Nathan Feiles, MSW, LCSW-R

@nathan-feiles-lcsw | contributor
Nathan Feiles, MSW, LCSW is a psychotherapist in private practice in New York City. He also offers specialized coaching online nationally and internationally. Nathan specializes in anxiety, relationships, depression, fear of flying, commitment issues, creative blocks, and migraines. Nathan is a graduate of New York University with a license in clinical social work, and is affiliated with National Institute for the Psychotherapies in New York City. For more information about Nathan's work and therapy practice, visit www.nathanfeiles.com.

Exploring How High Expectations Can Sabotage Relationships

Is it bad to have high expectations? Not necessarily. There’s nothing wrong with having certain standards for your life and for your relationships, as long as they’re within reason. However, the “within reason” is the tricky part. The line between “high expectations” and “unrealistic expectations” can be quite blurry. In my therapy practice, I specialize in working with people who face chronic disappointments in relationships and in various areas of life. You may have read my articles on “grass is greener” syndrome already, an issue which is often fraught with expectations that find their way to the unrealistic side of the fence. When struggling with a perception (or wish) of reality that can be difficult to align with actual reality, it can leave you feeling unfulfilled, hopeless, depressed, anxious, alone and many other feelings of defeat. What becomes especially difficult is when someone is unaware of their tendency to carry unrealistically high expectations, they may end up in a cycle of repeatedly looking for something better, leading to a perpetual cycle of sabotaging healthy and positive relationships. When caught up in idealized visions of relationships or reality, chronic disappointment and the feeling that nothing is ever good enough are generally following close behind. Why do people cling so tightly to unrealistic visions of reality, even when they can be so destructive to satisfaction? There are many answers to this question, and it’s generally a combination of things, which varies from one person to the next. However, one reason is that, for many, their lives have been built around these ideal visions. It can feel threatening and deeply disappointing to the world they know to allow themselves to adjust their expectations and perceptions of what the world “should” be. This is especially the case if someone has relied on these images as a version of what “happiness” will look like. For example, if you have defined “happiness” as having the right relationship be one where you feel in love and euphoric all the time — that you’ll never experience doubts, or disappointments, or have arguments, etc. — then allowing yourself to adjust to the fact that even the right relationships can be really tough at times may change your understanding of how much happiness is really possible to have. That the level of happiness you’re counting on from your relationship on its own may be unrealistic. In response, it becomes easier to push away the disappointments from the outside in order to preserve hope of attaining that level of happiness on the inside — however people in this situation tend to find that this high level of expectations from relationships ends up yielding more disappointment than it actually does happiness. This is where the self-sabotage generally ends up happening. You may find yourself continuously rejecting relationships while trying to find one that matches expectations that are nearly impossible to meet, instead of adjusting on the inside (this doesn’t mean you can’t be happy, but generally, happiness is found in the life balance more so than only in the relationship). And for many, it’s a never-ending cycle until they can see it happening and seek out help for it (this cycle is often difficult for one to break without help, as it usually runs quite deep). While relationships are one of the most common areas for this pattern to play out, these sabotage levels of expectation can be found in various areas of life. Any area where you’re experiencing chronic disappointment is worth taking a look at if it’s impacting your level of life satisfaction. Nathan Feiles provides therapy for “grass is greener” syndrome, depression or difficulty with life or relationship satisfaction.

How to Find Motivation When You're Depressed

Creating motivation when feeling depressed can be one of the most difficult things a person can do. An episode of depression can be physically and emotionally draining. The simplest of tasks seem to take maximum effort, and sometimes even beyond the maximum. Some may feel lethargic. It may be tough to make meals, clean up at home, take showers or even get out of bed. Navigating motivation when depressed can be tough because the instinct is often to wait for the energy to return — that if you give in to the urge to stay in bed for a few days, maybe you’ll be reenergized and recharged, hoping you’ll have exorcised the depression demons. Unfortunately, it’s not usually as simple as this. If everybody tried to wait out their depressive episodes, some people may be in bed for years. Unfortunately, fully giving in to our depressive urges can actually have a way of reinforcing them. Actively doing almost anything doesn’t sound desirable when feeling depressed, let alone confronting our depressive urges. While it’s important to give depressive symptoms the attention they need and to understand and learn about what’s underlying your depression , the concept of “mind over matter” can help create motivation when depressed. (Keep in mind, this isn’t meant as a cure, as much as a way of creating motivation in the midst of dealing with depression. ) I have seen with many people that the combination of psychotherapy along with creating a change in mindset using small, manageable steps can help shift the experience of depression . While this may not replace taking the steps to reflect and learn more about what’s causing the episodes, these steps can help us move forward with our lives while we continue to work on the underlying issues. Let’s look at some steps that can help: 1. Opposite action. In dialectical behavior therapy (DBT), opposite action is the idea of pushing yourself to do something that you know is good for you in order to prevent the reinforcement of a bad habit. For example, if you want to stay on the couch and watch TV all day, when realizing this only gives into depression , opposite action would say to get up and go out, knowing it would be a healthier choice. It’s very much a “just to the opposite of your unhealthy urge” technique. 2. Set an alarm. This isn’t only for getting out of bed. The alarm can be for anything that marks a symptom of depression . You might set an alarm to wake yourself up at a certain time to make sure you get out of bed in the morning, or you might set an alarm to signal a meal time if you’re missing meals, or signal time to do laundry, or run a particular set of errands, and so on. The alarm serves as a cue to draw your attention to a target area where you want to become more active in change. 3. Make your bed. Getting out of bed can be very tough with depression . The first step to take is to sit up on the bed, put your feet on the floor and visualize leaving all of your troubles and thoughts behind you in the bed. Then, get up and make your bed, leaving the troubles behind for the day. Making the bed is essential in this process, as it signals to your brain that there isn’t an option to get back in the bed for the day. As you make your bed, it can also be helpful to imagine the troubles you’ve left behind dissipating as the covers are pulled up. 4. Wash up. The more routine-setting steps you’re able to add on after you make your bed, the better. Try washing your face and brushing your teeth, or showering to help wake you up. With these kinds of steps you’re training your brain to understand that you’re getting ready for “something,” rather than simply a day lying around. 5. Get dressed. This is another important step in separating from the bed to the day. Sitting around in pajamas on the couch is still possible, even if you escape the bedroom. Getting dressed decreases the urge to lounge because again you’re reinforcing in your brain that you’re getting ready for something. 6. Go outside. This can be one of the toughest steps for people who struggle with depression — actually leaving the house. One of the problems with this step is that people are easily held back by not having a place to go. “OK, I can go outside … but then what?” So for this step, the idea is to not have a place to go. The goal is simply going outside, not the particular place you go once you’re outside. Go outside, close the door behind you, and do whatever comes to mind — a walk around the block, down the street, pacing in front of your house, getting in your car and driving on an errand, and so on. It can be anything or nothing at all, but the goal is to spend at least 10 minutes outside before going back in. 7. Choose one exercise. Getting your body moving is a good way to start feeling energized. Choose an exercise that works for you: walking, running, swimming, jump-roping, etc. Whatever you choose to do, make it a point to do it every day when you go outside. And if it’s an indoor exercise (like a treadmill), do it before you go outside. 8. Make a list of activities. Brainstorm activities that you’d enjoy doing. Include things to do at home and out with people (even if opportunities to include people may be limited during the COVID-19 pandemic, they could be good to include on the list for later on). Try to generate a list of things that includes others and that gives you some time to yourself. The activities can be a mix of productive (e.g. work-related) activities, and hobbies and self-care. 9. Schedule activities. Schedule the activities throughout the week. Try to plan out either one or two weeks ahead of time and actually write the activities into your calendar with specific days and times. Spread them out as much as possible and make sure to stick to the schedule. 10. Daily necessity schedule. This schedule is if you’re having trouble getting motivated to do your daily activities such as eating, cooking, showering, or other household chores. For this, you’re creating a daily home schedule. Choose the specific times you’re going to do each activity every day. It can be as specific as you feel you need: time to get dressed, brush your teeth, start cooking, eating, showering, turning off the tv before bed, and so on. This is to help you get your daily necessities actually functioning on a routine basis. 11. See family and friends. Of course, the opportunities to see family and friends may be limited at the moment, but this step may be helpful for once it is more possible again. This one is more about the people than the activity. Being around other people is often helpful for mood improvement. Schedule specific dates and times with friends and family, outside of the house. The more you can remove yourself from the environment of depression (usually the home and bedroom), the better. 12. Psychotherapy. It’s important to keep in mind that the desire to stay inside and lay around isn’t what causes depression — it is a symptom of depression . Psychotherapy remains a vital and necessary step throughout the process of dealing with depression . Even if you’re able to cope with some of the motivational issues through active steps, the internal issues that are causing the depression still need to be addressed in order to decrease and help resolve the depression , both in the present and for the future. What’s most important to keep in mind is that you’re likely not going to feel like doing anything discussed above. If you’re going to wait to “feel like doing it,” then it may not happen. Using opposite action will be the necessary first step — knowing in your mind that it will be good for you to take the steps to move forward. By also engaging in psychotherapy, you’re still able to give appropriate attention to what’s happening inside of you, including if medication may (or may not) also be helpful. You do have the power to increase your motivation and to move forward through depression . It may take some effort, but the opportunity is there for you to reclaim your life. Visit www.nathanfeiles.com to learn more about Nathan Feiles’ practice.

How to Find Motivation When You're Depressed

Creating motivation when feeling depressed can be one of the most difficult things a person can do. An episode of depression can be physically and emotionally draining. The simplest of tasks seem to take maximum effort, and sometimes even beyond the maximum. Some may feel lethargic. It may be tough to make meals, clean up at home, take showers or even get out of bed. Navigating motivation when depressed can be tough because the instinct is often to wait for the energy to return — that if you give in to the urge to stay in bed for a few days, maybe you’ll be reenergized and recharged, hoping you’ll have exorcised the depression demons. Unfortunately, it’s not usually as simple as this. If everybody tried to wait out their depressive episodes, some people may be in bed for years. Unfortunately, fully giving in to our depressive urges can actually have a way of reinforcing them. Actively doing almost anything doesn’t sound desirable when feeling depressed, let alone confronting our depressive urges. While it’s important to give depressive symptoms the attention they need and to understand and learn about what’s underlying your depression , the concept of “mind over matter” can help create motivation when depressed. (Keep in mind, this isn’t meant as a cure, as much as a way of creating motivation in the midst of dealing with depression. ) I have seen with many people that the combination of psychotherapy along with creating a change in mindset using small, manageable steps can help shift the experience of depression . While this may not replace taking the steps to reflect and learn more about what’s causing the episodes, these steps can help us move forward with our lives while we continue to work on the underlying issues. Let’s look at some steps that can help: 1. Opposite action. In dialectical behavior therapy (DBT), opposite action is the idea of pushing yourself to do something that you know is good for you in order to prevent the reinforcement of a bad habit. For example, if you want to stay on the couch and watch TV all day, when realizing this only gives into depression , opposite action would say to get up and go out, knowing it would be a healthier choice. It’s very much a “just to the opposite of your unhealthy urge” technique. 2. Set an alarm. This isn’t only for getting out of bed. The alarm can be for anything that marks a symptom of depression . You might set an alarm to wake yourself up at a certain time to make sure you get out of bed in the morning, or you might set an alarm to signal a meal time if you’re missing meals, or signal time to do laundry, or run a particular set of errands, and so on. The alarm serves as a cue to draw your attention to a target area where you want to become more active in change. 3. Make your bed. Getting out of bed can be very tough with depression . The first step to take is to sit up on the bed, put your feet on the floor and visualize leaving all of your troubles and thoughts behind you in the bed. Then, get up and make your bed, leaving the troubles behind for the day. Making the bed is essential in this process, as it signals to your brain that there isn’t an option to get back in the bed for the day. As you make your bed, it can also be helpful to imagine the troubles you’ve left behind dissipating as the covers are pulled up. 4. Wash up. The more routine-setting steps you’re able to add on after you make your bed, the better. Try washing your face and brushing your teeth, or showering to help wake you up. With these kinds of steps you’re training your brain to understand that you’re getting ready for “something,” rather than simply a day lying around. 5. Get dressed. This is another important step in separating from the bed to the day. Sitting around in pajamas on the couch is still possible, even if you escape the bedroom. Getting dressed decreases the urge to lounge because again you’re reinforcing in your brain that you’re getting ready for something. 6. Go outside. This can be one of the toughest steps for people who struggle with depression — actually leaving the house. One of the problems with this step is that people are easily held back by not having a place to go. “OK, I can go outside … but then what?” So for this step, the idea is to not have a place to go. The goal is simply going outside, not the particular place you go once you’re outside. Go outside, close the door behind you, and do whatever comes to mind — a walk around the block, down the street, pacing in front of your house, getting in your car and driving on an errand, and so on. It can be anything or nothing at all, but the goal is to spend at least 10 minutes outside before going back in. 7. Choose one exercise. Getting your body moving is a good way to start feeling energized. Choose an exercise that works for you: walking, running, swimming, jump-roping, etc. Whatever you choose to do, make it a point to do it every day when you go outside. And if it’s an indoor exercise (like a treadmill), do it before you go outside. 8. Make a list of activities. Brainstorm activities that you’d enjoy doing. Include things to do at home and out with people (even if opportunities to include people may be limited during the COVID-19 pandemic, they could be good to include on the list for later on). Try to generate a list of things that includes others and that gives you some time to yourself. The activities can be a mix of productive (e.g. work-related) activities, and hobbies and self-care. 9. Schedule activities. Schedule the activities throughout the week. Try to plan out either one or two weeks ahead of time and actually write the activities into your calendar with specific days and times. Spread them out as much as possible and make sure to stick to the schedule. 10. Daily necessity schedule. This schedule is if you’re having trouble getting motivated to do your daily activities such as eating, cooking, showering, or other household chores. For this, you’re creating a daily home schedule. Choose the specific times you’re going to do each activity every day. It can be as specific as you feel you need: time to get dressed, brush your teeth, start cooking, eating, showering, turning off the tv before bed, and so on. This is to help you get your daily necessities actually functioning on a routine basis. 11. See family and friends. Of course, the opportunities to see family and friends may be limited at the moment, but this step may be helpful for once it is more possible again. This one is more about the people than the activity. Being around other people is often helpful for mood improvement. Schedule specific dates and times with friends and family, outside of the house. The more you can remove yourself from the environment of depression (usually the home and bedroom), the better. 12. Psychotherapy. It’s important to keep in mind that the desire to stay inside and lay around isn’t what causes depression — it is a symptom of depression . Psychotherapy remains a vital and necessary step throughout the process of dealing with depression . Even if you’re able to cope with some of the motivational issues through active steps, the internal issues that are causing the depression still need to be addressed in order to decrease and help resolve the depression , both in the present and for the future. What’s most important to keep in mind is that you’re likely not going to feel like doing anything discussed above. If you’re going to wait to “feel like doing it,” then it may not happen. Using opposite action will be the necessary first step — knowing in your mind that it will be good for you to take the steps to move forward. By also engaging in psychotherapy, you’re still able to give appropriate attention to what’s happening inside of you, including if medication may (or may not) also be helpful. You do have the power to increase your motivation and to move forward through depression . It may take some effort, but the opportunity is there for you to reclaim your life. Visit www.nathanfeiles.com to learn more about Nathan Feiles’ practice.

Why Unmet Needs in Relationships Makes the Grass Seem Greener

“Grass is Greener Syndrome” is no joke. People often regard this issue with a quick wave of the hand: “Oh, you always think the grass is greener on the other side.” However, for people who struggle with this issue, it is incredibly frustrating and exhausting, mentally and emotionally. It tends to wreak havoc in various areas of people’s lives, especially in relationships , career or where to live, as well as other areas. One of my main specialties as a psychotherapist is working with people all over the world on this particular issue. Part of what makes the “grass is greener” struggle so difficult is that it’s actually a collection of underlying psychological and emotional processes that all come together to create the larger struggle, which is experienced as “Grass is Greener Syndrome.” While there are many components that blend together to create the foundation of “Grass is Greener Syndrome,” and they are all worthy of their own discussion (which will get their own posts over time), for now, let’s focus on the role of your needs and the starvation of needs. How Does a Need Become Starved? Everyone has needs, emotionally and practically. Some needs are more of a priority than others. Some are deal-breakers in various ways — like wanting to get married, or have children, or live in an area that has certain amenities, or work in a job that treats you a certain way, or that you find fulfilling, to be with someone who respects and supports your ambitions, etc. The list of possible needs can go on and on. However, what happens when you’re in a situation where only some of your most important needs can be met while others aren’t? Let’s say you’re in a relationship with someone who satisfies several things that are important to you. However, at the same time, you have other important needs that are essentially left untouched. Maybe you have a partner who is steady and secure, which perhaps is important to you, but struggles with the lack of passion (and other areas), which you also want in a partner. For the “grass is greener” thinker, this is an incredibly tough dilemma. The more a need goes unfulfilled, the more starved this piece of you begins to feel, and the more it begins to overshadow those needs that are actually being met. Eventually, the needs that aren’t being met become so starved out that you feel truly compelled to replace what you currently have with what you’re not getting. In the example above, the starvation of passion begins to completely overshadow the steady and secure qualities that are also important to you (it may resemble a feeling of deadness in the relationship and being drawn towards people who reflect what you’re missing). It begins to feel like you’re losing an important piece of yourself, and you feel that you won’t survive without it. Now, this wouldn’t be such a huge problem if you went to a new relationship and satisfied those needs that have been starved, resulting in more happiness and fulfillment. However, for the person stuck in the “grass is greener” process, what tends to happen next is that those needs are satisfied and fulfilled for a brief time in the new relationship . And then, the needs that are now not being fulfilled in the current situation (even if they were in the previous situation) begin to get starved out. In the above example, you feed the hunger for passion, but end up losing the stability and security as part of the tradeoff. The “All-or-Nothing” Problem “Grass is Greener Syndrome” tends to be a very black-and-white process. Some needs are fully being met, and other needs are totally neglected. There’s very little room or tolerance in the “grass is greener” process for a middle ground and emotional compromise without feeling like you’re starving in one area or another. It can become difficult to differentiate between needs and desires, or accepting varying degrees of satisfaction for the purpose of achieving greater balance. To be clear, this isn’t out of unwillingness; it’s a part of the “grass is greener” process. This black-and-white process continuously feeds the “grass is greener” issue. The dynamic of starvation-fulfillment and restarvation-refulfillment continues to cycle until the “grass is greener” process itself can be shifted, as a whole. What makes things even more difficult is how much more is going on in “Grass is Greener Syndrome” than just this starvation mechanism. Consider the starvation of needs to be one layer of the overall foundation of the “grass is greener” issue. Generally, by the time people start to experience the symptoms of “Grass is Greener Syndrome,” the underlying foundation has been well-established and very difficult to break on your own. When people come to me, they are often stressed, feeling hopeless, frustrated and burned out by the toll this issue has taken on them. If there’s any one piece of advice I can give someone who’s struggling with “grass is greener” patterns, it’s to not be afraid to seek outside help. Because of the deep multilayered complexity of this issue, and because of the intensity of the internal all-or-nothing tug of war, it’s very hard to be able to pull oneself out of it without unintentionally repeating the pattern again. It’s hard to have a clear and sound thought process about what is actually in your best interest when so emotionally entrenched in the depth of the issue. This all being said, as complex as it may be, it is very possible to overcome “Grass is Greener Syndrome.” I’ve seen many people come through the other end of this struggle. It may be hard to imagine shifting the cycle from where you are now, but I assure you it isn’t hopeless. Visit www.nathanfeiles.com for more information on Nathan’s practice.

Grass is Greener Syndrome: Euphoric Memories and Craving

“Grass is Greener Syndrome” is a really tough and debilitating cycle for many people who struggle with this issue. It can make people feel that they are never fully settled in life, repeatedly experiencing urges to find the better thing they are missing out on, leading to a pattern of changing relationships, careers, where to live or otherwise. While there can be a period of satisfaction and gratification on the heels of the most recent change, these feelings tend to wear off as time passes, thus restarting the cycle. There is a lot to say and understand about “Grass is Greener Syndrome” (GIGS), more than can be discussed in one article. It is quite a bit more complicated than simply a general “commitment issue” (though one of the symptoms of GIGS is a struggle with certain types of commitment). If you wish to read more about my work with “ Grass is Greener Syndrome ,” you can find articles I’ve written (as well as a webinar I presented on this issue) around the internet. In my therapy and coaching practice, “Grass is Greener Syndrome” and difficulty with settling down is an issue I’ve helped many people through over time. While the “grass is greener issue” is multifaceted, frequent nostalgic and euphoric memories are significant contributors to exacerbating this issue. These memories tend to create an idealization where nothing short of these perfect images is good enough. It’s one thing to have memories. We all have them, and many memories can bring a variety of emotional responses along with them — happy, sad, joyful, mournful, etc. However, with GIGS, the memories many people hold can create a deep sense of longing and craving. Some may think back to their childhood and recall images that bring a sense of deep nostalgia, and a yearning to return to this time of life, in some way. The prevalent feeling becomes: “Nothing will feel as good as this time in my life felt.” Or, with a relationship partner, there may be an imagined idea of the perfect relationship, therefore making anything that doesn’t fully fit this picture not the right relationship for you . Perfect Images, Perfect Feelings Sticking with the past for a moment, what ends up happening in this craving to return to an earlier time is a wish to either relive a feeling from the past, or to actually recreate the past environment in the present. The hope is that it will bring the exact level of emotional happiness and euphoria that the imagined feeling holds (the same is true for relationships, but here it’s the anticipated emotion of what the perfect relationship would feel like that is sought). This can be played out in a variety of ways in one’s present life, but the most recognizable GIGS response is the feeling that what you have now isn’t good enough because you’re not experiencing the complete satisfaction that these euphoric images hold. It can leave people feeling unsatisfied in their present situation, even if the current situation actually may be a good one. It becomes very all-or-nothing in the GIGS cycle — I need to feel X way, or it’s not good enough. While it’s more complicated than this (as GIGS is fueled by a deeper combination of issues that aren’t all discussed here), this struggle with euphoric memories/images and emotions is incredibly powerful. In GIGS, what often ends up happening is a quest for the environment that will bring these euphoric feelings — the perceived “right” relationship, career, place to live, social circle, etc. — as much as possible. This is the shiny new, greenest grass, and it feels great for a period of time — like you finally have everything you’ve been looking for. But as the newness starts to wear off, the euphoric emotion starts to fade with it (kind of like the end of the “honeymoon phase” of a relationship). This leads to the belief that the recent change wasn’t the “right” change, and it’s time to start looking again for that feeling — maybe the next one will be the one that sustains that feeling for the long haul (the honeymoon phase that never ends). Fantasized Emotions There is a problem with these euphoric and nostalgic images, however. And it can’t be overemphasized how powerful this actually is for people: These images that we idealize actually washes away the real emotions of that time. Simply said, we project emotions onto our past memories or future images. We see the images, and we lacquer them with a thick layer of euphoria (this happens unconsciously for various reasons, and could take a whole book to adequately discuss). In the process, we forget the difficult emotions that may have surrounded the earlier (or may surround the projected future) environment. In the present, we can’t literally connect with the past or future stresses, painful moments, the frustrations, the pressures of that time, the fatigue, and many other feelings that were likely around then, or may be around in the future images. This is somewhat similar to having a relationship breakup where months later you start to remember all of the good things, and forget how painful and upsetting that time together actually was. Imagine this on a much larger scale. There may be good feelings in these past or future images, however, there’s more to the emotional picture than we tend to experience with GIGS. These projected emotions can drive people into incessant loops of trying to match an exaggerated feeling. Stopping the Cycle I’m sure many reading this are wondering what the solution is. GIGS is an issue I’ve seen many people work through. It is possible to stabilize the back and forth struggle that dominates this issue. However, this is something that is very tough to conquer on one’s own without help. Many people attempt to do this on their own before reaching out to me — for example, they may try to just pick one side of the coin and force themselves past the issue. But, eventually, the cravings of the neglected side end up taking hold again. GIGS is not an easy cycle to force yourself out of. The mechanism that fuels “Grass is Greener Syndrome” is very persuasive and powerful, and it easily creates doubt and uncertainty about where you are in life when you’re stuck in the midst of the GIG process. It tends to be a vicious cycle that only reinforces itself, which makes it hard to break from within it. Simply said, don’t be afraid of seeking help. It is important to understand your own deeper struggle with this issue, and from there can work to end the cycle. Nathan Feiles provides therapy and coaching online from his NYC-based practice.

Why You Might Be Feeling More Overwhelmed During COVID-19

Almost everyone’s mental health has been impacted from the turn life has taken in the last few months. As things were, life was already stressful enough for many people prior to the coronavirus ( COVID-19 ) pandemic. There was more than enough anxiety , panic, depression , fear, worry, headaches and more to overflow our mental and emotional tanks. Life has always had a thick layer of uncertainty built into it — job stresses, family stresses, illnesses and so on. Now, that sense of uncertainty has multiplied many times over in addition to all the things in life that needed our attention before. On top of what was already filling the emotional pot, we now find ourselves trying to cram a whole new series of emotions, worries, anxieties, fears, unknowns and more into a space that was, for many, already boiling over before the virus even showed up. Whether you’re worried about getting sick, have lost loved ones or friends, have family members in a higher risk group; whether you have lost your job, could lose your job, or are coping with working full-time from home while also taking care of children and homeschooling them; you have experienced your thriving university campus life suddenly turn into being home with your family, or are isolated in your home by yourself; or if you are trying to cope with the loss of human-to-human contact, gathering, and fun that often serves to destress from the typical hustle of life — whatever the additional layers are for you, the mental health struggle from the recent changes and losses is very real. For each person, the brand of struggle may be different. For some it may be more debilitating anxiety or a higher baseline of anxiety, meaning functioning continuously closer to experiencing things like panic attacks , overwhelm and burnout, obsessive worrying, compulsive behaviors, anger, irritation and otherwise. Or, the struggle may be closer to a threshold of depression, shutting down, wanting to stay in bed until life returns to “normal,” difficulty feeling motivated or energized, or carrying an intense emotional heaviness or hopelessness. Or, for others, your relationship could be taking the brunt of the struggle, as well as other manifestations not listed here. Whichever your struggles tend to be, for many people, the stress of this sudden life shift has likely turned up the volume on what was already there. If you were already at a 9 or 10 (out of 10), then what happens now with so much unforeseen complexity and stress added to the picture? For many people, the unexpected life shift from the emergence of the virus is likely to be experienced as a form of trauma . It is something that no one really had space to internally prepare for before suddenly working from home, losing jobs, taking children out of schools and wearing masks to go outside. While before you may have just gone to the grocery store to pick up some food, conscious attention and awareness is now needed for what was previously a somewhat mindless task of walking around a store. There is a lot more to pay attention to now in general, which means more work for our brains to take on. When we don’t quite know how to internalize an experience, we end up adjusting and compensating (internally and externally) in different ways in order to work around it. But this doesn’t happen easily. It’s generally at the expense of something else. Think about it like time in a day: if you have two things on your to-do list between 9 a.m. and noon, you will experience your day very differently than if you have 10 things on your to-do list in that same frame of time. The whole layout of your day and how you experience the stress of the day will be different. If you have two things on the list, then you can likely feel a sense of having enough room for both things, and maybe also put some attention toward the three things on your afternoon list as well. But with 10 things on the morning list, the afternoon likely doesn’t even exist in your mind yet and there’s probably a question if you have enough room for what’s on the morning list. The point is, with every step of routine life having become magnified, small (and larger) details require thought and attention that weren’t previously necessary. This all in addition to what was already there. It’s almost impossible to not be overwhelmed right now with all that needs our attention. We may go through the motions of where life has taken us, but this doesn’t mean that we have an emotionally secure and stable sense of being in this new space. In fact, it’s possible that some people could still be experiencing the shock of the change, which can be experienced as an emotional numbness while functioning on a sort of detached autopilot. When in a crisis, people often try to avoid the psychological and emotional impact because the crisis itself can be so overwhelming. While it can feel like taking care of yourself is one more thing to do amidst the overwhelm, taking care of yourself is actually what can start to reduce the overwhelm and help you to regain your footing. When trying to “push through” a crisis on your own, the emotions can start to take over in various unhealthy ways. In short, don’t be afraid to ask for help, even if it’s just to have someone along with you to turn to through the process. You don’t even have to leave home for help, as therapists can meet online. Just because many people may be going through a similar struggle right now doesn’t make what you’re going through any less difficult or important. Nathan Feiles currently offers therapy and coaching sessions online from his NYC practice. Struggling with anxiety due to COVID-19? Check out the following articles from our community: An Activist-Therapist’s 15 Affirmations for Hope Amidst COVID-19 Hey You: It’s OK to Grieve the ‘Small’ Things You’ve Lost During the COVID-19 Outbreak What to Do If the Coronavirus Health Guidelines Are Triggering Your Anxiety or OCD How Can You Tell the Difference Between Anxiety and COVID-19 Symptoms? Feeling Calm in the Midst of the Coronavirus Pandemic Might Be a Trauma Response

What to Know If You Have Anxiety About Life After COVID-19

When living in a life full of daily routines, it can be somewhat easy to forget we are actually surrounded by risks every day. We become so normalized to our ways of living life that, for many people, “simple” things such as being within six feet of other people, touching a doorknob or going to a restaurant are rarely called into question. We may not register the risks of driving a car, walking down the street, eating food, walking down a flight of stairs, and so on. Going even further, the era of Tinder and other hookup apps brings plenty of risks that are often not even consciously registered anymore. Not only is there a risk of sexually transmitted diseases, but simply the possibility of passing illnesses back and forth has always existed when people are physically close or in contact with each other. None of this is new, whether we’re in large crowds (which has more risks than only illness), or on our own swimming in a pool. No matter how we look at it, in order to live a life that involves adventure, satisfaction and meeting basic necessities, many accept a certain level of risk as part of it, some risks higher than others. In my psychotherapy practice, I specialize in working with the various forms of anxiety that people struggle with in life. Part of this work can often involve helping people learn to cope with and live with uncertainty and unknown in life. In fact, one of my other specialties is helping people overcome fear of flying (there are articles around the internet about my work with this, if you wish to learn more), part of which involves emotional processes that are not all that different from dealing emotionally with the disruption of the coronavirus (COVID-19) crisis: being stuck a space where your sense of control over the environment is limited, leaving you to manage sitting with vulnerability, uncertainty and unknown as you navigate this space. Of course, there’s more to the process on a deeper level for both being in quarantine and for fear of flying, but there are some important parallels worth looking at when it comes to the idea of reentering the world after this extended quarantine. First, here’s the thing: many people would love guarantees of safety in life. It would be a tremendous relief to know without a doubt that when you go outside, you will return home safely and still be here tomorrow. It would be life-changing to have certainty that every single plane is going to make it from A to B without incident. But, in reality, no matter how small the odds are of catastrophe with many things in life that we take for granted, to some degree there’s always going to be a base level of risk to almost anything in life. The hope in dealing with the presence of risks is that we can learn to internalize the vast middle ground between guarantee and catastrophe, understanding that in many cases catastrophe is exceedingly rare, and in others there may be more risk that we take more precaution against (such as wearing a seatbelt in a car). What becomes problematic for people in dealing with these situations psychologically and emotionally is when they try to control the environment (and the vulnerability) beyond what is possible. There is a space (emotionally and literally) where active control remains possible (such as staying in your house to avoid an out-of-control pandemic, washing your hands, doing certain calming techniques in a plane, don’t speed in a car, etc.). But it’s important to understand that this reality of control only goes so far. We have limits as people to what we can actually control, and for many people when we cross into the space where control isn’t in our grasp, our emotions are taken with it. When it comes to dealing with deeply vulnerable emotions, there comes a point where the emotional response can be so overwhelming that you can’t control your way out of it. It may feel like the only thing that will make you feel better is to get the control back. This is commonly seen with heavy turbulence in fear of flying, and why I’m using this example of fear of flying alongside the concept of reemerging into the post-quarantine world. You can’t stop the turbulence, nor can you walk off the plane. You just have to ride along with it and learn how to be OK in it until it goes away. Which in many ways is going be the post-quarantine world, at least for a while. How can we expect to live in the world as we did a few months ago if we are going to be continuously exposed to our vulnerabilities and limitations as human beings — living in the understanding that with life inherently comes risk? The truth is, we already do this every day in many more ways than we are consciously aware of. However, the COVID-19 pandemic has been an all-too-real reminder of the vulnerability we face as human beings. That, in the end, there are parts of life we can control to help ground ourselves, and then there are parts that are out of our control that we’re going to have to learn how to tolerate, sit with and embrace in order to be able to enjoy a satisfying and gratifying existence in the world without hiding from life. Going back to the idea of guarantees, I’m sure all of us would love to get back to a place where the threat of COVID-19 doesn’t exist, and then we can reemerge into the world just as before, maybe still with other worries and anxieties to deal with but at least without worry of this particular virus. However, from the information we have to this point, it doesn’t seem the risk of the virus will be gone when the quarantine ends, and possibly not for many months, if not years. For many of us, this is a scary thought. That in order to live our lives again, we’re going to have to reemerge into a society where contracting coronavirus is a threat that will remain there on some base level every day (much like other things already are). Holding out for the guarantee may result in debilitating each of us in our quest to get back to our lives, as opposed to allowing for the acceptance of this risk that will be there, either way. Yes, there are things we can control, and we should still take precautions, such as understanding when is the appropriate time to reemerge into society — this article isn’t suggesting we should recklessly end quarantine early, by any means — or washing our hands, wearing masks, not touching our faces, working from home again temporarily if the virus shows up somewhere close by (or immediately isolating in the future if/when you show symptoms of illness), and so on. But overall, in order to live life, we’re going to have to understand and in many ways accept that at some point, we’re likely to cross paths with the virus. Of course, sitting with uncertainty and unknown is often much easier said than done. If you find it difficult to handle sitting with lack of control or vulnerability, or sitting with uncertainty or unknown, or dealing with varying levels of anxieties (panic, worry, overwhelm, etc.), then therapy would be a good place to go for help in these areas. For all of us, learning to tolerate risk and uncertainty will be a significant part of embracing the post-quarantine world. Nathan Feiles, LCSW-R currently offers therapy online, and after the quarantine will also return to seeing people in-person in his NYC practice. Struggling with anxiety due to COVID-19? Check out the following articles from our community: How Can You Tell the Difference Between Anxiety and COVID-19 Symptoms? What to Do If the Coronavirus Health Guidelines Are Triggering Your Anxiety or OCD 6 Tips If You’re Anxious About Being Unable to Go to Therapy Because of COVID-19 7 Things to Do If Social Distancing Is Triggering Your Depression 10 Face Masks People With Chronic Illness Recommend

What to Know If You Have Anxiety About Life After COVID-19

When living in a life full of daily routines, it can be somewhat easy to forget we are actually surrounded by risks every day. We become so normalized to our ways of living life that, for many people, “simple” things such as being within six feet of other people, touching a doorknob or going to a restaurant are rarely called into question. We may not register the risks of driving a car, walking down the street, eating food, walking down a flight of stairs, and so on. Going even further, the era of Tinder and other hookup apps brings plenty of risks that are often not even consciously registered anymore. Not only is there a risk of sexually transmitted diseases, but simply the possibility of passing illnesses back and forth has always existed when people are physically close or in contact with each other. None of this is new, whether we’re in large crowds (which has more risks than only illness), or on our own swimming in a pool. No matter how we look at it, in order to live a life that involves adventure, satisfaction and meeting basic necessities, many accept a certain level of risk as part of it, some risks higher than others. In my psychotherapy practice, I specialize in working with the various forms of anxiety that people struggle with in life. Part of this work can often involve helping people learn to cope with and live with uncertainty and unknown in life. In fact, one of my other specialties is helping people overcome fear of flying (there are articles around the internet about my work with this, if you wish to learn more), part of which involves emotional processes that are not all that different from dealing emotionally with the disruption of the coronavirus (COVID-19) crisis: being stuck a space where your sense of control over the environment is limited, leaving you to manage sitting with vulnerability, uncertainty and unknown as you navigate this space. Of course, there’s more to the process on a deeper level for both being in quarantine and for fear of flying, but there are some important parallels worth looking at when it comes to the idea of reentering the world after this extended quarantine. First, here’s the thing: many people would love guarantees of safety in life. It would be a tremendous relief to know without a doubt that when you go outside, you will return home safely and still be here tomorrow. It would be life-changing to have certainty that every single plane is going to make it from A to B without incident. But, in reality, no matter how small the odds are of catastrophe with many things in life that we take for granted, to some degree there’s always going to be a base level of risk to almost anything in life. The hope in dealing with the presence of risks is that we can learn to internalize the vast middle ground between guarantee and catastrophe, understanding that in many cases catastrophe is exceedingly rare, and in others there may be more risk that we take more precaution against (such as wearing a seatbelt in a car). What becomes problematic for people in dealing with these situations psychologically and emotionally is when they try to control the environment (and the vulnerability) beyond what is possible. There is a space (emotionally and literally) where active control remains possible (such as staying in your house to avoid an out-of-control pandemic, washing your hands, doing certain calming techniques in a plane, don’t speed in a car, etc.). But it’s important to understand that this reality of control only goes so far. We have limits as people to what we can actually control, and for many people when we cross into the space where control isn’t in our grasp, our emotions are taken with it. When it comes to dealing with deeply vulnerable emotions, there comes a point where the emotional response can be so overwhelming that you can’t control your way out of it. It may feel like the only thing that will make you feel better is to get the control back. This is commonly seen with heavy turbulence in fear of flying, and why I’m using this example of fear of flying alongside the concept of reemerging into the post-quarantine world. You can’t stop the turbulence, nor can you walk off the plane. You just have to ride along with it and learn how to be OK in it until it goes away. Which in many ways is going be the post-quarantine world, at least for a while. How can we expect to live in the world as we did a few months ago if we are going to be continuously exposed to our vulnerabilities and limitations as human beings — living in the understanding that with life inherently comes risk? The truth is, we already do this every day in many more ways than we are consciously aware of. However, the COVID-19 pandemic has been an all-too-real reminder of the vulnerability we face as human beings. That, in the end, there are parts of life we can control to help ground ourselves, and then there are parts that are out of our control that we’re going to have to learn how to tolerate, sit with and embrace in order to be able to enjoy a satisfying and gratifying existence in the world without hiding from life. Going back to the idea of guarantees, I’m sure all of us would love to get back to a place where the threat of COVID-19 doesn’t exist, and then we can reemerge into the world just as before, maybe still with other worries and anxieties to deal with but at least without worry of this particular virus. However, from the information we have to this point, it doesn’t seem the risk of the virus will be gone when the quarantine ends, and possibly not for many months, if not years. For many of us, this is a scary thought. That in order to live our lives again, we’re going to have to reemerge into a society where contracting coronavirus is a threat that will remain there on some base level every day (much like other things already are). Holding out for the guarantee may result in debilitating each of us in our quest to get back to our lives, as opposed to allowing for the acceptance of this risk that will be there, either way. Yes, there are things we can control, and we should still take precautions, such as understanding when is the appropriate time to reemerge into society — this article isn’t suggesting we should recklessly end quarantine early, by any means — or washing our hands, wearing masks, not touching our faces, working from home again temporarily if the virus shows up somewhere close by (or immediately isolating in the future if/when you show symptoms of illness), and so on. But overall, in order to live life, we’re going to have to understand and in many ways accept that at some point, we’re likely to cross paths with the virus. Of course, sitting with uncertainty and unknown is often much easier said than done. If you find it difficult to handle sitting with lack of control or vulnerability, or sitting with uncertainty or unknown, or dealing with varying levels of anxieties (panic, worry, overwhelm, etc.), then therapy would be a good place to go for help in these areas. For all of us, learning to tolerate risk and uncertainty will be a significant part of embracing the post-quarantine world. Nathan Feiles, LCSW-R currently offers therapy online, and after the quarantine will also return to seeing people in-person in his NYC practice. Struggling with anxiety due to COVID-19? Check out the following articles from our community: How Can You Tell the Difference Between Anxiety and COVID-19 Symptoms? What to Do If the Coronavirus Health Guidelines Are Triggering Your Anxiety or OCD 6 Tips If You’re Anxious About Being Unable to Go to Therapy Because of COVID-19 7 Things to Do If Social Distancing Is Triggering Your Depression 10 Face Masks People With Chronic Illness Recommend

Should I Still Go to Therapy If I Have Nothing to Say Today?

Spoiler alert: Yes, you should still go. Here is a compiled scenario to protect confidentiality: “I was having one of those days where it just felt like everything was fine. Nothing really happened since my last session, and I didn’t really have anything important to talk about today. Nothing was pressing, and I didn’t understand why I should go to therapy today if there was nothing I needed to get off my chest or talk about. “But then I remembered that therapy isn’t supposed to be only for the days or weeks when there’s an overflow of stress, anxiety or other stuff going on. I understood that therapy is a deeper process than only dealing with the surface emotions. So even with nothing prepared to talk about, and not knowing what the point really was today, I decided to drag myself into therapy anyway. “At first, I just sat there for a couple of minutes and didn’t really say anything except for a couple of comments about the weather or something like that. I was nervous that we were going to sit awkwardly in silence for the next 45 minutes, which was part of the reason I almost didn’t come in when I had nothing to talk about. But then, after sitting there for a couple of minutes, I just went ahead and said it to my therapist: “I really have nothing to talk about today.” After that moment, it turned into one of the deepest and most valuable sessions I’ve ever had (so far).” It can be quite common for the days where nothing is emotionally or mentally prepared prior to the session to end up being some of the deepest and most enlightening sessions. This doesn’t diminish the benefits of the sessions where the topics of conversation and emotions are at the ready, as much as it speaks to the benefits of therapy even when it doesn’t feel needed that day. It’s easy to think that because there is no stress or major issue to talk about on the day of a session that it must mean there is actually nothing to talk about or happening at all. However, when the layer of stress and emotional activation is removed, it actually allows the space for a new layer of depth to open up and emerge. It can be tempting to underestimate the power and influence of what sits below the surface because it’s generally not fully in our conscious minds. And some might think, “Well, if I’m not thinking about it consciously, then it doesn’t matter, right?” Unfortunately, no, it’s not as simple as this. The stuff that sits below the surface is often most responsible for creating and reinforcing the cognitive and emotional patterns and struggles that we find ourselves dealing with in daily life. While on one level therapy serves the purpose of reducing the layer of emotional activation when it’s overflowing, which can provide its own sense of relief, getting into the layer(s) below the surface is often where the more in-depth and longer-term changes start to happen. When the emotional overflow layer is removed, this is when it becomes more readily possible to reflect on, engage with and understand ourselves. As the conversations start to move into the deeper layers of oneself, the underlying parts that people are often looking to improve really start to emerge more here. For example, it’s one thing to temporarily make the surface layer of anxiety go away until they return next time; it’s another to understand on a deeper level why these patterns of anxiety keep returning as they do and to change these patterns longer term. These deeper, more uncon scious parts of ourselves are generally what drives our mental and emotional life experiences — why we emotionally respond the way we do to situations in life, why we think about things in the way we do, why we may be caught in a pattern of emotional or relational struggling, etc. And while it’s not always easy to engage with the deeper parts of ourselves and change these patterns, summoning the courage to get to know what we carry with us can often lead to some of the most gratifying and healing parts of the therapy process. I will add here to bear in mind that simply starting a session with nothing to say doesn’t automatically mean you’re going to leave the session in awe, enlightened or suddenly changed or healed. This wouldn’t be a realistic approach and would likely lead to disappointment. So, be careful not to fall into the trap of expecting great epiphanies or keeping one eye on what the “big” result will be in a session. The overall message is that even when it seems on the surface like there’s nothing to say that day, if you keep an open mind and remain curious about yourself, there is likely to be a greater benefit of showing up to therapy that day.

Different Types of Anxiety Require Different Types of Treatment

Anxiety is often seen as a collective ball. An all-encompassing state of being you either have or don’t have. But in reality, there are various forms of anxiety one could struggle with (and they are not all optimally treated by the same therapeutic approaches as the other). Let’s start with what’s commonly known as generalized anxiety disorder (GAD). GAD is the most common form of anxiety where people feel psychologically, mentally, emotionally and/or physiologically anxious (from mild to severe). It can be difficult to calm your thoughts, there may be incessant worries, rigidities, avoidances, rumination and physically feeling like it’s difficult to sit still. It can cause hyperventilation, or a sensation you are carrying more energy than your body can handle and you are not sure how to get rid of it. Another type of anxiety is separation anxiety. This particular form of anxiety actually can reach into other types of anxiety. For example, I’ve found that many people who experience separation anxiety can experience GAD as well, but it is not one and the same. Or interestingly, I have observed in my work that many people who struggle with a fear of flying actually can also struggle with separation anxiety. This isn’t 100% across the board, but it’s enough to notice the trend. People often experience separation anxiety without fully realizing that’s what it is. I’ve also found that while separation anxiety generally originates developmentally early in childhood, it can be further exacerbated into adulthood by continuous exposure to parents and caretakers with narcissistic behaviors growing up. With parent(s) who are narcissistic, it can become difficult to feel a fully empowered sense of self. Instead, growing up you can often be treated as an extension of the parent with narcissistic behaviors. When parents tell you there is one way to live life, and that their way is the way life “is done,” they’re essentially raising you to be little versions of themselves. They control your upbringing and life in their vision of it, rather than allowing you to shape your own. Self-actualization can become scary because the unconscious feeling is that without this parent, you can’t exist as a separate self. You often learn to need them to guide you and can’t fully trust your own judgment in decision-making. It can be very complicated to detach from parents who are narcissistic when you feel helpless to guide yourself. I’ve found this form of separation anxiety is often experienced the most in adulthood with co-dependent intimate relationships and a difficulty individuating, relying on a heavy dependency on the parents (or the partner as a stand-in for the parent). As painful as these relationships can be at times, they can still be quite difficult to detach from or create effective boundaries with. Then there is also anxiety related to intimacy. This is another one that impacts people in creating relationships and friendships, but they may not realize that’s what the problem is. Anxiety with intimacy can happen for an array of reasons, but I’ve found it’s generally linked to a greater fear of being hurt, left or abandoned, shamed or being vulnerable and sitting with a lack of emotional control in the relationship. This can create a dynamic of being an arm’s distance in relationships. You may feel like you want to be closer and experience the intimacy, but whenever those opportunities present themselves, the safer route is taken to hold back. The reaction is generally unconscious and you likely may not even be aware you’re doing it in the moment. This can lead to feeling less fulfilled in relationships and friendships, or also finding it difficult to commit in a relationship. The above are just some short explanations of some common anxieties. They are each quite complicated in nature and tend to take much more than a paragraph to fully understand. Other anxieties can include anxiety related to sex, social anxiety, test-taking anxiety, dating or relationship anxiety, anxiety or fear of conflict or confrontation, commitment anxiety, fear of ending up destitute or being fired, fear of flying, fear of being alone and others. These anxieties can all exist in their own right, and can develop from different places for each person. In my practice, I specialize in working with the many faces of anxiety. It’s possible to struggle with just one or more than one type of anxiety at a time. GAD is often present alongside of other anxieties, but this actually isn’t always the case. And just because someone struggles with GAD doesn’t necessarily mean they struggle in the other areas too. What’s notable here is that while the term “anxiety” is often used as a catch-all for a collection of symptoms; in reality, the various types of anxieties do not all originate from the same place or impact the same life situations, even if they can result in some similar forms of physiological and emotional experiences at times (and they can also result in very different symptoms and responses as well). It sometimes can take a bit of exploration and reflection to understand where a deeper form of anxiety is coming from. It’s not necessary to figure it all out by yourself, and it’s important to take the necessary time to understand the particular form of anxiety you are struggling with. People often come to me describing previous anxiety therapies they have had, only to find that they were being treated as if their anxiety was GAD simply because the manifesting symptoms were similar to those seen with GAD. When treating one form of anxiety as if it’s another, it’s more likely the anxiety will either return or keep recurring.