Tag Archives: life

Set-Ups, Near Occasions & Solution-Focused Brief Therapy

Haven’t we all had times we felt set up for failure?

Near occasions. Think of them as set-ups. Human beings are spectacularly good at setting ourselves up, for good choices and for the not-so-good, too.

We Catholics refer to near-occasions of sin – the people, places, things and behaviors that we might see as “set ups” for us to make poor choices. There’s nothing inherently “bad” about gathering at a bar and grill with friends, but if you are trying hard to maintain your recovery as an alcoholic, it is a “near occasion.” It’s a set-up to make good choices even tougher. Likewise, the trip to the mall to “just walk around” when you’re trying to work your way out of debt. Why set yourself up for failure?

In the same way, there are what may be called “near occasions of Grace,” the people, places, things and behaviors that increase our odds of making good choices. The friends who are uplifting and don’t gossip; the entertainment that doesn’t feed envy or anger; the activities that make the rest of the day better. We “set up” the likelihood of good choices, too.

Solution Focused Brief Therapy (SFBT) similarly looks at people, places, things and behaviors. You may be thinking, well, duh, what sort of therapy does NOT focus on solutions? Different forms of therapy have different emphases in terms of finding solutions. For example, psychodynamic therapy emphasizes developing insight that leads to new choices; behavior modification focuses on step-by-step actions to guide the client towards reaching goals. In SFBT, there is a particular emphasis on the clues (factors that set up outcomes) in people’s lives and using these clues and the client’s strengths to develop solutions. In many ways, it is looking for near occasions of the goals the client has for therapy. When has the goal in question already happened, or part of it happened?  What was going on then? What was happening right before that? What were you doing? What were others doing? As a team, we investigate the near occasions of success so the client can use the clues to develop solutions that make sense for that client’s life.

Just as a quick example, let’s consider the person who realizes that getting the morning off on the right foot tends to lead to a better day, all-around. We look at examples of those “better days.” What did happen in the morning? What happened the day before that might have contributed to that morning? There are usually plenty of clues and examples of times when the person has been successful in doing things that either led to a “better day” or set the stage to some degree.  Some clues might be eating a reasonably healthy dinner, getting to bed “on time” and not using the phone or other screened device, getting up on time and getting out of bed right away instead of starting the phone-scroll. The person identifies the factors and then we look at how to increase the incidence or likelihood of those recurring. Breaking it down further, let’s take the dilemma of the phone next to the bed and its appeal as a way to deal with insomnia, or its interference with just getting out of bed on time. “I can’t leave it in the kitchen. It’s my alarm clock,” people will assert. Yes, I understand- and I understand that I bought a little travel alarm clock – a couple of AA batteries that have thus far worked for years – that wakes me reliably every morning whether there’s a power outage or not, and I do not have my phone over there, flashing lights and buzzing every time an artist friend posts a painting. It seems many other artists are night owls. The solution, if what is wanted is actually a reliable alarm clock function, can be had for less than fifteen dollars.  If the phone is off in another room, you’ll have to get out of bed to get to it. And by then you will probably have done something besides scroll – brushed your teeth or started the coffee or fed the dog. You will be vertical, approximately on time, and therefore have “set up” a more likely success story about getting into your day “on time.” The phone by the bed is a “near occasion” of extra time awake during the night, more time in bed, and then being rushed, grumpy and unprepared for the day. Nothing is inherently bad about the phone – but it might be part of a “set up.”

We all have “near occasions” – of sin, grace, good choices, bad choices. The negative ones have less power when we know what they are, and the good ones can exert their power when we focus on them.

What are they thinking?

What are they thinking, we wonder. It’s a question we toss about in conversation. It frequently comes up with someone is doing something that seems self-destructive, or bizarre, or just unexpected.  For psychotherapists, like myself, a lot of people seem to believe we have a secret insight into what some particular person is thinking. Of course, I don’t. I have theories, sometimes, based on study and thirty-plus years of experience in mental health and sixty-plus years of experience being human, most of that as a voracious reader. But even with all that, I am often stymied and stumped as to what someone is thinking.

I recently dropped off art for a show and met another artist. We were introduced, we shook hands. He is a tall man with big, baseball mitt-sized hands. At least, compared to mine. And my small hands are twisted up and deformed with arthritis, with many joints completely failed, such that my ability to hold a brush or a pastel stick is pretty much a miracle. What was this man, a visual artist whose attention to detail is apparent in his work, thinking when he squeezed my hand as if I were a big man with whom he was about to enter an arm-wrestling contest? I don’t know, but what comes to mind is unkind. So, I try to assure myself it was a moment of oblivion.

We have many people in our neighborhood who walk their dogs and assiduously clean up after them. There is one person (I hope and pray it is only one because it is almost unbearable to think there are more) who very carefully picks up after their dog with proper little dark plastic bags, knots the bags carefully … and then leaves them behind. On the sidewalk, on someone’s driveway and once on the table at the end of our driveway where we had set out the abundant crop from our starfruit tree to give away. What was this person thinking as they left their little present next to the box of starfruit and the big sign announcing, Free Fruit? I hope I never figure it out. My husband, who is better-hearted person than I am, suggested that perhaps it was dark and they thought they were just adding to the trash pile. Hmmm.

What are they thinking when … we all wonder. And I am sure people wonder it about me. Certainly, my little adventures such as hiking up and down canyon walls and white-water rafting when I don’t even know how to swim generate some of that. Then there are the times when I nervously blurt out something stupid, awkward but well-intended when a friend shares difficult news, such as a scary health diagnosis. Being a professional is not a vaccine against that. And perhaps about you, too, sometimes, inspire people to wonder, what were they thinking? Reminding myself of this helps me give a little grace to other people’s weirdness or inconsideration, because I definitely have my moments of being weird, inconsiderate or just plain oblivious.  And at those times, no doubt someone is wondering, “My gosh, what is she thinking…?”

Quitter’s Day Part 3: Know Thyself

Micro? Macro? Or just bored?

Toe in the water, a cannonball dive, or just hanging out poolside?

Do you go for a haircut and, if it’s a new-to-you-stylist, ask for a half-inch trim so you can find out whether they actually listen and measure – or just grin and say, “Do whatever you want”? That’s your small vs big change preference in a nutshell. Then there’s never making any change that isn’t forced upon you by circumstances, like that little mishap when you to do layers like the stylist you follow on YouTube.

Because, if you’re a small-change person and you tried to take on too much in one step, you may become overwhelmed. Small-change people are often big-picture people: they see a small change (spend fifteen minutes a day learning a new language, for example), and immediately realize that fifteen minutes comes from … somewhere. And somewhere ought to be figured out so nothing important is accidentally left out. A small-change person will do better with a small and carefully planned step into change, and build from there.

But … if you’re a big-change person and you tried to make a small change, perhaps you got bored. It seemed hardly worthwhile. In that case, experiment with suiting your temperament.

Or maybe you just got discouraged because persistence with any change – big or small – can be difficult. Being persistent, sticking with the essentials, isn’t easy for most people. If it were, we wouldn’t marvel at the accomplishments of those who have developed outstanding skills in any particular domain. We know “outstanding” takes persistently showing up and doing the work.

Whatever the reason – too much, too little, just bored – maybe this week do a reboot that suits your temperament as an experiment, and see what happens.

In Autumn, the Truth is Revealed

In autumn, the truth comes out.

And by autumn, I mean any autumn. Autumn the meteorological season before winter; Autumn on the calendar; Autumn in our life span; and Autumn in the liturgical year.

In every case, if you step back far enough, you can see the patterns. The photo op brilliant foliage reveals what was there all along, shaped by experience.  In spite of the sometimes-brutal clarity of autumn, I love this time of year.

Deciduous trees that turn yellow, gold and orange in autumn are not so much changing color as revealing the color that has been resting underneath, hiding under the green of chlorophyll. As the days grow shorter and cooler, chlorophyll production decreases. The leaves have always been golden. The trees have experiences, and these matter, too. Perhaps there has been plenty of rain and the soil is rich, or perhaps a hurricane has blown off so many small branches that the tree suffers malnutrition from a lack of chlorophyll. Then, too, if it is the sort of tree that turns red, its intensity will be impacted by sugars manufactured and stored; more sweetness makes for a more brilliant red.

In October or November, looking back at the resolutions, motto, word or intentions for the new year, the truth is revealed. In March one might kick that can down the road; even in June there is still “plenty of time.” But in autumn, reality comes to visit. We either did, or did not, step up and out into the life we intended to try to make. The combination of who we are (like it or not) and the experiences thrown at us by life bring the outcome we assess in the autumnal review of our intentions for the year. I’ve had the same motto for years now because apparently I’m a slow learner.

In the mirror, in the season of life poets call autumn, we see the person we have been all along, plus our experiences. The smoothness and sameness of youth is gone for those in midlife and later; laughter and tears, pain and care, habits – good and bad – all are revealed. A twenty-five-year-old might hide bad habits, but by forty-five, the entire body shows the pattern and at sixty-five, odds are the mind and spirit are far from what they promised to become before a bad habit became an addiction. On the other hand, there can be an explosion of energy, creativity and spiritual growth at in the autumn of life that startles those who mistook the responsible behaviors of younger years for that person being “boring.” This is when adult children wonder if their parents have gone a bit crazy – taking up new hobbies, traveling, refusing to be properly “old.” No, they were never actually boring, just busy with lifegiving, the drive that Erikson called “generativity,” that leads people to make sacrifices for others, and trees to manufacture food out of sunlight to nourish themselves and the seeds for future trees.

And then the liturgical year winds around, ending about four weeks before Christmas, with the Scripture readings for the last few weeks focused more and more on the last things – our own death, the final judgment, the need to take account of how we are living and make changes in accord with the highest good.  How appropriate that this unveiling of the reality beneath happens in such a pervasive way – that we are offered the chance see ourselves, our year, our years in total, through the same golden lens.

Happy mid-autumn; wishing you all the golden light the season offers.

Ouch! Hey! and, Yay!

It can be hard for parents to make the changes they see would be best for their families. Every good idea seems like a Sisyphean struggle.

Sometimes it’s useful to start very small. Let’s begin with a short, very simplified review of behavior modification from Psych 101. We’ve got positive reinforcement (YAY), negative reinforcement (also YAY) and punishment by application – life does something to you (OUCH), or withdrawal, when life takes something away (HEY!).

Let’s say it is noonish on a pleasant day, I have a break, and decide to take a walk outside. I will enjoy the breeze, the birds singing, a chance to move and clear my head. I will come back to the desk feeling invigorated. I have been positively reinforced. I did an action, or stopped an action, that resulted in something good (my uplifted mood).

A few hours later, it will be about 3 PM and I may have the beginning of a headache. I glance at my water bottle and realize I am way behind on fluids, so I drink a few glugs of water. In short order, the headache dissipates. I have been negatively reinforced: I did a desirable action, and something bad went away.

Punishment, on the other hand, is entirely different. If, feeling a bit bored, I decide to scroll through the news of the day, I might feel depressed and then realize I have wasted my break reading bad news (HEY!).  Or, I may notice the beginnings of a headache and, instead of a drink of water, start with a few chunks of delicious, smooth dark chocolate and then (OUCH) my headache may well get worse.

The point of this little meander through intro psych lessons is that, when making changes, maybe it will progress better if you find ways to start with positive and negative reinforcement rather than what will seem like punishments.

For example, let’s say you think that at least one weekend afternoon of family time without devices would be a good start. Teens and even younger children may not agree. Wrestling their phones and tablets away is feasible, but they will consider this HEY!, and their resulting dopamine withdrawal symptoms to be OUCH for them; their miserable behavior may be a big OUCH for you.  But if a family activity inherently means no devices and then everyone has fun, we now have a big YAY in place the OUCH and HEY! What might that include?

Being outdoors in nature, where devices may not work properly anyway. A movie outing. A museum that requires devices be silent and away. Physical activities. Someplace where there is no phone or internet signal. Or just take a deep breath and impose device-off mode around a slice of a day and spend it in actively doing things that would not be improved by device distractions. Have fun. Don’t lecture about how fun it was (that’s an OUCH). If your kid mentions it was pretty fun, you can agree and take that as YAY – an invitation to repeat as possible.

Hard Changes

Most of us have some changes to make. And most changes are not so easy. That’s why people postpone them, or poke at the edges, or just pretend the problem will go away by itself. Sometimes people convince themselves there isn’t even a problem, really; that it just depends how you look at it. Maybe so. But maybe there’s something that needs changing.

Let’s say you have a teenage child, or a child approaching the teens. S/he is cranky, sullen, uncooperative with chores, sulks during family meals and resists being on time for school and other appointments. S/he wants to spend time alone, in the bedroom, with electronics. The child is depressed and/or anxious and/or obsessive and/or perpetually angry. You know the situation will change, one way or the other. Everything changes. If you do nothing, you are gambling that your child will continue down this road and somehow, at 18 or 19 or 20, wake up, shake themselves off like a wet Golden Retriever and come out of their bedroom, smile and say, “Wow! How could I have been so wrong?!”

Yeah, I doubt it, too.

If you have this situation and need to take it on, it can be hard to know where to start. Here’s a suggestion: if the situation is not a crisis, then the most practical first step may be to start with yourself.

You will have to change. Perhaps you have to start the change process by being sure that all the adults in the house are on the same page in your expectations. Perhaps you need to get yourself on the right path.

You go first. You get enough fresh air, and time in nature, and sleep, and healthy nutrition, and balanced physical activity. You strive to do interesting and challenging things in what little free time you have. You will, quite naturally and incidentally, spend less passive screen time. You’ll be leading from strength rather than being a target for adolescents’ favorite criticism: that we adults are hypocrites. You’ll be in a much better stance to steer positive changes for your tween or teen.  

It’s Just an Experiment

You know how it is. You want to make a change. Something needs to change. Maybe the kitchen needs organizing, or you need to sleep better, or be less stressed…whatever it may be. You want to get it “right.” And that’s where the freeze happens. “Right.  It has to be right.”

But what if there’s no way to know what is right for you without experimenting?

For all the chatter the past few years about science, and following science, there seems to be a misunderstanding of what science is. Science is more of a verb that a noun. It has more in common with, Hey, let’s try THIS and see what happens, than with learning a few things and deciding that’s it – that’s all there is to know.  You can see the difference in real time when SpaceX runs another experiment with the super heavy and the personnel there are excited about how much they’re learning and thus able to improve, while some people in the press call it a “failure.”  No, “failure” would be not doing or, having done, failing to study and learn. That’s failure.

At an individual level, let’s say you decide to take guitar lessons. You have no idea how to do anything with a guitar, but it’s been a long-time dream. Unless you are younger than five, you surely wouldn’t pick up the guitar, strum at it, and wonder why you didn’t sound like Carlos or Angus or Eric or Brian or whomever. You would have to spend many hours, experiment after experiment, building and reinforcing the new neural connections and fine motor skills that lead to the ability to play guitar. You would not call the outcome after the first, or tenth, or thirtieth, lesson a “failure,” properly, unless you gave up in impatient disgust and stuck the guitar in the closet, where it will peek at you through the clothes hanging in front of it and reproach your surrender until you sigh and try again or give the guitar away.

If you are looking at making a change, and feeling stuck, reframe what you are doing as experimenting.  Move the coffee mugs to that cabinet, over there, closer to the coffee maker, and see how you like it.  Buy a battery-operated alarm clock and leave your phone in the kitchen overnight for a few weeks and see what happens. Try turning screens off during meals, or leaving the audio off in the car, for a month or so.

Start the experiment, and then pay attention. That’s a critical part of an experiment. What happens in the absence of the old behavior? What seems better? What’s harder? What is your theory on why it’s better or worse? Can you build another little experiment – not a long-term commitment – on this one? It’s an experiment, for goodness’ sake, not a marriage.  That is science, and that is a way to get unstuck, make changes and work around any lurking perfectionism.

Why didn’t you call me?

The Mystery of the Missing Phone Call

If you leave voicemail and I do not call you back, odds are it is because the voicemail did not come through, or, as sometimes happens due to cell phones, it was impossible to understand.  During 2024, there was a week in the autumn in which my cell phone record clearly shows no phone calls and yet later, several people complained about having called and receiving no call back. Their number popped up showing they’d called during the week in question, but the cell phone call logs of that week showed no such call. These things happen; it is regrettable and out of your, and my, control. If there is no call in a day or so during the business week, please call again! 

If you email me and ask me to call you, I will email back and invite you to call me. Sometimes people find this annoying or avoidant. I have two reasons for this.

First, I cannot be sure that whomever is emailing (or texting) is the person in question. That is why we therapists have requests about not sending confidential information by text or email.  Believe it or not, several times in my over quarter-century in practice, people have left voicemail or email with a name and number that was not their own. They had decided that “Alex” was in need of a therapist. In their imagination, leaving unsuspecting me a message to call “Alex” was a way to have “Alex” unexpectedly encounter a real, live therapist and jump at the chance to make an appointment. This is not how it ends up, believe me. On occasion, people have called and directly requested that I call some family member or friend, and I decline. I appreciate the honesty in the latter case, but it is still inappropriate.

Secondly, I cannot be sure that I will be calling when it is safe and private.

Thanks for calling!

Loneliness can kill you…Part 1

According to new research from the journal Nature, Human Behavior published on January 3, 2025, loneliness and social isolation lead to molecular changes that, in my simple terms, seem to set the body up for serious problems – increased risk for dementia, depression, cardiovascular disease, diabetes, stroke, and early death.  The researchers’ recommendations include routinely asking about loneliness and isolation, the way a health professional asks about sleep habits, alcohol use, and drug use.

If you are lonely on an ongoing basis, this is for you.

Loneliness can strike through no fault of one’s own.

Losing your spouse, for example, or a best friend, will almost inevitably lead to a long stretch of deep loneliness during the initial year or so of grief, and can continue beyond, as the bereaved person struggles to outsource some of that emotional, intellectual and spiritual intimacy to other relationships. In a healthy marriage, you share all sorts of confidences with a spouse that you simply might not share with anyone else – fears, dreams for the future, spiritual insights and struggles, and the warmth of shared memories that are no one else’s but the two of yours.  Somehow, some of that must be extended to others, and depth built over time. It an absolutely monumental task to parcel out these small slices of the immeasurable depth of a healthy marriage.

Moving, alone, to a new city, for a new job, can be exciting, but the reality can include aching loneliness when everyone at the new job goes home to their lives and you go to your apartment and try to figure out how to build a life. Developing the big, and small, connections that make a place feel like home can be daunting, and for most people, it takes longer than they had ever anticipated.

Loneliness hits other people, too. Those who are living primarily second-hand, separated by screens and trying to substitute electronic connections for human ones, are often intensely lonely. Some people interact with others in person, but the conversations are shallow, guarded and therefore nearly empty of connection and meaning. This type of loneliness can be even more painful, because it seems inexplicable; how can a person live with family or a partner and yet feel deeply lonely?

So, what to do? Unfortunately, the impetus is mostly on the lonely people to do something differently.

Here are some suggestions I would give to a client in such a situation.

  1. Go to church or synagogue. If you are grieving, try to go back to your own – but if that’s painful, go somewhere else, at least for now. If you are new to the area, just find a place that seems like a possibility. Then go to the hospitality time afterwards. Introduce yourself, and invite people to tell you about the faith community. Do not stand around with your cup of coffee and wait for people to notice you. Set a goal: perhaps that you will introduce yourself to three people, get their names, and ask a little about this community. See what happens. Try to focus on the other person; make the conversation a chance to get to know them and about their community – not about you. If it goes fairly well, go back the next week, greet those three people (and anyone else you met) by name if you can, re-introduce yourself without taking them forgetting your name personally, and see if you can meet a couple of other people. Within a month, you will have some acquaintance with a dozen or more people and have a solid idea if this community offers activities for education, worship and service for you to join.
  2. Even if you usually like to do things solo join at least one activity – one exercise class, one art class, one talk at the local bookstore, etc. – on a regular basis. Get to be a regular. Greet other people.
  3. Volunteer in your community. Do this with others. Doing good solo is beautiful, but if you’re not getting out of your head and focused on others in an interactive way, you are missing part of the point.
  4. Be friendly but don’t try to bully people into being your friends. For example, if you are new to the area, don’t wear out your welcome with the neighbors who came over to introduce themselves on moving day.
  5. Please do not use alcohol or other substances, or resort to hanging out having drinks as a way to cut loneliness.
  6. Be patient and keep trying! Think of these steps as experiments. Track what happens over time; be willing to change to a different experiment if the first one isn’t working after a month or so.

As you can see, the remedies for loneliness all include getting out of your head and into the world. Focusing on others, in small ways (such as greeting them and showing interest) to big ones (such as volunteering), is a critical part of overcoming loneliness. This can be really hard, because loneliness tends to make people even more withdrawn, more insular – it is a self-perpetuating problem unless you boldly step out, even with small but courageous steps, into focus on others.

More about connecting with others in Loneliness can Kill You, Part 2, coming soon.

7 Things to do When Life Is Crazy

Sometimes, life just goes horribly sidewise.  This week, like most weeks, I spent time with people who have lost their homes to natural disasters, lost their job, had loved ones die, and sometimes are grappling with multiple serious problems.  The world seems crazy, you can feel like you’re going mad, and it is oh-so-easy to slide into attempts to numb the pain that are ultimately harmful.

It’s easy to advise people on what NOT to do – don’t drink alcohol. Don’t use drugs. Don’t eat a lot of junk food. Don’t let yourself scroll through social media and/or your newsfeed for extended periods of times. It’s easier, though, to “do” than to “not do.”  Anyone who has tried to break a bad habit knows that; it’s easier to “eat an apple” than to “not smoke/drink/eat a bag of cheesy poofs the size of a pillow.”

So, here are seven things to do – and keep doing – when life is crazy

  1. Say grace. Say grace when you get to sit at a table and say grace – together – when you eating a granola bar in the shade after another few hours of trying to make sense of the debris that used to be your home.  Say grace when you are out on a hike, just about out of water, and have miles to go. G.K. Chesterton famously noted he said grace when he sat down to write, to draw, etc.  A moment of gratitude shifts the focus from the mud to the mountaintop.
  2. Put the social media/news scrolling down and, instead, watch something that will make you laugh, preferably either an episode of a sitcom or a funny movie. Why? These require sustained attention, will bring a focus on characters who have ups and downs, and have the potential to make you laugh. Laughter releases dopamine – that feel-good chemistry that helps you heal.  Make it better and share that humor break with someone else. Sharing laughter with the person you love helps that sense of connection that seems strained, or even lost, when life has gone crazy.
  3. Eat food that is good for you. Ongoing extreme stress causes havoc in your body, including your brain, and getting decent nutrition is essential to your well-being, now and later.  I did the price comparison:  a precooked chicken, a bag of salad, some fruit and a little something else healthy, for example, feeds two or four people far cheaper than most or all fast food. Your brain will thank you.
  4. Listen to music that is soothing: piano or guitar, instrumental jazz, classical, baroque:  as tempting as it may be to listen to “angry” music because you feel so angry about what’s become of your life, that will only reinforce your distress.  Let peace soak into you, however slowly it may come.
  5. Check in with other people every day. Reach out to someone to see how s/he is doing. It helps us get out of our own heads, our experiences, and feel less alone.
  6. Get outside, preferably in the morning, for natural light exposure. You don’t need to bake in the sun; just get out there. Take a walk if you can.  Early natural light helps the brain regulate the sleep/wake cycle, setting you up for a healthy rhythm of melatonin production over the course of the day.
  7. Ask God to show you where He is at work in the events of your life, because when life goes crazy, the fog can make God’s loving presence hard to detect. Ask for the grace to notice the helping hands, the kind words, the moments of clarity.

I’m sorry if life has gone crazy. It is scary, and lonely, and disorienting when disaster strikes. If you find that you are sinking, reach out for help:  call your local helpline (in Pinellas County, FL the number is 1-888-431-1998, for the new Care About Me program that helps match those in crisis with an appropriate mental health provider).  Call a friend, a family member, or, if you are feeling unsafe and considering suicide or plan to harm yourself or others, go seek immediate help via 911 or go to an emergency service location.  When life has gone crazy, it is natural to feel frightened, confused and even helpless, but remember that none of us were designed to “handle it all.” We are, in fact, designed so that our strengths are distributed so that each has something to offer but none has every gift and ability.  Please reach out for help if you feel you are sinking.