a longing for the elusive sweetness of feeling/ knowing they are finally ‘home sweet home.’ Yoga practices that balance second chakra energy (e.g., Seated Spinal Flex) help bring us home.

“I Am Enough” Meditation
Find a comfortable seated position, lengthen your spine and gently close your eyes. Begin taking full, satisfying breaths, focusing your attention on the sensations of your inhalation and exhalation. After several breaths, bring your focus to the second chakra, low in the abdomen just a few inches above your pubic bone. Imagine you could feel the energy of the breath coming in and out of your second chakra. Allow yourself to feel the flow of that energy. Begin a silent mantra of “I am, therefore I am enough” on each inhale, and “I am, therefore I am enough” on each exhale. Continue this breath for 3-11 minutes. When you feel ready to complete the meditation, bring your attention to the center of the chest, called our spiritual heart. Breathe in and out of your spiritual heart three times repeating, “I am, therefore I am enough.” Know that you are enough, you are home and you can stay. When you are ready, slowly begin to open your eyes.

Addiction – the experience of craving in this way and looking for the ‘quick fix’ in whatever form it takes – is a signal that we are out of balance. One of the ways to approach addiction, therefore, is to seek the experience of balance, rather than reactively seeking the quick (and actually unbalancing) fix. An important element in addressing any addiction, not just food addictions, is to balance our blood sugar. When our blood sugar is out of balance, it typically triggers the feeling of craving and a state of reactivity; the quick fix becomes very hard, if not impossible, to resist. Our ability to be choiceful and response-able is greatly compromised. The best way to balance our blood sugar is to eat three full, satisfying meals at least 3-4 hours apart, with no between-meal snacking. If you feel a strong need for sweet, sugary treat, the best time to have it is as a lunchtime dessert, when it is least likely to have as strong an impact on your blood sugar. Snacking prevents our blood sugar from stabilizing by keeping it in constant movement.

Know that it is absolutely normal to grieve the loss of your addiction; it is like losing your best and most trusted friend. Know, too, that every addict struggles with being present in their bodies, in their lives and in the world. Recovery is a process of developing awareness and acceptance of all that you are, without judgment and reactivity. With this awareness, you begin to confront the truths your addictive behaviors were ‘protecting’ you from, and in so doing you reveal to yourself the truth that you already are, and have always been, whole and enough.

 

“The most terrifying thing is to accept oneself completely.”
~ Carl Jung

“Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it.”
~ Rumi

”Real healing can begin only when we finally learn to be present in the places where we have been absent.”
~John Welwood

 

 

Book review: The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life, by Susan M. Orsillo, Ph.D., and Lizabeth Roemer, Ph.D.

A book review by Lisa Anyan Smith

We live in a stressful world.  Anxiety is a part of the human condition.

Many people complain of feelings of anxiousness, ranging from occasional mild worrying to full-blown anxiety disorders such as Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Social Phobia, or a specific Phobia.

Although anxiety is a normal human emotion, we find feelings of anxiety unpleasant and typically try to avoid experiencing them.  Attempts to avoid  anxious feelings may include overeating, drinking alcohol, watching TV, taking prescription medications, or staying away from situations or people that may trigger anxiety. In their new book, “The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life,” Orsillo and Roemer propose that avoiding anxiety or attempting to control it does not ease pain and suffering.  Rather, avoidance brings its own costs.  The authors suggest that to break free from anxiety, instead of avoiding anxious feelings, we practice coping strategies that allow us to turn toward and pay close attention to anxiety.  Turning toward something that we would usually avoid and taking a fresh look at habitual responses are crucial components of mindfulness.

Before exploring how mindfulness can help us break free from the grip of anxiety, let’s look at an example of what anxiety is.

Jody recently moved to New York City from Alabama to start a new job.  Heading into a corporate meeting, she notices that most of her coworkers are already seated and chatting with one another.  She takes a chair between two groups already engaged in conversation and begins shuffling through her papers.  She feels her anxiety rising.  Some of the thoughts that go through her mind include, “I don’t fit in here,” “My clothes are all wrong,” and “They must think I’m an idiot.”  She feels her face flushing, palms sweating, and pulse quickening.  Thinking of the friends she left behind at her former job, she feels a wave of sadness and regret.  She despairs as she thinks about the years ahead of her, just knowing that she will always feel alone.  For the duration of the meeting, she keeps her eyes downcast, contributing nothing to the discussion.

As this story illustrates, components of anxiety include thoughts, emotions, physical sensations, and behaviors.  Evolutionarily, humans are hardwired to feel fear.  Fear is actually a helpful warning that alerts us to potentially dangerous situations.  When we perceive a threat, the fight-or-flight response kicks in to ready us to combat or escape from harm.  The physical symptoms we experience when this response occurs (increased heart rate, rapid breathing, adrenaline rush, etc.) are merely side effects of the body getting ready to fight or flee.

Compared to fear, anxiety is a more subtle but chronic state.  Whereas fear is an automatic response to a threat we perceive as immediate, anxiety includes thinking about or imagining some possible threat we may come up against in the future.

Orsillo and Roemer’s research indicates that our struggle with fear and anxiety does not come from any actual harm caused by the physical sensations of these emotions.  Rather, it arises from our reactions to these emotions and the thoughts, sensations, and images that accompany them.  Criticizing ourselves for feeling fear or anxiety is what hurts us, not the fear and anxiety themselves.  This is where the turning inward is helpful.  Mindfulness can help us replace self-criticism with compassion.

Simply put, mindfulness is a specific way of paying attention.  It involves “purposefully expanding your attention to take in both what you are experiencing inside – your thoughts, feelings, and physical sensations – and what is happening around you.” (p. 81)  The key concepts of mindfulness include 1) Noticing – becoming fully aware of the thoughts, feelings, physical sensations, and images that you experience, as well as the details of your environment; 2) Curiosity – approaching experiences with openness; and 3) Self-Compassion – acknowledging that the reactions we have are part of being human, accepting what cannot be controlled, and treating yourself with kindness and care.

The authors provide a series of exercises progressing from a 5 minute breath exercise through a number of informal and formal techniques to practice mindfulness.  Readers are also encouraged to download audio recordings from the book’s website to listen to while practicing or to record their own scripts.

Shane trembled as she waited her turn to stand behind the podium and deliver her speech.  She had agreed months ago to make a presentation before her colleagues at the real estate convention, even though she was terrified of public speaking.  As the previous speaker was concluding his remarks, Shane felt her stomach churn.  Her neck felt tight and sore, she felt the blood rushing to her face as she blushed, and she began sweating profusely.  “Why, oh why did I ever agree to this?” she thought.  She recalled the incident in high school when she had forgotten her lines in the school play, and now she relived those old feelings of embarrassment.  “It will be just like in high school!”  “These people will think I’m so stupid.”  “No one will ever refer any business to me again, ever!”

Orsillo and Roemer would say that Shane is experiencing “muddy” emotions.  This occurs when we bring in memories of past events – and conjecture about future possibilities – into the current moment.  If Shane were to take a moment to be mindful of the immediate challenge, she would realize that she is muddying her current anxiety by worrying about “what if” rather than focusing on “what is.”

The authors write in a style that is easy to follow and offer many vignettes to provide examples.  They also address the questions that many readers may be asking:

But isn’t mindfulness a Buddhist principle?  Is it a new age fad? What if I have different spiritual beliefs?  

The term mindfulness indeed originated with Buddhism, but the idea has recently been included in research and therapeutic settings.  In fact, mindfulness practice has been shown to decrease anxiety, insomnia, stress, risk of coronary heart disease, substance use, chronic pain, and fibromyalgia, and increase attention, sexual functioning, quality of life, and immune system functioning.  The book does not focus on the religious aspect of mindfulness.

How can I find the time to practice mindfulness?

While research suggests that more practice is associated with greater benefit, the authors offer a variety of techniques including exercises that only take 5 minutes a day.  They also point out activities that you can do mindfully, such as eating, walking, washing dishes, folding laundry, petting your dog, cooking, listening to music, or hugging a friend.

How can mindfulness help with anxiety? 

By this time you may be thinking, “Gee, thanks, but no thanks.  I’m already acutely aware of my anxiety.  Why on earth would I want to focus on it more?”  Yes, it is seemingly counterintuitive, but mindfulness can actually help us notice what we are experiencing and make choices about how we want to respond, rather than automatically reacting in ways that hold us back from fully engaging in our lives.  Let’s look at one more example that illustrates the value of mindfulness:

Sam was on a third date with Chris.  He had been single for a long time and knew that he wanted to develop an intimate relationship.  He was quite fond of Chris, and was getting signals that the feeling was mutual.  As the talk turned more personal, he felt his pulse quicken, his chest tighten, and his mouth get dry.  He felt the urge to change the subject so he wouldn’t risk feeling vulnerable and getting hurt.  He watched Chris for cues, and thought he saw a frown of displeasure when Sam talked about a low point in his life.   What Sam really wanted to do was excuse himself, pretend to go to the bathroom, and run like hell out the back door of the restaurant.  However, he really wanted to build a connection with Chris, so he chose to remain in the situation.

Often the things that really matter to us, like loving people, forming emotional connections, taking on challenging tasks, or caring for those in pain and suffering, bring with them emotional pain.  In these cases, living a fulfilling life means that we notice the pain and allow it, rather than trying to make it go away.  Mindfulness can help us to embrace our entire range of emotional experiences, making it easier to make these choices and enrich our lives.

 

Additional Reading:

Boyce, Barry (Ed.). The Mindfulness Revolution. Shambhala Publications,  Inc., 2011.

Germer, Christopher. The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. Guilford Press,  2009.

Matheny, Kenneth B. & Riordan, Richard J. Stress and Strategies for Lifestyle Management. Georgia State University Press, 1992.

Nhat Hanh, Thich. Peace is Every Step: The Path of Mindfulness in Everyday Life. Bantam Books, 1992.

Siegel, Ronald. The Mindfulness Solution: Everyday Practice for Everyday Problems. Guilford Press, 2010.

Book Review: “Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting” by Michael D. Banov, MD

A Book Review by Molly Keeton Parnell, Ph.D.

I am pleased to have found a book that I can recommend to clients, family, and friends who are dealing with depression and wanting to better understand their treatment options. While the title of the book indicates the subject matter is that of antidepressants, Dr. Banov does a thorough job of discussing various alternatives to traditional medication therapy, including psychotherapy, supplements, exercise, healthy eating, light exposure, yoga, meditation, and more. The fact that the discussion is not limited only to antidepressant medication makes this book much more worthwhile, in my opinion.

Over the years of providing therapy, I have talked with many clients about antidepressant medication. I have found that it is very, very rare that clients feel immediately open to this option. Many come around and try antidepressants and many do not. I am always amazed by what strong opinions exist about medication therapy. People feel that it is “not natural” (neither is cataracts surgery, but most don’t object to this), that they “shouldn’t need it,” or that they should somehow be able to overcome a chemical imbalance through sheer will. It is not the fact that a person has a negative reaction that bothers me – perhaps we should all be more cautious about our medical care. It is this strange phenomenon that average people suddenly seem to fancy themselves a medical expert when it comes to mental health medications. For example, when I was pregnant, I had to be on blood thinner medication. This involved giving myself injections once or twice a day for the entirety of my pregnancies. I certainly received many reactions from people who knew about this (mostly sympathy and some shock at the thought of taking shots everyday), but I never once had someone tell me that I probably didn’t need the medication, that my doctors didn’t know what they were talking about, that blood clotting disorders don’t really exist, or that I could fix my clotting issue by adjusting my attitude. People almost never question treatment or medication for heart disease, Alzheimer’s, or high blood pressure, but when it comes to mental health issues everyone is suddenly an expert. And most likely they haven’t read the first word about depression or its various treatments.

Mental health disorders and their treatment still carry an enormous stigma in our society, despite the fact that an “estimated one quarter of the population will suffer from depression at some point in their lives” (p. 10) and antidepressants are “the most commonly prescribed class of medications” (p. 7). Because of this stigma, depression is more often hidden and dealt with privately. The downside of this is that many, many people do not comprehend the realness of depression, how it differs from the regular sadness and stress we all face in life, and the serious consequences that can result.

When I think about depression, a funny story comes to mind about my sister. She was living in Oregon with some mountain biking enthusiasts who invited her to join an on-road trek one day. Although she had not done much biking, she was a lover of exercise who was in great health and very good physical condition. She figured she was up for the challenge. From almost the very beginning she had great trouble keeping up. She felt discouraged with herself, first frustrated by her poor performance and then questioning if she had been crazy to think she could do this. She felt embarrassed for others to see her struggling and felt badly for slowing them down. She began doubting everything she knew to be true of her fitness, wondering if maybe she wasn’t in great shape, if her daily runs were not really all that impressive, if she wasn’t a real athlete at all. Finally, one friend who knew she could do better took a quick look at her bike. Guess what they found? Her tires were not properly inflated. She was literally doing twice the work to get half as far. Imagine her relief to discover this – not only was she not the utter failure she was beginning to feel like, but also the rest of the day was sure to go much better. As she set out again, looking forward to the ride ahead, she found that she was still struggling to keep up. The same feelings of embarrassment, self-doubt and inadequacy followed. After more time and more struggle and more slowing down of the other bikers, someone took a second look at her bike. This time they discovered that her brakes were functioning improperly and were actually partially applied. For every push of her pedals, the brakes were working against her by trying to stop her in her tracks. Once this problem was resolved, the day went much more as she had envisioned. She was not at the head of the pack, but she was certainly capable of an afternoon ride with some friends.

I promise that this story is true, and although I am sorry that my sister had to suffer through it, I am so grateful to have this excellent analogy of how depression can feel. It is not necessarily that a person with depression can’t function, that they lay on the sofa all day crying or feeling like dying, that they don’t leave the house, feed the cat, go to work, etc. Though depression can look this way at its extremes, many people with depression can continue to function in their lives to the point that others may not even know they are suffering. It is just that the effort it takes to get through normal daily tasks can feel overwhelming. For many, depression comes on quite gradually so that they might not fully notice its presence in their lives. Like my sister on her mountain bike, they may simply think they are lazy, unmotivated, and incapable of achieving their goals. They may chastise themselves for not being able to get their lives together, get things done, or function as well as other people seem to. Not recognizing that depression plays a part can have devastating consequences. Their goals, dreams, relationships, productivity may be slipping away while all the while self-loathing and hopelessness is growing. Depression leads to a great deal of suffering, and not recognizing and getting help for depression leads to worsened depression and therefore greater suffering. It affects not only the person who has it, but their loved ones as well.

Dr. Banov points out that the “emotion of depression” must be distinguished from “the illness of depression” (p. 38). While we all have feelings of sadness or despair at times, the illness of depression (sometimes referred to as a chemical or clinical depression) is a medical condition that causes changes in the physical body and brain. Brain scans of people with depression have shown decreased activity and even atrophy in the hippocampus (plays a role in mood and memory), prefrontal cortex (responsible for planning and attention), the amygdala (generates emotional response during emotionally charged events), and the thalamus (serves as the “communication hub” between our thinking and feeling areas in the brain) (p. 76-77). Depression also can cause or exacerbate other health problems, by affecting insulin levels and blood sugar, compromising the immune system, and leading to elevated blood pressure as well as reduced muscle tissue and bone thickness (p. 79).

Dr. Banov’s book is so packed full of information, any attempt to summarize would be futile. He covers the types of depression, the brain mechanisms that are involved, the various medications used to treat depression, how these medications are believed to work, research studies that both support and do not support their use, typical side effects and how to manage them, generics versus brand names, what to do if your anti-depressant begins to lose effectiveness or causes a numbing of your emotion (not its intended effect), if antidepressants are addictive (they are not), the when and how of discontinuing an antidepressant, and how to deal with special circumstances such as drug interactions, travel, surgery, or pregnancy. Dr. Banov also covers in depth the importance of having a check up for your physical health and the many physical disorders with symptoms that can mimic depression (i.e. thyroid disorders or diabetes).

If you suspect that you or someone you care about is dealing with depression, I highly recommend this book. It contains so much useful information, it could actually be overwhelming for a person with depression to try to decipher all at once. My personal recommendation would be to read the first few chapters to determine if you might be experiencing depression and what your treatment options are. If you do decide to take antidepressant medication, I would suggest that you wait until that time to read more about side effects or long term use. Having read the book myself in just a few days, I can honestly say it is a lot to absorb. Some topics are covered in incredible detail, such as the functioning of neurotransmitters in the brain, and other topics could have used slightly more attention, such as the types of psychotherapy and how alcohol and illicit drug use can worsen depression. To his credit, I appreciate Dr. Banov providing an incredibly comprehensive look at all issues relevant to the topic of depression, even if the reader may want more information on the few areas of special interest to them.

In reading this article and possibly reading this book, I hope that the first message you will take away is that depression is real, and it is serious. It is also quite treatable. Antidepressant medication has been in use since the 1950’s and is improving every year. While most people do not like the idea of taking medication, I can tell you that the vast majority of clients I have known who have taken it have found it to be effective and quite easy to tolerate. While they might initially worry that it is not natural or will change their personality in some way, I have heard many a client say “I finally feel like myself” again once the medication kicked in.

As I stated in my introductory paragraph, one of the best things about this book is its emphasis on treatment strategies other than antidepressant medication. If you want a truly unbiased look at the pro and cons, research support and lack of support, you will find it all in this book. If you want tips on how changing your diet can help and specific foods or supplements that might alleviate depression, you will find that information. I think the best piece of wisdom in the entire book is Dr. Banov’s early recommendation to assess your “depression and antidepressant attitude” (p. 15). Take a moment to evaluate any automatic thoughts or assumptions you have about depression and its treatment. Know that this is your bias and that you are likely to be influenced by it now and in the future.  Be on the lookout for when this bias starts to creep in and do your homework to get a fair and balanced perspective.

Here is my bias: I believe that Western medicine has many drawbacks, including a quick-fix mentality and too often a focus on symptoms rather than the cause. When I think about what we ask our bodies to do, given what we put into them nutritionally, I am sometimes surprised that we function at all. I know that my car runs on gasoline, and I never attempt to make it run on water, sugar, sand, or olive oil. Yet, because we can get by eating a diet of processed foods, we often do. I do not know what percentage of depression might be caused by our diets, lack of exercise, spiritual disconnect, etc., but I am guessing a certain number of people could improve their depression by focusing on these aspects of their lives. Some people, however, will also need medication plus these other things to make their lives rich and fulfilling.

I do not suggest that all of my clients consider antidepressants – not by a long shot. I have seen some clients for years before this type of discussion has ever come up. With other clients, it might be mentioned in our first session. It all depends on how much a person is suffering. In many cases, I think it makes sense to try other things first – healthier foods, sunshine, exercise, yoga, social contact, etc. But if your life feels like it is unraveling and the damage is starting to mount up, an antidepressant may very well be the best choice. There is no rule that you can’t do all those other things too. Most importantly, do something to treat your depression. You deserve to feel better.

How to Be a Good Listener

How to Be a Good Listener: 12 Ways to Listen Closely…and Kindly

By Lori Hope

(Reprinted from Beliefnet.com)

A magnificent array of diverse and unique individuals populate this beautiful planet, but as different as we are, we share at least one fundamental need: to feel heard and understood. Most of us would like to think we can easily satisfy that need with our friends and loved ones, but we often fall short. I know I do. I learned that when I had cancer, and instead of finding open ears, I often encountered open mouths eager to spout advice or share stories. I saw myself in those people, and consequently set out to do unto others as I wished they had done unto me. I wrote a book fundamentally about listening, and I discovered along the way a huge bonus. I was not only a better friend, but I was able to attract new ones. So listen up – learn the art of listening – and feel the love!

First, Practice Actively

Listening well is an art – a skill honed by practice, study, and observation. And though it seems passive – after all, people talk TO us – it is indeed an activity and can require great effort. Seeing genuine listening to be active listening will prepare you for the immensely satisfying work it takes to really hear someone.

Open Your Eyes

Good listening isn’t just about ears, it’s about eyes. Maintain eye contact, and don’t give into the temptation to glance around. I’ll never forget meeting John Kennedy Jr. at a reception in New York, and noticing that while I spoke, his eyes never left mine, even though we were surrounded by luminaries. I felt like the most important person on Earth. Also, read the speaker’s body language; if their eyes are not meeting yours, they may feel uncomfortable or could be hiding something.

Move your Body

When you’re truly engaged, your body reacts by leaning forward, and your pupils dilate. Though you can’t control your pupils, you can show you’re listening by moving your body instead of your mouth. Nod; move forward in your chair; and if you’re close enough, physically and emotionally, gently touch the speaker’s arm.

Keep Your Mouth Closed

“Keep your ears and eyes open and your mouth shut!” commanded a boot camp officer in a documentary I made years ago. When I’m about to listen to a friend who needs to talk, I think of that or “You have two ears and one mouth; use them in that proportion,” and remind myself to count to at least two before speaking. (By the way, keeping your lips together still allows you to give that most vital vocal sign, a soft “mmm-hmmm” that shows you are listening.)

Forget Yourself

It’s natural to relate what someone else says to your own experience and respond without thinking (I sometimes call that “blurting”), but considerate listeners keep their focus on the speaker. Even though you may have something important to say, try not to worry about how wise, clever, or empathetic you’d like to appear. Just concentrate on the speaker, which belies your wisdom and compassion more than anything.

Don’t Interrupt

As tempting as it is to interject your thoughts, hold back. It’s insulting to cut someone off when she’s voicing an opinion, but it’s even more hurtful when she’s sharing a feeling, especially a difficult one. When you interrupt, it can feel like a denial or discounting of your friend’s emotions.

Resist Multi-tasking

Most of us have become adept at cleaning off our desks or even checking Facebook while talking on the phone, but if you really want to hear what someone’s saying, it’s a good idea to let go of everything else while you’re involved with your conversation. Even if you’re only cleaning the kitchen counter, it’s easy to get lost in the sponge or the stubborn stain instead of the details of your friend’s story.

Limit Possible Distractions

“I know my own face has fallen when someone listening to me [a caregiver who has trouble even asking for time for myself], stops me in the middle of some gut wrenching moment to answer a call,” said my friend Dana Hopkins, a cancer survivor who took care of her husband when he had cancer. She advises turning off your cell phone when you really want to listen. Not only will it limit distractions, but will signal to the speaker that you’re serious about hearing what he has to say.

Be a Mirror, Not a Window

Listening is not about inviting people into your soul; it’s about entering theirs. To let them know you’re hearing them, reflect back to them what you think they’ve just said, with a “What I think I hear you saying is that…” or “It sounds like what you’re saying is…”

“Mother, May I …..?”

Remember what your mamma taught you? “Say ‘please,’” or in other words, ask permission, especially before offering advice. Sometimes a loved one just needs to vent or talk, and feel heard. They may not want to hear what they should or shouldn’t say, do, or feel, and if you ask, “Would you like my take on this?” you let them know they’re not only being heard but also respected.

Withhold Judgment

When I produced documentaries about homeless people, teen parents, and others facing tremendously difficult life challenges, they easily opened up to me about their deepest fears and desires, and I think it’s partly because I was able to suspend any judgment about them, and just listen with an open heart and mind. Most of us can tell when we’re being judged, and clamp up accordingly.

Don’t Interrogate – Do Ask Gentle Questions

When you question someone too intensely, it can feel voyeuristic – like you’re more interested in learning something than actually hearing someone. So when you do get an opportunity to ask questions, ask open-ended ones that give the speaker a choice, such as “Do you want to tell me more about that?” Encourage your friend to elaborate or discover things themselves by asking, “What did that feel like?” Or “What options are you considering?”

Empathize

In addition to reserving judgment, try to put yourself in your loved one’s shoes. What are they feeling? How would you feel? When you put yourself in that head-and-heart space, you can’t help but listen well; that is when you feel compassion — a word which means “to feel with” – and truly understand.

Lori Hope is the author of Help Me Live: 20 Things People with Cancer Want You to Know. Visit her online at LoriHope.com.

Limitations

By Claire N. Scott, Ph.D.

One of my father’s favorite sayings was:  “You can do anything if you just put your mind to it.” My father practiced what he preached.  Raised in poverty and having only an eighth grade education, he rose to become a successful businessman, lived in an upscale neighborhood and put his three children through college.  My father’s advice and example has served me well.  It has led me to set my sights high, work hard and not give up easily.

Unfortunately, it’s also fostered some not so admirable traits.  On the negative side I developed perfectionistic expectations of myself and over-inflated ideas about my capabilities.  It also created a drivenness that still makes it hard for me to relax.   I saw failures as catastrophic and shameful – and my fault.   On the one hand I had a lot of self-confidence, but I also had a deep-seated hidden fear that I was either lazy or inadequate, or both.  Early on I began to careen between episodes of obsessive drivenness and exhausted self-indulgent collapse.    This lurching and the shame that went with it ultimately led me into therapy.

In therapy I learned to face the fact that I could NOT do anything I put my mind to, but accepting this did not come easily.  To this day I still have to remind myself that it’s okay to have strengths and weaknesses.  I still struggle with finding the balance between what’s reasonable to expect of myself and what’s not.  I love my can-do attitude and I’ve accomplished much.  But I’ve also failed at things, and I’ve found it’s important to be able to acknowledge and accept when I can’t do something as well – and even more that there’s no shame in that.  I tell my clients (and remind myself) that my brilliance is all tangled up with my mistakes.  What a freedom it is to finally believe that!

I’m certainly not the only one who got some version of the perfectionistic drivenness scripting.  We’re faced with a lot of injunctions in this culture about pushing through our limitations:  sayings like reach for the stars, never say never, difficult things take a long time — impossible things take a little longer, energy and persistence conquer all things.  The idea of giving up or saying I can’t is severely frowned upon in this culture.

THE  OPPOSITE  EXTREME

One can also learn to deal with difficulties from the opposite extreme.  We can err on side of denial or minimization of our limitations – or alternatively we can err on side of wallowing in our limitations, using them to excuse our stuckness or lack of effort.  We all have known someone who lets their problems overwhelm them, who gives up at the first sign of trouble, who blames others for their struggles or can’t see that they are handicapping themselves.  Chances are we’ve even been one of “those people” at some point in our lives.  People who say “yes, but” and then recite the reasons that any effort on their part won’t work.  People who won’t start for fear of failing.  People with good intentions who procrastinate or wait for motivation to fall from the sky.  People who, consciously or unconsciously, set themselves up for failure with their self-defeating, negative attitudes.

One explanation for such self-defeating behaviors is learned helplessness, i.e., learning that one shouldn’t even attempt to gain control over or deal with a challenge because the situation is hopeless and they’re helpless to change it.  A good example is a training technique used to control elephants.  A young elephant is chained to an immovable object by a thick, unbreakable chain.  The young elephant tries and tries to get itself loose, to no avail.  After a while the elephant will quit trying.  Eventually the elephant, even when grown and possessing incredible strength, can be held captive by a thin rope tied around its ankle and anchored to a small stake in the ground.  The elephant was “scripted” to understand that its efforts were futile.

Obviously there is a continuum between these two extremes of “You can do anything if you put your mind to it” and giving up before you even try.  Is there an ideal place to exist on the continuum?  Perhaps theoretically, but in reality most of us probably waffle a bit between the two depending on the circumstances and other variables involved.

And other variables there are aplenty, particularly if we mean those variables which act upon us (as opposed to those upon which we act).   Although we are loathe to admit it, the truth is that we are controlled by internal and external forces far more than we can exert control over them.  We prefer to focus on that which we can control and ignore or minimize that which we cannot control.  Pema Chodron talks about the dangers of such denial in her book When Things Fall Apart.  She explains that we are mistaken in our tenaciously held belief that there is any solid ground upon which to stand anywhere.  She points out that we are in fact always building our lives on shifting sands, always in the midst of change, and that we must learn to embrace this impermanence, this lack of security, this “groundlessness” that is the unalterable state of our being.

Teilhard de Chardin, the French philosopher, is eloquent (if frightening) in his description of all the various aspects of human existence which result in groundlessness.  He speaks of the various limitations and “diminishments” as “little deaths” that assail us from within and without:  “…bits of ill fortune that block our way, hem us in, force us to deviate from our path … an obstacle that breaks us, the invisible microbe that kills the body, the little word that infects the mind, all the incidents and accidents of varying importance and varying kinds, the tragic interferences (upsets, shocks, severances, deaths)” that come between us and what we want. There are “natural failings, physical defects, intellectual or moral weaknesses, as a result of which the field of our activities, of our enjoyment, of our vision, has been pitilessly limited since birth.  Others lie in wait for later on:  as brutally as an accident or as stealthily as an illness.  All of us one day or another will come to realize if we have not already done so, that one or other of these sources of disintegration has lodged itself in the very heart of our lives…  And [when it acts upon us] then we impotently stand by and watch collapse, rebellion and inner tyranny.”  (p.81-82)

BALANCE

Learning how to deal with the reality of limitations in a healthy way is not an easy job.  As we have seen there are dangers in dealing with limitations from either extreme – denial or collapse.  It is difficult to find the balance between the two:  a healthy sense of confidence and a willingness to try balanced by a realistic understanding of the limitations and diminishments we all face.  Rudyard Kipling’s poem If (included in this newsletter) offers some wise words on maintaining one’s balance among all sorts of triumphs and trials.

Pema Chodron also has much to say on how to live happily in the midst of our groundlessness.  She says that things routinely fall apart and that to attempt to escape this is folly.

We think that the point is to pass the test or to overcome the problem, but the truth is that things don’t really get solved.  They come together and they fall apart.  Then they come together again and fall apart again.  It’s just like that.  The healing comes from letting there be room for all of this to happen:  room for grief, for relief, for misery, for joy.

When we think that something is going to bring us pleasure, we don’t know what’s really going to happen.  When we think something is going to give us misery, we don’t know.  Letting there be room for not knowing is the most important thing of all.  We try to do what we think is going to help.  But we don’t know.  We never know if we’re going to fall flat or sit up tall.  When there’s a big disappointment we don’t know if that’s the end of the story.  It may be just the beginning of a great adventure.  (p. 11-12)

In an interesting article by the Quaker author John Yungblut, he espouses the idea of “hallowing one’s diminishments” – meaning to make holy one’s diminishments.  He was referring to a creative, intentional attitude toward one’s limitations rather than merely a negative resignation to a cruel fate.   The first step to such a hallowing for him was a “deep-going acceptance.”  He said, “I practiced imaging acceptance of the diminishments as if they were the gift of a companion to accompany me on my way to the great diminishment, death.  … In this case, cooperating with the process in terms of maintaining a friendly attitude toward it would be a way of hallowing the diminishments.”  Hallowing can be thought of as the intentional holding of a limitation or diminishment in a sensibility that neither denies the affliction nor abhors it.   It’s a way of letting go of the emphasis on what has been lost and embracing instead the something new that has replaced it.

In one of the Carlos Castaneda books, the shamanic master Don Juan expresses a similar attitude.  He said we should all live as though “Sister Death” stood slightly behind us and to the left, our constant companion as we journey through life.  Rather than avoid or deny her reality, we should consult her about the choices we make throughout our lives.

Another well known author who echoes this sentiment is Ram Dass in his book Still Here.  You may remember Ram Dass because of his famous (and infamous) departure from the Harvard faculty, with his colleague Timothy Leary, in the 1960’s.  He wrote a book, Be Here Now, which was immensely popular at the time.  His more recent book Still Here was written in 2002 after he had suffered a stroke.  He became a semi-invalid after his stroke, confined to a wheelchair.  He could no longer walk or drive his sports car or play golf or surf.  He acknowledges going through an initial stage of self-pity about being the victim of such a horrible debilitating occurrence.  Ultimately, however, he grew to feel he had been blessed by his stroke.  He referred to it as having been “stroked by God.” He said, “… Now I’m learning to take my healing into my own hands.  Healing is not the same as curing, after all; healing does not mean going back to the way things were before, but rather allowing what is now to move us closer to God.” (p.5)   Although limited in ways he used to value so highly, he has learned to value the person he is now and value life as it presents itself today.

It isn’t always easy to recognize when one needs to slow down and let go or when one needs to step up and try harder.  If we are going to find a good balance and enjoy our lives as much as possible, we need to both accept limitations and reach for the stars.  We have to honor our “can’t do” attitude as well as our “can do” attitude.  Perhaps the most famous and often used words to express this sentiment are found in the Serenity Prayer:

God, grant me the serenity

To accept the things I cannot change;

The courage to change the things I can;

And the wisdom to know the difference.

There are no easy answers to the question of limitations.  I wonder what your experiences with limitations have been like.  When was it healthy for you to push past your limitations and go after your goals?  When was it better to acknowledge your limitations, quit beating your head against a brick wall and learn to accept?  If you’d like to respond to this article and share your own story, please send me an email.  Perhaps we can explore this issue more and publish some of your stories (anonymously of course) in a future article.   ClaireScott@KarunaCounseling.com.

Bibliography

Castaneda, Carlos.  The Teachings of Don Juan:  A Yaqui Way of Knowledge.  Berkeley, CA:  University of California Press, 1968.

Chodron, Pema.  When Things Fall Apart.  Boston:  Shambala, 2002.

Dass, Ram.  Still Here:  Embracing Aging, Changing, and Dying.  New York:  Buckley Publishling Group, 2000.

De Chardin, Teilhard.  The Divine Milieu.  English translation London:  William Collins Sons & Do., LTD, 1960. Originally published in French as Le Milieu Divin.  Paris:  Editions du Seuil, 1957.

Peterson, Christopher; Maier, Steven; and Seligman, Martin.  Learned Helplessness.  New York:  Knopf, 1995.

The Serenity Prayer is the common name for an originally untitled prayer by theologian Reinhold Niebuhr.  This prayer has been adopted by Alcoholics Anonymous and other twelve step programs.

Yungblut, John.  On Hallowing One’s Diminishments.  Wallingford,PA :  Pendle Hill Publications.  1990.

Procrastination

by Melissa Kulick, Ph.D.

If the topic of this article has caught your attention, I’d go ahead and read it now if I were you.  For most people who identify themselves as procrastinators, deciding to come back to it later  is a likely set-up for never getting around to it.

Despite the fact that procrastination is so widely practiced, I find it can also be incredibly misunderstood. Procrastination is often written off as laziness, but it is not that simple. True procrastination involves avoidance and is the result of any of a number of underlying factors or causes, which will be discussed below. If you are looking only for a quick how not to guide for overcoming procrastination, a number of practical tips can be found at the end of the article. I do not advise, however, skipping to this section. Experience has shown that if you don’t identify and address the underlying causes of your procrastination, you will probably procrastinate in applying these strategies, as well.

What Procrastination is Not

Before jumping into a detailed discussion of what procrastination is, it will be helpful to distinguish it from what it is not. There are legitimate reasons for putting an action or activity off and it becomes our responsibility to be honest with ourselves as we assess our motivations. Among the reasons we might delay action for reasons other than procrastination are:

1) When you lack the skill or knowledge to complete a task. You could, however, then procrastinate seeking the required knowledge or informing an appropriate other person of your situation.

2) When you have a legitimate illness or physical problem.

3) Ignorance – When you genuinely lack the awareness of the task or awareness that you have permission to work on it.

4) Situations where there are problems matching personal priorities with those of others. Again, this is where communication is required, and you could procrastinate in delaying this action.

5) Taking of a legitimate break following an appropriate period of activity.

6) Delays based on self-knowledge of your most and least productive work times during your day.

What Procrastination Is

When we talk about procrastination, we are referring to unhealthy putting off or avoidance of tasks, especially those that would be positive or helpful for us to accomplish. To understand (and ultimately overcome) our procrastination, we need to begin to explore what may be the motivation(s) – both conscious and unconscious – behind our choice to procrastinate. (Yes, we are making a choice, whether we experience it as intentional and deliberate or not.)

Why We Procrastinate

The motivations involved are fears and/or negative self-statements related to our self-worth. These fears and self-statements mainly stem from a number of commonly held, though irrational, beliefs. Albert Ellis, a pioneer in the field of rational emotive psychotherapy, proposed a lengthy list of such irrational beliefs. Among those that may impact procrastination are:

1) That it is a dire necessity for us to be loved or approved by virtually everyone we know.

2) That we should be totally competent, adequate, and achieving in every respect if we are to be considered worthwhile.

3) That it is awful and catastrophic when things are not the way we’d like them to be.

4) That it is easier to avoid than to face certain difficulties and responsibilities.

5) That our past behavior determines our present behavior.

6) That there is one right and perfect answer to our problems or situations and that to not find this right answer is catastrophic.

These can be incredibly powerful, foundational, beliefs. If you found yourself nodding in agreement as you read any of these, keep them in mind as we go on to discuss the various fears that may underlie our procrastination

I referred earlier to procrastination as a choice. In many ways, when we choose to procrastinate, we are making a decision based on a cost-benefit analysis; we are determining that what we see as the potential cost of taking action outweighs the expected benefit.

Among the possible reasons for procrastination, fear is a strong motivator of action (or inaction), and can come in a number of forms. It is the combination of fear and issues related to self-worth that fuel most, if not all, of our procrastination.

1) Fear of Failure – Holding a belief that our performance determines our worth (especially if we doubt our ability) can create a resistance to risking taking action (and thereby risking our perceived worth.)

A variation of this fear is Perfectionism. In this case, the only perceived measure of success is perfection, and this can apply both to the finished product as well as to an expectation that the effort involved be smooth and even effortless. Anything less than flawless and/or easy is seen as failure – and you become a failure, particularly in your own eyes

2) Protecting an Image of Competence – There are two forms this can take:

Novice Phobia – The fear of putting yourself in a new or novel situation and in the position of being a learner, and therefore not perfect or immediately competent. If I can’t do it right or perfect the first time, I won’t even try it. The anticipated cost, again, is a loss of perceived (by self and/or others) worth.

Fantasy of Competence – Avoiding facing a challenge directly by failing to prepare adequately for it, putting out a full effort, or giving yourself an adequate amount of time to complete it. This strategy, called self-handicapping, allows us to continue believing that we would have done a fantastic job if only we’d tried harder or had more time.

3) Fear of Success – Fearing unwanted anticipated consequences of success: that significant others in your life will be envious or threatened and reject you; that you will continue to be expected, by yourself or others, to maintain or achieve success; or that you or others will want even more from you. The cost of action, of course, is the negative consequences for you.

Another way that the fear of success can lead to procrastination is as a direct expression of a lack of self-worth. We avoid taking action that would be helpful to us because we do not believe we deserve to have, be, or achieve whatever the action would allow us to. This is a form of self-sabotage.  We undermine ourselves. This is also expressed as not seeing ourselves as worth the effort that may be involved in certain activities, regardless of the size of the task (e.g., brushing our teeth.).

4) Rebellion – One other motivation for procrastination stems from a desire to resist authority. Procrastinating in this case allows you a sense of power and control. The perceived cost is that working means submitting to someone else and giving up power.

Overcoming Procrastination

To overcome procrastination you need to address the motivation for your procrastination and honestly confront the question of whether you have a genuine desire to change your patterns. You need to ask yourself if you are motivated by the Pleasure Priority and, if so, if that is how you want to live. If your real priority in life is to have a good time, and you’re genuinely okay with that, then you need to stop kidding yourself and give up unrealistic fantasies of achievement; that’s not what fuels you. If you’re starting from this place but are wanting to work toward more of a balance between having a good time and being successful, a place to start is to recognize the need to learn how to delay gratification and work toward a later payoff.

To allow yourself to let go of the fear of failure and the paralyzing effect of perfectionism, it is very important to make the distinction between what we do and who we are. Our actions do not determine our worth. It is also important to remind ourselves that >we can not control others perceptions, opinions, thoughts, feelings, or actions.

A novice phobia can be addressed by remembering that we are all novices at everything at some point. When we allow our actions to be controlled by this fear, we are trying to protect an unnecessary false pride. If we do away with this pretense, we won’t have to spend all that energy maintaining a front that only limits us in the long run, by depriving us of the chance to learn and grow.

If you find yourself protecting a fantasy of competence, put your abilities on the line – repeatedly. You can then assess your true capabilities. You may have to give up unrealistic expectations or fantasies, but these weren’;t going to be fulfilled, anyway, if you continued to avoid and procrastinate. This will allow you a realistic sense of your strengths and weaknesses (we all have them), which will then enable you to set realistic, accomplishable goals for yourself.

If you find yourself procrastinating as a way to express resistance or as an act of rebellion, know that this is an indirect, passive-aggressive, way of expressing or achieving control. Set a goal for yourself of learning to deal with interpersonal difficulties in a direct manner and of seeing where your choice lies in situations. You likely have valid experiences and emotions that deserve to be acknowledged and expressed.

If you realize you are battling a fear of success, know that you are fully entitled to success and fulfillment. It may be helpful to explore the messages you hold inside you that tell you otherwise, as they can be indicators of tender spots within you that could benefit from some compassionate attention. Also remember that you can’t control others thoughts, feelings, etc. If, upon honest examination, this fear appears to be reasonable in a particular situation, ask yourself what steps you might be able to take to address the issue directly and/or whether this is a symptom of unhealthiness in a relationship.

In the case of self-sabotage, at the risk of sounding trite, awareness really is the first step. Acknowledge that this is forming the motivation for your choices and actions, and work on believing that you <u>are</u> worth the effort and do deserve to have, succeed, achieve, take care of yourself, etc. Practice. Don;t let a novice phobia get in your way here, either. It will be natural for resistance to come up as you begin to try on this new way of relating to yourself. That;s okay. There;s an approach used in the 12-Step recovery programs that you can borrow, which is to fake it til you make it. I prefer a slightly different wording, however. Ask yourself what you would do if you actually believed you deserved success or happiness, and then let yourself do it.

Behavior can be a powerful tool in identity formation. Not only do our beliefs about who we are or are not impact our choices regarding the actions we will and will not take, but our actions can create a picture of ourselves that can aid us in our future efforts. This is one way in which acting as if can be very helpful. If you start, for example, doing the dishes after each meal or beginning to read an assignment the day it is given (regardless of any internal pull to put it off), and you see yourself doing this repeatedly, your internal image of yourself begins to shift from someone who lets dishes pile up in the sink or someone who leaves assignments until the last minute to someone who does their dishes right away; or someone who gets a jump on their assignments. These internal ideas of who we are, while they do not define us, can definitely affect the choices we make.

Low self-worth and procrastination form what can be a debilitating vicious cycle where we start out feeling bad about ourselves and so are unmotivated to engage in positive action on our own behalf and we procrastinate and this only reinforces and increases our negative thoughts and feelings about ourselves, leaving us even less likely to act productively the next time. Break this cycle any way you can.

Self-compassion is going to be an important element as you work to change the habit of procrastination. Remember that procrastination as a style of approaching life tasks is an ingrained pattern that took a long time to develop, has been practiced repeatedly, and has been reinforced by (often lots of) internal messages. You should realistically expect that it could take some time to throw off such a well-rehearsed way of being. Many people find it helpful to address some of the obstacles they face in overcoming procrastination, especially their negative or restrictive internal messages and fears, over time and with a trained therapist.

Some Practical Suggestions

Sometimes we procrastinate starting a task because we feel overwhelmed by the seeming enormity of what we must accomplish. When this happens, the most effective approach is to break down the task into more manageable pieces, and this can be done by either dividing the task into individual steps and taking each step one at a time, or by breaking down the time spent working into small segments, contracting with yourself to work for even just minutes at a time. You can then consider renewing the contract once you’ve done that much.

Other things you can do include: creating structure by establishing a set time for a routine – by doing this you are building a new habit; modifying your environment to make it more conducive for working, or moving yourself to more favorable location; go ahead and do it when you think of it; make the most of momentum when you have it – keep going, even if it involves switching tasks; set up reminders for yourself if necessary; create a contract for yourself that includes both a work plan and a reward for yourself.

The most important thing is to start; start taking more responsibility for yourself (and seeing yourself as response-able) and start being more compassionate with yourself. Be both honest and gentle with you; you are a work in progress. And you are worth the effort.

Managing Anxiety and Depression Using Diet, Nutritional Supplements and SAM-e

by Darby Christopher, LMSW

Please note: This article should not be taken as advice for how to treat any particular condition. Individuals should always consult with their doctor before making any lifestyle or dietary changes, as some natural substances are harmful to specific medical conditions. Never stop taking any prescription medication without the advice and care of your doctor.

 

Introduction

The decision of whether or not to take prescription medication for anxiety or depression is a personal choice an individual makes based on many factors. This choice is made in conjunction with a doctor and often with the help of a therapist. For many individuals, prescription medication is not only a good fit, but the best fit for their particular constellation of life experiences, genetics and environment.

This article is written for individuals who, with the help and consultation of their doctor and therapist, would like to try to use diet and dietary supplements to manage their issues with anxiety and depression without, or in conjunction with, prescription medication. It is also intended to provide information for individuals to explore more fully on their own and with their doctor and therapist.

There are many factors that can affect a person’s mood and energy level, such as diet, proper rest, psychotherapy, exercise, spiritual practices, environment and relationships. This article will focus on diet and biochemistry, while acknowledging that each of these areas are interconnected and equally important.

Why Nutrition Matters

Our bodies need well functioning neurotransmitters, such as serotonin and dopamine, to experience enjoyment, relaxation, focus and motivation. From a holistic perspective, many factors aside from nutrition can affect how well our bodies are able to produce these chemicals. Yet, inadequate nutrition will result in a diminished ability to produce the chemicals we need to feel good. (Inadequate nutrition may result from a tainted food supply, lack of affordable healthy food, absorption problems in the body, and misinformation or inattention to diet.)

What our Bodies Need Nutritionally to Make Feel Good Chemicals

According to Dr. Charles Gant, author of End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, there are four primary groups of neurotransmitters that are responsible for feelings of well being, relaxation and focus. They include endorphins and enkaphalins, serotonin, GABA, and dopamine and norepinephrine. (Serotonin also contributes to an ability to sleep well.) What our bodies need is to ingest the nutrients necessary to manufacture these items. So, what are these nutrients?

Let’s start with serotonin. Specific cells in our bodies manufacture serotonin using the amino acid tryptophan, working in conjunction with vitamin b6, vitamin c, folic acid and magnesium. Some foods that contain tryptophan include cheese, soy products, seafood, meat, poultry, whole grains, eggs, beans, peanuts and sunflower seeds. Some foods that contain vitamin b6 include tuna, bananas and a variety of green vegetables.

GABA, a neurotransmitter that promotes relaxation, is produced from the amino acid glutamine, working with vitamin b6, vitamin c and magnesium, among others. Foods that contain glutamine include chicken, fish, eggs, beef, beets, dairy, beans and cabbage. A wide variety of fruits and vegetables contain vitamin c, and magnesium is found in specific beans, seeds, fish and green vegetables.

Tyrosine is an important amino acid that contributes to the production of dopamine. Food sources of tyrosine include fish, chicken, pork, whole grains, dairy, beans, nuts and seeds.

The reader may have already noticed that the common admonition to eat a wide variety of fruits, vegetables, whole grains and proteins applies to managing anxiety and depression. As the intention of this article is to provide a broad overview, the above examples are illustrative. The reader is encouraged to research and explore more of the specific proteins, vitamins and minerals that manufacture the various neurotransmitters and which foods support their production.

The Benefit of Whole Foods

Because many of the nutrients that our bodies need to manufacture neurotransmitters now come for sale in a bottle at our neighborhood stores, a word about eating whole foods is in order. In their book Paradox & Healing, Dr. Michael Greenwood and Dr. Peter Nunn discuss the Chinese Traditional Medicine (CTM) concept of “Qi,” or, energy, that is a part of whole foods. They contend, “ …it is the “whole” herb or food which has the Qi and its strengthening properties, not any isolated extract which is called for. In other words, the difference between taking vitamin C in capsules and eating fruit which contains the vitamin is profound.” Recent research into the benefits of phytonutrients found in whole fruits and vegetables corroborates the concept of Qi.

Likewise, in his book Food Rules, Michael Pollan says that, “Foods are more than the sum of their nutrient parts, and those nutrients work together in ways that are still only dimly understood.”  Pollan is a reporter who set out to investigate all of the competing dietary claims in the media. He discovered a very simple truth, which is that the Western diet, with all of its processed foods that he calls “edible foodlike substances,” makes people sick, and traditional diets, no matter what whole, natural foods they consist of, promote wellness. Pollan sums up his discovery of what we should eat in what he calls seven simple words: “Eat food. Not too much. Mostly plants.”

Supplements

Having made a case for the benefit of whole foods, our attention will now turn to the possible benefits of nutritional supplements that come in bottles. Just as in some cases prescription medicine is indicated, there are cases also where nutritional supplements, under a doctor’s supervision, are beneficial. These situations might include cases of nutritional deficiency, attempting to overcome an addiction, as advocated by Dr. Gant, or as a personal preference to combat the effects of anxiety and depression.

Many studies have shown and proven the efficacy of treating various conditions with nutritional supplements. Conversely, concern for supplement use may include the body subsequently under producing the item being supplemented, or other imbalances. (Always consult a doctor when considering nutritional supplements, as they can be harmful or even fatal in excess amounts or when combined with certain conditions.)

Of the many supplements on the market today, a few examples will suffice here. If increased serotonin is desired, a product called 5 HTP may be indicated. The amino acid tryptophan turns into 5HTP in the body along the way to making serotonin. GABA can be purchased directly, as can the amino acid tyrosine, which the body uses to make norepenephrine and dopamine. Fish oil aids in overall brain health, and multivitamins enable the chemicals in our body to do their work.

Inositol is another nutrient for sale that contributes to brain health and helps the body metabolize nutrients. Dr. Fred Penzel reports success in his studies with inositol and trichotillomania (hair pulling), to cite one example.

Herbs, such as St. John’s Wort and hormones, such as estrogen, testosterone and thyroid, are also sometimes indicated in the treatment of depression. As with any supplement, careful attention must be paid to combining herbs and hormones with other treatments, and should take place only under a doctor’s supervision.

SAM-e and Methylation

A popular and increasingly well known product on the market today is SAM-e, which is a naturally occurring substance in the body whose function is to act as a catalyst promoting the chemical reactions that allow the body to produce desired substances. These chemical reactions are known as methylation pathways. SAM-e’s benefit is in taking the raw materials available in the body and producing the desired result, including the regulation of neurotransmitters. Many studies have shown the benefit of SAM-e to alleviate depression.

Conclusion

Individuals who are seeking ways to address their anxiety and depression without or in conjunction with prescription medication may find that a well balanced regime of exercise, meditation, proper rest, social support, work with a therapist, and attention to diet may give them the help and relief they are looking for. For the diet portion of this plan, whole foods are essential. Supplements can be added under a doctor’s care and may be beneficial, but do not take the place of whole foods. Informed consultation with a doctor or therapist may help determine an individual’s best course of action, and some trial and error may be expected along the way to discovering what combination of elements will work best.

Bibliography and Recommended Reading:

Food Rules, by Michael Pollan

End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, by Dr. Charles Gant and Dr. Greg Lewis

Paradox and Healing: Medicine, Mythology & Transformation, by Dr. Michael Greenwood & Dr. Peter Nunn

Web site, The World’s Healthiest Foods, http://www.whfoods.com/

Web site, The Podell Medical Practice: Merging Traditional Medical Practice and Alternative Therapies, http://www.drpodell.org

Practicing Yoga Off the Mat

by Dr. Melissa Kulick, Ph.D., RYT

While the physical practices of yoga have enjoyed increased popularity in the west over the past several decades, yoga is, in fact, an ancient philosophy and spiritual approach to being.  The word “yoga” comes from the Sanskrit word yuj, which means “to yoke,” and is often translated as “union.”  Yoga is an interfaith practice, meaning it does not require the practitioner to hold any particular spiritual or religious belief — or any at all.  It simply encourages us to adopt a certain way of being with ourselves, both on and off the mat.

When we practice yoga on the mat we are looking for that place in each asana (pose) where we find our “edge.”  The edge is any physical, mental, or emotional experience that is challenging to us without being overwhelming; a place of effort and engagement but not strain.  It is the challenges we encounter that allow us to stretch and grow.

Finding our edge in a given moment or situation allows us to feel safe and remain open — to be present exactly where we are — as we encounter life’s challenges.  For someone faced with a huge task that leaves them feeling stuck in avoidance and procrastination, finding their edge may mean breaking the task down into small, manageable pieces, or allowing them to set time limits for themselves on each work session.  For someone confronting an addiction, it might be asking a trusted friend to accompany them to a first twelve-step meeting.  Staying mindful of our edge in a given moment is crucial in creating an optimal working environment in psychotherapy — where the safety exists that allows for deep transformational work to occur at pace where one stretches and grows without feeling overwhelmed.

On the mat, it is said that we are not ‘practicing yoga’ if we are attempting to force a pose – to push our body beyond our edge. If we are experiencing pain (as opposed to the sensations of a tight muscle experiencing a stretch, or feeling a pose in a joint) or if we are not able to maintain steady breath in our posture, then we are likely forcing our bodies beyond a state of wellness and balance.

Learning – encouraging and training ourselves – to recognize when in our lives we are attempting to force something to happen, is a valuable tool. A great deal of tension and unhappiness is caused when we try to control outcomes (by some form of ‘scheme’ or manipulation) or ignore obstacles and resistances that are telling us that the direction in which we are trying to move is not in our best or highest interest. Yoga teaches us to turn to and within ourselves, and become better attention-payers to the messages available to us – to our breath and body, and to the more obvious and subtler voices of our intuition.

Mindfulness is a central component in the practice of yoga, often referred to as developing the witness mind.  The witness mind simply observes the thoughts that fill and move through our head, as well as the sensations in, and movements of, our bodies.   As witness, we are taking note of — compassionately.  What we are not doing is judging or comparing, though we may well notice that the thoughts running through our mind in that moment are doing just that (e.g., “She’s so much more flexible than me.  I stink at this.”)  You might also notice that your thoughts have jumped right out of the current moment, for instance to what you are going to eat for dinner that night.  When our witness mind observes that we have engaged in judgment or left the present moment, it simply names the experience “judging” or “not present” and returns to focus on the pose and on the breath — with compassion and without judging where we’d just been.

The physical practice of yoga on the mat can literally be ‘practice’ for living that same way of relating to ourselves off the mat.  After experiencing our witness mind on the mat, we may find ourselves having difficulty completing a task at work and notice we have begun to berate ourselves inside our head. Once we have noticed and acknowledged the thought, we can simply take a breath and let it go, returning to the task at hand. Or we may be engaged in a conversation with a good friend who is telling us about some fabulous trip she has planned, and we hear some petty or jealous thought line begin.  Again, once we are aware of the thoughts, we can choose to simply acknowledge their presence and let them go, without further indulging them or putting ourselves down for having them.

When we practice yoga on the mat we experience poses, and our bodies in poses, differently from day to day.  I have heard it said that we bring a different body to the mat every day.  Yoga teaches us to be unattached to — and not defined by — the body we brought to the mat yesterday or might bring tomorrow. “Beginner’s mind” is a term often used to refer to this coming to the mat without any assumptions, needs or expectations of what we will encounter or experience there. We use our witness mind or our beginner’s mind in the course of our daily lives when we similarly notice the stream of thoughts running through our heads and the movements and sensations of the body, and choose not to identify with, buy into or react to them.  We are not our thoughts, any more than we are the bodies we bring to the yoga mat or elsewhere.

The Breath

One of the primary things that set yoga apart from other forms of physical exercise is its focus on breath awareness.  Movements are linked with inhalation and exhalation, and the release of exhalation is often used to help us more deeply open into a pose.

The breath is a most powerful tool for helping us stay in the present moment.  My guru (yoga is historically an oral tradition passed from guru to chela, or student to teacher) teaches that, “If you can control your breath, you can control your mind. If you can control your mind, you can control your life.” By practicing breath awareness both on and off the mat, we gain the ability to practice another yogic tool, hesitation.  It is hesitation that allows us the moment to choose non-reactivity, non-judgment and compassion.

When you bring awareness to the breath, it becomes prana. Prana is life force energy.  There are many practices in yoga, called pranayama, which means “control of the life force”, that allow us to effect the flow of pranic energy within us.

One great way we can take our yoga practice off the mat is by practicing pranayama, or breathwork, wherever we need it.  Here are some basic techniques you can try when needed:

Ida Breath and Pingala Breath

Our nasal flow can have a lot to do with our energy.  There are three main energy channels that run along our spine.  The sushumna is the central channel and correlates with our spine.  The ida is the path of the left nostril.  Its energy is associated with the moon, and is gentle, cooling, and inward.  The pingala is the energy of the right nostril.  It is associated with the sun, and is more, fiery, outward, and strong.  Our typical breath is such that one nostril is dominant for a little less than two hours at a time, and then it is switched to the other side.

Ida Breath

Because the ida channel is gentle, cool and soothing, this breath can be used in situations where we are feeling anxious, overheated, or needing to calm or steady the mind.  It is also helpful for insomnia.

Technique:

Sit in a comfortable position with the spine upright and long.  Using the right hand, keeping the palm flat and fingers together, raise it up and use the thumb to block the right nostril.  Take long, deep breaths through the left nostril only.  You may want to begin with practicing this for 3 minutes and build up to 11 minutes.  If you start to feel your energy getting out of balance, you can restore balance with a right nostril breath.

Pingala Breath

Because the pingala channel is powerful, hot and dynamic, this breath can be used when we need to stimulate or increase our physical or mental energy.

Technique:

Sit in a comfortable position with the spine upright and long.  Using the left hand, keeping the palm flat and fingers together, raise it up and use the thumb to block the left nostril.  Take long, deep breaths through the right nostril only.  You may want to begin with practicing this for 3 minutes and build up to 11 minutes.  If you start to feel your energy getting out of balance, you can restore balance with a left nostril breath.

Ujayii Breath

Translated as the “victorious breath,” the ujayii breath is a breath commonly encouraged of practitioners to maintain throughout their asana practices. Also referred to as “the ocean-sounding breath” for the sound created in its practice, this breath is considered the most effective yogic breath for reducing stress and anxiety.  The sound, itself, can be incredibly soothing.

Technique:

The breath is like sighing with your mouth closed. Begin by inhaling through your mouth making a sighing sound and, while still inhaling, close your mouth. See if you can still hear the sound. You’re essentially drawing breath across the back of your throat, over the glottis. As you exhale, begin again with your mouth open making a sighing sound, then continue the breath as you close your mouth. Once you feel comfortable with it and can hear the sound on both the inhale and exhale continue the breath with your mouth closed only. This breath can be done as a regular practice for a set amount of time (e.g., 3 or 11 minutes) or can be done at any time during your day when you are feeling a need to bring greater calmness to your being.

Karma Yoga

Here’s one final note on another fabulous way to practice yoga off the mat.  As mentioned earlier, yoga is a thousands-year-old philosophy of being.  One path of yoga, karma yoga (karma literally translates as “action”) focuses on the performance of seva, selfless service, as a path to enlightenment and liberation.  Even if enlightenment and liberation are not what you are after, I honestly know of no better way to pull myself out of a crappy mood than step outside myself and give to/help/serve someone else. To quote a swami I know, it’ll help you “get over your cheap self.”  You can do this in a large way by volunteering your time to feed or serve the poor or ill, but you can also do this by making the effort to hold the door for the person coming out of the store as you’re going in, or by making a point of smiling, making eye contact with, and saying hello to people you pass on the street — without being attached to the response.  It costs us nothing.  And since, as another yogic teaching tells us, “energy follows thought,” holding that openness of thought and heart toward others will create an open flow of energy within our own being.

On or off the mat, you need to be nothing but the truth of who you are in this – and every -  moment.

Namaste.

Recommended Reading

Bringing Yoga to Life by Donna Farhi

Yoga and the Quest for the True Self by Stephen Cope

In addition to her psychotherapy practice, Melissa, who is a certified teacher of Classical Yoga and Kali Natha Yoga, is also developing yoga sets specifically designed to address various mental health issues.

Transitions

by Lisa Anyan Smith, Ph. D.

“I watch the ripples change their size
But never leave the stream
Of warm impermanence and
So the days float through my eyes
But still the days seem the same”

~ David Bowie, “Changes”

Change is an inevitable part of life.  Transitions are all around us – births, deaths, graduations, anniversaries, moving to a new residence, marriage, divorce.  Beginnings and endings are occurring constantly.  Some are small and mundane:  the ringing of the alarm clock to signal the start of a new day, or the finishing of a good book.  Some are major and catastrophic:  the destruction of the World Trade Center buildings, or the recent earthquakes in Haiti and Chile.

Some changes are initiated by us, while others are imposed upon us by outside forces, or seemingly fall from the sky out of the blue.  Some transitions feel more welcome and comfortable than others.  Some feel downright unpleasant.

What can we learn from change?  Perhaps the answer, in part, lies in chaos theory.  While musing about various changes I have experienced over the past year, I came across a book entitled “Seven Life Lessons of Chaos:  Timeless Wisdom from the Science of Change,” by John Briggs and F. David Peat  (New York:  HarperCollins, 1999).  The scientific term “chaos” refers to an underlying interconnectedness that exists in apparently random events.  Briggs and Peat deftly relate some of the complexities of chaos theory to everyday life, and I would like to share some of their lessons with you.

Lesson One:  Being Creative In each moment, we have the opportunity to let go of prejudices and automatic habits.  This letting go frees us to be open to the power of uncertainty, and thus creativity.

Lesson Two: Using Butterfly Power Chaos theory suggests that each one of us possesses the power of “subtle influence,” much like the idea of a butterfly flapping its wings on one continent that leads to hundreds of thousands of tiny interconnected events that culminate in a hurricane on another continent.

Lesson Three:  Going with the Flow Consensus decision-making models involve much deliberation and discussion before an agreement is reached.  The process can feel chaotic.  However, when a decision is reached, all parties claim ownership and are committed to the decision.

Lesson Four:  Exploring What’s Between Chaos theory holds that life is both simple and complex.  When life seems most complicated, a simple solution may be just around the bend.  Conversely, what appears simple on the surface may be incredibly complicated.

Lesson Five:  Seeing the Art of the World Chaos is as much about art as it is about science.  William Blake urged us to …”see the world in a grain of sand, and an eternity in an hour…”  While observing birds, squirrels, and chipmunks at your backyard feeder, you may notice that although there are repeating patterns, something unexpected and random occurs that keeps you engrossed.

Lesson Six:  Living Within Time Rather than thinking of time as a one-dimensional line running from past to future, chaos theory allows for elasticity in time.  I especially enjoyed the story of monk who stops to listen to the beautiful singing of a bird in the woods.  Upon returning to the monastery, he discovers new faces.  While he was listening, all his friends died and an entire century passed.

Lesson Seven:  Rejoining the Whole To live deeply and fully, we seek awareness.  Yet as soon as we sense that we are seeking, awareness escapes our grasp.  Chaos theory, as applied to change, requires that questions remain unanswered.  Perhaps we learn more from the journey, than when we reach the destination.

So how can chaos theory impact our everyday life, and what does it have to do with change?   Well-known to those participating in recovery programs is the Serenity Prayer, which asks  “…grant me the serenity to accept the things I cannot change; courage to change the things I can, and the wisdom to know the difference.“   While we strive to effect positive changes from within, and struggle to adapt to changes that appear from without, we can remind ourselves that chaos does not necessarily need to be tamed.  Sometimes the path of least resistance is the way we are meant to follow.  Yet “least resistant” is not synonymous with “easy.”  Although we may not be able to make order of chaos, we can find calm within the storm.

“When we can no longer change a situation, we are challenged to change ourselves.”

~ Victor Frankl