Boulder Counselor and Therapist | David Robbins, MA, LPC

Often when the subject of psychotherapy comes up one thinks of rehashing the past and analyzing the current situation using the conceptual mind. As if we can think our way out of different emotions. The mindfulness approach to working with the condition we call anxiety would be very different than this. As a therapist who utilizes mindfulness I encourage experience – meaning we directly contact our body and sensations associated with an emotional experience. We don’t think about them – we tune in and feel them directly as they are happening in the present moment. With anxiety these sensations are often quite unpleasant – a lump in the throat, tightness in the chest, difficulty breathing, perhaps tremors in the body, sweating, clenching the jaw, flushed skin, etc. With a mindfulness experience in psychotherapy we learn how to contact and direct our concentration and awareness to be with these sensations without being overwhelmed by them. Breaking them up into manageable pieces instead of one chunk of overwhelming anxiety that feels as if its going to break us apart or send us into panic. There is of course a mental element to this experience as well – often the mind is teeming with negative dialogue – perhaps worries or fears, or potential negative outcomes. For many people who experience anxiety there is also an inner dialogue of self-hatred. With a mindful approach to psychotherapy we also learn how to look at and witness these thoughts directly – we do not fight them as often we attempt to do to make unpleasant thoughts go away. Thoughts are often an unconscious battle or an attempt to distract us from the unpleasant sensations in the body. If the sensations in the body can be observed and stayed with – using an unconditional awareness they naturally resolve and integrate. Often our thoughts are so strong they move us out of the body and into the mind, and we get overwhelmed with the content of these thoughts. These thoughts are overwhelming us and also interrupting an organic experience of emotion in the body. If this experience can be tracked with awareness – it often resolves into a healing, releasing and integrative experience. As an experiential psychotherapist it is my job to facilitate and teach you how to be with your emotional experience this way. With mindful awareness we encourage complete experiences of emotions – that are uninterrupted – and allow you to heal and let go of the sense of stuckness that accompanies months or years of interrupted emotional experiences that overwhelm and accumulate in our bodies and minds.

With a mindfulness-based therapy we learn how to embrace our experience without having to resist or fight it, allowing ourselves to heal without fear. If you are interested in learning more or scheduling an appointment or free consultation call 303-225-2700.

Eye Movement Desensitization and Reprocessing (EMDR) is a comprehensive, integrative psychotherapy approach. It contains elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2.

EMDR psychotherapy is an information processing therapy and uses an eight phase approach to address the experiential contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.

The above information about EMDR was taken from the EMDR Institute Website. For further information on EMDR follow this link.

I utilize EMDR as a adjunct therapy to my unique blend of mindfulness based experiential therapy. It is also possible to use this treatment as a standalone therapy for certain clients who desire this, assuming this is the best possible modality for working with the the presenting issue. In our first few sessions together we will discuss various options for working with your particular situation and decide the best possible way to proceed.

Anxiety can come in many forms. It can range from a low level agitation, chronic worry, specific phobias or fears, to flashbacks of traumatic experiences and full on panic attacks. Mindfulness-based therapy in very effective in treating and resolving the reactions that create anxiety. These reactions, that are the core of our suffering, are usually a constellation of mental activity (thoughts) and body activity in the nervous system (emotional type body sensations). By using a mindfulness approach we can desensitize ourselves to reactions we experience, both mentally and physically, and reduce or eliminate the suffering produced by situations that would have previously been very unsettling or even terrifying. The mindfulness approach to working with anxiety allows one to gently accept and feel their experience without being overwhelmed by it. On the level of thoughts, one can work with anxious thoughts using mindfulness as a anchor and keeping ourselves from getting too wrapped up in agitating or fearful thinking, worrying, etc.

Most of my clients begin feeling relief from anxiety after the first 2-3 sessions. If you are interested in finding out more feel free to contact me for a free 20 minute consultation, in person or on the phone.

Often when we are feeling sad, depressed, or stuck in our lives we feel this sense of void in our lives. This may be slowed thinking, emptiness at an emotional level or just the sense that things are still in our lives – not alot is happening. I experience this feeling as a heaviness in body, with an energy that has a downward movement. Mentally, things are slow and maybe there isn’t much occurring there except for some circulating repetitive thoughts. Often, I experience this first thing in the morning, before my ‘self’ has fully coalesced.

This is actually a unique opportunity. This void might be correlated with emptiness or ‘nothingness’ that is talked about in Buddhist psychology. A Buddhist teacher that I study with calls this the great unborn and Gestalt therapist Fritz Perls refers to this experience as the fertile void. Both of these terms suggest a creative aspect of this void or empty state. There is potential in nothingness, but the Western culture (where efficiency and constant production are prized) often fails to see this as a valuable experience. There cannot be manifestation without nothingness, we must have times of stillness where we do not produce. In fact, I would go as far as to say that we must rest in nothingness sometimes in order to be able to create sometimes.

In my experience as a student of spirituality, a musician and a psychotherapist I have been shown that the most fruitful and creative times for individuals come after a period of nothingness, void-ness, or emptiness that is completely embraced by that person (or group). Often an experience of this kind of not-alot-happening is seen with aversion or distaste and we try to push it away or move out of it, perhaps even feeling a sense of dread or fear. I would suggest that a more useful and healing way to approach this void-like space is to accept it or even welcome it to the best of our ability. Being curious about it – what does this feel like…what is this, we might ask ourselves.

The more we embrace this time of nothingness the greater the rewards in terms of what springs forth from the fertile void. We tend to suffer greatly when we try to push through this and make something happen. Instead, paradoxically by feeling and embodying the nothingness or fertile void as much as we can, it seems to move into another energetic space quite quickly. The struggle with it seems to elongate the experience and enhance a belief that this period of nothing will not pass. Often we simply need to give up and feel the emotional/physical experience of void – it is a form of rest mentally, physically, and emotionally. I might liken it to the time in between planting and harvest, when there is no sign of the plant yet, but we must wait for patiently for the water and fertilizer to do their jobs. If we get out of the way by simply letting this process of fertile void occur the harvest you experience will be worth waiting for.

This way of framing depression, stuckness, or nothingness in our lives goes very contrary to many of our beliefs, largely because of where we were brought up. Often it is helpful to seek out therapy or counseling, or some kind of support to help us unwind the beliefs and resistances to this experience that can keep us in a state of depression, anxiety, fear, or stuckness.

Most of us at some level assume or believe that we ‘should’ feel joyful. On the other side of this we probably believe that we ‘should not’ feel fearful. I am most interested when talking about feelings or emotions, such as joy or fear, in looking at the bodily sensations that make up this feeling in the body. You might experiment with this by recalling a time when you felt joyful. Bringing this memory in all its technicolor detail into your mind. Then drop into your body, particularly paying attention to the jaw, throat, chest, stomach, pelvis and notice what sensations are occurring. For me it is expansion in the chest a freedom and looseness in the jaw and throat – that is what I notice most. What do you notice most? Identify that – this is your body’s experience of joy – this i what the mind categorizes as joy when it occurs in the body.

We can do the same with fear. Bring up a memory in which you experienced a fearful time. Again noticing the body – I feel tension in the jaw and a general sense of constriction and tension in my chest and stomach. Notice what your experience is in the body.

Our ‘normal’ or homeostatic state is most likely mid way between these two extreme poles of feeling/emotion. As dynamic beings we need to understand we may move through these sensations, but they will arise and fall away, leaving us somewhere in the middle. We can welcome both of thes states and the dynamic rising and falling, contraction and release, of bodily sensations that leads us there. We don’t really need to strive for either state and we will experience both, if we allow the full spectrum of these sensations. Giving ourselves the permission to feel both poles of emotion and to let go of striving for any idealized state is the key.

Pema Chodron, a revered teacher in the Shambhala Buddhist tradition refers to this as letting in all unwanted guests (and the wanted ones such as joy, happiness, hope, etc.) In the end it is just our experience, our life – by allowing joy we allow fear and by allowing fear we allow a full experience of joy.

In the course of my work doing couples therapy and in my own committed relationship, I’ve noticed one of the biggest challenges is communicating honestly, with compassion and empathy. The Mindful Couples Dialogue, offered here, is a way of approaching difficulties around conscious communication.

With our romantic partners, we often get caught in habitual ways of communicating. You may find yourself avoiding certain topics that you fear may cause conflict, or withholding information that may be emotionally charged or challenge our view of what our partner can ‘handle.’

It is true that relationships bring up our biggest fears, vulnerabilities and insecurities. Your partner may have a reaction to what you want to communicate or share about. It is, however, important to enter into dialogue that may be challenging to one or both of you, as really hearing, understanding, and empathizing with each other has the potential for great healing. This is a wonderful opportunity that romantic relationship offers us.

Our habitual communications with our partner often feel dry, rehearsed and without vitality. This is the case with anything routine and habitual. I am going to suggest here a new framework for interacting that will allow and your partner to interact with more presence and authenticity.

Identify an Issue

One helpful way to identify an issue is to ask your self: What in this relationship or within myself feels unfinished or unresolved?

Then close your eyes and allow that question to fall away. Be aware of the thoughts and feelings that arise. There may be something, a situation or a feeling, or a pattern that has been re-occurring in our lives – something that comes up in our thoughts, perhaps accompanied by fear or anxiety.

Give this issue a name. Perhaps jot down the thoughts and feelings that arose from this exercise.

Make an Appointment
The next step is to make a time with your partner to talk about this unfinished and unresolved issue. Allowing a time when you two have an hour or 2 discuss it. It is best to do this at a time when you both can make your best effort to be present and unpressured by other obligations.

You may bring this up with your partner by saying: ‘There is something important I’d like to talk with you about, can we figure out a time to sit down and spend some time discussing this?’ or present it in whatever what feels comfortable to you.

The Dialogue
In this format of communicating mindfully we will give up the usual tennis match style of communication that happens, particularly around emotionally reactive or conflictual issues. I will ask you instead to have one of your be the sender and one to be the receiver.

The Sender
The sender’s job is to communicate in a non-judgmental way about the issue that they identified in step one. To this end we will not use statements like ‘You make me feel so angry when you…’ and instead own our own feelings our own reactions. The formula for this would be to state things in this format:

I feel _________ when you ____________(fill in the behavior here).

An example: I feel angry and hurt when you come home late from work without calling to let me know.

This type of a statement will diffuse much of the defensiveness that gets in the way of our partner really hearing and understanding how we feel. The golden rule here is to talk about your feelings and reactions using I-statements. Also, to talk about behavior without judging or blaming your partner.

It is important to specifically label behavior. We would not want to say ‘I feel resentful and hurt when you you act like a jerk.’ Instead we would label the behavior that we react to. ‘I feel resentful and hurt when you won’t answer my questions and ignore me.’

I would then expand on this to include anything that comes up for you in the moment perhaps: ‘When you ignore me and don’t answer my questions it reminds me of when my Mom gave me the silent treatment when I was a kid. I felt so sad and powerless when she did that.’

It is important to pause between each statement and take a breath, allowing whatever needs to to arise. And communicate what you are feeling and what comes up for you in this non-judgmental way.

Only say a few sentences at a time, as your partner (the receiver will be reflecting back what you have said.)

The Receiver
While the sender is speaking, the receiver will be doing reflective listening. This will be difficult as all sorts of feelings and thoughts will be coming up in reaction to what our partner is saying. Our main job here is to put our feelings and thoughts ‘on the shelf.’ You might envision putting all ‘your stuff’ on a shelf or in a container and you will get your chance to share.

For the moment I want you (as the receiver) to listen to what your partner is saying and try to understand what they are saying. After a few sentences you will then paraphrase or reflect what they have said using your own words. It is helpful to imagine walking in your partners shoes – and expressing to them what you imagine it must of felt like to them.

For example:

‘I hear you saying that when I don’t answer your questions and you think I’m ignoring you that you feel hurt and resentful. This reminds you of when you were a kid and your Mom gave you the silent treatment. That must have been really awful for you to feel so sad and powerless. Is that right?’

Every so often ask the sender if there is more, or if you got that right. The sender can then correct the receiver if they didn’t feel they understood correctly. The goal here is to hear and understand your partner, so try to refrain from defensiveness or reaction if your partner corrects you.

You should proceed in this way, with the sender continuing to share and the receiver continuing with reflective listening – showing understanding and empathy.

Switching Roles
After a certain amount of time the Sender will feel that they have been heard and understood. The sender should let the receiver know that they feel finished. At this point, the sender and receiver will switch roles.

It is important to take a few breaths in between switching roles just to come back to yourself, to touch your thoughts and feelings. Now the receiver is the sender and you can take your thoughts and feelings off the shelf. It is your turn to speak and be heard and understood by your partner. You may notice that what you thought and felt before the dialogue has shifted and changed. Speak from what is true for you in the present. What you are thinking and feeling now?

You should then proceed until your partner feels complete as the sender.

This process fosters a sense of in the moment communication, as we pause and let the partner reflect back to us, more may arise or we may get the sense of being understood on a deeper level. Often we are so busy in emotionally reactive dialogues and arguments preparing our defense or our new attack that we never really hear or acknowledge what our partner is saying. This process of speaking one at a time, and listening and reflecting bypasses this tennis match style of communication. Give this a try – practice makes perfect!

Often the most challenging part of this is thinking and crafting our words to remove blame and just identify our reactions and the behavior that may have trigger them. Remember, no one ‘makes us’ feel a certain way. One partner behaves, the other reacts. We each own our own feelings and have to take responsibility for them.

The job of the receiver is also difficult to remain calm and open despite feeling reactive to what the sender is saying. Just remind yourself that you will get your turn and try to really hear and open to what your partner (the sender is saying).

This exercise can be a profound paradigm shift when it comes to communicating with your partner. I often suggest that the first dialogue that a couple attempts in this way be for an issue that is about a 4 or 5 in intensity (with 1 being the least intense and 10 being the most intense and conflictual issue). In other words, start with something small to practice with and work from there to the bigger and more emotionally reactive issues.

Best Wishes,

David

Having the blues for a few days at a time is normal. Usually these feelings are temporary and will pass after a few days. If you experience low mood, sadness, and hopeless for weeks, or even months at a time, there is a good possibility you are dealing with depression.

Some of the common signs/symptoms of depression are:

* Persistent sad, anxious or “empty” feelings
* Feelings of hopelessness and/or pessimism
* Feelings of guilt, worthlessness and/or helplessness
* Irritability, restlessness
* Loss of interest in activities or hobbies once pleasurable, including sex
* Fatigue and decreased energy
* Difficulty concentrating, remembering details and making decisions
* Insomnia, early–morning wakefulness, or excessive sleeping
* Overeating, or appetite loss
* Thoughts of suicide, suicide attempts
* Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

If you are experiencing these symptoms, over the period of two weeks or more, it would be a good idea to see a counselor or mental health professional. Medication can be a very valuable part of treatment for depression, but studies show that the most effective outcomes for those suffering with depression come with the use of counseling and medication. Counseling has also been shown to be at least as effective, or in some cases more effective than medication alone.

Often, when we are depressed we have lost touch with our inner world. We have numbed out and are wrapped up in ruminations, or persistent thoughts that often have a flavor of despair, desperation, and hopelessness. We often feel lethargic and heavy in our bodies, without much energy.

Despite this lethargy and exhaustion, getting out of the house and moving can often be one of the most effective forms of treatment for a depressive state or low mood. I often recommend 3-5 days a week of a half hour of aerobic exercise, such as jogging, or a vigorous walk. Even a short walk can make steps towards elevating our mood.

When I work with clients who feel depressed, I stress the movement away from the hopeless (and often non-stop) train of thoughts that run through one’s mind when we feel low. We cannot stop the thoughts, but we can loosen their hold on us and question our belief in the negative things that our thinking may be saying to us. If we can feel the body, we can start to dis-believe and let go of negative thinking patterns that are perpetuating depression. We can also reconnect with our body and awareness of the sensations of our body. In doing this we naturally move away from negative thoughts and energy starts moving in the body. When we begin to re-engage with our bodies we become more present in ourselves and our lives – this is a movement towards health and healing.

Below is a simple mindfulness exercise to start loosening the hold of negative thinking and re-connecting with the body:

Sit in a quiet place where you will not be disturbed, allowing 5-10 minutes
Begin to feel your feet on the floor (you may only be aware of a slight pressure or the flow of blood etc.)
Notice when your attention has been drawn away from the sensations in your feet
When you notice this gently let go of whatever you’ve been paying attention to.
Gently come back to noticing your feet and the sensations in that part of your body. (we are not trying to stop our thoughts, just to move our awareness to the body allowing the thoughts to continue in the background without paying attention to them.)

This sounds incredibly easy, but if you try it you will find how hard it is to stay concentrated just on the sensations of the feet. Our thoughts are very distracting and seductive; particularly when we are in a low mood or depressed state. If you practice this once or twice a day it will become easier to be aware of the negative thinking that perpetuates depression, and you will be able to quickly move away from them, and into your body. This will loosen the hold of your negative thoughts and usually our sad and hopeless feelings will begin to subside as well. Give a try.

You are more than your thoughts. Through this simple mindfulness exercise it becomes apparent that we can choose whether or not we believe negative and self-critical thoughts. Often our thoughts are simply a habitual script we learned at some point and are repeated in our minds during an associated mood or feeling state. These thoughts lose their power over us when we choose not to believe them by moving our concentrated awareness back into the body (as in the exercise above).

In the case of depression, negative or self-critical thinking can often perpetuate low moods and disturbing feelings. If we loosen the hold of our negative thinking often sad, hopeless, or despairing feelings will merely arise and pass away, rather than becoming a solid and perpetual state.

If you believe you are experiencing depression, do yourself a favor and seek out counseling. A therapist or counselor can help you learn to skillfully work with depression and re-connect to your life so your depressed feelings will lift and you can get back to living the life you want.

A researched model of treatment for depression, that works with mindfulness of the body to break through ruminative thinking patterns and relieve depression is Mindfulness-based Cognitive Therapy MBCT. I use this model of therapy (as well as other therapies) to help clients struggling with depression to regain equilibrium and feel better about themselves and their lives.

For additional resources on the depression, types of depression and treatment visit NIMH page on depression.

Warm Regards,

David