Introduction to Interpersonal Nonduality

Most often when we go to a group, a workshop, a class, or even a meditation we are learning content through some presentation, or in the case of meditation we are being guided into directing our attention in a specific way to try and produce a specific result.

While these modes of working have much utility for too many reasons to list here, from the perspective of Nonduality they all fall within a structure that looks like something like this:

Process = Sense-of-Self + Directed Attention + Content.

Which then culminates in:

Sense-of-Self + Directed Attention + Content = Attempt Towards Intended Outcome

They all operate within a framework that tacitly assumes we need to identify with a sense-of-self and direct our attention towards some object. That is, they all operate within a framework of Subject towards Object with the intention of producing some result (e.g. learning, relaxation, insight).

Again, this does not mean these approaches do not have value, or utility. This kind of learning has been essential for all of us. Also, many different perceptions and experiences can and do arise within this framework, which can include experiences outside of the perceptual habit (e.g. during process of guided meditation, there is an experience of expansiveness of Self, or even selflessness). However, regardless of outcome the process can reinforce this underlying structure of perceptual habit.

Interpersonal Nonduality is a completely different process of interaction through which we are connecting with another or others with the primary intention of embodying Nondual Awareness.

Within the context of interactions in this intentionality, whatever we say, or don’t say, is of little importance. We aren’t trying to direct our attention in any which way, because attention is simply awareness that has been narrowed, and there is no narrowing necessary here as we are connecting with awareness as the backdrop of the entirety of any and all experience.

There is no content being presented, no concept to learn, and while one could argue that the intended outcome is to rest in the effortless experience of Nondual Awareness, we wouldn’t know if we were achieving that outcome because there would be no content of awareness to signal any achievement and nothing to compare achievement or non-achievement to.

Furthermore, the Sense-of-Self that is implicit in other processes is not necessarily a given variable in this context. Meaning, just because in the rest of our lives we assume that our Sense-of-Self may be somewhat concrete, we don’t start with the presupposition in Interpersonal Nonduality. We don’t start with any presupposition. Rather we start with an effortless non-presupposition, or what we might call innate not-knowing.

If we return to the formula I posited earlier of:

Process = Sense-of-Self + Directed Attention + Content

In Interpersonal Nonduality we might render this something like the following:

Process = Innate Not-Knowing = Sense-of-Self (None and/or No Presupposition) + Directed Attention (None and/or Awareness Itself) + Content (No Content) = Outcome-Whatever-It-Is

So in this sense we aren’t doing anything, but there is no pressure. There isn’t some suppressive silence. Rather, the shared recognition is simply that whatever words we have can not or ever capture the profundity and simplicity of awareness itself. We can talk about awareness, but our words are not themselves awareness. And yet somehow, our words are not, not awareness. Yet in this framework there is no work to be done, we simply have the opportunity to share and rest in the awe of the ground of experience itself.

Nonduality and the Psychotherapy of Transcendence

How does nonduality relate to psychotherapy? How might it be distinct? Is nonduality a method or approach to psychotherapy? What does nonduality offer psychotherapy?

In order to answer these questions we must start with how we understand who and what we are and what therapy is. In technical terms (which you can leave aside if you choose) we must try to understand the ontology behind our approach in order to understand the epistemology. That is, we must be differentiate how each approach sees itself in relationship to the process of being human or if you favor redundancy, being a human being.

Encyclopedias could be written about what psychotherapy actually is. Generally speaking, we can think of psychotherapy as an interpersonal methodology applied with the intent of helping the client develop awareness/insight and into their mental, emotional, and behavioral patterns in order to facilitate change. Some schools of therapy may frame therapy more centrally as a process of skill-building also aimed at facilitating change.

In either instance, therapy operates within a primarily secular worldview that is both individual to each therapist, and in the context of the therapeutic interaction intends to stand outside of belief (unless that is we specifically seek out a faith-based therapist) resulting in opaque or inexplicit ontology. Yet, whether or not belief is explicit it is impossible that the therapist and client would not include their respective world-views in the therapy process. Meaning, how the clients understand themselves in relationship to their world and existence must be part of the therapy process and by proxy how their therapist understands themselves in relationship to the world is impossible to eradicate from the therapy process, no matter how client-centered our values are.

Why am I making this point? Well the aim of conventional psychotherapy methods are built upon presuppositions that both client and therapist bring into the room. In the most general, structural sense some of these presuppositions are:

• the client exists as a sense-of-self

• the client is experiencing problems related to that sense-of-self

• those problems are related to one or more areas of dysfunction within the sense-of-self system

• those problems may be explained variably by different epistemological and etiological concepts (i.e. therapeutic theories and methodologies).

• emotional and relational development are emphasized as structurally formative factors in problems with the sense-of-self

• therapy seeks to ameliorate problems of the sense-of-self

These presuppositions are distinct from a nondual orientation to therapy which may respond to each point as such:

• the client sense-of-self exists as a relativity (some schools of psychotherapy may agree) and from another perspective the sense-of-self is non-existent; it is empty of self-nature

• “Problems,” or the roots of mental affliction, arise from the client’s identification with the sense-of-self as being substantial

• investment in remedying the sense-of-self reinforces the belief that the sense-of-self is ultimately existent and important

• Nonconceptual/Nondual Awareness is the ground of all experience

• the experiential revelation of Nonconceptual Awareness naturally divests energy from the identification with the sense-of-self, emphasizing experiential selfless spaciousness

• the conceptual mind may or may not naturally re-assert itself into Nonconceptual space

• The conceptual mind is divested of it’s relevance

• Resting in experiential selfless spaciousness

• Problems can not be constituted; awareness is unstructured; there is no it, there is no that, there is no I, there is no there.

The aims of conventional and nondual psychotherapy are different. Conventional therapy is a useful and important endeavor. It often implies certain presuppositions that are not explicit, however the reality is that most people who go to therapy find it helpful. In therapy we look at how we became who we are identified with today, and how certain patterns of emotion, affect, and thought serve or do not serve us— broadly speaking.

Nondual therapy is a totally transpersonal-consciousness based approach which is based on going beyond identification with the sense-of-self to an innate, experiential ground of being that has nothing to do with who we think we are. This is a psychotherapy of transcendence.

Selling happiness? Not so fast…

Do you ever feel exhausted from the constant influx of advertising? Just how each of us is assaulted by strategies every time we pick up a device. You may even notice that the language I am using here could remind you of that strategy. This is the language people and companies use to try and get you to buy their goods and services. Basically, the goal is to convince you that you are missing something that will improve the quality of your life. That’s the formula. While I’m not necessarily saying that such advertising is ALL bad (services do help people, and so do products); I think it is important to cultivate an awareness of the mental/cognitive structures that this advertising capitalizes on.

Such advertising is dehumanizing because it pits yourself against yourself. It plays on and reinforces your greatest insecurities. It markets to you an ideal version of yourself. It shows you images of happiness so repetitively that you can’t help but question, what if? What if it’s correct? You might think, I can’t take the risk, I’ve got to try! Often depression is talked about as if it is some abnormality as opposed to “mental health.” Yet, we can be marketed products and services that tell us we are missing something tens or hundreds of times a day and we are expected to be “mentally healthy.” Now clinical depression has a lot of potential contributing factors, I’m not saying we can reduce it to this one thing. However, if we just think this through logically, what can we expect to happen to our sense of selves if we are constantly assaulted with the message that we are missing something? Think of a child or teen. What do we expect to happen to a child or teen’s self-esteem if they receive the message 10 times a day, over 365 days per year that they are missing something? I would say that is a conservative estimate as well.

Rather than try to sell you something in this context, I’d like to throw out some radical ideas that maybe you can experiment with inside yourself, reminding your children, or your grandchildren.

·       You are not missing anything

·       There is no “one” way that you are supposed to look

·       There is no ideal life, no matter who tells you there is

·       Hardships are unavoidable, and rather than trying to avoid them we can learn how to use them to grow and connect us to the hardships of all beings

·       Comparing ourselves to others hurts, even though we all do it. The truth is that we can learn how to do it less if we are taught. We all arrive in this universe with different circumstances that are not always comparable.

·       What we have in a material sense has nothing to do with feeling satisfied internally

·       Our greatest capacity as humans lies within our own self-knowledge

·       Happiness is not a commodity, it’s not something we can have or not have, something we can buy or sell. It is a way of relating to self and other.

·       True happiness transcends relating to other as other, instead sees other as self

Suicide Awareness Resources

As some of you may know, May is #MentalHealthAwareness month. I was so saddened to hear about recent teen suicides in our community. While such losses can overwhelm us with confusion and grief, some avenues for further prevention are to continue to educate ourselves, to have the difficult conversations, to make sure that we let others know that they aren't alone and that we are here to provide support. Listed below are links to resources on suicide education and prevention.

Warning Signs: https://suicidepreventionlifel...

Facts and Statistics: https://suicidology.org/facts-...

Teens: https://suicidepreventionlifeline.org/help-yourself/youth/

Resources for Suicide Loss Survivors: https://suicidology.org/resources/suicide-loss-survivors/

Story of Hope & Recovery: https://youmatter.suicidepreve...

National Suicide Prevention Lifeline: 1-800-273-8255 or text CONNECT to 741741. You also can contact them through their website.

There is always someone who can support you.

Affect Tolerance: What Is It, And Why Does It Matter For Your Mental Health?

If there were just one idea you could latch onto when thinking about mental health, “affect tolerance” would take you a long way. I’m not saying it’s the single most important component to mental health, but it’s up there. Before explaining why this idea is so important, let’s first define some terms.

Simply put, affect is your feeling-state—or your feeling-experience in a given moment. While it may be splitting hairs to distinguish affect from emotion, we might think of affect as less personal than emotion; that is, it’s the experience of emotion. While we often use the word “mental health,” our experience of emotion isn’t located somewhere inside of our head or thoughts only. Rather, emotion also includes a bodily experience or an embodied experience. We might call this experience our affectual state.

Now that we’ve got that definition out of the way let’s talk about the idea of affect tolerance. What’s so important about tolerating our embodied emotional experience? Let me give you a concrete example. Everyone knows about the idea of anger management, but what really is the inability to manage anger? If we can not tolerate the embodied experience of being angry, we will likely need to compensate for this somehow. That is, if we can not tolerate the affect of anger, we are going to have to get rid of it somehow.

Most often, we think of people needing anger management when they have an issue with controlling outbursts of anger. They can not tolerate the affect of anger inside themselves, and therefore they express it in ways that are verbally or physically harmful to themselves or others. This is a pretty concrete example of a negative outcome of low affect tolerance.

Another option is that one could suppress or deny their anger. A seemingly good choice, for a period; however, it just so happens that suppressed feelings and feeling-states don’t just disappear into thin air. While we may think this option is “better” than outbursts of anger, both of these approaches come with the potential for severely negative outcomes from a mental health perspective. I won’t go into all the problems that suppressed feelings can cause, but let’s just say they are too many to count.

But affect tolerance does not just apply to anger. It also applies to our ability to tolerate the experience of feelings of sadness, jealousy, shame, fear, and really any emotion. If we cannot tolerate the felt sense of these feelings, then we have to try to get rid of them somehow either by transforming them into something else, acting them out, or suppressing them. Often (but not ALL the time) this difficulty in tolerating affect can then start to show up as one or more mental health symptoms. For example, if I can not tolerate my feelings of sadness, maybe I start to feel anxious whenever something reminds me of my sadness. Over time, my unexpressed sadness might build up so that more and more things remind me of it, and thus more and more, I feel anxious. Then bang, a therapist might say I have an “Anxiety Disorder.” But really, what I have is difficulty tolerating my feeling-state of sadness.

The prior example is very simplified. I’m not saying things are always that straight forward. However, I am saying that without the ability to tolerate our affect, we are more likely to experience mental health symptoms. Therefore learning to tolerate our affect can be thought of as a primary goal in therapy work. The good news is that it is a very learnable skill.

Before ending the article, I’d like to give you some tips and tools to better develop your affect tolerance. I’d also like to point out some behaviors that can negatively impact affect tolerance and contribute to issues for you now or down the road.

Activities That Support Affect Tolerance:

1. Mindfulness Meditation- You probably guessed this one if you read this far. Mindfulness is all the rage in mental health, and there is a good reason for that. In Mindfulness practice, we begin to learn how to observe our thoughts and feelings without reacting to them. This effectively helps us develop the skill to tolerate our feeling-states.

2. Journaling- When we journal we express our thoughts and feelings and can see them in front of us. Over time this process can allow us to accept our feelings as they are without acting them out or shutting them out.

3. Drawing- You do not have to be an artist in order for drawing to be helpful. I know I’m not. However, drawing or coloring touches into the right side of our brains which is thought to be the side connected with our emotions. Even if we just choose a color to represent our affect state and start scribbling that color, we give ourselves an opportunity to develop a tolerance for and express that affect state.

4. Therapy- One goal of therapy is about learning the skill to tolerate our affect. Most therapists have developed this skill through their own therapy process, or through sitting with other folks for countless hours as they express their feeling-states. When looking for a therapist, try to find one that helps you feel at ease in sharing your feeling-states, no matter what they are.

Activities That Do NOT Support Affect Tolerance

1. Substance Use- Any substance use that alters our mood in a significant way can negatively impact our ability to tolerate affect— especially if it is habitual use. This really deserves a longer post, but in essence, even if I don’t use alcohol or marijuana or something else because I WANT my anger or sadness to go away, the process of getting high or taking the edge off does change my feeling-state from one state to another. If this is repeated over time, I may become LESS tolerant of my feeling-states because I’ve learned that I can change my mood almost instantly with little effort. The problem is not only can I start to depend on the substance to tolerate my affect even if I don’t intend to, but if you take away the substance I haven’t practiced other skills for affect tolerance, thus I will have start from square one every time…

2. Raging, Blaming, or Shaming Others- Sometimes people think that the opposite of suppression is to unapologetically let their anger and hostility out onto others. This may allow them to experience some temporary relief, as they have discharged their intense feeling-state. However, this is NOT what is meant by affect tolerance… rather it indicates an inability to tolerate affect. As we do this, we may become accustomed to managing our feeling-states by placing them onto others. However, the end result is that we will experience MORE conflict in our relationships, more pain, and less peace of mind. These are the opposite outcomes of true affect tolerance.

3. Disavowing, Suppressing, Denying Our Feelings- Disavowing means that we say that we don’t feel some way when we actually do. Suppression is when we “stuff,” our feelings away, hide them, or deny that they exist. These are all indicative of an underdeveloped ability to tolerate affect. While these may function as a short-term coping strategy, in the long term they could contribute to mental health symptoms, unsatisfying relationships, and/or poor self-esteem.

Conclusion: This article is an introduction to the idea of affect tolerance and its importance to all of our mental health. Developing affect tolerance is a consistent practice that is very attainable for most people. It isn’t always easy, however, and it takes work. But the reward is worth it as we start to notice ourselves feeling more at ease with our feelings, ourselves, and able to talk about our emotions more readily in our relationships.

Distinguishing Two Kinds of Attachment

Attachment is an important idea in both contemporary psychology, and in the genesis of Buddhist thought. However, for folks who share an interest in each of these disciplines, it’s possible to get tripped up on the word—that is if we are trying to connect the attachment in psychology to attachment in Buddhism we may begin to scratch our heads. Despite utilizing the same word (at least in translation), these two concepts are totally different.

Attachment in psychology is based on the research of John Bowlby and Mary Ainsworth. This research focused on the bond between infant and mother. In essence, the theory postulates that the child may develop different “styles,” of attachment bonds based on their relationship with their primary caretaker. The ideal attachment bond being a “secure” one. Developmentally speaking, this bond forms a kind of template that the child then brings into future relationships—even into adulthood.

Let’s zoom out a little to address the importance of security for a child. As humans we depend on our parents for a long time relative to many other species. Security in relationship to our parents quite literally could mean the difference in our survival nowadays and also in our evolution as a species.

Yet, when that security is absent from the side of the caregiver (and there are many ways this can happen… I won’t get it into all of them here) then the child has to develop other strategies to cope with this insecurity. This idea lends itself more to the more traditional psychoanalytic concept of defenses… however it is definitely relevant to attachment.

While I am taking a very broad brush stroke here, I am attempting to illuminate the connection of these ideas of attachment and security in relationship to our development as individual and relational human beings. In an ideal sense we need relational security as human beings in order to feel at ease. When we don’t get that, it’s possible we can have trouble regulating our own emotional realities, and relating to others.

However, the reality is that we live in a fundamentally insecure world. While developing security is essential to emotionally healthy relationships, there is also the idea that existentially speaking, nothing can ever be that secure. This is what Buddhist thought seeks to address.

There are many different strands of Buddhist thought, however they all seem to emerge from the idea that not only is our world fundamentally in flux, always changing, but our self is too. In fact, according to Buddhism, if we look closely what we call “the self,” is more of a conglomeration of constantly changing streams of consciousness than a static entity. If we look even more closely, we might discover that “the self,” is not able to be found.

Attachment here is when we try to concretize or fixate something that is by nature always changing. We try to hold on to that sensation of joy as long as we can only to find out that it’s replaced by a loss. Inversely, we might try to get rid of the feeling of loss by eating a whole bunch of ice cream. We might feel better momentarily, but then we might feel sick. This is sort of a game our minds play to try and somehow keep us from pain, but according to Buddhism the end result is always that we end up feeling quite sick. That is because we try to dictate to “reality,” the terms that are acceptable to us, but this is not really possible because everything is always in flux.

So attachment in Buddhism, the literal translation of which is “thirst,” is really considered to be the primary cause of dis-satisfaction in life—which is sometimes translated as suffering.

Why am I making this distinction? Well, terminology is difficult. In the US, Buddhist thought is often lumped into the psychology category and for better or worse these two traditions are associated here. The two kinds of attachment are about entirely different topics: relational development and existential malaise. Sure they may intersect, but their contexts are different.

I believe both are relevant to our understanding of psychology and mental health as a whole. We should just be careful about defining our terms clearly, understanding their appropriate contexts, and discussing how they are functionally relevant to us as human beings.

Is Cannabis Good For My Anxiety or Depression?

There are some folks out there who consider cannabis to be a panacea—a substance that is effective for all ailments. When it comes to mental health, I've read that some believe marijuana helps anxiety, depression, and PTSD (1), …but is this really true? Does weed actually help with these issues? When one does some research into this subject, it is very likely they will find mixed messages.

The reality is that there are many unknowns about marijuana use and mental health. However, just because there are unknowns doesn't mean we should throw caution to the wind. Rather, I would be inclined to interpret that such results suggest exercising extraordinary caution when it comes to using cannabis in any way related to mental health. Let's look at why…

Research has shown a correlation between marijuana use and depressive symptoms. A 15-year study of a group of nearly 2,000 adults in the US showed that marijuana use increased the risk of major depression at the follow up by nearly four times (2). According to the same study, marijuana use was specifically associated with an increased risk of suicidal thoughts and chronic low-energy (anhedonia), both symptoms of depression. Similarly, the CDC noted an increase in suicidal thoughts of heavy cannabis users compared to non-users. That being said, it is unclear if these results are causally related to marijuana use or simply due to already depressed people trying to medicate themselves with weed. I myself am reluctant to turn a blind eye to the correlation. 

In another study, researchers found that cannabis use was correlated with a significant self-reported reduction of depressive symptoms in the short-term. The same study noted that repeated marijuana use led to no long-term symptom reduction or remission and may increase depressive symptoms over time for some people (3). Another way of thinking about this research's findings is that marijuana is often used to alter mood. Still, over time such mood alteration does nothing to actually change the patterns of this mood or the individual's relationship to the mood. Lastly, I will state that long-term marijuana use has been associated with amotivational syndrome, a term to describe apathy, social withdrawal, and lower level of everyday functioning (4). We will return to some of the ideas in the following paragraphs. Still, for now, let's look at how cannabis may impact anxiety.

What should we expect in regards to marijuana and anxiety? Most are aware of the paranoia and anxiety that can accompany early exposure or overexposure to marijuana. Of more interest to me in this segment is the interplay between marijuana as it impacts the processes of anxiety over time and the impact of self-medicating anxiety with marijuana. 

One thing is relatively certain regarding chronic marijuana use and anxiety. Research indicates that long-term users are more likely to develop social-anxiety than non-users (5). Additionally, while using cannabis could help relieve anxiety with the correct dosage in the short term, one study reported that anxiety symptoms returned upon cessation of marijuana use (6). In considering the usage of cannabis as a treatment for anxiety disorders, it is important to note that regular use is likely to include tolerance. This pattern may increase the risk of anxiety upon cessation of use and, thus, psychological dependence on marijuana (7). According to Volkow et al. (2017), as of the time of that study, there have been no randomized controlled trials to show sustainable benefits of marijuana as a treatment for anxiety disorders (7).

What’s the issue with “dependence” If I think cannabis helps with my anxiety or depression? Most people know that marijuana does not include the same physical dependence that heroin or alcohol does. However, there is evidence that there can be withdrawal symptoms associated with long-term use which may include: aggression, anger, irritability, anxiety, insomnia, anorexia, depression, restlessness, headaches, vomiting, and abdominal pain (8). Perhaps not everyone would experience such symptoms, however it is important to note that these are genuine possibilities.

Some cannabis advocates may argue that it is more natural than pharmaceuticals, which may carry their own set of side-effects and potential withdrawal symptoms. While it is true that pharmaceuticals may entail negative side-effects and withdrawal symptoms, these are closely monitored by a psychiatrist, whereas marijuana is most often self-administered. While I can understand the reservation about pharmaceutical intervention for anxiety or depression, I also want to bring attention to an aspect of cannabis dependence that I don't see many marijuana advocates talking about: psychological dependence.

Psychological dependence is often over-looked by pro-pot advocates for reasons I can only chalk up to a lack of knowledge. Stea (2019) described this issue clearly: 

“cannabis can reward by enhancing positive feelings and can also be relieving insofar as it can almost immediately take away the experience of uncomfortable emotions. But evidence-based psychological treatments of many psychiatric conditions involve learning skills to confront and engage with difficult emotions, not avoid them. If cannabis is being used to avoid uncomfortable emotions, thoughts, and memories, it can lead to the development or worsening of symptoms. In other words, repeated temporary relief from psychiatric symptoms by using acutely-mind altering substances is not therapy, and in fact, often runs counter to therapy” (1).

Let me break this down a little more. When we use a substance like marijuana, we alter our mood. This mood-alteration is what people often call “getting high.” That is, using cannabis in any form changes our mood from one state to another. This is why people think marijuana can help with anxiety or depression because they may feel immediate relief. The problem with this is that if we are using cannabis—or any other substance or behavior—to try and change how we are feeling, we are avoiding some aspect of our experience. While this may bring short-term relief, we can grow to depend on marijuana more and more so that we turn to weed every time we feel down, anxious, upset, or angry. If we do this, we may never develop the skills to accept and manage our emotions. Most people have heard of the popular show Arrested Development. Arrested development literally means that we have stopped developing psychologically speaking. Chronic marijuana use or use of any substance may keep us from developing healthy coping strategies that will allow us to function fully in our lives and relationships. 

Our emotional health is directly correlated to our mental health. If we are not able to accept, talk about, and cope with our emotions, then we are much more likely to have issues with our mental health AND our relationships. Why is that? Our emotions are innately part of us. They guide our self-care and our relational needs. That is part of why I prefer to use the term emotional health as opposed to mental health. Paradoxically, even difficult emotions are essential to our emotional health. If we are constantly trying to get away, change, or manipulate difficult emotions, we are more likely to experience anxiety or depression. Why is that? Because difficult emotions are simply a part of life. Therefore, learning how to accept and tolerate these emotions is going to be the best for us in the long term. Emotional well-being includes the capacity to experience the full range of human emotions, while continuing to be in touch with a sense of purposefulness in life.

Because I have a background in studying Buddhist thought, I will also mention a Buddhist perspective on this topic. The Buddha’s principal teaching was to say that dissatisfaction in life is caused by craving. This isn’t just a craving for chocolate or even weed. Craving here means attachment or aversion to however life is showing up for us. That is, when we are attached or averse to anything, we suffer. Please don’t take my or Buddha’s word for it; observe your own experience. When we use weed to try and alter our mood, we are in effect averse to an experience that we are having…From the Buddhist perspective, there can only be one outcome here… and that outcome is dissatisfaction… needing more… and a lack of lasting contentment.

However, you don’t have to believe in Buddhist philosophy to change the patterns of marijuana—or any other—dependence. The first step is always to be aware of the consequences that this pattern of behavior is having on you. Sometimes folks are not even fully aware of these negative consequences until they have some time away from the substance. I know that was how it was for me. The good news is that you can change this pattern. The best motivation happens inside of you, with your own clarity as to how this behavior is an obstacle to you living the life you want to live. Here are some ideas if you want to cultivate a change in your relationship to marijuana or any other problem behavior.

Things to try:

• Make a list of consequences of your substance use. Be honest. Notice if there is a part of you present that wants to rationalize or minimize these consequences. Ask others (see below) if they have observed negative consequences from your use.

• Practice meditation. This helps you develop an awareness of your mental patterns, and with greater awareness comes greater choice. Also, meditation is a coping strategy that can provide us with sustainable changes in our state of mind.

• Attend a Marijuana Anonymous meeting. Yes, they exist. They are full of stoners like me, and maybe you. If you allow yourself to get over your own judgments, you may find a new family of loving, supportive people.

• Ask your friends and family about their perceptions of your use. Sometimes if all of our friends and family smoke weed, they may not see the negative impact it has on us. However, if you have friends or family that use less than you or don’t use… ask them about their experience with your weed usage.

• Journal before and after you use cannabis. Journaling is an excellent practice to help us develop an awareness of our patterns. Journaling before we smoke can help us learn about the feelings we may be trying to get away from by smoking. Journaling when we are coming down or after using may help us develop an awareness of the less desirable side-effects from our use.

• Consult a therapist. When someone comes to me with a chronic weed habit, my first order of business is to try to educate them on how this pattern may be negatively impacting their emotional well-being. Typically, I will tell someone that it is hard to make sustained progress in therapy while regularly using marijuana to self-medicate. That is because therapy is meant to help us learn new ways of coping… If someone is using weed to deal with challenging emotions, they are unlikely to be able to get an accurate readout of how these new coping strategies are helping. That being said, I have extensive experience working with substance use and can work with folks at whatever level of readiness they are to change. Look at my page on addiction here or contact me for a free phone consultation.

(1)Stea, J. N. (2019). "Is cannabis good or bad for mental heath?" https://blogs.scientificamerican.com/observations/is-cannabis-good-or-bad-for-or-bad-for-mental-health/

(2)Bovasso, G.B. (2001) Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry. 2001 Dec; 158(12):2033-7.

(3)Cuttler C., Spradlin A., Mclaughlin R.J. (2018). A naturalistic examination of the perceived effects of cannabis on negative affect. J Affect Disord. 2018;235:198-205. doi:10.1016/j.jad.2018.04.054

(4)Lac A., Luk J.W. (2018). Testing the amotivational syndrome: Marijuana use longitudinally predicts lower self-efficacy even after controlling for demographics, personality, and alcohol and cigarette use. Prev Sci. 2018;19(2):117-126. doi:10.1007/s11121-017-0811-3.

(5)National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. Washington (DC): National Academies Press (US); 2017 Jan 12.

(6)Walsh Z., et al. (2017). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review 2017;51:15-29.  

(7)Volkow N.D., Hampson A.J., Baler R.D. (2017). Don't Worry, Be Happy: Endocannabinoids and Cannabis at the Intersection of Stress and Reward. Annual Review of Pharmacology and Toxicology 2017;57:285-308. 

(8) Grinspoon, P. (2020). Harvard Health Blog. https://www.health.harvard.edu/blog/if-cannabis-becomes-a-problem-how-to-manage-withdrawal-2020052619922

Letting Go of Anxiety: It May Be Easier Than You Think!

We have ALL experienced anxiety at one point or another in our lives. It is that gnawing sense that something is wrong, even if we are not sure exactly what. The American Psychological Association defined anxiety as: “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.” Simply put, anxiety is uncomfortable.

While many may experience periodic anxiety related to the events or circumstances in our lives, some of us develop more chronic anxiety that can have a negative impact on our emotional well-being or day-to-day functioning. Anxiety is a very common issue that leads people to seek out mental health treatment in order to get support in overcoming the challenges that it presents.

The Good News: Anxiety is HIGHLY Treatable

The APA noted that anxiety disorders are highly treatable and that most people respond positively to therapy. In fact, the APA reported that many experience the reduction or elimination of symptoms of anxiety after several—or fewer—months of treatment and that some feel relief even after a few sessions. This is great news! Unfortunately, the Anxiety and Depression Association of America reports that under 37% of folks dealing with anxiety disorders receive treatment. I can only speculate as to why that is. My guess would be that some combination of lack of access to mental health resources, stigma, and lack of access to mental health awareness all play roles in the prior statistic. That being said, help is available and regardless of your income status you deserve support to help you overcome your anxiety. Lets look at some ways we might understand anxiety more fully so that we can move towards healing it.

Getting Anxious About Your Anxiety Only Makes it Worse!

This is a point commonly cited in the evidenced-based therapy model called Acceptance and Commitment Therapy. When we get anxious about our anxiety, we effectively are developing an anxiety feedback loop. This is not only unhelpful in terms of relieving anxiety, it actually most often makes it worse. In the following paragraphs, I will discuss some ways to minimize the potential of getting anxious about anxiety itself. Please note, that these ideas are introductory and should not replace seeking help if you need it!

Anxiety as a Cycle

Let’s take a look at the anxiety feedback loop a little more fully. As I stated in the last paragraph, when we get anxious about our anxiety we develop an anxiety feedback loop. In this light, it may be more helpful to think of anxiety as a cycle rather than an isolated event. According to Cognitive-Behavioral theory, this cycle is held together by our thoughts, beliefs, feelings, and behaviors. The anxiety feedback loop predisposes us to interpret our experience through a lens of fear and worry, and when we do we are likely to alter our behavior to avoid whatever triggers anxiety in us. Therefore, from a CBT perspective it is best to become aware of the thoughts that contribute to our anxiety and to truly examine their validity. In this examination, its possible we may arrive at alternate conclusions than the ones we accustomed to; conclusions that are outside of the anxiety feedback loop. From a CBT perspective cognitive distortions often contribute to anxiety. So we want to be able to ask ourselves if we are stuck in unhelpful thinking patterns, and if we are to try to develop new ways of thinking about our experience. A therapist can help guide you through this process, and often it can bring significant relief from anxiety.

Anxiety as Physiological, or Somatic Sensations

In the anxiety cycle, thoughts are not the ONLY aspect of our experience that are present. Rather, accompanying thoughts are physiological, or somatic (simply a word for our felt-sense of our bodies) sensations. Often these sensations are uncomfortable as in the experience of bodily tension, irritation, the feeling of being ungrounded, or even an increased heart rate. In the anxiety feedback loop, what can happen is that we can say to ourselves these sensations shouldn’t be happening. Of course, this is natural to say. Instinctively we want to move away from discomfort. However, the problem is that when we tell ourselves that something shouldn’t be happening when it is already happening, we are most likely going to experience more anxiety. Why is that? Because in rejecting what is happening for us already, we may feel paradoxically less in control which can then feedback into our anxiety. Therefore, many approaches to the treatment of anxiety such as ACT, CBT with exposure therapy, and mindfulness based treatments actually suggest that we learn to tolerate or observe the uncomfortable experiences rather than trying to suppress, avoid, or judge them.

Mindfulness & Self-Observation

For many, the suggestion of learning to observe or tolerate these sensations associated with anxiety is sort of underwhelming. “But I want the sensations to go away!” Of course everyone wants relief, it is only natural. I have experienced chronic pain, so I really understand. However, because anxiety is a cycle we have to be aware of the parts that keep that cycle in place… And the evidence shows that trying to reject our experience typically feeds back into the anxiety. Thus, rather than replicate this cycle, the suggestion is to learn the capacity to observe without reacting. This is really what the practice of mindfulness is. It is a kind of self-observation where we learn to notice our mental patterns without stepping inside of them.

The mindfulness that is practiced in the mental health field originated in the context Buddhist thought and practice. In Buddhist thought, suffering or dis-satisfaction is caused by attachment or aversion. Now this can go as deep as you’d like it… However, the main point here is that this is exactly the same for anxiety. As natural as it may be, aversion to the physiological and somatic experience of anxiety actually increases our suffering. Therefore, to practice observing without reacting allows us to more readily accept our present-centered experience, which while it may include sensations that we calling “anxiety,” likely also includes other sensations, the space around those sensations, and the observation of those sensations. In other words, mindfulness or meditation allows us to widen our mental aperture which so often gets narrowed when we are in an anxiety feedback loop.

Final Thoughts and Suggestions

Anxiety is challenging to cope with, but it can get better. Sometimes people get better quickly, sometimes it takes longer. Regardless, there are practical steps you can take to reduce the impact of anxiety in your life. Therapy can be extremely helpful in helping folks get unstuck from the anxiety feedback loop. Learning to identify our thoughts that contribute to anxiety can help us choose alternative ways of understanding ourselves and our experience that don’t contribute to the cycle of anxiety. Self-observation or mindfulness practices help us learn to observe without reacting which ultimately helps us to reduce our anxiety over time. For folks new to mindfulness, there are many apps that teach this practice. Head space and Calm are apps with a variety of guided approaches to meditation. I personally recommend the work of Dr. Richard Miller and iRest which is an evidenced-based guided meditation practice shown to help with depression, anxiety, and trauma. iRest actively supports us in cultivating the skills to observe without reacting to our body sensations. It also helps us cultivate a relaxed state of body and mind. I also wrote this blog post on tips to develop a regular meditation practice. Read more about my approach to anxiety, or contact me for a free phone consultation about how therapy can help.

Boundaries 101

Boundaries are an often cited, yet commonly misconstrued psychological idea. Difficulty with boundaries is one of the most common issues I see with clients dealing with a variety of presenting problems—from anxiety, and depression to life transitions and relationship conflict. I had the good fortune of completing a two year training with the former Bay Area affiliate of the John Bradshaw Center where a premium was placed on learning boundaries.

Perhaps the easiest example of a boundary system is that of the cell wall. Simply put, cell walls keep out the bad stuff and let in the good stuff. While that may be an oversimplification, it is a helpful guiding principal. Similarly, our boundaries are a part of our emotional self-care system. They express a limit, whether that be physical, emotional, sexual, intellectual, or spiritual. When we have poor boundaries, we open ourselves to harmful experiences or dissatisfactory relationships. On the other hand, if we have too rigid of boundaries, we might not let in some of the emotional nourishment we need.

I teach people that boundaries are always connected to our feelings and needs. You might say that feelings are our best guides to our needs and limits. Often when people come to therapy, they have difficulty identifying their feelings. This is common, and not a reason to feel shame. However, when we have difficulty identifying our feelings, it is very hard to ask for what we need in relationship and to set limits.

The first step in having good boundaries is to develop awareness of our feeling states. How do I experience myself when I am angry? Sad? Ashamed? Scared? Hurt? Knowing the cues to these emotional experiences allow us to plug into our emotional self-care system, to clearly define our needs and limits. For example if I know I am sad, I might just need to ask for some reassurance or for someone else to listen while I express my feelings. If I’m frustrated or resentful with someone else, its very possible I have been neglecting my boundaries. If these feelings arise, there is always an opportunity to check in with myself and say… “Do I have a limit here that I haven’t expressed?” “Is there something I am needing that I haven’t asked for?”

Boundary work is a practice. It’s an ongoing learning process that takes time, self-observation, and self-love. We are all works in progress. I am confident that you can learn boundary skills and that knowing these skills will benefit you greatly. I will post more in the future about this very important topic, but for now… be well!

5 Tips For Cultivating a Meditation Practice During COVID

Despite the challenges that it presents, living in the time of COVID also offers us a unique opportunity to look at how we practice self-care. Of all the forms of self-care practice, perhaps the most commonly recommended is meditation, or mindfulness. In this post, I am going to discuss some tips for developing a regular meditation practice. I have practiced meditation in fits and starts since I was 20 years old, with extended periods of daily meditation. It changed my life, and it could very well change yours. So here it goes:

1. Consistency is the best way to practice. In almost all cases, is better to practice a little (5-10 mins) regularly than a lot rarely. Meditation is a form of workout for your mind. When we work out, we start small and build up. Other ways to help stay consistent is to develop a routine. Try choosing the same time every day, or meditate after you do something else that you do everyday (e.g. brushing your teeth). Try meditating in the same place. Find what works for you, and do your best to commit to that daily.

2. Don’t judge your practice. I can’t tell you how many times I have heard, “I’m not sure meditation works for me… I was so distracted while trying to meditate!” People often think they are supposed to be laser focused from the get go during meditation. While some advanced meditators may get to that stage (so I have heard) for most of us this is NOT realistic as we start out… In fact, distraction is a normal part of meditation! What is important is that you are paying attention. It is best to not place such high expectations on our meditation practice, and to see it as a process of learning about our minds.

3. Try some different meditations, but then stick to one practice that you connect to. I am all for people trying different meditations. There are apps that may guide you through several different kinds of meditations. However, at a certain point if we are trying so many different meditations we might end up getting confused. We might not be able to develop a rhythm or relationship with that practice. In meditation the idea is that we are not giving ourselves MORE to think about. Therefore, I suggest that once you find a practice you connect to that you give it some time to go deeper with. That is not to say you have to be locked in forever, just try being consistent with one practice for a month or two. If you feel inclined to try something else after that, then go for it. If you are comfortable in your practice at that time, then keep it up!

4. Be kind to yourself. If you miss a session, don’t beat yourself up. If you are so distracted during a session that you lose hope, don’t worry. You are human, and meditation is not about being perfect. There is no benefit to shaming or putting undue pressure on yourself. Rather, try to remember what motivates you to meditate. What is good about it. Meditation is a privilege, not an obligation. It is something to do for your health and well-being out of self-love, not self-hatred.

5. Enjoy it. This one might seem difficult if you are new to meditation, and just learning how much your thoughts run the show. Yet, I am very confident that if you stick with it, you will find pockets deep enjoyment that come with giving our minds the opportunity to rest. No need to chase the experience, but when it shows up its okay to appreciate it and gently remind yourself that this is one of the greatest gifts you can offer to you!

Building a Legacy

I am not a fan of the hyper-individualism that is marketed to us everyday. I have no intention for the name Legacy Psychotherapy to be used to sell you the idea that I can help you “be your uniquest self.”

Yet, I do believe that our actions have enormous significance. What we do speaks volumes about who we are. And I’m not saying this to try to pigeon-hole anyone either. When it comes to leaving a legacy, what we leave is in our actions.

Good therapy should reflect this. The proof is in the pudding. That is, good therapy should support us in learning to take actions that are of significance to us, or in alignment with our values. Additionally, it should support us in learning to not take action when that action would compromise our values.

Therapy is a self-awareness building exercise. Family therapy is a self-and-other awareness building exercise. When we develop awareness of our patterns, and motivations behind our behaviors we actually increase our ability to make choices about how we want to act. That is, with increased awareness, there is increased choice. It is my opinion that such choices offer us the opportunity to live a life full of meaning, self-empowerment and integrity.

In therapy, I first try to understand what motivates “problematic” behaviors in my clients, whether in adults, children or in families. We do this by bringing attention to and reflecting on our feelings, thoughts, and behaviors. Often there are feelings that have never been talked about, or we might struggle to verbalize. In learning how to talk about these feelings, we open the door to new possibilities for our actions.

However, there is no perfect. This process is one of continual trial-and-error. With children this takes patience and support from parents. With adults this takes learning how to accept the myriad of feelings that are part of our human experience. In each case, I am here to support you along the way. I am so confident that you or your child can make progress through this process, whether it is with me or another therapist. One of my mottos is that “showing up is half the battle.” If you have questions pertaining to the therapy process, please reach out to have a free consultation with me. I would be glad to offer my experience to you.