Let's talk about Covert Narcissism.

Narcissism is a big topic that we're talking about a lot and we're starting to notice it in different people and different scenarios.

What we think about is the obvious overt narcissism. But let's talk about covert. Which is often hidden. It's more subtle. Someone might not be like that loud overt grandiose, those are narcissistic traits, but they might still have some deep seated ones. And those people can be challenging to deal with.

Characteristics of Covert Narcissism

So some characteristics of covert narcissism are insecurity and sensitivity. Someone is very sensitive to criticism and rejection and they hide and mask that need for admiration behind some like modesty and shyness.

And then you'll also often see some passive aggressive behavior. So instead of being upfront and confronting or direct, someone's passive and aggressive about it.

And then they also often have this victim mentality. So instead of taking responsibility for different actions or behaviors, it's often blaming others.

And then lastly is more emotional manipulation. So that can look like some guilt tripping or backhanded compliments. Those types of things are really common in interactions.

Differences Between Covert and Overt Narcissism

So just to go back, let's do covert versus over narcissism. So overt- is the loud, grandiose, behaviors. They seek attention, really arrogant, right? And then the covert is a little quieter, a little hidden, modest, but sometimes you can sense underneath there's this grandiose sense of self worth.

And what they have together, which makes the narcissistic, is these traits of entitlement. And then the biggest piece is the lack of empathy. That's the thing that you are noticing is their inability to put themselves in somebody else's shoes, the inability to be able to have that empathy for others.

Effects of Covert Narcissism on Relationships

Next let's talk about the effects of covert narcissism on relationships. Sometimes you can feel out a covert narcissist by they're very emotionally draining. So whether that's a family member or a coworker, partner or a friend, it's this subtle manipulations or constant need for reassurance which can be really draining.

You'll often see some gaslighting and invalidation. Gaslighting really means they will make it difficult that you start to doubt your own perceptions and emotions. So you'll feel a certain way and they'll say things to make you think, wait, did it happen that way? Wait, do I feel that way? And then that lack of accountability. So again, blaming others, not taking responsibility for how they're behaving.

So some red flags that you'll see are this chronic victimhood, really sensitive to feedback, that pattern of passive aggressive behavior and some hidden superiority.

And so anytime you're feeling like confused or like maybe you're being manipulated in behaviors, and you're noticing it's a pattern with somebody, start to really think about your past interactions with them and see if are they displaying some of this covert narcissist behavior.

Coping with Covert Narcissists

So how do you cope with some covert narcissistic behaviors?

Like a lot of things, set boundaries, emotional and mental boundaries to protect yourself. So that might mean you're not on the phone with somebody for three hours as they talk about all the ways in which they're a victim or someone else is to blame, so you really put boundaries around that. That's just an obvious one. Or if you notice they're emotionally draining you, then maybe you set some boundaries of needing to leave, or you don't take on what they're trying to do.

You want to avoid engaging in power struggles. Any time they're seeking to maybe gaslight you in a way or have you think that what you're feeling or perceiving is not true. And then you on this power struggle of like, no, I do feel this way or no, I did experience it this way. Don't bother. Just- you identifying yourself what's happening and let them move on. Don't engage in it.

Then lastly, you're going to want to seek support. So whether that means from a family member or friend, or maybe therapy also can be really helpful. So you can learn when that's coming up and then you can easily begin to pull away and notice when these toxic behaviors are happening.

So in conclusion it's just important to notice this covert narcissism, because it's not as obvious and over time it can really deplete someone depending on how close you are to that person. Your own self esteem and your ability to regulate your own emotions, your ability to have clear perception. So you really need to take care of yourself and do that.

And if you are in a really close relationship with somebody, say if it's your partner or that's your boss, you really are going to need a lot of extra support. And if you're not able to get that and do enough of healthy boundaries, that's when it might be time to reach out to a therapist.

And Therapy Now SF, we are well equipped in working with people that are in these challenging relationships and we can help you cope in better ways to deal with that.

In cognitive behavioral therapy (CBT) “cognitive distortions” are simply tricks of the mind. The brain convinces us of something that is untrue. Often, they are the result of trauma in our pasts, but they can also occur without traumatic experiences. Of the many common distortions in CBT, “blaming” is one of the most widespread and can be very destructive.

What Is Blaming?

Blaming is simply the act of assigning responsibility for something that happened. However, it’s usually a negative act – you blame someone for breaking your favorite coffee mug, but you rarely blame someone for mowing the lawn, for instance. In most situations, blaming as a cognitive distortion involves assigning guilt or responsibility for how we feel to someone else. “He makes me feel bad about myself,” for instance, or “She makes me feel inadequate”.

The Effects of Blaming

Blaming ultimately leads to negative emotional conditions. The person placing blame often feels resentment, anger, or even hatred for the person they blame. The person being blamed often feels defensive, hurt, or angry if the blaming is vocalized or communicated in other ways.

What Do We Blame Others For?

Often, blaming does not center on physical actions. Instead, we blame others for how we feel, what we think, or our negative behaviors. For instance, a substance abuser might blame his abusive parent for his drug problem.

While the parent certainly contributed to the situation and there is no doubt that traumatic events can lead to addiction, blame in this case shifts responsibility for individual choices (the decision to do drugs and continue to do drugs) to someone else. Does the abusive parent have some responsibility in this situation? Yes. But the drug abuser must also face his own responsibility in terms of continued behavior.

How to Recognize Blaming

Anytime you notice that it's "blah, blah happened because of blank." You know, if you're sort of defensive about it. "It's because of my boss that I'm so stressed." Any of those "If so and so didn't do whatever, I wouldn't feel this way."

Sometimes the blaming is subtle and it's described as frustration or even self righteousness. If you're constantly feeling like things are unfair those are some blaming tendencies.

Then there's emotional signals. If you're continually feeling resentment and frustration those are ways to notice that too.

How to Stop Blaming

Changing blaming behavior can be challenging, but it is possible.

1. Identify and stop unhelpful thinking patterns. When something happens and we blame someone else, we often tell others about it. The act of recounting the situation compounds its effects and reinforces our negative emotions. The next time you find yourself blaming someone, try not talking about it and observe how your mental situation changes.

2. Own your emotions. We often blame others for how they “make us feel”. However, by understanding that no one can make us feel anything – we make ourselves feel things – you can begin to break the blaming cycle. As you establish control over your emotions, you will find that the words and actions of others have less and less impact on how you feel.

3. Consider therapy. Often, blaming (whether blaming others or blaming yourself) stems from traumatic experiences in your past. Physical, emotional, and sexual abuse are common causes, but any traumatic experience can lead to blaming. Working with a therapist, you can uncover the underlying causes and begin to institute positive changes.

Ultimately, blaming is an attempt to assign responsibility to our emotions, thoughts, or actions to someone else. Understanding that our thoughts and emotions are our own, and that our actions are our responsibility, is the start of healing.

Let's talk about love languages. I feel like it's something that we hear about all the time and, I think they're very effective to understand even just in basic terms of what it is. And usually when we're talking about love languages we're talking about a partner, an intimate partner, but they are also effective in any sort of relationship with family and friends. So keeping that in mind as well.

What are the five love languages? They are words of affirmation, acts of service, receiving gifts, quality time, and physical touch.

I'll very quickly go through each one. They're relatively obvious, but I'll give a little example so that way it's even more obvious.

Physical Touch

So first off, we have words of affirmation, and this is literally verbal expressions of love. So that can be compliments, words of appreciation just simply saying, I love you. Anything that's kind and encouraging for someone that words of affirmation is important to them, that is huge and can go a long way.

Acts of Service

Next is acts of service. This is the old saying of, for some people, actions speak louder than words. Doing something for someone that's thoughtful, like maybe cooking them a meal or helping with a chore or taking the kids to school Any of those things can show love in a very tangible way.

Receiving Gifts

Next is receiving gifts, obvious, but it's not about this materialistic idea of gifts, and the more money you spend or anything like that, it's really more the thoughtfulness behind the gift. Something that's maybe meaningful or a well timed gift. For people that this is important to, that often means that someone's really been listening and they said they needed something or really wanted something. And then out of nowhere, that person ends up getting it. And it's because their partner was listening. So that's a huge way and a very powerful expression of love.

Quality of Time

Fourth, we have quality of time. So this one is all about not just spending the time, but the undivided attention quality time. Focused and meaningful time with somebody, minimal or no distractions, just you and them. That for somebody is how people can feel love. And sometimes that means watching a TV show together. So it doesn't have to mean, and that can be considered a distraction, but if that's something that's important and spending that time and that can work. Or going out to dinner is another one. Taking a walk. Any of those. Putting your phone away, essentially.

Physical Touch

And lastly is physical touch. So for some, physical connection, like holding hands or hugging or any sort of gentle touch on the arm, whatever that is can be a really powerful way for someone to feel loved.

And so for most people, I would say it's not like one of these is the only way they feel love. Most of us, all five are important to some extent. But maybe one or two are really that love language idea that really means the most to somebody.

The importance of a love language is it can improve communication in relationships. And it can enhance emotional connection and understanding.

Just having these practical tips for expressing love is a great way to be with your partner in a way that makes sense to them. You're just speaking their language. And it can be something in daily life that can be helpful.

So I encourage people to have these conversations with your partner and even having them with friends too, what is important to them, I think can just continue to build stronger relationships overall and be really helpful.

So if love languages is something that seems important to you or that you're interested about, it can also be helpful to not only talk to your partner about it, but to also talk to a therapist about it and figure out with them what that can look like. Problem solve with them. Different ways that you can do that. Anytime you're talking to a therapist, you're going to be improving your insight both into yourself of what's important to you and then also into what's important to your partner.

Let's talk about coping with uncertainty and building one's psychological flexibility. So uncertainty, I actually literally just talked to a client about this and keeping things very anonymous. But for him, he was, both moving and finding a new job.

And so as you can imagine, one of those alone would be incredibly stressful, but to have two of them in tandem is incredibly overwhelming as he was feeling. So it can be helpful first off to even just define all the uncertainty that's happening and being able to label it can be really helpful.

And then realizing that, I need to be flexible around all of this. And what are the areas that I can control? And what are the areas I can't control? And so it can also be doing things like I can control. I need to prioritize what I can control. I need to make lists of what I can control. I need to be organized.

And then it's also when the mind starts to get really anxious and go down rabbit holes to be able to, first notice that your mind's doing that, because that's a big piece of these automatic thoughts that happen. We don't even notice it's happening. All of a sudden, 20 minutes later, we're just in a fog and we're super anxious and our heart's pounding because we've been going on worst case scenarios and everything that can happen.

So one way is to be mindful and to try to stay present. You're going to want to reframe negative thoughts. And then also, build a support network of people that you can talk to, people that are helpful that you can talk to, whether that's a friend, a family member, a coworker, or a therapist.

And sometimes it can be helpful even just to talk out loud, everything that's bothering you, as opposed to just having it swirl in your mind.

Practical Tips for Coping with Uncertainty

And then moving on to some practical tips. So you're going to want to develop a routine. So having a schedule for yourself is really helpful. So that might mean for two hours in the morning, from 9:00 to 11:00, you're going to be looking for a job.

And then from, 11:00 to 12:00, you take a break, you go for a walk outside. 12:00 to 1:00, you have lunch. 1:00 to 3:00, you look for a place to live, a place to rent, apartment, whatever that looks like for you. So having a really set schedule and incorporating things to take care of yourself, like going for a walk, going to the gym, talking to a friend, whatever that is.

And then next, you're going to want to set realistic goals for yourself. Not a big goal of my goal is to find a job. Great. Yes, that's right. But what are the small goals? And so it's, from 9:00 to 11:00, when I'm looking for a job, I'm going to make sure I apply to two jobs in those two hours. So that means you're going to be writing your cover letter and getting your CV all set. And you're trying to break down what those goals are.

Then next you're going to want to practice some self compassion and being kind to yourself. This uncertainty, like in the example that I gave, these are two major transitions in somebody's life. So of course it's going to make you anxious. Of course, it's going to make you worry. And there's so much unknown, so much uncertainty. So how can you be kind to yourself? Talk to yourself, kindly. Take care of yourself. Do the things you need to do. So that way it's a little bit easier.

And then again, I'm going to just repeat it because it's so important is you're going to focus on what you can control. And the things you can't control, you've got to let go. And you've got to say that to yourself. That right now I can't control. I'm going to have to let that go. I'm going to watch one way to think of it as a mindfulness technique is I'm going to put that thought on a leaf and let that leaf go down that river.

Benefits of Building Psychological Flexibility

So some other things that happen that when you practice all of these tips and these interventions it's going to increase your resilience to be more psychologically flexible. It is going to help you be a better problem solver. It's going to improve your well being. So it will decrease anxiety and possibly depression.

So anytime you can adapt to change better, the better off you're going to be. And it's like a muscle, like anything else, the more you can adapt to change in a flexible way, into the unknown in a flexible way, it will be easier the next time something like this comes around.

And if you're feeling like you're still really overwhelmed after trying these different tips which is also understandable, that might be a time to get extra support and to reach out to a therapist.

At Therapy Now SF, we work all the time with people around anxiety and depression. And often that does stem from just so much unknown and uncertainty or a big transition in your life. And so our therapists are well equipped in helping people handle that and problem solve and get those coping skills and move on and walking you through the step. So you're not alone with them.

The power of journaling for mental health.

And I think we hear a lot about Journaling and, does it really help? And those that journal can tell you that it is extremely helpful. Some of the benefits of journaling and when we talk about journaling, what does that mean? Literally writing down your thoughts. That is this big thing of journaling, is just writing down your thoughts, your stream of consciousness, writing down whatever is going on for you.

And so some of the benefits of journaling that research has shown is it reduces stress and anxiety. It improves your mood and emotional well being. It enhances self awareness, so it builds insight. And it also improves personal growth. It helps one process trauma and it helps you process difficult emotions.

Types of Journaling

So there's a lot of different types of journaling. Some of the four main ones that we hear about and that are really studied the most are Gratitude Journaling, Emotional Release Journaling, Goal Setting Journaling, and Reflective Journaling. So those are probably self explanatory, but I'll just do briefly what each one is.

So Gratitude Journaling is literally writing out statements like I am grateful for blank. So I am grateful for being able to wake up today and do my job. I'm grateful that I got to spend time with my good friend today.

Emotional Release Journaling is often when something is really stressful or maybe even traumatic has happened and you are literally just releasing emotions. So I felt sad that blank happened. I feel angry that blah, blah, blah.

Then there's Goal Setting Journaling. And that is, taking a big goal, say of wanting to run a marathon and you're writing the smaller goals of today I ran 2 miles tomorrow. My plan is to run 2.5 miles. I felt great after I ran those miles. I felt like I was purposeful today, that I accomplished what I wanted to do.

Reflective Journaling. This is when you are reflecting on the day. Reflecting on who you are, your value system, where you want to go. It's just a general sort of reflective practice of what has happened that day or in the past couple days. How did it make you feel? Is it something that you want to keep doing?

How to Start Journaling

So ways to start journaling. You're going to choose a type of journal that suits your needs. You're going to set aside time, regular time for journaling. So it might mean literally setting your alarm at a certain time each day.

For some people that's morning for others afternoon can be challenging because you're working, but if that works for you, great. Or maybe after work or before bedtime is another common time to journal. You're going to write freely without the self criticism. So I think that's the hard part is we like feel embarrassed or something like that.

It's literally just a free writing time. And then you're going to later want to reflect on the entries that you've done. And so that's a way to keep yourself accountable to be able to process, see how far you've come, all of those types of things.

Practical Tips for Journaling

So some practical tips. Start with short, consistent entries.

That doesn't mean you're sitting down for an hour or even 30 minutes. It might mean you're sitting down for two minutes. And you're starting it out. And then maybe you're increasing that up to five or 10 minutes. But you want to make things feasible so you actually do them again. You can use prompts if you feel stuck. So that means you could go to Google and ask what are some good prompts. And some prompts might be, what's one thing I did today that I'm proud of? Or again, this grateful idea, that's a huge journaling technique. Or what's one thing that made me feel confident today? Any of those prompts can be helpful. You want to keep your journal private and that way that'll encourage you to be honest. And then you want to combine journaling with other therapeutic practices. So with maybe talking to a therapist or meditating or going for a walk before, after any of those things.

Journaling is just another way, it's often used in conjunction with other mental health strategies.

And if you're having a hard time getting started, you could reach out to mental health professional at Therapy Now SF. We have a lot of therapists that will encourage journaling, or you can even bring your journal in and talk to a therapist about what you wrote.

I have a lot of clients who've done that in the past and it's a way to be self reflective and to process a little bit more, go a little bit deeper into those journal entries.

Sleep impacts how our brain functions, how we emotionally regulate. It impacts our relationships. It obviously impacts mental health, anxiety and depression.

Some of the main common sleep disorders and their effects are Insomnia, that's something we hear about a lot. And I think we maybe overuse that a little bit of oh, I have insomnia just because you had a couple of nights of not sleeping although that's really distressing and not great for the body.

Insomnia is really a consistent not being able to sleep for more than a couple hours at a time or in little spurts. And so it's difficulty falling asleep or then staying asleep.

And then there's sleep apnea, which is interrupted breathing during sleep and that's something that's a medical diagnosis that can help using different sleep devices.

And then there's also restless leg syndrome, and that's uncomfortable sensations leading to an urge to move your legs.

Benefits of Good Sleep Hygiene

When we have good sleep hygiene, we have an improved mood and emotional stability. There's enhanced cognitive function and memory, reduced stress and anxiety.

There's going to be reduced depression as well as better overall physical health.

Tips for Improving Sleep Hygiene

You want to maintain a regular sleep schedule. So that would look like Going to bed every night at 10 pm and maybe reading and then falling asleep at 10:30 and then consistently waking up at say 6:30- 7 am. So whatever that is that's just a made up schedule but whatever your schedule is that you're consistent and so that you even do that on the weekends which I think people think I can catch up on sleep on the weekends but actually will negatively impact you. You really want to stay the same.

And if you do take naps you really want to keep those 30 minutes or less. So that way you don't hurt your sleep that night. So another way is to improve your sleep hygiene. You want to create a restful sleep environment. So that looks like, you want to limit the amount of light you get in the morning.

And you also want to limit exposure to screens before bedtime. So your phone or an iPad or your computer you want to avoid caffeine and heavy meals close to bedtime. So for some people, avoiding caffeine, that means you stop your caffeine intake at noon that day. For others, you might be able to push it a little bit more. 2 or 3 pm. But really you want to not do anything much after that.

Another thing you want to do is incorporate relaxation techniques, such as meditation or deep breathing that can be really helpful before sleep.

When to Seek Professional Help

If you're doing all of that consistently and you're not really noticing any improvements and you're still really struggling with sleep, that's when you may want to seek professional help.

When these persistent sleep problems, despite your good sleep hygiene practices, are happening and they impact sleep issues on daily functioning and your mental health. And so that's when you really want to reach out to somebody who either specializes in sleep or who's just a mental health professional.

And at Therapy Now SF, we have therapists that help with all of these facets and they can really help you improve your sleep and then overall mental health.

Building resilience. This is one of the most important things I think that you can do in life. We are all going to come across challenges and trauma and some of us more than others in different ways and stress is an unfortunate part of everyday life.

There's varying degrees depending on our lives. But the way we can manage that is by building our resilience. So first, let's understand what resilience is. It is the ability to bounce back from stress, from adversity, from difficult situations. And like I mentioned, trauma is a big piece of this, but if you haven't experienced some specific trauma doesn't mean, you're not still stressed and having a challenging time or struggling or suffering. And so resilience is absolutely needed. Another piece of understanding what resilience is, is it involves adapting positively to challenges, being flexible maintaining a mental wellbeing, and being able to move forward despite these setbacks.

When individuals, it helps individuals recover from hardships and from that, those hardships potentially even grow stronger through those experiences and be able to handle difficult situations better and cope than you did before. That can be a silver lining to a challenge is you now have gone through it, you've built these coping skills, you've built this resilience, and now you're more equipped and better adept to handle challenges in the future.

Characteristics of Resilient People

We've all probably seen resilient people. We've met them, maybe we're even one of them. So some characteristics of resilient people are being adaptable to change, being flexible to change. Change, any sort of transition, even something as what could seem benign as moving moving where you live could...

That's a massive change, right? And so some of us handle that better than others and those that are resilient look at that as a new experience as something positive. So again, it's how you frame it. So when you maintain a positive outlook, when you're able to see a silver lining or see that an experience has both positive and negative, but you're choosing to focus on the more positive piece, that is a form of resilience.

And those are people that tend to be more resilient. And lastly Someone who's resilient, they're much better at problem solving. They have great effective problem solving skills. They look at a challenge and they see, How can I solve it?

Benefits of Resilience

Some of the benefits are you have an improved ability to cope with stress. You're able to manage the emotions that come up, the anxiety that comes up when you're stressed.

And just being able to be flexible and not be so bothered when there's a challenge. You have overall enhanced emotional well being. You have probably less anxiety and depression. Relationships are better, they're more supportive. Your job doesn't really feel as stressful, maybe you even enjoy it. Just overall there's enhanced well being.

And then lastly, there's just greater overall life satisfaction. You have joy in things. You experience that you feel happy. You are able to do your day to day without getting overwhelmed and feeling like when things come up, you have the confidence to manage them and deal with them.

Factors that Influence Resilience

So what are some of the factors that influence resilience? Some of the personal factors are you have that self efficacy piece, that confidence, when something difficult happens there isn't an immediate anxiety of what am I going to do? How am I going to do this? Just that there's less self doubt. The self talk looks very different. It looks more like I've been through something difficult before. I can handle this. I can do this. Okay. Is this something I can change? Okay. How can I change it? Is this something I can't change? Okay. How can I begin to accept it? And what does that look like?

And then some external factors are the supportive relationships and community that you have.

Strategies to Build Resilience

Lastly, the strategies to build this resilience.

We talked a lot about what it is, what it looks like. Now how do we build it?

So you're developing a growth mindset. These challenges that come up, they are opportunity to learn. The phrase growth mindset got a lot of popularity these past couple of years. How do we look at these difficulties and take it more as a positive and challenge ourselves.

Another one is practicing self care. So we're going to do that by prioritizing our physical and mental health. So that means having good boundaries with people, with work. Knowing when we need a break for something. Knowing that we need to exercise and eat well and have healthy relationships.

All of those things. The more we practice our self care, the more resilient we are when a stress comes up. If we're exhausted and hungry and stressed out, and then some sort of challenging thing happens at work we usually don't have the bandwidth to deal with it. And so we just lose all that resilience.

But if we have all of those other things in place, we're feeling confident and resilient and then it just becomes alright, how do I handle this project that's due next week and I don't know where to begin. Okay, I'm going to problem solve around it.

Another one is we're going to strengthen social connections. The more supportive relationships that we have, the easier it is to ask for help, to get help, to be supported, to have positive support in our lives.

And lastly, we're going to cultivate that optimism. Situations that happen, that are challenging, they can be looked at from so many different perspectives and depending on the person and who they are it will do that.

And when you see someone who is more resilient, they often are focusing on those positive aspects. And it doesn't mean they're ignoring the negative aspects, but it also means that's not where they're putting all their weight into it. If you can begin to notice the more positive things, you have a mindset shift. Things start to look different. They become less stressful.

If this all seems too challenging and we've had a lot of difficulties in our life and maybe resilience isn't something we know how to do Therapy Now SF is great. Our therapists are great about building that resilience. That's one of the main things that we do. You can reach out and talk to somebody and get that support that you need.

A big topic is perfectionism and how do we overcome perfectionism? A lot of us can relate to, even if maybe we don't say, Oh, I am a perfectionist, we can say we have perfectionist tendencies or perfectionism is something that creeps in every once in a while. And maybe you can't, you're one of the lucky ones and that's great.

But it usually plagues most of us at some point in our life. And for some of us, it's just a day to day challenge. So let's define perfectionism and the impact it has on mental health. So it's the relentless pursuit of flawlessness. It's often accompanied by critical self evaluation and concern over other people's judgments.

It usually, or almost always, means you have unrealistic high standards for yourself. You put a lot of pressure on yourself to meet these standards. And understandably, that's going to lead to a lot of stress, anxiety, depression, burnout exhaustion. Yeah, it can be a lot if it's really intense for you.

And the last piece of it is as you're, striving for this perfectionistic way for this excellence, right? It will, in turn, it can hinder your personal growth and being, because you have such a fear of failure that you're not able to complete tasks that you need to do or be creative or get things done.

It can really make somebody stuck and almost paralyzed to do things. I'll talk about that a little bit later.

Signs of Perfectionism

So there's signs of perfectionism and a little bit of what I talked about, but I'll go into a little bit more of what the characteristics and what it works looks like.

So you're setting these unrealistic high standards. The obvious one is it shows itself at work. That's where you can really usually see it. But, people do this as a parent setting really high expectations, like what are other parents doing?

And then in turn, you put that on your kids. Or even how you are in relationships, you need to be the perfect daughter or the perfect friend. The perfect coworker, all of those things. So it's not just at work, in terms of the tasks or the projects you're doing, it can also be in the relationships that you're building.

Another sign is a fear of failure and making mistakes. So you worry and maybe even ruminate about mistakes and what those negative consequences will be. And that in turn leads to our next sign, which is you then procrastinate. And that's because the concern and the fear is that you're not going to meet those standards.

And so instead of just saying to yourself I'm going to do the best I can, or I don't need to be perfect or whatever. You end up not being able and you just get stuck and paralyzed to even do the tasks. And so you delay them and then you worry more and worry more.

And then that's when anxiety develops.

Psychological Roots of Perfectionism

When we're talking about perfectionism, it's helpful to know what the psychological roots of perfectionism are. So they often come from early experiences and upbringing. So that might have been a harsh critical parent or teacher or coach.

Maybe even later on it can happen, right, from a boss or manager. And then it also some other roots of that is a desire for control and approval. And that can also be from as a child if love was conditional based on if you did things or how well you did things.

So that's the approval piece. And then the control piece is often sometimes if you struggle with some anxiety is also another way that we try to control things. And so perfectionism also plays into that as well.

Negative Effects of Perfectionism

So the negative effects of perfectionism, and I mentioned it very briefly a little bit ago, but I think let's talk about a little bit more. Negative effects of perfectionism are chronic stress and anxiety, extreme fatigue, exhaustion.

And this isn't your run of the mill stress. It can be just persistent and really can be really debilitating for a lot of people. Another negative effect is burnout and decreased productivity. This obviously is, we can relate that the most to work, but it definitely happens in the day to day and as who you are, again, as maybe a parent or in your relationship with your partner or even as being a friend.

And this is the strained relationships piece. So it if you're always trying to be perfect in everything you do. do, it's going to make you also avoid some friendships or avoid interactions with family members. Because it's just like this idea of if I can't do it just right, I'm just not going to do it at all.

And so then that can be really isolating as well.

Strategies to Overcome Perfectionism

So now the most important piece is what are the ways, the strategies to overcome perfectionism. So it's setting realistic goals and breaking these tasks into manageable steps. Often people with perfectionism have goals that are just not attainable whether that means they need to get some project done within an hour and then they're frustrated they couldn't do that. Or this PowerPoint needs to be absolutely perfect.

And so they spend hours upon hours when really it shouldn't have should have taken half or a quarter of that amount of time. So it's setting realistic goals, knowing when to stop, even if something isn't exactly perfect. And then breaking it into manageable steps. It's practicing self compassion. Treating yourself with understanding and kindness, just with care and how you would treat another person is how you then can treat yourself. When those perfectionistic thoughts come up, you want to challenge them. So when these irrational beliefs are happening, you want to replace them with more balanced thinking. And so that, of course, takes being mindful, noticing when they're even irrational. Because if you've been operating in one way and being perfectionistic for a very long time, sometimes you don't even notice you're doing it, right?

It's just automatic. So it's being able to notice when they come up. Being able to have a more balanced way of thinking. And lastly, this might be the most challenging, which is embracing those mistakes. Which does sound really difficult. Looking at mistakes as opportunities for growth and being able to tolerate a mistake.

So maybe you had a project at work and your manager gives you constructive feedback. Instead of spiraling into a place of self criticism and horrible things that maybe you say to yourself, it's like, all right, I made some mistakes. How can I now not do this next time? Or what can it look like next time that would be different? Or everybody makes mistakes and I'm human like everybody else.

And so how can I move on from this instead of beating myself up. We see a lot of people at therapy now SF who have perfectionistic ways of being and levels of how it disrupts their life and all, again, with work or relationships and procrastination, I think is one of the biggest things that it does.

Being able to recognize this is such a challenging pattern for me, that I'm not able to do this on my own. I need a professional. I need some outside support to help manage that. I don't even know how to replace my irrational beliefs and make my thinking more balanced. And so that's when it can be helpful to reach out to a therapist and together work on bringing the awareness. And then learning how to replace that way of thinking and behavior.

And so that way it looks different and you're not struggling as much and decreasing anxiety and decreasing depression and just overall decreasing your stress. It's not a bad thing to reach out. It doesn't mean you're making a mistake or that you're a mistake because something's wrong with you because you have perfectionistic ways. Being self compassionate about that and recognizing when maybe it's time I get a little bit of help.

Let's talk about the power of self compassion, what self compassion is and how to cultivate it more in your own life.

I think self compassion is something maybe a few years ago was really buzzy, but I think maybe it's not as much in the zeitgeist as it was. It's still incredibly important and something that as a therapist, we're talking to our clients about all the time.

Something I'm trying to remind myself of all the time. It's not the easiest thing to do. And so it's great to continue to make it a conversation.

So what does self compassion mean? It means treating yourself with care and kindness and understanding with empathy. With... I was going to say with compassion, that's obvious.

And realizing that not just everybody else has imperfections, but that we, of course, have imperfections and struggles. And one of the best ways that I try to explain this to clients and even friends and to myself is the empathy you have that you would give to a friend. Turn that back on yourself.

Give it to yourself. That's really, as simple as saying, What would I say to a friend? And then turning on yourself. And sometimes when I think to myself, Oh, how can I be self compassionate? What would I say to myself? My mind goes completely blank. And so then that's when I have to literally say, what would I say to a friend? And then it just rolls off the tongue.

So let's talk a little bit deeper into the components of self compassion. So self kindness, like I mentioned, is treating yourself with understanding and care instead of that harsh judgment. Another piece is having common humanity, recognizing that suffering and personal failure are part of the shared human experience.

They are part of life and keeping that at the forefront of what's going on in context. And then mindfulness. So observing our negative thoughts as they come up. We can't change any of our thoughts or have self-compassion if we're not noticing it at first. And then when you are observing them, you're noticing those feelings with openness and clarity without over-identifying with them.

Benefits of Practicing Self-Compassion

So the benefits of practicing self compassion when we do this, we can start to build emotional resilience. And what that means is we can help ourselves recover quickly from setbacks. The more resilient we become, the more flexible we are, just the easier it is to get through life's day to day challenges.

And when we have massive setbacks or challenges. We'll have overall improved mental health. That one might be obvious. But to be a little more specific is linking that to lower anxiety, depression, and stress. And another piece of improved mental health means we're going to have better relationships.

We're going to be able to support our friends in a better way because we're being kinder to ourselves. So we're feeling better. So we have the emotional bandwidth to be able to support other people. Not just friends, but of course, family members, coworkers, neighbors. Anybody that's in your community, you're going to have more empathy for them because you're having more empathy for yourself.

And then lastly is personal growth so You can pursue your goals without as much fear. Learning is a little bit easier. You're looking at difficult things as more of a challenge, not as a barrier that you can't overcome.

Practical Tips for Cultivating Self-Compassion

When we're practicing mindfulness and engaging in mindfulness exercises, that means being aware of all of your senses. When we're being more mindful, we have an openness and a curiosity into what our thoughts are.

Most of us just operate in autopilot. And so our thoughts are just whizzing by and it's habit and we don't really think twice of it. But when you're practicing mindfulness, you start to tune in to what those thoughts are.

And next one is just, in general, being more kind to yourself. So when those self critical thoughts come up, how can you replace that with more supportive words. And I think the other piece is that sometimes when we have critical self thoughts, we then criticize those thoughts and get mad at ourselves for those thoughts. And and then you're mad at yourself for doing that. And it just becomes like you're stacking on top of each other.

And so instead of that, again, it's this curiosity of ah, you label it. That was a self critical thought. And okay, what would be an alternate way to handle that. And then another piece would be recognizing our common humanity, that everybody struggles, that life is challenging in general, we all suffer in different ways and it doesn't help to be angry at ourselves.

And then lastly would be self compassion exercises. That can look like writing yourself a letter that's more compassionate, or a guided meditation, or reading a book that's maybe a self help book. Any of those things will help self compassion.

And if you're interested in learning more about self compassion, one of the main leading researchers is Dr. Kristin Neff. I actually went to a talk of hers a couple of years ago, and this is what she does.

This is her day in and day out. And she's absolutely incredible in how she phrases these things. And I think one of the things that she talks about is it can feel really cheesy to think of self compassion or that people feel like if they're not hard on themselves and they won't achieve their goals and all this kind of stuff.

And what her research shows is actually, it does the opposite. That when we're very self critical it actually stunts us being able to complete our goals. It stunts how we interact in a relationship. It makes our anxiety and depression worse and all of those things. So there is legit research that shows what self-compassion can do.

And that it doesn't have to be something that's cheesy or overhyped. It can just be something that you're practicing in the day to day. And if you're really having a hard time with even understanding how to do this, that's where talking to a therapist is really helpful. And our therapists at Therapy Now SF try to practice this with themselves like we all do and definitely encourage it. And when working with our clients. So it's something that we're, again, it's just a work in progress. We're all trying. Anybody would be lying if they said they did all the time. And it's just the practice, you just keep going. And it's challenging sometimes and not others. But you keep plugging away.

An important topic that I think a lot of us experienced or we know someone that does experience this, which is social anxiety. So I think we all know that as a general term and you hear it running around all the time of, oh I've social anxiety, or I have some social anxiety. And not to say that people aren't experiencing social anxiety, but it might not be completely diagnosable.

But again, even though that they're experiencing it, that's still really important. And what we're going to talk about is ways to manage that, whether it's minor and it comes up a little bit of discomfort, to impacting you to the point where you're really not able even to socialize. So let's start with the definition of and symptoms of social anxiety.

Understanding Social Anxiety

So social anxiety disorder is the more technical term, also known as social phobia. It's a very common mental health condition. And it's an intense fear of social situations where one might be scrutinized by others.

So there's statistical prevalence of this, pretty high: 1 in 10 people experience social anxiety at some point in their lives.

I would say it's even higher than that, but those are the numbers that the research shows. And then there's some demographic variations as well. Often people start to experience it in childhood or adolescence with a median age around 13 years old. It's common for social anxiety to develop after the age of 25.

And gender-wise, women are more likely to be both diagnosed and experience social anxiety 1.5 to 2 times higher than men.

And then there's an urban versus rural difference as well. And urban areas are higher and the possible reason for that is just there's more social interaction demands in urban areas.

Psychological Strategies

Social anxiety, like I mentioned earlier, can be incredibly debilitating. But with the right strategies, it can be managed and overcome. So that's an exciting piece.

Some very effective ways to manage social anxiety are cognitive behavioral therapy also known as CBT.

And basically what that is something in the environment happens, you have thoughts about that experience, and you have bodily sensations about that experience, and then you act in a way because of that.

For example, I'm going to a work mixer. And this would be social anxiety provoking for me, actually. And so my thoughts would be, might be, what am I going to talk about? Are they going to think I sound stupid? Do I ask them about their job? Do we talk about personal? What if there's silence? And then immediately now I'm anxious. My heart starts racing. Maybe my palms are sweating. And then my brain isn't functioning as well and I'm not able to just talk comfortably as I would with a friend.

So ways to handle that are exposure therapy. So it's gradually facing that feared social interaction. So it might be, in that example, maybe you go for 30 minutes. And before that you're talking about ways that you can, maybe you're prepping a little bit, so maybe you're saying like, you think of some topics that you can talk to people about, maybe you're doing a little role play in your house by yourself or with a friend.

And so you're getting ready for that. There's also mindfulness and relaxation techniques for reducing the symptoms. So mindfulness is you're getting aware of all of your senses. Relaxation techniques might be to some deep breathing... again, some kind of calming statements, some reassuring statements.

Lifestyle Changes

So then there's lifestyle changes as well. So regular exercise we know can be really helpful and anxiety reduction overall. Having a healthy diet.

So if you're about to go to this work event, you might not want to have a ton of caffeine, because caffeine - it helps you stay awake. If you have too much of it, it might produce some anxiety. Your heart might start racing and your thoughts might start racing and it's can be a little bit intense.

And then you also want adequate sleep. That's a really great way to manage anxiety. Often when we don't have a lot of sleep, we immediately feel anxious and out of it.

Practical Tips for Managing Social Situations

So some practical tips for managing social situations.

A little bit what I talked about before. So some preparation, planning, and maybe rehearsing what social interactions can look like. Doing again some deep breathing, some grounding techniques. And then some positive self talk and affirmations. This is all helpful and it can be helpful to do on your own.

Seeking Professional Help

If again, it's so debilitating for you that you're noticing you're not seeing friends, you're having a hard time interacting with co-workers and going to parties and all these different things, then that might be the time to consult a mental health professional. And you can look into the different types of therapy and counseling that's available.

Like I mentioned, CBT is one of the most popular ones. It's one of the most evidence based and effective ways for social anxiety of treatment. And lastly, if it's really debilitating, medication can be really helpful too. And maybe that means, medication short term until you get a grasp and you get all these tools under your belt, or it might mean medication longer term and that's okay.

We all have different chemistry, biology, and different life circumstances. And so doing what you need to help yourself is totally fine.

Building a Support System

And then, lastly, building a support system. The more comfortable you can even be with friends and family, it's like practice. And then they're also supportive of you to help you do these things.

You can join support groups. There's social skills training programs. There's public speaking programs. There's different online communities and other resources for social support.

So to sum everything up, social anxiety is incredibly common. Most of us, I would say, have some level of it at some point in our life.

So we can all empathize with someone who's really struggling with it. We possibly know someone who really struggles with social anxiety. And so ways to manage that are some of the ways I mentioned of practicing, positive self talk, maybe some CBT, doing exposure, building up to bigger events. Practice really does make perfect in this area. Having a good support group, a social community and yeah, just keep at it. It does get better over time and there's going to be, for lack of a better word, you're going to have missteps and you got to keep pushing forward and not give up for those missteps.

And like always, if it's really debilitating and these things that you can't do on your own, which for a lot of us, that's the case, reaching out to a mental health professional.

And if you're in California TherapyNowSF has many therapists who work with social anxiety. And so that's something that we can definitely help with.

Navigating life transitions. This is something we can all relate to. We've all had some form of life transition in our life. There's obvious ones moving, starting a new job, starting a new school or just starting school. Maybe Losing a loved one, maybe retirement, the ending of a relationship, the start of a new relationship, any sort of health challenges... Okay, I'll stop.

That's enough. We all get the idea of what a life transition is. So they can be very challenging, but with the right strategies and mindset, they can be navigated successfully, and they can also be looked at as a growing opportunity. And a challenge that's positive and can help us grow in ways that we couldn't think of.

But we've got to be mindful of all these things to actually make it so that way it can be done in a relatively successful way. Some impacts of life transitions are, they can have a massive emotional and psychological toll. They can create a lot of anxiety.

They can bring on depression. It could be triggering for trauma, such as losing a loved one. It can be a lot and that stress can be so much that it can impact our sleep, it can impact our eating our social engagement, our ability to focus. And whether that's work or just in general our ability to be present in life.

So there's a lot of ways it can impact us. That's why it's important to have some strategies.

Psychological and Emotional Strategies

So one strategy for a life transition is acceptance and mindfulness. So if this transition is happening and you don't have control that it's going to happen either way, even if it's a positive thing, you're moving to a place you always wanted to move to, it's still a massive transition and a big change. So having acceptance of what you can and can't control can be really helpful. Embracing that change. And doing your best to stay present. So when those anxious thoughts come up, you're noticing those thoughts and you are also maybe challenging them to more logical and rational statements and doing some self care of what would be helpful right now so I can bring my anxiety down.

Like it's really intense. Can I go outside for a walk? Can I take a shower, can I talk to a friend? Any of those things to help manage that anxiety. Some cognitive behavioral strategies as well. So noticing when these negative thoughts come up. Actively challenging those thoughts .And then helping yourself develop a more positive outlook.

Being flexible is a huge way to go about this. That helps with resilience. So the more flexible and our ability to adapt and change, the better off we're going to be in the long term.

Practical Steps for Managing Transitions

Some more practical ways to manage any sort of big transition or even small transition, is by doing a lot of planning and preparation.

So setting realistic goals for yourself, creating some sort of action plan And with this, you still want to be flexible and adaptable. Another one would be building a good support system. Being able to rely on family and friends, professional networks, if needed maybe some support groups, even looking online for ways to manage it and really reaching out to different support systems.

Maintaining Physical and Mental Health

Ways to maintain your physical and mental health. So having healthy lifestyle habits are going to help. So like I mentioned before, maybe you go for a run. Regular exercise is going to manage both anxiety and depression. Having a balanced diet.

All of these are setting you up for success. So that way you still may feel some anxiety, but at least you've slept well and you went for a walk and you went to the gym and you ate a balanced meal. Your anxiety could be a lot worse than it actually is.

And then doing some self care and stress management. Self care can look like allowing yourself to, at night, read a book.

A book that you like. Whatever that looks like for some people that is a crime series for others that's like a positive psychology or a fantasy novel, whatever you like, that would be the one to do. And doing what you can to just manage that stress, having a schedule anything to prevent burnout.

Professional Guidance

If things become too challenging and, you've tried all these things that I've just mentioned, reaching out for professional guidance and support is also really helpful.

At TherapyNowSF we have a lot of people that have just moved to San Francisco, or have just moved to California, or are starting a new job, ended a relationship. Just had a call the other day for probably all these things.

Those are really common experiences. People sometimes feel like that stress is too much, understandably, and so it takes reaching out to a professional.

Another way to go about it is also, you could have a career or life coach they can provide some direction and motivation as well. And so to sum everything up: Can you embrace the change?

Can you recognize there might be some growth there? And even if the change is a negative one, like losing a loved one or the ending of a relationship that you didn't want to end, there will be growth there in time. And it can be from self discovery. It can be from managing anxiety in a different way this time that helps you manage it better next time.

It will build resilience and help you handle future changes. And also, I think, give you that confidence that I've been through hard things before I can do it again. And reminding yourself those stories of when things were difficult and it doesn't stay usually difficult forever and it does get better.

So keeping that in mind, keeping that hope idea in mind.

Let's talk about the impacts of social media. It's something that is talked about a lot. I feel like it's always these negative ideas and connotations around it. And not to say that's not true. And there's also some positive too.

And so it's a balanced, it can be a balanced way to engage in the world. Let's talk about both the mental health positive and negative impacts. And then let's also talk about how to engage with it in a healthy way.

Positive Impacts of Social Media

So let's start with positive. Some of the positive impacts are you can stay connected to friends, family, co-workers, someone you met at a restaurant... who knows. Someone you dated, someone... your neighbor. There's a lot of people you can stay connected to. That's cool. You see what they're up to. And then you can also have access to different support groups, mental health information. I like it for shopping, personally.

That can be a little dangerous, of course. Maybe I should move that into the negative impacts.

Negative Impacts of Social Media

And then, so what are the negative impacts? The big one, the really big one that I think we all can automatically think of, which is the social comparison piece. We all do it as humans.

We're always, unfortunately comparing ourselves to other people. It's just a natural part of being a human. It's how we have frame of reference into our own identity and who we are and what we want out of life. But when we do it a lot, and some of us do it more than others for varying degrees, it can lead to low self esteem.

It can lead to depression, anxiety. It can lead to feelings of doubt, self-doubt, insecurity. Significant negative impacts. Another big one is the prevalence of and the impact of cyberbullying. That's huge. And cyberbullying isn't just, sometimes we think of that for, 18 and under for younger people, but that is, as we know, absolutely not true.

People get behind a keyboard and go nuts and say things that would never say to somebody in person. And that happens to everybody. And I think the younger people are going to be more susceptible and vulnerable, but that doesn't mean we're not all impacted, especially as adults. And then the last one is, anytime we're excessively online or, on social media, we're reducing the real life interactions and productivity that we can do.

It's a distraction and sometimes we need a little distraction, but if again, we're using it in an excessive way that's not a very healthy way to go about it.

Strategies for Healthy Engagement

So some strategies for healthy engagement: You're going to want to limit that screen time and ways to do that are different monitoring tools.

There's different apps for that. There's ways you can set an alarm or, I'm going to go on Instagram for 20 minutes right now, and I'm going to cut myself off then and really sticking to it and having those boundaries. And another way to have healthy engagement is to follow more positive accounts and to unfollow the negative ones.

I think another piece around this is maybe not getting too lost in the comments where the negative comments can lay. And lastly, being mindful of the emotional responses that you're having and engaging in a thoughtful way. And what does that mean, right? Immediately, if you can start to feel like a lump in your throat and you're having bodily sensations or frustration or whatever.

And so then you ask yourself, what's going on right now? Why do I feel this way? And often it's some social comparison that we're doing, or, I think a big one that this happens for is people are traveling and it's like, oh, how do they get to travel? I'm at work. I'm at home. I'm taking care of kids.

I'm... whatever. And often people only post when they're traveling, and they only post when they're going to a cool restaurant, or doing an activity, or they're not posting when they're cleaning their kitchen and putting their kids to bed or whatever the more mundane things.

Summarizing all of that it's helpful again to think that: It's not just all negative and that there are some positives. So how do we increase those positive interactions? And just monitoring your time, noticing those interactions, trying to follow the more positive accounts and making sure you're still engaging with people in person as well.

And maybe you're using it as a tool to keep connected with people that you don't see as often. And then maybe it's a way to make plans with people that you then can see more often because you realize you miss them. Lastly, if this becomes, for some of us too big of a distraction or too difficult, it can be helpful to reach out to a therapist to talk about how it's making you feel insecure or having self-doubt and just talking to a professional about the effects of it and ways to manage it in a more effective way.

Understanding boundaries. Let's start with types of boundaries. There's emotional, physical, and time boundaries.

Emotional boundaries are feeling respected, feeling safe, feeling understood.

Physical boundaries, that might be more obvious. Also being safe, consent, feeling like you have control of your physical self.

And lastly, time boundaries, can be as simple as when you're meeting a friend and they show up two hours late and you're just sitting at the restaurant. Or in terms of like work and having those time boundaries of you stop at a certain time and your boss allows that or your colleagues allow that. And so those are sort of time boundaries.

The benefits of setting these boundaries are reduces stress. You have better relationship satisfaction. You have increased self esteem. You are overall just it's better mental health when there's clear boundaries. And in saying that some people are easier to have clear boundaries with than others.

Some people automatically have appropriate boundaries with each person and then others, you might have to start essentially teaching them your boundaries.

Recognizing the Need for Boundaries

When you notice somebody has poor boundaries, so maybe you're starting to feel resentful or taken advantage of listen to that, notice it and start to recognize, okay, that means that I need to start to set some limits and what works for me and knowing for you what works.

And so maybe it's automatic that you're someone who's a people pleaser. I can relate to that. I tend to be. And so I have to, I've had to, and it doesn't mean I've figured it out by any means, but it does mean I'm working on it. And to say no to things or just say, actually, that doesn't really work for me.

This works for me. Or if I need more time to think about if it works for me, Hey, let me think about that and get back to you.

How to Establish Boundaries

And so when you're establishing these boundaries, you're really looking inwards and figuring out what you need, what works for you and also what you want. And then it's communicating those boundaries to that person.

You're communicating them assertively. You're not, of course, being aggressive. You're just being Direct and clear. And then, if you're dealing with somebody who doesn't have the best boundaries in general, you've got to be then consistent with them of maintaining those appropriate and healthy boundaries for yourself, because the reality, unfortunately, is that if we're inconsistent with someone who doesn't have the best boundaries, we will then go back to feeling resentful and not cared for and wanting to just distance ourselves.

So in some ways. often training somebody to do that. And I think again, this can happen in all of our types of relationships. I think sometimes families are the ones we think of first because we've become so habituated to what their boundaries are from growing up with our family.

And so it takes us sometimes time to be unwind and realize actually, that doesn't feel good or that I don't want that to be anymore. And so then it's, like you're training somebody, but you're having to retrain them when you've been one way for 25, 35 years. So that can be really challenging. And that's where consistency is huge.

Dealing with Boundary Pushbacks

And so in saying all of that, there can be boundary pushbacks. People getting frustrated with you, getting mad at you, not understanding, you've been one way this whole time. Why are you now being this other way? It can be jarring for people, so I think having some empathy around that too of, if, you've been operating one way for however many years and then all of a sudden you're flipping the script and you're changing that narrative.

It is going to be challenging for someone to understand, but that doesn't mean you shouldn't do it. It just means you've got to now learn how to handle that resistance, staying firm, staying compassionate. It doesn't mean inflexible, rigid boundaries. It can be boundaries that are compromises and that you are negotiating what works for them and what works for you.

But always go back to the self reflection piece of, is this compromise okay for me or am I just compromising because I can't handle the resistance.

Maintaining and Adjusting Boundaries

So check ins are really helpful, when you're maintaining and adjusting these boundaries. You're checking in with yourself. Maybe you're checking in with the person to and figuring out, having that reflection, having that insight of what works for you. Being adaptable can be really helpful to changes and knowing that relationships grow and change.

And that's totally appropriate and that you're allowed to do that.

So in conclusion, with all of this boundary setting and having your own boundaries, is a necessary part of life. For some of us, it's easier than others. For some of us, it is harder. And it starts with that self reflection piece, that checking in of what's working for you.

Am I feeling exhausted by this person? Am I feeling disrespected by them? Is this a continual pattern that I'm noticing? If so, I've got to start setting some boundaries and I've got to start setting emotional boundaries, time boundaries, and I've got to do that in a compassionate way and a way that works for me, but is also consistent and appropriate.

And relationships are such a integral part of our lives and our happiness and our contentness and well being. And so the more you can have healthy boundaries, the healthier and happier you will be in all of these types of relationships. And at Therapy Now SF, we work with people in relationships all the time.

That's another one of our main categories that people come in with. And again, it's relationships of all type: romantic, familial, friendship, and professional. And being able to discuss with a neutral third party and someone who is an expert in what boundaries can look like and helping you sometimes give you the words of what you can say to somebody else.

That's something our therapists are really great at doing and therapists in general are really great at doing. And reaching out to somebody if you're really struggling with what boundaries look like, it's okay to reach out, past your own circle, to figure out what's needed for you.

Let's talk about the impact of narcissism in the workplace and strategies for management and coworkers. Narcissistic personality disorder, I feel like it's a little buzzy right now. And that's fine because I think our culture has developed where a lot of people have some characteristics of narcissism. But that doesn't mean they qualify for the diagnosis of narcissistic personality disorder.

But in saying that it's okay to be able to know for yourself how to work with somebody who maybe is showing some of these traits and characteristics. So I'm going to talk about it in a general sense, and then also with somebody who maybe does actually have that diagnosis. And when you're working with somebody who has some narcissistic traits it's challenging whether they're above you, equal to you, or you're managing them.

And the receiving end can have a lot of negative mental health impact, for yourself. And when you leave the workplace and you questioning yourself. So it's important to be able to know how to manage that for yourself and how to manage the person, essentially, how to work with them.

Recognizing Narcissistic Behaviors in the Workplace

Some of the characteristics are a need for admiration, a lack of empathy, a tendency to belittle others, gaslighting can be common, making others feel less than. In team dynamics, or if someone's above you, it's really challenging, obviously, if someone's above you, and they're doing this, it can totally disrupt team cohesion, communication, workplace atmosphere, it can erode trust, and your ability to feel comfortable and safe to take risks, to be able to be yourself, essentially, authentic self.

Consequences of Unchecked Narcissism

It can decrease your job satisfaction, it increases stress, it can make you have self doubt, it can chip away at your own self esteem. There's challenges to productivity, decision making processes and, in general project outcomes.

Strategies for Management

Let's get into some management strategies. Let's start with setting boundaries. So boundaries are important for everybody whether it's narcissistic tendencies or not.

Setting clear boundaries looks like being able to express what you need, being able to say no to things, being able to appropriately say what doesn't work for you, how something even makes you feel. And, even like very basic, a boss that is showing these tendencies, wants you to consistently stay late or work later from home and, maybe every once in a while that can work for you or it's appropriate you have a project, but if this is a continual thing, or they're calling you on weekends or any of those it can be you explicitly saying, "I'm working between these hours, I can get back to you at this time," or maybe even not responding. My recommendation is always being communicative up front. If those boundaries aren't accepted or respected, then it maybe looks like not responding until, you're back in the office at 9am. Whatever.

Some other ways are, giving constructive feedback, ways that are clear and specific. Saying something like, "when we were in the team meeting this morning, when you said blank, it didn't feel constructive to me. It felt like you were putting me down. And I think in the future it'd be helpful if you gave me similar feedback and it could look like this."

And you're not attacking somebody. You're really talking about their behavior. You're not saying, you did this, you always make me feel blah, blah, blah, because of your personality. No, none of that. It is focusing on the behavior.

And then another piece would be being very Specific about what your role is.

And if it can be common that again, someone, I think one of the most challenging if someone's above you really, because that is a lack of power, right? Being able to explicitly say, " my role is this, it seems like so and so, maybe that would be more appropriate for them to do this other piece of the project."

Coping Strategies for Co-Workers

So some coping strategies when you're having to deal with someone who's displaying these characteristics is, maintaining some professional distance, protecting your own emotional health, it might mean you aren't as vulnerable with them about your personal life because maybe they use that against you or don't make you feel respected in what you're telling them.

So effective communication, like strategies that we talked before are if maybe somebody easily gets emotionally heated or things escalate, you're going to want to deescalate that situation by talking calmly in a low voice and not trying to trigger what's going on for them.

Lastly, and this is always an option, is to seek out extra support, and maybe that means trusted colleagues or, if needed, human resources. And I don't think that has to be a last resort. I think that can be, I would recommend trying some of the other things that we've just talked about, but it is totally appropriate to do either of those if it is become a toxic work environment for you.

Building a Supportive Work Environment

Building a supportive work environment. One of the best ways to do that is to promote empathy. Empathy is a great way to mitigate narcissistic behaviors. It's also just a great way to have a good work environment, but one of the ways to deal with somebody that has some narcissistic behaviors is, to give them empathy while at the same time setting your boundaries and having effective communication.

If you're in a position to train managers or other colleagues, I think it can be helpful to talk about different personality types and ways to have an inclusive work environment and ways to work with people that have diverse ways of doing things.

And having regular reviews can be really helpful, and that can be a way to give feedback that maybe doesn't feel as scary in the one-on-one process. You're still doing all the effective communication of focusing on behavior and being clear and direct, but it can be less scary than having a one-on-one.

Being Prepared

Narcissistic behaviors in the workplace are challenging. The reality is most of us will see it in some capacity. So having an expectation that is probably going to happen, get that support that you need from colleagues or outside colleagues, being able to express how it makes you feel to them, then having communication with the person in general, having empathy towards them while setting appropriate boundaries, talking about their behavior and what it was like for you.

And having even the awareness to know It's not you and you're not personalizing it. It is the person and their challenges and being able to have some distance between that.

Reach Out to a Professional

At Therapy Now SF, we work with a lot of people that have a lot of work stress. That's one of our main complaints that people come in wanting to work on. And sometimes it has to do with someone that they're working with or above them has narcissistic behaviors.

Sometimes it doesn't. But it can still be helpful to talk about all these different personality types. The best way to respond to somebody, not react to them, but to respond to them. And at Therapy Now SF, our therapists are very skilled at helping with those communication in that boundary setting.

How do we choose a therapist in San Francisco? This is a question that many people ask me, and at Therapy Now SF, the way we go about it is I'm the first point of contact, and I assess what's going on symptom wise, what's bringing you into therapy right now, and then from there I think of our therapists and their personality styles, their different theories they use, and ways of being and engagement and everything, and then I sort of sorta match them.

Let's get into the details of when you are looking for a therapist and what that can look like.

First off, I would say, take your time. There's no rush. You can, most if not all, almost all, I would say therapists offer a free, like a 15 minute sort of phone consultation or video consultation so you can get a feel of somebody of who they are and their personality and see if you click.

In San Francisco specifically, there's such a variety of people, of cultures, of therapeutic approaches, of just the different schools they've been to. There's such a plethora, which is wonderful, but it can also be a little bit overwhelming.

Assess Your Needs

 So start with assessing what your needs are.

So what do you want to achieve with therapy? You can think about what your symptoms are like maybe you're struggling with some anxiety. You feel nervous. Often you worry a lot. You're in your head. You are ruminating about different things. That can translate into the everyday mundane.

It can also translate into work and your relationships. So if that's something you're going through, think of, what you're wanting to work on around that anxiety. Then if you want, you can, you don't have to do this, but you can also look into different therapy types. So you could do this by, just simply Googling, what's effective for managing anxiety.

You can look at what's evidence based, or you can look at what people have found helpful in the past such as, cognitive behavioral therapy is really popular for managing anxiety, but it's also not the only way to go. There's ways that somatic interventions are really helpful for anxiety or narrative therapy is really helpful.

And what the research actually shows, the literature shows, is that what's most important is not necessarily the theories a therapist uses, it is the relationship you build with the therapist. And so really keeping that in mind when you are talking to potential therapists.

Research Potential Therapists

 When you're looking into therapists, you can look into their qualifications and their credentials.

There's different types of licensures. There's LCSW, which stands for Licensed Clinical Social Worker, MFT or LMFT, which is Licensed Master's Family Therapist, a PhD or a PsyD, which is a doctoral in psychology. My personal sort of feelings around this degree can matter or cannot matter.

So much of it again is personality and compatibility and connection with your therapist and their experience with what you're wanting to work on. And how that experience aligns with your needs and sort of your values in life.

Consider Logistical Factors

 So then you want to consider some logistical factors.

Are you wanting telehealth? Are you wanting video sessions, phone sessions, or are you wanting in person? And then, even like deeper into the logistics, if you are wanting in person, make life a little bit easier for yourself. Maybe get somebody who works close to where you live or where you work.

You wanna decrease as many barriers as possible to get to therapy. But at the same time, if you find the right fit across town could be worth it.

And you're going to find out their availability. What is their scheduling look like? What times work for you?

You're going to look into your insurance and what the fees are. Some insurance companies will have a list of in network therapists. Others will be what's considered out of network, an out of network provider. And so they will be what we call private pay or self pay. The landscape has really changed in the past even five years where a lot of insurance companies are reimbursing for an out of network provider.

And that's huge. And that reimbursement rate can be anywhere from 50 to 80%. But the way to find that out is you have to directly call your insurance and find out what your plan does. Most therapists can't really tell you, what your Blue Shield Blue Cross specific plan will have.

In fact, they shouldn't tell you because every plan is different. So you need to find that out, do a little legwork for yourself.

 Check Reviews and Testimonials

 So then another piece is check their reviews and testimonials. The one challenge with getting reviews and testimonials, as a therapist, as I can tell you, is that one, ethically, legally, we actually can't ask our current or former clients for them.

So it has to be totally voluntary and therapy is private and confidential. So a lot of people don't want to be vulnerable and say they're going to therapy, there's still stigma, unfortunately around therapy. That can be helpful. Or if you have a friend who's been to a therapist, you can think of maybe seeing them.

That can be helpful unless you maybe want some space between your friend and your friend's therapist. And so maybe that therapist can recommend somebody for you.

Assess Your Comfort Level

 So then what I talked about earlier is you want to schedule that consultation. And take your time. Think of maybe some questions you want to ask. And think of the compatibility. Talking to them, do you feel safe with them? Do you feel like you can open up? Do you feel like you can be vulnerable? Do you feel like they're not going to judge you? Those like basic, basic ground level is extremely important because this is a person you're going to be talking to about possibly your deepest secrets, things that maybe you struggle to share with friends and family and you want to make sure this therapist can handle that and make you feel like you want to keep opening up.

I would say one of the last things is really trust your gut. Sometimes we can talk to somebody and we can't pinpoint why it just doesn't feel right.

And so you don't have to put words to that. You can just let yourself know something about that conversation didn't feel right to me. So I want to move on. Sometimes what I even encourage potential clients to do is if something does feel good over that consultation, schedule that first session.

You're never forced to continue for the rest of your life with that therapist. You can go, test it out for three sessions, I would say. And then if it's feeling great, continue. If it's feeling like something's off, or maybe you can pinpoint what's off, then move on, find another therapist.

In conclusion, take your time, trust your gut, have those conversations, talk to your friends or family about maybe how that conversation went. Again, do you feel safe? Can you be vulnerable? Can you open up? Can you build a relationship? Again, that relationship piece is huge. And that is the best predictor of feeling better, of achieving your goals, and of making the progress that you want to make.

So let's talk about understanding and addressing gaslighting. I think this is a term that in the past, I would say five years, I have clients talk about once a week. And often it's talked about in terms of maybe a partner that my client is worried is narcissistic. And so I want to clarify a few things before I even get into gaslighting. First off, not everybody is narcissistic.

I think that's also become a really buzzy common personality trait that people are saying, or it's really a symptomology. And those that have some narcissistic traits almost always do gaslight. So there is that. So let's, let's just get into it.

Identifying Gaslighting

 Let's just talk about what gaslighting is. So it's a form of psychological manipulation.

Specifically what that means is it's making a person question their sanity, their reality, their perception, or their reasoning.

This can happen in a friendship, this can happen in a intimate relationship, this can happen at work, this can happen anywhere, this can happen at the grocery store.

It can be like denying what somebody said, or that an event even took place, or that their perception of the event is wrong. And if you've ever been on the other side of this, which most of us had at some point, it's infuriating on that end, on your end, if you're being gaslit. It's invalidating.

It can bring up anger and rage and feelings of sadness and can bring up childhood stuff, bring up a lot of stuff. So, if you're in a, you know, say friendship, a close friendship, or with a partner and they're doing this a lot, then it's going to have a massive impact on your mental health. And also start to question your perception of reality which can really, be damaging for somebody.

The Psychology Behind Gaslighting

 So, what's the psychology behind gaslighting? Why do people gaslight others and and some of the power dynamics involved? It can be... be a lot of things. Some of the things that can be are:

• Someone's trying to maintain control in the relationship.

• It can be a matter of not having trust in a relationship.

• It can be someone acting out trauma they experienced, say, growing up or in past relationships.

• It can be a form of self esteem, lack of self esteem.

So there's a lot of reasons why someone does this and why it happens and sometimes some people know they're doing it. Sometimes they don't even know they're doing it. Both are difficult to deal with.

How to Respond to Gaslighting

 How do you respond to gaslighting? So I think this is, this is probably the toughest part. A lot of it has to do with first, if you start to identify it, one thing you can do is, well, talk to your therapist about it. If you're seeing some, a therapist, if you're not maybe a trusted friend.

If it's your friend that's gaslighting you, talk to another friend, someone that you do trust, that you trust their perception of the world and their reality of the world, that you trust that they know you well, and maybe explain to them the scenario, and try to explain that scenario in the most factual way possible of stating what the other person said and really trying to leave the emotions out of it.

Another way if things are really bad and, and I hope for somebody, it's not really this bad, but if it is, if you have, you know, intense conversations with somebody right afterwards, write down what each person said.

And that way, if the conversation comes back up later on, you actually literally have documented notes. Again, that is if something is really, really bad. And so I hope that's not the case.

So once you've identified that, yes, this is some gaslighting behavior, you need to protect yourself. You need to set boundaries.

You need to speak directly. And if it's really bad, maybe consider what that relationship is serving you compared to the mental anguish it's giving you. And seeking support, whether that's family, friends, and or a therapist.

Healing from Gaslighting

 So ways to heal from gaslighting. It's going to be a lot of rebuilding one's self esteem. Rebuilding your perception of reality.

Having healthy, good relationships where people validate your feelings, your experiences. Professional help is always really helpful with that. You have an unbiased third party who can really give it to you straight of what they're seeing and what's going on.

So in conclusion of all of this. It's helpful to have awareness of what gaslighting is. To be able to identify what's going on. To maybe understand what is the psychology around why someone might do this. And how to respond to gaslighting. And then to really take care of yourself if it's happening. And to really evaluate that relationship. And not all relationships are meant to last. That means friendship or whatever, intimate relationship. And so really doing an audit of your relationships and figuring out the healthy quality relationships that are in your life.

It can be a great way to go about this because you have a professional who's helping you really dissect and figure out what's going on.

By Dr. Andrea Zorbas

We're exploring how to be happy in a relationship, which is a significant topic for many. There's a common misconception that being in an intimate relationship automatically means you should be happy. Initially, most are familiar with the honeymoon stage, where everything feels blissfully perfect, and dopamine levels surge, enhancing happiness. But as time passes and we get to know each other better, seeing each other's faults and facing conflicts, the reality sets in, making the relationship feel more real and often more challenging.

Communication is Key

Communication is everything in a relationship. It's widely acknowledged as challenging but crucial. Effective communication involves being open and honest. The most important aspect, I believe, is active listening. It's beneficial to use "I" statements, focus on expressing your feelings, and employ non-blaming language. However, it's equally vital for your partner to actively listen, validate what you're saying, and not just wait for their turn to speak. A technique I recommend to couples and individuals is to repeat back what the other person has said in your own words to ensure understanding. This can slow down the conversation and might be a bit annoying, but it leads to much better outcomes. Effective conflict resolution also includes taking breaks when discussions get too heated, especially if emotions might lead to regrettable statements.

Maintaining Independence

Maintaining some independence is another key to happiness in a relationship. It's natural to experience some codependency in romantic relationships, which often gets a bad rap. However, Dr. Susan Johnson, a leading couples therapist, talks about a healthy codependence while also maintaining independence. Balancing shared interests and activities with individual pursuits and maintaining separate friendships are essential. It’s about keeping a sense of self, ensuring your ideas and values remain intact and are positively influenced by your partner in healthy ways.

Practicing Appreciation and Gratitude

Practicing appreciation and gratitude is crucial, yet often overlooked in the hustle of daily life. Simple gestures like thanking your partner for picking up groceries or doing dishes can significantly impact their feelings of being valued. Such acknowledgments are not only affirming but also encourage more helpful behaviors, reinforcing positive interactions within the relationship.

Fostering Intimacy and Connection

Fostering intimacy and connection is vital, especially over time. This can be through regular date nights, shared activities, or new experiences together. It's essential to plan these moments because daily life's busyness tends to get in the way. Remembering to incorporate physical touch, whether initiated by you or your partner, is also crucial in maintaining a close connection.

Handling Challenges Together

Viewing yourselves as a team is critical when facing challenges. Supporting each other and showing empathy during tough times can make handling life's hurdles much easier than when you're alone. Remember, teamwork doesn't just help in overcoming difficulties; it also strengthens the bond between partners.

Conclusion

In summary, key components to happiness in a relationship include effective communication, maintaining independence while being interdependent, practicing appreciation, fostering intimacy, and handling challenges together. Learning about each other’s backgrounds, needs, and how to meet in the middle can also enhance understanding and respect within the relationship. All these elements contribute to growing together and supporting each other to be the best versions of yourselves.

By Dr. Andrea Zorbas

Let's talk about how to be happy at work. How important is it to find happiness at work? We're at work a lot of hours of our day, of our week, of our life. Job satisfaction, in general, is going to contribute to our overall well-being, our overall state of happiness and contentedness.

Identifying What Makes You Happy at Work

What are some things that make you happy at work? That's where you start. You want to identify for yourself what brings you satisfaction versus the things that don't bring you satisfaction, and that's going to be different for everybody. It really is being self-reflective and trying to figure out what works for you.

And in doing that, some of the questions you can ask yourself are what is my passion, what do I feel my purpose is both in life? And then how does that translate to what is my purpose at work? What do I gain value from, what brings me meaning? And then from there, also personal growth.

We know that personal growth gives us a lot of satisfaction, especially in our jobs. So, that is another huge piece of where can I grow? Why is that important to me? Ask yourself a lot of why questions, why is this my passion? Why is this my purpose? And then digging even deeper from there.

Building Positive Relationships at Work

Another way to be happy at work is to build positive relationships. We are social beings. We need connection. Even if you're someone who considers yourself more introverted, that doesn't mean you don't need quality connections. It might mean you need less than an extrovert, but you're going to need those quality relationships.

And maybe that's even just one. And if you're extroverted, of course, you probably want a lot of those relationships at work. So, finding those colleagues that are supportive, that listen to you, that validate you, that you have fun with, that you can go to lunch with, take a walk with, or maybe even grab a happy hour drink with.

Creating a Positive Work Environment

Creating a positive work environment can involve simple things like personalizing your workspace to reflect your personality and interests. Ensuring you have a work-life balance and setting healthy boundaries is crucial, particularly in work cultures that may not initially support this. It's about making space for well-being and recharging.

Facing Challenges Positively

Facing challenges at work is inevitable, but viewing them as growth opportunities is key. Being resilient, flexible, and adaptable in the face of change and challenges keeps you engaged and helps in personal and professional development.

Seeking Growth and Development

Seeking continuous personal and professional development is crucial for job satisfaction. Set goals aligned with your personal values that are realistic and attainable. This pursuit of growth not only improves your skills but also keeps you motivated and fulfilled in your work.

Conclusion

In summary, happiness at work involves identifying what brings satisfaction, fostering positive relationships, creating a supportive work environment, facing challenges with resilience, and continuously pursuing personal and professional growth. Reflecting on how your work aligns with your personal values can transform your professional experience into one that is not only bearable, but joyful and fulfilling.

By Dr. Andrea Zorbas

The decision to end a relationship is never easy. It's a journey fraught with emotional complexities and the potential for pain on both sides. Understanding how to navigate this difficult decision can make the process more manageable and respectful. This guide aims to provide compassionate and practical advice for those facing this challenging transition.

“Breaking up is a profound life change that requires courage, honesty, and sensitivity”

Knowing When It's Time to Break Up

Recognizing the signs that a relationship has run its course is the first step. Persistent feelings of unhappiness, fundamental differences in values or life goals, and a breakdown in communication can all indicate that it might be time to part ways. It's essential to reflect deeply and honestly about whether these issues are surmountable or if they signal a deeper incompatibility.

Preparing for the Breakup

Once the decision is made, preparing yourself mentally and emotionally is crucial. Consider the timing, setting, and how you'll communicate your feelings in a way that is clear, compassionate, and respectful. Planning this conversation in advance can help ensure that you express yourself effectively and reduce the potential for unnecessary hurt.

Having the Breakup Conversation

• Be Direct and Honest: Clearly state your feelings and the reasons for your decision without being overly harsh or critical.

• Use “I” Statements: Focus on your feelings and experiences rather than placing blame.

• Be Prepared for Their Reaction: Your partner may feel shocked, upset, or angry. Try to remain calm and empathetic, allowing them space to process their emotions.

• Offer Clarity: Avoid giving false hope if you're certain of your decision. Clarity can help both parties move forward more definitively.

Dealing with the Aftermath

The period following a breakup can be one of intense emotion and adjustment. Prioritize self-care and seek support from friends, family, or a therapist. It’s normal to feel a range of emotions, and allowing yourself to grieve the loss is a healthy part of the healing process.

Moving On

Moving on from a relationship involves both healing from the past and looking forward to the future. Engage in activities and hobbies that you enjoy, reconnect with yourself and your interests, and gradually, you'll find the strength to open yourself up to new experiences and opportunities.

Conclusion

Breaking up is a profound life change that requires courage, honesty, and sensitivity. It's about ending one chapter of your life with respect and dignity, for both yourself and your partner, and laying the groundwork for future growth and happiness. At Therapy Now SF, we understand the complexities involved in ending a relationship and offer guidance and support to help individuals navigate this challenging process. Remember, it's okay to seek help during this time, and taking steps towards healing and self-discovery can lead to new beginnings and personal growth.

By Dr. Andrea Zorbas

In the bustling rhythm of modern life, finding moments of peace and presence can be challenging. Mindfulness, a practice rooted in ancient traditions and validated by contemporary psychology, offers a path to achieving a deeper sense of calm and clarity. At Therapy Now SF, we integrate mindfulness into therapy to enhance mental well-being, fostering a connection between mind, body, and spirit.

What is Mindfulness?

Mindfulness is the practice of being fully present and engaged in the moment, aware of our thoughts and feelings without judgment. It's about observing our inner and outer experiences with acceptance, compassion, and curiosity. This practice helps break the cycle of automatic, reactive thoughts and behaviors, leading to greater emotional regulation and self-awareness.

Benefits of Mindfulness in Therapy

Mindfulness in therapy has shown remarkable benefits, including reducing symptoms of anxiety, depression, and stress. It aids in improving concentration, enhancing resilience, and fostering a greater capacity for empathy and compassion. By cultivating mindfulness, individuals can develop a more compassionate and understanding relationship with themselves and others.

Mindfulness Techniques Used in Therapy

Several mindfulness techniques can be seamlessly incorporated into therapeutic practice:

• Meditation: Guided or silent meditation helps quiet the mind and focus attention, teaching patience and acceptance.

• Breathing Exercises: Focused breathing techniques can help center thoughts and reduce anxiety, promoting relaxation.

• Body Scans: This technique involves mentally scanning the body for areas of tension and relaxation, encouraging a mindful connection with physical sensations.

Case Studies and Research

Empirical studies support the efficacy of mindfulness in therapy. Participants in mindfulness-based therapy programs often report significant improvements in mental health outcomes, including decreased symptoms of psychological distress and enhanced quality of life.

Integrating Mindfulness into Daily Life

Beyond the therapy session, mindfulness can be a valuable tool for daily living. Simple practices such as mindful eating, walking, or even engaging in routine activities with full attention can extend the benefits of mindfulness into every aspect of life.

Conclusion

Mindfulness in therapy offers a powerful approach to enhancing mental health and well-being. By fostering a mindful presence, individuals can navigate life's challenges with greater ease and resilience. At Therapy Now SF, we are committed to incorporating mindfulness practices into our therapeutic approach, empowering our clients to live more fully engaged and emotionally balanced lives. Through mindfulness, we can find a path to inner peace, improved mental health, and a deeper connection to the world around us.