It was the perfect September evening – the air was cool and crisp – a blessed respite from the oppressive Kansas summer. I was finishing up my evening walk. Normally my friend Dina was with me, but tonight I was alone. As I gazed up at the stars dotting the black sky, a feeling of dread washed over me.

I felt vulnerable. Exposed.

Someone could fly over right now and shoot at me.

Irrational? Normally, yes. But not this night. This night was September 13, 2001. Barely 48 hours since our world was invaded and changed forever. Normal things like taking walks and getting gas and dropping my kids off at school were now laced with fear and anxiety. Even walking in my ridiculously safe neighborhood left me with a profound sense of uneasiness.

Since that time, I–and all of us–have had to regain our bearings and do normal things without feeling fear. We have had to figure out how to keep moving while accepting the reality that everything can change in an instant.

The anniversary of that awful day—combined with the images of devastating earthquakes and hurricanes and fires that are currently invading our physical and emotional space—has got me thinking a lot about how to find a balance in this reality.

As a therapist, I hear story after story of people trying to manage their own disasters. The mother whose daughter committed suicide; the wife who refuses to bail her husband out of jail because that’s where he belongs; the man who madly loves a woman who abuses alcohol (and him) and can’t decide if life would be better with or without her. The teenager who probably isn’t going to get asked to prom and wouldn’t be able to afford a dress if she was.

Our stories are different, but in one way or another, we all have to face the reality that life just isn’t turning out the way we thought it would. And when the world literally crashes down around us – when the marriage fails, the storm batters, the fire threatens or the earthquake divides – how do we even begin to do normal things like buy bread at the grocery store or brush our teeth or take the dog for a walk?

When we lose anything—a person, a dream, our minds—we can’t help but think how absurd it is that people are still trimming their toenails, stoplights are still changing and banks are still keeping normal business hours.

Whether we like it, understand it or want it to be, the ordinary and the tragic will always end up occupying the same space.

It seems a little much to wrap our tiny brains around.

I’ve found that thinking dialectically can help.

A dialectic refers to the “synthesis of opposites.” It allows us to find truth in two seemingly opposed ideas: I don’t want to go to work, but I need money. My kid drives me crazy but I would give my life for him.

Completely opposite ideas that are true at the same time.

To think dialectically, we have to learn to be “both/and” instead of “either/or.” When we face tragedy, we have to open up our hands and hold the grief and joy side by side. It’s a messy business, but it can be done.

And really, it must be done. I have had one-time appointments with people who couldn’t do it. I have met with them and heard their stories, but then they leave.

“You can’t help me,” one beautiful grieving mother told me as she walked out my office door, “you can’t bring my son back.”

Broke my heart, because I knew she was right on both counts.

People do though – they find ways to grieve and go on at the very same time.  The woman who started Mothers Against Drunk Drivers. The man who dedicated his life to finding missing children after losing one of his; millions of others who, in the face of unspeakable tragedy, wake up each morning and keep doing ordinary and extraordinary things.  These courageous souls decide not to let their pain define them, and instead to allow it to do something good.

So just how do we go about living both/and in an either/or world? Here are some ideas:

Learn to practice radical acceptance—This came from Marsha Linehan, the woman who developed Dialectical Behavior Therapy. Radical acceptance says, “It is what it is. I didn’t choose it, I don’t want it, I didn’t ask for it, but it’s on my plate, so what am I going to do with it?” Joni Eareckson Tada is an accomplished author, speaker and artist. She became a quadriplegic at age 18 when she miscalculated the depth of the lake she was diving into. She draws amazing works of art–with her mouth. This is a woman who has mastered the art of radical acceptance.

Find something to live for that is bigger than yourself – many people find this in spirituality. Like Job, they cry, they scream, and they rage at God, and then, when they are exhausted, they sit quietly and listen. They gain perspective and decide that to build a life worth living, they must find something worth living for.

Invite gratitude to be a part of your life – I know from experience that gratitude is transformational. When I get crabby about being stuck in traffic, I can be grateful for a car to drive and a job to go to. When I get irritable about having to park on the 6th floor of the parking garage, I can be grateful that my legs and lungs work well enough to get me up the stairs. Gratitude takes the edge off my irritability and allows me to see the good in the difficult.

Stop being invested in outcomes – This is a hard one, because we are an outcome-oriented people. But letting go of responsibility for the outcome and living well in the process can slow us down, clear our thinking, and help us figure out what’s most important. Your kid may not go to med school. Your boss may not give you the promotion. Not getting what we want can be enormously disappointing, but it can also lead us down paths we never would have ventured onto otherwise.

Get busy creating a life that reflects your priorities – There’s nothing like a good natural disaster to get our attention. Crisis has a way of stripping life down to its most basic priorities. I’ve noticed that when people start to get healthier, they naturally start working on creating a life that is more reflective of their priorities. I once worked with a woman whose husband walked away from a lucrative career in the oil business to go to floral school. Simplify your life, get out of debt, find a job you love, invest your life in people instead of things.

Lean in to the pain – Ugh – one of those overused-but-true clichés. When pain or anxiety or grief or despair overwhelm you, instead of running from it, lean into it. What can you learn about yourself and others? Where are you vulnerable? What do you need? What are you settling for? What are you doing to numb or ignore the pain that is trying to get your attention?

The same sun that melts the wax can harden clay

And the same rain that drowns the rat will grow the hay

And the mighty wind that knocks us down

If we lean into it

Will drive our fears away.

Sharon was a 45-year-old woman who led an idyllic life. Her husband had a good job, her children were healthy and they lived in a desirable neighborhood in a beautiful home. By her own description she was an introvert, but had a few good friends and enjoyed doing crafts and decorating. So why was she coming to see me?

Anxiety. Sharon was experiencing near-panic attacks almost daily—for no apparent reason. She couldn’t identify any real triggers. She led a healthy lifestyle – exercised daily and tried to get enough sleep. Nonetheless she was nearly crippled by an overwhelming sense of dread that accompanied her every move. Medication provided some relief, but not nearly enough.

This is a more common story than you might think. I see clients regularly who struggle with symptoms of anxiety, depression, binge-eating or trouble controlling their tempers. For all intents and purposes their lives are pretty stable – they take medication, they have support, and they have good jobs. And yet they are plagued by feelings they can’t seem to shake.

If you are stuck in your own mental health journey, here are some possible reasons why:

  1. You have unresolved trauma – when I ask people about their “trauma history” most of them say they have never experienced any. After all, not many of us have lived in war-torn countries or have been victims of violent crime. However, from a psychological perspective, the concept of trauma encompasses more than you might think. I’ll be writing a lot more about this in the future, but keep in mind that trauma can be a single event (such as witnessing a serious accident) or a chronic experience (such as being raised by a parent who is an alcoholic). Unresolved trauma can create problems for years and years – even if the brain doesn’t remember the details – the body does, and can cause us to react to even minor triggers as if they are big events. If you see yourself overreacting (road rage?) to minor offenses or experiencing symptoms of unexplained sadness, anxiety or fear, it would be worth exploring the possibility of unresolved trauma with the assistance of a qualified therapist.
  2. You are not getting enough quality sleep – I have experienced transient symptoms of anxiety for years without any real cause. Since I tend to do “all the right things,” I had long ago decided this was just something I’d have to live with. However, this past summer I was diagnosed with sleep apnea. I was surprised to learn I was waking up 14 times every hour (a fairly mild case, though it sounds pretty disruptive to me!). I began treatment and was not surprised to find that my daytime sleepiness decreased dramatically. What did surprise me was a decrease in my anxiety symptoms. As a therapist I know that sleep impacts our mental health – what I didn’t realize was just how much. If you have any concerns about the quality of your sleep, please discuss this with your primary care doctor, because it may be impacting your mental health more than you realize.
  3. You are not exercising or eating right – I know, blah blah blah. I’m not even going to go into all the details, because you know I’m right. Poor diets (high in sugar and processed foods) and lack of movement make us feel like crap. No amount of medication in the world can provide all the benefits of a healthy diet and exercise regimen. If you want to feel better, you have to treat your body with the respect it deserves.
  4. You live in a toxic environment – I wish this scenario wasn’t as common as it is. However, the number of people I work with would take a nose dive if no one had to live in a toxic environment. If you have a spouse, boss, sibling, parent or co-worker who chronically bullies, demeans, mistreats or criticizes you, it is very likely that you will remain stuck—no matter how hard you work outside the relationship. Imagine if I have a special plant that lives in a plant home. I come to visit this plant once a week. I take it outside in the sunshine. I talk to it, give it plant food and water and nurture it. When I leave, I return it to the home, but unbeknownst to me, the caretaker is abusive. He carries it around by the leaves, stores it in the basement and drains all the water from the pot as soon as I leave. Week after week I will return to the plant – dumbfounded as to why it looks so unhealthy. I often feel this way with certain clients. We do such good work in the hour that I see them each week – and yet, appointment after appointment, they return to me in a new state of despair. No amount of TLC can overcome a toxic environment – if you’re in one – get some help. You deserve it.


Okay – there are other reasons people get stuck, but these are 4 biggies. By the way – our friend Sharon had some unresolved trauma in her past. Once we worked through it, her anxiety improved dramatically. 

If you feel stuck, don’t you owe it to yourself to find out why?

Want to learn more about getting unstuck? On September 15, 2017, I’m launching my new online course: STOP STINGING START LIVING. This course provides help for people who have problems managing their emotions and their relationships. For more information, email me here.