How do I find a good counselor?
By Lissa Carter, LCMHC
Update, 3/7/22: I’m delighted to announce the addition of Julie King Murphy, JD, NCC, LCMHCA to our practice! Julie is accepting new clients and is seeing people in person and via telehealth. Learn more about Julie here.
I’ve been receiving inquiries from a lot of wonderful people lately, people who are attempting to prioritize their mental health and are struggling to find a counselor to work with. Sometimes I wish that I could work with every single person who reaches out to me. I hate it when my practice is full and I have to turn people away, even though I know there are thousands of wonderful counselors out there, many who might be an even better fit than I would have been. I hate it because I know that, when a person is struggling and suffering, even the tiniest setback can feel insurmountable, and when your vulnerable request for help is answered with a formulaic “I am not accepting new clients right now” the feeling of rejection could be enough to stop you from trying again.
Let me start by stating an unfortunate truth: finding a counselor is not an easy process. It is not a simple process. And ever since the COVID-19 pandemic, finding a counselor who has openings for new clients has been more difficult than ever.
I’m hoping this post can offer, at the very least, some answers to the questions that people looking for a counselor ask most frequently---and the ones they might not know how to ask. I’m hoping it can demystify mental health lingo, empower you to ask for what you need, and offer you a sense of greater agency in both the search for a counselor and, later, within the counseling relationship.
I’ll pose questions in the likely order you would need to ask them, as you engage in the process of finding a counselor for yourself or someone you care about.
Would a counselor help me?
In general, if you are experiencing difficulty in familial, intimate, or work relationships, overwhelm, anxiety, depression, grief, anger, a sense of futility, a sense of helplessness, attacks of panic, self-loathing, seeing or hearing things that others don’t see or hear, role changes (such as becoming a parent, losing a child, divorce, marriage, loss of a parent, dramatic change in career, health, or identity), discomfort in your relationship with substances, food, sex, media, alcohol, and/or other coping mechanisms, confusion about your own behavior patterns, or a sense that accustomed methods of handling emotions and thoughts are no longer working for you, counseling can help.
If you are feeling dissatisfied with your career, education, or finances; or you are struggling in a specific area of life that has more to do with a deficiency of skills than with emotional or mental problems, you might be better served by seeking out an employment, financial, or life coach, or by taking a class that will teach you the necessary skills. If you are being targeted, bullied, profiled, or abused, legal recourse followed by counseling might be the most helpful course of action.
Will counseling take away my symptoms? Or should I seek medication first?
If your anxiety, depression, helplessness, or thoughts/beliefs/feelings are so debilitating that you cannot realistically engage in the process of counseling, you might consider medication as a first course of action. Talk to your primary care physician or psychiatrist (if you have one) about how you are feeling and ask if medication can help. Studies show us that a combination of medication and counseling is more effective, in most cases, than medication alone, so once you are feeling regulated enough, revisit the idea of counseling.
Another caveat here—counseling actually won’t take away your symptoms. A good counseling relationship is more about learning new ways of relating to your thoughts, feelings, relationships, and behaviors. Can counseling change your life and offer you relief? Yes. Will you walk away from counseling and never experience anxiety, depression, or suffering again? No---because these experiences are part of being human. However, a good counseling relationship can help you handle these experiences in a much more compassionate, much less debilitating way.
Okay, I think counseling can help. Where do I start?
There are several important considerations here. I’ll take them one by one.
a. Financial investment.
Do you have insurance? If so, you may want to call your provider and learn what their mental health copay is. Ask if you can see mental health providers that are out of network, and if so, what the increase in your cost would be. Ask if seeing a mental health provider will cause your insurance provider to mark you as having a “pre-existing” health condition that will increase your insurance rates. Ask if your insurance has limits on the number of mental health sessions you can engage in per year, and if you have to meet a deductible before they start paying for mental health. Ask if they cover the issue you will be seeking help with (most insurances—don’t get me started—won’t cover family or couples therapy at all). If you know you want to use your insurance, the first place to start your search for a counselor is through your insurance provider’s database of in-network counselors.
Are you uninsured? Check into free local programs; the VA offers free counseling for veterans and many nonprofits offer free counseling to certain populations. Call 211 or visit https://www.211.org to discover local nonprofits offering counseling in your area. You can also ask if your school or place of work offers counseling; many universities and schools have onsite counseling and increasingly the workplace offers EAP or EAN (Employee Assistance Plan or Network) services with anonymous free counseling. You can also try https://openpathcollective.org , an alliance of counselors that offer low-cost, sliding scale counseling to the un- or under-insured.
On search tools like https://beingseen.org, https://www.therapyden.com, https://www.atherapistlikeme.org, and https://www.psychologytoday.com/us, you can search for a therapist that accepts your insurance. You can also filter by licensure type and modality (see below) and check to see that the therapist practices in-person or telehealth, is accepting new clients, and/or has experience with the particular issue you hope to address.
b. Licensure.
Licensed counselors have completed rigorous education, supervision, and testing processes and maintain ongoing continuing education. I cannot overemphasize the importance of making sure that your counselor is licensed. Licensure is separate from education—you can complete a master’s degree in mental health counseling, psychology, or social work without attaining licensure.
That said, there is an alphabet soup of licenses that can make it really difficult to know what to look for. Here’s a quick glossary: For every licensure, there is an associate level (such as LCAS-A, LPCA, LCMHC-A, LCSW-A, and so on) which means that the counselor has passed a counseling exam and is under supervision while they accrue the hours of experience necessary for full licensure. Then there is the full licensure level (LCSW, LCAS, LPC, LCMHC, and so on) and the supervisory licensure level (LCMHCS, CSI, and so on) which means the counselor has undergone additional training to supervise other counselors.
Very generally, you would seek an LMFT (licensed marriage and family therapist) if you are interested in couples or family counseling, an LPC (licensed professional counselor) or LCMHC (licensed clinical mental health counselor) if you are interested in mental health counseling, an LCAS (licensed clinical addictions specialist) if you are interested in substance use counseling, and an LCSW (licensed clinical social worker) if you are interested in mental health counseling with a larger systems/case management approach.
However, you may come across LCMHCs who are highly trained in couples and family work, LCSWs who specialize in somatic and trauma work, LMFTs who specialize in working with adolescents, and so on. We’ll cover trainings and modalities in the next question. However, if you have found a counselor and they are licensed, you can certainly ask them about their training and experience in the specific issues you are seeking help with. For a more comprehensive glossary of mental health titles, go here: https://www.networktherapy.com/directory/credentials.asp
If you know you want to see a therapist with a specific licensure, start your search by googling the licensure board for your state (i.e.; north Carolina licensure board for marriage and family therapists, or California licensure board for clinical addiction specialists). Most licensure boards keep a directory of therapists licensed in your state.
c. Modality
To complicate things further, counselors train in specific modalities after completing their general education. These modalities may target a specific issue, or they may constitute a broad theory/approach to counseling.
You may be drawn to a specific modality because studies show it is the most effective for your particular set of symptoms, such as DBT (dialectical behavior therapy) for the diagnosis of borderline personality disorder; or ERP (exposure and response prevention) for a diagnosis of obsessive-compulsive disorder; or EMDR (eye movement desensitization and reprocessing) for single-incident traumas.
Or you may be drawn to a specific modality because it matches your comfort or interests (Expressive Arts therapy for the creatively inclined, dance or movement therapy for those who prefer to process nonverbally, SE (somatic experiencing) for those who prefer to go inward and connect with the wisdom of the body, narrative therapy for those who enjoy writing and metaphor, etc. )
There are so many modalities that I cannot begin to do them justice here. Browse this list to learn more: https://www.goodtherapy.org/learn-about-therapy/types
If you have worked with a therapist you particularly enjoyed, ask them what modality or theory they practiced.
If you know you want to work with a counselor trained in a specific modality, you can use any of the popular therapist search engine tools like https://beingseen.org, https://www.therapyden.com, https://www.atherapistlikeme.org, or https://www.psychologytoday.com/us and filter your search results by the modality you want. Make sure to follow up by asking the counselor, during your consultation, what training they have completed in that modality.
I found a licensed counselor who works with the modality that interests me. Now what?
First of all, I highly recommend that you start with a short list of 3 to 5 counselors instead of just choosing one. This will empower you to find the best fit instead of pressuring you to stay with the first counselor you call. It will also help keep the ball rolling if you hit a scheduling roadblock or discover that the counselor you hoped to work with has no openings. Let’s be real: the process I am describing is a ton of work at any time, and when your mental health is suffering it can be downright exhausting. You don’t want to lose steam and give up because the one person you picked is nonresponsive or doesn’t feel like a good fit.
Visit the website of the counselors you have picked out (again, use sites like https://beingseen.org,https://www.therapyden.com, https://www.atherapistlikeme.org, https://www.psychologytoday.com/us and https://openpathcollective.org to generate leads) and read some of their blog posts and how they describe their work. Does it feel like a good fit? If not, trust your gut and move on.
If you like what you see, and the counselor is licensed and accepting new clients, schedule a consultation with them. Most counselors offer a free consultation by telephone, telehealth, or in person. Usually you can book this directly on the counselor’s website or by calling them.
Again, make sure you schedule at least 3-5 consultations so you don’t feel pressured to go with a counselor who might not be a good fit. Shop around. The highest predictor of success in mental health counseling is a good therapeutic relationship, so you really want to pick someone you feel comfortable with, not just the person with the most years of experience or the best-sounding degree or the most polished website.
What should I ask the counselor during the consultation?
The most important advice I have here is this: Remember that you are interviewing them. Sometimes an odd power dynamic arises in therapy where the client can feel as though the counselor is the expert and has all the power. Try to remember that this is a job interview, and you get to decide if you want to hire this counselor.
Don’t be afraid to ask questions about cost, frequency, and scheduling. Trust your sense of whether this person is warm, compassionate, and nonjudgmental enough that you would feel safe talking about vulnerable feelings and experiences. If you have had bad experiences in counseling before, bring that situation up as a hypothetical and ask how the counselor would handle it. For example, “if a client came to you and shared that they were feeling angry enough to hurt a family member, how would you handle it?” or, “if a client shared a difference of opinion or a critique with you in session, how would you handle it?” Ask about the counselor’s experience with the issue that you are struggling with, and ask about their training in the modalities that interest you.
Make sure to assess whether the counselor has openings that fit your schedule, accepts your insurance, and meets in person/via telehealth (whatever your preference might be). Don’t be afraid to ask about their safety protocols for COVID, or whether their office is ADA-accessible.
The most important thing is that you feel comfortable with the counselor you choose. We can’t do good work with people we do not feel comfortable with. I would even go so far as to say that you should feel the counselor genuinely cares about you as a person and is interested and curious about what you have to say. Whatever their level of expertise, it is only as good as their ability to communicate and share it with you.
What if I find more than one counselor I like?
There are many incredible counselors out there! One question that can help you discern whom to work with if you’ve found more than one viable candidate is “what voice is missing in my life?”
Here’s what I mean by this. Some of us are surrounded by critical, argumentative people. In that case, it could be helpful to choose a counselor who offers lots of compassionate support. Some of us are surrounded by unconditionally loving friends who automatically take our side. In that case, it could be helpful to choose a counselor who is more direct and confrontational. Some of us need a directive voice in our lives, a voice that offers scaffolding and objectives to help us reach our goals. Others have too much of that already and need a voice that urges self-compassion instead of perfectionism. What voice is missing in your life? Hint: it’ll probably belong to the counselor that makes you feel a little bit anxious/nervous/excited because you can sense this relationship may lead to actual change.
How will I know when to leave counseling?
There are a few red flags that indicate you should leave counseling. These include:
The counselor breaks confidentiality by talking to people you have not authorized them to talk to (this does not include their legal responsibility to report in certain situations, all of which should be covered in the initial paperwork you sign)
The counselor makes sexual advances toward you or violates your physical boundaries without consent
You do not feel safe enough with the counselor to open up (perhaps the counselor has been inattentive or disrespectful, or has acted angry, blaming, or rude without attempting to repair the relationship)
The counselor does not respect the terms of your contract (cancels sessions without warning, changes the price and/or terms of counseling indiscriminately, is unresponsive when you attempt to communicate, does not listen to your feedback)
You have been showing up regularly, practicing any exercises the counselor offers, and participating fully in each session, but you are not experiencing any change or any progress toward your goals. When you bring this up with your counselor, they dismiss you, act defensive, or refuse to make any changes.
Note the difference between feeling uncomfortable/challenged and feeling unsafe. Good counseling takes us onto new ground and out of our comfort zone. It can be tempting to leave counseling when it gets uncomfortable, so ask yourself this question: “Is this discomfort in service to becoming who I want to be as a human being? Are the uncomfortable feelings I am experiencing right now in the interest of helping me achieve my goals?” If the answer is yes, push through. If the answer is no, it might be time to find a new counselor.
If you have found a great counselor and have addressed most of your goals in counseling, you may find that although you are feeling better you do not want to leave the counseling relationship because it is helpful or enjoyable to have this time to talk through the challenges of life in a supportive environment.
If you find that most of your sessions feel conversational, and counseling poses a financial burden, it’s worth evaluating whether you wish to continue in counseling or if you may be ready to leave. Please note that there is nothing wrong with continuing in counseling for as long as you wish, but it is always your choice to leave when you are ready. Don’t be afraid to talk it through with your counselor if you think you are ready to leave.
I hope that this post is helpful, although it is by no means comprehensive!
One of my most cherished hopes for my vocation is that mental health can become easier, simpler, and less expensive to access. In the meantime, please reach out for any support or help you need in navigating the process.
You are worth the time and effort it takes to find the right counselor. You matter, and you do not have to suffer alone.
If you have questions or suggestions, please feel free to comment below or email me directly at innerlightasheville@gmail.com.
Hard things are hard
by Lissa Carter, LCMHC
I can’t presume to know what life is like for you as you read this. I can share that, lately, life for many of my clients has looked like one unrelenting challenge after another. It wears you down. I would like to speak to the part of you that is exhausted, overwhelmed, and grieving:
It’s okay. You are not alone. Of course you are tired. Of course you are sad. You are allowed this, you are allowed to travel the full spectrum of the human heart, and this spectrum includes some times when living feels like a hardship. That’s part of the dignity of being human.
You don’t have to fix it. You don’t have to paste on a smile or a stoic expression and plow through as though all is well. You are allowed to face the day, the world, your life, with the emotions and thoughts that are true for you.
And yet life does not wait for us to grieve or rage or collapse. There are children that need to be fed and work meetings that need to be attended and trash that needs to be taken out to the curb, and none of these things have stopped because of our exhaustion.
Still, there is a subtle difference we can cultivate here if we practice compassion toward ourselves. It looks like standing at the stove, preparing breakfast for the children, letting the tears roll down your cheeks. Letting your family see that today, it is hard, and you can do hard things.
It looks like dressing in an article of clothing that through its weave or color calls in the strength and resilience of your ancestors, or a bracelet that was given by a friend and can symbolize, for you, her kindness or her courage. In this way you can mirror to the outer world your inner life (there is a whole fascinating history here, the kosmetikos, that I will one day devote an entire blog to).
It looks like answering “How are you?” with honesty that respects your true feelings: “It’s been a rough day, but I am finding the strength to do what needs to be done.”
Every day offers us numerous choice points, when we can choose to move toward the person we want to be or choose to move away from sensations of discomfort. Choosing to move toward the person we want to be does not eliminate the discomfort. But it does help us shoulder it with a sense of agency, with the knowledge that in doing this hard thing we are choosing to show up to life in a way that matters to us. There is a power in that.
We face so many moments in our lives in which pain is unavoidable. There’s a wonderful metaphor from Acceptance and Commitment Therapy that I use for myself and for my clients in these moments:
You are standing at a train station. You are headed north to attend the wedding of a beloved friend. The southbound train pulls in to the platform behind you, and the train is lovely to behold: shining, polished, its passengers ensconced in comfortable velvet seats with personal entertainment systems.
Then your train pulls in , at the northbound platform. It is in horrifying shape, rusty, decrepit; the windows are smeared and the passengers look shifty. You are reluctant to board this train, so you wait, and it pulls away. No matter, you think; another train will pull up.
Another train does pull up, but it is just as decrepit as the first. What do you choose to do?
Do you continue to wait, possibly even missing the event you had so looked forward to?
Do you board a southbound train, carrying yourself away from your destination, but enjoying a comfortable journey?
Or do you take a deep breath and board the train north, knowing that even though it will cause some discomfort it is carrying you toward the place you want to be?
We can spend our whole lives waiting for the “right” train that never arrives.
There is discomfort in doing hard things. But there is also a terrible cost incurred in avoiding them, in turning away from them, in letting the train go by.
We are in a moment together—-as a species and as a planet—in which there is no easy choice. We are being asked to shoulder discomfort again and again. I want you to know that you are not alone in your weariness, in your sadness, in your pain. And I know that we can do hard things, and we can be compassionate to ourselves as we do them. You deserve to show up as the person you want to be, even when it is hard.
Instead of pushing yourself mindlessly through the slog today, take a moment to dig into your personal “why”:
I am making breakfast for my kids because it matters to me to send them into the world with warm and nourished bellies.
I am attending this meeting because I want to show my coworkers that they are seen and that they matter.
I am brushing my teeth because I respect the elder I will become, and I want her to be free of tooth pain so that she can focus on saving the world.
When we get in touch with the deeply personal meaning underlying the challenges we face, we infuse them with purpose. And that does not make hard things any easier, but it does make them more meaningful.
Please do not hesitate to reach out if you need help. We are in this together.
Epigenetics and Empathy
By Lissa Carter, LCMHC
These are hard times. Many of us are exhausted. For months, we have been sitting with the shadow: the unhealthy coping mechanisms that emerge when we spend too much time alone. The addictions that come out of the woodwork when we are under stress. The relational patterns that tax the family system under lockdown. The projection of our physical/financial/emotional fears onto others, the way we frantically search for someone to blame for all of the changes. And now we are sitting with the collective shadow of systemic racism.
In this environment of scarcity and exhaustion, it can be so very easy to put the blinders on and muscle through. To blame some Other person or group of people whose thinking is not like our own, or whose actions defy our understanding. To step out of empathy and into righteousness.
But as we know from decades of research, humans who are connected creatively and empathetically fare better than humans who have shut down those areas of the brain that foster connection (I wrote more about this here.) When we step out of empathy, we abdicate the very skill set that is most likely to lead us toward long-term survival.
Empathy is threatened when fear shuts down our willingness to connect and puts us in fight-or-flight. So one key skill for strengthening empathetic response is paying attention to context.
Empathy and Attribution Error
When we are in grief, or rage, or overwhelm, the part of the brain that makes rational, logical decisions is less accessible. Think about a woman who has lost her only child. If she falls to the ground in the midst of the funeral and begins to tear the floral arrangements into pieces, how do you respond?
a) that woman must have mental problems or
b) that woman is consumed by grief, my heart goes out to her
Most of us respond with “b”. When we understand context, we can attribute a person’s behavior to the context rather than to the intrinsic character of the person.
But what if you didn’t know the context? What if all you saw was a woman tearing up expensive floral arrangements and screaming?
Chances are, in that case we might erroneously think this woman is a disturbed or destructive person. We would be committing an all-too-human mistake known as fundamental attribution error.
The fundamental attribution error is the tendency to attribute our own actions to context (I am speeding because I am late to pick up my daughter, and she must be so worried!) yet to attribute others’ actions to innate character flaws (that guy is speeding because he is a jerk). We commit attribution error when we disregard context, and evaluate behaviors as though they occur in a vacuum.
Assuming that someone must be fleeing instead of jogging because he is wearing a style of shorts I don’t associate with jogging is an attribution error. I can address this error in myself by pro-actively seeking out the stories and life experiences of people who think/live/speak differently than I do. This starts a positive feedback loop in which my openness to others’ perspectives increases my understanding of and empathy for others, and my increased empathy and understanding makes me more likely to listen openly to the experiences of others.
But there is another layer to consider here.
Empathy and Epigenetics
Context does not only occur in the present moment. We have learned through recent studies in epigenetics that the environmental context a person lives through can leave genetic markers that impact the DNA expression of two generations of descendants. (read more about this here).
This means that a woman who survived the holocaust might have a granddaughter who, never having met her grandmother, struggles with high anxiety and hypervigilance. A grandfather who fought in the war might have a grandson who startles at every loud noise.
So consider this: the context that tells me the grieving mother is behaving appropriately is the death of the child. What about a historical context in which generation after generation has experienced brutal separation from their children? This is new research, so we can only begin to grasp the ramifications on a people that have experienced generation after generation of atrocity, from kidnapping to forced labor to family separation to lynching to profiling. How might it change your ability to empathize with the anxious action of an individual to understand that behind that action are several generations of traumatic experience?
If we truly make the effort to understand not only the individual but also the historical context of an individual’s behavior, we can strengthen the muscle of empathetic response rather than reacting out of fear or anger.
Building your Empathy
So far, we have learned that you can actively build your empathy by seeking out the stories of people who have a different perspective and life experience than you do. You can increase empathy and avoid attribution error by pro-actively observing both the present-moment and historical context within which people act.
But there’s one more fascinating way that epigenetics can inform empathy. In studies of mice, scientists were able to demonstrate that adult mice— those that had directly survived trauma as well as their descendants—who were given healthy, stress-free environments to live in were able not only to heal their own traumatic expression, but also to change the epigenetic markers they passed down to their children. From this we can infer that it may be possible to heal entire chains of ancestral trauma within the space of one generation.
But to do so, we need to create a healthy, stress-free environment for the survivors of ancestral trauma.
What does an empathy look like that takes as its mission the active creation of a healing environment for our brothers and sisters? I don’t have the answers, but I suspect it looks like picking up the bulk of the educational and emotional labor. I suspect it looks like offering resources that have been accumulated through privilege to provide scholarships, to build platforms and networks for unheard voices and undervalued perspectives. I know that it means (and I hope this goes without saying) eliminating the primary stressor of racism in the day-to-day experience of this generation. Or, if that is too much to hope for, in the day-to-day experience of the next generation. I know it looks like asking ourselves, every day, How can I use my resources to ease the burdens of others?
Action Steps
We can acknowledge and make room for the very real intergenerational grief and mourning that needs to happen. We can read up on the history and context of current events. We can educate ourselves about systemic racism. We can refrain from pointing fingers at individual actions until we understand the context in which they are happening. We can remember that when a person is experiencing deep grief or rage, it is not a time to be logical or engage in rational debate. It is a time to listen, provide empathy, and create a safe space for emotional processing.
Empathy isn’t something we have or don’t have. It’s something we practice, and we practice it by listening, by creating space in our minds for the perspective of others. We know from the work of Stephen Porges that social engagement is our most adaptive human response. There is too much at stake to be working with anything less than our most adaptive human response.
I have learned, from the privilege of witnessing my clients every day, that if we lean into our empathy, remarkable transformations are possible. I have so much hope that we can love ourselves and our neighbors through this. I have deep hope that we can emerge more empathetic, more deeply connected, on the other side.
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Self-talk Saves the World
By Lissa Carter, LCMHC, LCAS
Hey, PSA: If you have been irritable lately, if you have been lashing out more frequently or finding yourself feeling keyed-up, judgmental, and selfish, there’s a reason for that.
Collectively, we are experiencing a decrease in oxytocin and an increase in cortisol.
Oxytocin is the bonding hormone released when mothers nurse their babies, when partners make love, and when friends hug. It also functions as a neurotransmitter that aids us in feeling a sense of connection and belonging. When we do not hold each other, when we do not engage in warm and caring physical interactions, our oxytocin levels diminish.
Cortisol is a hormone that, when released, takes us out of connection and drops us into fight-or-flight. When we feel fear about our own physical health or the survival of our family, when we ruminate on the state of the economy, the planet, and the species, the amygdala perceives a threat and sends signals that increase cortisol. When cortisol surges, so does vigilance, violence, and reactivity.
Over time. a chronic reduction in oxytocin and uptick in cortisol will shape a personality that is less connected, empathic, and creative and more vigilant, reactive, and avoidant.
Given that close connection has been our best evolutionary strategy, these neurological changes do not bode well for a successful response to the crises our species is facing. We do not do our best thinking in fight-or-flight. We do our best thinking when we are connected, aware, and focused not only on our own survival but on a more allocentric sense of the survival of the whole.
So what is a socially responsible mammal to do? On the one hand, we need to care for each other by maintaining careful social distancing. On the other, we know that abstaining from connection can shape personalities that are less empathic and more reactive.
Kristin Neff’s research on self compassion points one way out of this double-bind. It turns out, the microcosm of your relationship to yourself generates oxytocin and cortisol just the way your relationships to others do.
This means that even as you practice social distancing, you can reshape your neurochemistry by relating to yourself differently.
Let’s create a completely hypothetical situation to demonstrate how this works.
Let’s say, in this 100% made-up scenario, that I’ve been noticing myself acting selfish. Specifically, I’ve been responding to feelings of scarcity by hiding chocolate from my children. When I notice myself doing this, I respond with self-castigation: why am I hiding the chocolate from my children? I am a self-obsessed monster who doesn’t care about anybody but herself. I am just like that terrible, terrible man in Anne Frank’s diary who stole food from children in the night!
My amygdala hears this self-censure the way it would hear anyone else yelling at me, and prepares my body to release cortisol and adrenaline in preparation for a fight.
Here’s the problem: I am now disconnected from my empathy and creativity and plugged into my shame and fear. These two states are reciprocal inhibitors—if I am locked in shame and fear, I am more likely to behave selfishly, not less.
Fight-or-flight turns us inward; it removes the focus from the well-being of the whole and absorbs us in relentless self-protection. I cannot access empathy from this place.
What if, instead, I were to notice myself hiding the chocolate and smile the way I smile indulgently at a dear (if quirky) friend? What if I told myself tenderly “wow, you must be feeling really afraid to do something like that. This is really different than who you want to be, so you must be super uncomfortable.”
Now, instead of releasing cortisol, I’m generating oxytocin. Instead of shunting all of my consciousness toward fight-or-flight, I am maintaining awareness, empathy, and a connection to logical, creative thinking. From this place, I am far more likely to take a deep breath, remember who I want to be, and call the kids into the kitchen for brownies.
This works whether you believe it or not; it’s in the wiring. Even if you feel silly hugging yourself and telling yourself you’ll be okay, your brain will still generate oxytocin as you do it. And your brain doesn’t care if you’re a lifelong pacifist; if you continue to criticize and judge yourself your cortisol will spike and you’ll become more prone to lashing out.
We are, individually and collectively, sitting with the shadow. All of the convenient distractions and helpful Others to project our issues onto have vanished, and we are forced to face uncomfortable, distressing truths about ourselves that we’ve always been able to dodge before.
If we are going to survive this with our empathy intact, we face a twofold task: we must learn how to relate to ourselves with compassion even as we come to terms with unwanted, shadowy parts of ourselves we would prefer to avoid.
Shadow work isn’t easy, but it is simple. In a nutshell, it looks like this:
Catch yourself doing or saying something that you don’t like, take a deep breath, and excuse yourself. Don’t let yourself get caught in justifying your actions or blaming someone else (even if they are being shadowy too!)
Let yourself notice what it feels like in your body. As these thoughts and emotions swirl around you, what does it feel like beneath your toenails? How fast is your heart beating? What colors are showing up behind your eyelids?
Imagine a loving, compassionate friend laying an arm across your shoulder, or squeeze yourself in a hug. Breathe. Let the emotions and thoughts get as big and painful as they are going to get. Let yourself see and feel the thoughts and actions that are out of integrity, notice what they cost you, and refuse to abandon yourself.
Rock, squeeze, breathe. Listen to what these emotions and thoughts are trying to tell you. Offer yourself compassion for the discomfort you are feeling, and stay present until the worst of the painful thoughts and feelings has passed.
When you feel ready, ask yourself what will help you step back into integrity. Then do that.
If we can maintain tender connection to ourselves even when we are uncomfortable, we begin to learn how to stay. If we can stay—connected, aware, kind, and thoughtful—even in the middle of big scary uncomfortable emotions like shame and scarcity and fear and loss—we might just get out of this okay.
So that’s our work, alone in our “alchemical huts” as Martin Shaw has described our little units of quarantine— to befriend ourselves as we are, not as we wish we were. To tend the connectedness and belonging of the one relationship we all have access to, the relationship with ourselves. To not turn away when we do something scary or gross or icky, but to keep a compassionate witness.
The more familiar we are with this territory in ourselves, the better we can navigate it out in the big, shadowy world. We’re going to need your ability to face the unattractive parts of human nature. We’re going to need your oxytocin supply as we face greater and greater storms of human vigilance and reactivity.
As Dr. Steve Aizenstat says, it’s the intolerable image that holds the healing. If we can sit with that intolerable image, if we can face it instead of pushing it away, we will learn how to maintain relationship under even the most difficult circumstances.
If you can learn to stand yourself in your moments of deepest ugliness, you can learn to stand anyone’s ugliness without losing your ability to love. And love is what makes us a species worthy of survival. Love is what will get us through this.
Safety and Sound
By Lissa Carter, LCMHC, LCAS
