Raise your hand if you've ever criticized yourself for having to sneeze. Oh, I'm sorry, did that sound ridiculous? 

Okay, raise your hand if you've ever criticized yourself for not being able to "get over" something, for not being tough/kind/flexible/resilient/giving enough, for simply, as the kids say "feeling your feels." 

Lots of virtual hands and nods, I know. Because it's our shared experiences. 

Today I'm going to talk to you about a few ways we respond to our stressors without necessarily knowing it. This will help you recognize the same or similar patterns in yourself. 

What we often don't realize is that the actual situation at hand and the way we are responding to it are two distinctly different things that happen to come in quick succession.

Being harsh on yourself about what just happens to be happening is both unfair and unhelpful.

We already talked about how pregnancy can offer a sometimes heightened sense of your feelings and how that can be useful if you can work with it. Part of that process involves getting to know your style of relating to your stress, which may include one of these three patterns.

A trigger shows up, BAM. Do you :

1. Try to ignore it or numb out (via work, television, substances)? When we do this we often overflow later (hello rage, anxiety, panic) for a seemingly unrelated reason. Or we may act passive aggressively. 

Elise just told Mila, who she considers a close friend that she’s 14 weeks pregnant and Mila barely registered a response, much less an enthusiastic one. Elise feels a momentary heavy feeling spread across her chest and then one second later changes the subject. In the car, she talks on the phone non-stop, and once home binge watches her favorite show Her husband arrives with takeout, but forgot Elise’s favorite item and she yells at him for being totally selfish and unsupportive. Oh, and she “accidentally” leaves Mila off her shower list. 

2. Notice you’re upset and then swiftly internally judge or berate yourself for it? 

Lorraine is 38-weeks pregnant and her mother-in-law just had the brilliant idea to come for a month-long visit, to be here for the arrival and to help in the first few weeks. Lorraine loves her MIL, but finds her to be a bit intrusive and judgmental. She knows clearly that this plan is a bad fit for her, but can’t shake the thoughts “This is such a generous offer, I must be so mean for wanting to turn it down, “I am so selfish for wanting these last few weeks for me and hubs and then for us and the baby.” 

3. Become all-consumed by the stressor, making it hard to tend to anything else? In this case, the internal message seems to be "If I think about this long enough the answer will appear," when really ruminating can be quite immobilizing. This is the type of relating to stress that is often present in those who have anxiety and/or depression - often with the addition of guilt and shame. It's painful. 

Sarah is excited to have become pregnant after close to a year of trying. She was excited for all of five minutes before starting to worry about labor. She looked some things up on the internet to ease her mind and it led her to have more questions. What will labor be like? Do I want an epidural or not? How am I ever going to do this? And then, how am I going to take care of this baby? In an almost trance-like state, she read and googled and thought and thought, and in an attempt to help herself feel better through information, she stopped engaging with friends and other interests. 

Any of these sound familiar to you?

​While they are all different, what these styles have in common is that there is a fundamental rejection of allowing for the feeling. And that rejection is causing more pain.

One benefit of counseling during pregnancy is that you get to identify your unique way of responding to your stressors, which can be so illuminating in and of itself. But there's also a bonus: You then get to choose a more helpful response. 

The next installment will focus on some options there - ones you certainly can use even if you don't make it into the therapy room! 

For right now, for this moment, go ahead and try this: Place one hand on your heart (another on your belly, if you wish). Feel the warmth this simple gesture creates. Rest in that warmth for just a moment.

Listen. Until you know that there are options for how you can respond to stress, life is going to feel like it’s happening to you instead of you feeling like you’re living your life, with a balanced combo of pleasant, neutral, and difficult experiences. 

Which would you prefer?

Yours in wellness, self-care and compassion,

Shana
​
​Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

​I recently shared several ways to know when counseling during pregnancy may be right for you. I wanted to write you a short list of why pregnancy is the absolute perfect time to seek counseling. I wanted it to be cute and catchy. I failed.

It’s too important y’all. Why? Because if you’re reading this you are either in the process of, or considering bringing a new little human being into this world. It’s the start of a miraculous marathon and you will get pooped the f___ out, period.

But if you warm up, pace yourself, and anticipate obstacles, you’ll be in a better position for the long haul, to avoid injury, if you will. 

So I’m fleshing it out, point by point, starting with benefit 1: 

You will get to know your triggers, which will help you, A, cope when they arise, or B, avoid them altogether. 

We're all swept into difficult emotions from time to time, be it sadness, worry, fear, anger, and even rage. 

During pregnancy you may notice that this happens more frequently or perhaps more, um...surprisingly - as in why do I feel like I could shoot fireballs out of my eyes when my partner forgets about our prenatal appointment? Or, why am I weeping behind my desk after my manager gives me a piece of constructive criticism? 

While hormones are a huge culprit in this heightened sensitivity, that doesn't mean there isn't useful information in your emotional experience. When you get intentional about paying attention, patterns emerge. 

Let's go back to weeping behind your desk. You explore the reaction, noticing your thoughts, feelings, and physical sensations. When you got the feedback you felt ashamed and defeated, your heart felt heavy and you thought "I am incompetent." You start noticing other times this has come up for you, and get to work disentangling the experience, and finding a more balanced view.

Perhaps you had a critical parent, a one-time humiliating school experience, or have a long time propensity towards perfectionism that never went challenged because it served you in some way(s). 

Regardless of the reason, with some effort towards compassionately bringing awareness to your experience, being consumed by feelings if inadequacy transforms into something like "sometimes getting feedback triggers feelings of defeat and incompetence.” 

Now you have a bite sized piece to work with. 

Perhaps naming it takes away half it’s power. Maybe you do a strengths search and identify the times you had a strong sense of feeling competent. Or you learn how to bring loving touch to your body in that moment and let the wave pass.

Just like that you have options. Which one is right for you is to be determined. That’s why starting the conversation is key. 

In addition to learning what you need when in the face of your triggers, there may be some that you avoid altogether.

No, you can’t necessarily avoid feedback at work (nor would that help your larger need for growth, right?), but perhaps you have some toxic relationships that you’ve been having trouble drawing boundaries around, and now feels like a good time.

Or you notice some of your triggers are not people or settings, but sensations, such as being hungry. You don’t like that she-devil or anxious-annie who appears when you’ve waited too long to eat, so you learn to gnosh every couple hours, or whatever suits your mind-body needs. 

While avoidance as a defense mechanism can be unhealthy, avoiding things that are actually harmful to us is excellent self-preservation, for yourself and your growing baby.

Your objective during this time-limited, opportune phase is to figure out what you are better off living without and what you choose stay in contact with, but relate to differently.

The next installment will discuss more about not what is happening, but how you are relating to it (spoiler alert: you have options there too!)

Yours in wellness, self-care and compassion,

Shana
​
​Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.

I"ve written about hypocrisy before, and also about my personal experience forgetting to attune to my own needs, waiting, like so many until I'm feeling super low/immobilized/crazypants.

But one of thing I've yet to mention is that nasty P word ; Perfectionism. Oh how I loathe thee, because you're so damn stifling. You get in the way of good-enough-ness, you stop things before they ever really start. You're as critical as the day is long. Like the last-day-of school-long,  or your-toddler-is exercising-his-free-will-via-throwing-himself-on-the-ground-in-response-to-all-your-offers-of-the-wrong-food-and-your partner-has-to-work-late-long.

Perfectionism is a bit misunderstood, because it's not about something being perfect per se; it's about you not being good enough unless and until you've figured out the exact right version of something, whether that be a response to someone, the creation of a product, or the a role you are playing. 

It's a set up to never accept what is. Which is unfortunate, cause that's where all the good stuff lives. 

I'd say perfectionism is at the crux of many of my clients' struggles, thereby making me (this is going to be the cheesiest thing I've ever said, but in the name of giving less f*#@*s. down with OPP - other people's perfectionism. 

As a person who specializes in working with high functioning women who are invisibly experiencing anxiety and depression, it's no surprise that these tendencies show up.

Every week I sit across from these amazing individuals who have accomplished so many things in some of the big life domains: education, occupation, relationships, friendships, family life, and still have a sense that they are doing life wrong in some way. 

So we greet the experience, develop compassion together, find and activate a more authentic way to operate, and round out the story. It helps, but it's hard until it isn't anymore - for the person experiencing it, and for the witness. You know what I mean because we all have those people we admire, who don't seem to see themselves in the same light we do. 

Okay, WAIT, stop.  I set out to write about me today, to do it free-write style, with little editing. I set out to actually embody the experience of imperfectionism, if you will. 

So, bear with me, this is what I wanted to say:

I'm certain that the big P is why I haven't written consistently for so long. Okay, initially I stopped because pregnancy stole my attention span, and then mama life, BUT at the same time there entered an epidemic of 3 things you should do if...5 things you should know about..wellness-related content. I found it dizzying and sometimes empty. When it isn't I like it and share it with you on my Facebook page. But I'll admit, for a minute there, I thought I had to do that or  do nothing.

Also, lots, and I mean LOTS of niche therapist marketing came on the scene like a tidal wave telling me about the right way to do this and the best way to do that, and my response was to shut my ears and computer and just do good direct work with my clients. 

I have a touch of rebellious spirit, and when I'm told what to do, I, I sometimes stop listening altogether. Like any number of character traits, it's at times helpful (prevents the blind following of things that don't feel right) and sometimes hindering (leads to missing out on certain possibilities).

Luckily with self-awareness we get to work with such traits, turn the volume up and down, as appropriate. We get to build discernment into our lives. Here is a good place to mention that #therapycanhelp

Anywho, I'm a bit embarrassed to say it, but I lost my momentum and thought I had to think of the Right way to pick it back up. But I know no such thing exists.  

The truth is I have some things to say, and however long it takes me to organize them, I'm back, starting with imperfect posts, and we'll see where we go from there. 

Separate and unrelated, but while I have your ear, I wanted to share my latest wellness pick-me-up. I've been doing a 5-minute meditation upon waking up. I use Insight Timer, but there are plenty of others too. (check out my resource page for more recs). It's a great way to start the day feeling grounded, and it's pants optional. So there's that.

Okay, all for now. 

Yours in wellness, self-care and compassion,

Shana

Have a question or comment? Feel free to share in the comments section.
​
​Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.

The time has come to search for your therapist.
You've identified your needs, specified your criteria, thought a bit about your budget and are ready to get some names. Congratulations.

I'm going to tell you some of the most common ways to get a list going, add a touch of inside scoop, and then you can decide what feels best for you.

Word of mouth

Getting recommendations from people you know and trust is a wonderful place to start.

What does this sound like? Whatever fits with your style of asking.

​“I'm looking for a great therapist. Do you know of anyone”?

“I'm having a really hard time since mom died. I think it's time to talk to someone. I know your wife went through this last year. Can you recommend any specific resources”?

Of course, you have to feel comfortable telling people you're looking for a therapist, which in an ideal world wouldn't be a second thought. But if if you are feeling shy about asking around, you're not alone. It's not you, it's stigma.

While I personally think those asking for help and allowing themselves to be vulnerable are the bravest people out, for the sake of getting what you need, there's always:

 “My friend is looking for a therapist. Have any recommendations”?

There is something special and subtly community-building about word-of-mouth referrals.

I've been on every side of this. My love-of-a-therapist for years was recommended whole-heartedly by a colleague of my mom's when I was 17 years old. I, in turn, recommended her to a few of my closest friends over the years, and they to theirs.

On the therapist end, I notice that when client's are referred from people who really know me, they are more open and trusting right from the beginning.

There is nothing wrong, of course, with being slow to warm up, but my point is that there is something comforting about having even a distant familiarity with a person, even if that means your brother's neighbor's daughter's friend was greatly helped by her or him.

Insurance/EAP Lists

These. Are. Long.

Don't let that deter you. Since you've narrowed down some of the specifics you're looking for, you can whittle this list as well.

You can take this list from 100 to 10 just by plugging in your needs. 

You can usually search by preferences, such as zip code, gender, language capacity and/or specialty. Whoever pops up should have a little “about me” blurb.

Once you've found a few good options, you may be ready to start calling, or you may want to do a little more research online.

Internet Search

We all know it's a vast world online, so searching the web for a therapist can be intimidating if it's your starting point. However, if you've already found some names, it's one way to check them out further.

If you are starting from scratch, here are some good things to know.

Search Engines

Of course, you can do a quick Google search and see what you see. But when I type “San Francisco Therapist,” up pops 19,000,000 results in .52 seconds. The top ones, of course, are those with paid advertisements, followed by links to popular therapy directories.

While you may stumble upon a website you like within that search, it might be more helpful to simply start with a directory.

Online Therapist Directories

Psychology Today, Good Therapy, and Therapy Tribe are some of the most popular online directories, and each will give you some sense of your potential therapist's style. If you're specifically looking for a low-cost option, Open Path Psychotherapy Collective provides just that. 

Again, you can plug in your preferences and numerous options will appear. These sites are typically more fleshed out than the online insurance lists, so, cross-referencing may bring you a fuller picture of who you're looking for.

Here you can see how therapists describe their work in a nutshell, how long they've been practicing, and their general price range. You can see their faces and, more often than not, links to their websites.

If reading each and every detail is what helps you decide, do that. If you have a gut instinct about one or a few (perhaps you like one woman's smile, perhaps another one's sense of humor), great. Go with it.

Yelp

Aah, Yelp, every business owner's frenemy (an outdated, but perfectly descriptive term).

For those seeking services it's, of course, enticing to receive information not presented by therapists, but by those who know them, either as consumers or colleagues.

I would probably not recommend this domain as your starting point, but more as the finishing touch on your search.

I say this largely because, unlike other types of businesses, it is actually against ethical standards for therapists to solicit testimonials from clients, for reasons beyond the scope of this article. This, in and of itself, leads many therapist to not want to add their businesses to Yelp. Basically, it's not a representative pool of therapists.

When you do see therapists on Yelp, they typically have reviews from colleagues, recipients of services that are not therapy per se (workshops, consultation, coaching, etc.), and some clients who have found them and volunteered reviews. (Here's a link to mine, for reference)

This is an excellent way to see what others have to say. Maybe someone's description really resonates with what you are seeking. Perhaps it's the last detail you were needing to hear in order to move forward, which is great!

If there are negative reviews, look for a pattern and/or a substantive critique. If someone has one negative review because they didn't call someone back or there was some kind of misunderstanding, I wouldn't necessarily count that person out, if there are other factors that appeal to you.

Note: When therapists have a lot of reviews from clients, it's typically because someone has found a way around the basic ethical standard. Perhaps it's a group practice that has the administrative capacity to solicit testimonials in another way. This is a smart business move, but it's important for the general public to know that it is just that. Again, tons of useful and true information in the content of the reviews, but not a representative pool of your local therapists, just a small business savy cross-section.


Okay, about sums it up on searching for a therapist. Hopefully using one or more of these methods with get you a short list of possibilities, and next we'll go over what to say and expect when you call.

Yours in wellness, self-care and compassion,

Shana

Have a question or comment? Feel free to share in the comments section.
​
​Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.

It's the last Monday of January 2016 - the first of the final seven days in which we can still ride the impetus of the new year towards personal growth.

On another day I might have felt like time was moving too quickly (It's the 25th? Seriously?), but today, perhaps because it's the fourth Monday in this generously long month, I feel like this week is a great opportunity. 

I want you to see it that way too. I really want you to see it that way if getting started with therapy is on your list of things-you-know-you'll-benefit-from-but-don't-know-where-to-start. Today I'm talking to you.

Let's all widen the scope of this new year's intention thing and consider that the whole month can be used to decide what we want to cultivate and what habits we may want to put in the not-serving-me-anymore bucket.

My sense is that people are naturally doing just that – thinking about these things, which is terrific in and of itself. It's really something to let into your consciousness that you'd like to hand over some heavy items you've been holding to someone you don't yet know. 

Or even to notice that the ways you've been coping – maybe numbing, overworking, blaming, intellectualizing – are neither sustainable nor satisfying.

Sometimes, though, thinking turns into ruminating or looping and we feel stuck. And one of the quickest ways out of rumination is to step into action.

But what action is the most appropriate for you? It's probably one of these three categories:

1. Those whose task is to clarify what they are seeking.
2. Those whose task is to start their search.
3. Those whose task is to reach out using the information they hold.

Over the next couple weeks, I'm going to walk you through some of this territory in an effort to help you find what you need. 

I will offer some questions to ask yourself that get at specifying what you're looking for. Next up will be multiple ways to search for a therapist, no matter what your budget. And finally, I'll offer support around reaching out, including what to say and what to expect in response.

But for today, what if you locate where you are right now? What category do you fall into? Answering this question may be a bigger step than you even know.

Yours in wellness, self-care and compassion,

Shana
​
​Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.

Nearly two years ago I published this letter, the intro starting with: 

I'm going to start wearing a tee-shirt every day that reads "No, I am not pregnant." This is simply because I got married last fall and I have slowly come to notice (mostly due to countless confessions) that people in every domain of my life are wondering, bless their hearts. Seriously, I find it endearing, because it seems to come from a good place and because this just happens to not be something that bothers me. 

However, in other areas of my life, the constant inquiry about my life events did get to me, particularly around transitioning out of college and graduate school. I found others' questions intrusive and pressuring no matter how well-intentioned.

A 10-month-old baby, and a thousand "are you going to have another" questions later - starting about four seconds after I gave birth - in addition to numerous women coming to me with their discomfort about the "are you trying" question, this concept is up for me again. And I know for a fact I'm not alone, which is lovely.

Since graduations, weddings, and babies are all currently in season I offer this again to you and yours, for modifying, tattooing on your forehead, or just for a soft touch of comic relief. Enjoy and remember to keep your eye on your own work. You know best. 

Dear person-inquiring-about-my-impending-important-life-transitions,

It's funny you should ask, I was just switching back and forth between obsessively asking myself the same question and doing anything in my power to not think about it. 

The truth is that I don't have a clear answer, which feels scary. I am still making choices and have no control over some of the factors going into the final decision, which feels scary as well. Even if I choose a [job, partner, school, career path, etc.] the feeling might not be mutual, and yet I still have to make all this effort to choose wisely. I have to trust the [Universe God, Goddess, Spirits, etc.] despite a lot of uncertainty, and that can be difficult at times. 

I know that your curiosity is natural, and, unless you're a perfect stranger trying to make conversation, you have probably played at least a minor role in my life and therefore my life path. So it kinda feels like we're in this together. 

This sentiment seems especially present when you give me all your opinions along with your questions. It's like we better make sure we cover all our criteria, in order to not make a fatal error, which would really affect us negatively. 

While I appreciate all the inclusiveness, the trouble is there are a lot of us, which makes things difficult for me in a couple of ways. One, for each person whose [happiness, pride, satisfaction, sense of accomplishment, etc.] it seems is riding on this, the bigger my fear of disappointment becomes. 


Sometimes the pressure builds and builds until I feel like I will burst. You might recognize this scenario from such episodes as I-just-yelled-at-you-for-asking-if-I'd-finished-writing-my-[job-application, essay, vows, etc.] and I-know-it's-just-a-commercial-I-don't-know-why-I'm-crying.

The other problem arising from the group discussion of my life decisions is that sometimes the conversation is so loud that I can't hear myself think. Even though it may look like I'm not listening at times, I am hearing all the commentary and, like it or not, considering it. I know I am lucky to have people who care enough to offer advice (even if it's unsolicited 90% of the time), but I ultimately have to listen to my own voice, my own wisdom, and in order to do so, I need some space. 

I think if I had that space I could also come up with questions to ask you (and you and you)! I don't mean to be ungrateful or rude. I know you have the best intentions, and my best bet is that you have no idea that you are the seventh person to ask me about this today. I also don't want you to think that this topic is off-limits completely, but there are some small things you can do to make these conversations easier:

First, maybe you could take a moment to imagine  being in my position and think about what you would want and need. Also, just asking a couple questions before diving into the details would help, like “Would now be an okay time to ask about so-and-so,”? or “Would it be okay to offer my opinion on this”? 

This way I'd feel like I have a choice in the matter instead of feeling surprise attacked all day. I would really appreciate that.

The last thing I'd like to add, while I have your attention, is that in addition to this upcoming life decision, the rest of my life is moving swiftly along. Sometimes I care way more about my crush, the new burrito spot I just discovered, or the latest episode of Scandal. We can talk about those things too. 

Anyway, thanks for asking.

Love,

Me

I have long believed that you don't always have to buy in to different self-growth strategies in order for them to work. I hold on to this belief because of feedback from clients who tried and/or modified tools even when they weren't sold on them, from friends who did the same, and of course, from doing this myself. 

Why do I bring this up? Because I'm going to go ahead and recommend that you go into a bathroom stall before your next job interview and stand like a bear for two minutes. 

Okay, technically, it's called "power posing" and if you carve out 20 minutes to watch this Ted talk given by social psychologist Amy Cuddy you will learn all about it.

The main takeaway, based on the guiding belief that "Our bodies change our minds, and our minds can change our behavior, and our behavior can change our outcomes," is that we can present ourselves as more confident without necessarily feeling that way, and by doing so we will induce confidence.

Remember, the prescription is for a two-minute exercise that might help you land a job. So what do you have to lose? Check it out:

Feeling like you need more than a power pose to feel like your best self? Connect to support today!