How to Disobey “Worthless” Thoughts

How to Disobey “Worthless” Thoughts

If you believe you are “worthless,” it can bring on crushing feelings of depression and shame. But worthlessness doesn’t only impact how you feel. It also profoundly impacts what you do next. When you believe you are “worthless,” you might:

  • Not ask for help
  • Silence your voice
  • Say ‘yes’ when you’d prefer to say ‘no’ (or vice versa)
  • Deny your own needs
  • Stick it out in a toxic workplace or relationship
  • Stop trying
  • Quit things that matter most to you
  • Isolate from friends or family
  • Spend money on others but not yourself
  • Behave recklessly
  • Cover up, conceal, or hide
 
The trouble is, the more you behave as if you are worthless, the more shame you feel, the more you believe you are worthless. This perpetuates more of the same stuck behavior. It’s a vicious circle.

 

DISCLAIMER: Before we dive in too deep, as detailed in my post “Why I Think ‘Worthless’ Isn’t a Feeling AND Why that Matters,” I see “worthless” as a judgment NOT a feeling. Worthlessness is a malleable belief system that can be changed as you alter thinking, change behavior (the focus of this article), and heal from past hurts or traumas.

 

CHALLENGE: Imagine for a moment that a miracle took place while you were sleeping and you wake up in the morning fully believing that you are a person of infinite worth. Really stick with the image for a few minutes even if it’s difficult. Grab a piece of paper and jot down your ideas about how you interact with your day differently if you were to see yourself as WHOLE and WORTHY.

 

Depending on how deeply the belief of worthlessness has taken hold, perhaps behaving as if you are a person of worth starts with taking care of basic tasks of living, such as:

  • Rolling out of bed (maybe rolling on to the floor if that’s what gets you started)
  • Getting dressed in clean clothes
  • Taking a shower
  • Brushing your teeth
  • Checking the mail
  • Scheduling that doctor’s appointment or dentist appointment you’ve delayed
  • Getting in to see a counselor or psychiatric medication prescriber

 

If your beliefs about worthlessness have impacted your relationships, behaving as if you were a person of worth might look like:

  • Reaching out to friends or family you find trustworthy
  • Practicing vulnerability (again, with those you find trustworthy)
  • Accepting an invitation (or declining an invitation if your experience of worthlessness involves co-dependent people-pleasing)
  • Putting yourself out there to make a new connection
  • Raising your standards for friendship or dating
  • Setting boundaries with someone causing you harm
  • Speaking up about something you’re needing

 

If beliefs about worthlessness have impacted you at work or school, behaving as if you are worthy might involve:

  • Requesting accommodations
  • Applying for that promotion or job change you’ve been too scared to try, even if it doesn’t work out; as a student, perhaps trying out for the school play or a position on a team (regardless of outcome)
  • Going back to school later in life
  • Asking for help or more training
  • Giving yourself a break to prevent burnout
  • Making a change to your schedule to accommodate what you’re really needing
  • Living like Teddy Roosevelt’s “Man in the Arena”(however that translates for you)

 

If body image struggles have been a source of worthless thoughts, perhaps behaving as if you are fully worthy involves:

  • Buying clothes that fit your body comfortably at its current size
  • Nourishing yourself with consistent food intake throughout the day
  • Moving your body in ways that feel joyful but not self-punishing
  • Not letting your body hold you back from living your life (ex. Going swimming, traveling, dating)
  • Asking your doctor not to weigh you unless it’s (truly) needed medically
  • Respecting your body with your thoughts (get your inner bully in check)
  • Reading the book “Body Respect” by Lindo Bacon for even more ideas

 

These are all only examples. You will customize your behavioral REBELLION against worthless beliefs based on how worthlessness impacts you.

ASK: What action does worthlessness want you to do? You can either obey or disobey. Real change happens when you begin to DISOBEY.

In Dialectical-Behavioral Therapy (DBT), there is a skill called “Opposite Action” that helps shift negative beliefs with different (opposite) behavior. Here’s a video where you can learn more: https://www.youtube.com/watch?v=wkxOICjG2is

 

The big idea is this– If acted as if you are a person of worth EVEN BEFORE YOU BELIEVE IT’S TRUE– you can impact how you feel about yourself positively. Sometimes Action comes before Belief. Sometimes Action comes before you Feel any differently.

 

As mentioned above, many folks that experience worthless beliefs have trauma experiences that have contributed to low self-worth. If you’re curious about the impact of past experiences on worthless beliefs, ask yourself..

 

  • When did you first start to believe you are  “worthless?” Did someone in your life send you this message– directly or indirectly?
  • Did you have experiences of emotional neglect that taught you that your feelings or needs weren’t valuable?
  • Did you experience physical, sexual, verbal, or emotional abuse at anytime in childhood or adulthood?
  • Did you experience other Adverse Childhood Experiences(ACES)?

 

Let’s not pretend that any of this work is easy, especially if you are feeling depressed! That’s why many people get support from a professional therapist when doing this work. Don’t hesitate to reach out for support. You’re worth it!

 

Why I Think “Worthless” Isn’t a Feeling AND Why that Matters

Why I Think “Worthless” Isn’t a Feeling AND Why that Matters

Have you ever been so dejected or depressed that you began to question your worth as a person? What triggered that moment for you? Was it:

  • A rejection, break-up, or abandonment?
  • A harsh word or critique that hit like an arrow in the heart?
  • A failure to live up to your own expectations?
  • Feeling in over your head, burned out, or unable to perform?
  • Something else?

As counselors, we often hear clients describe their feeling during these moments as “worthless.” It’s as if some lack of performing, achieving, belonging, or approval could strip away a person’s value as a human, leaving them with a sense of emptiness.

Do you have a sense of self-worth that goes up and down? A conditional self-worth that is dependant on being liked or on your achievements? As you’ve perhaps experienced, having a conditional self-worth can be risky:

  • Perhaps you overwork, overachieve, and compulsively climb ladders trying to prove yourself. Do ever really reach the finish line or are you stuck on a hamster wheel constantly striving? Does that cost you time with your family or friends? If a setback occurs, do you name yourself “failure” and pay a cost with anxiety, depression, or a suicidal urge?
  • Perhaps you base self-worth on the condition of others’ approval (which can go up or down). Do you have a good or bad day depending on if someone else’s reactions to you? Does that ever lead you to over-committing or people-pleasing? Do you hold back, minimizing your voice in relationships? If a subtle rejection occurs, do you notice yourself having a big emotional response?

Perfectionism is the embodiment of achievement-oriented or approval-oriented self worth. Brene Brown describes perfectionism and its cost best:

“Perfectionism is not the same thing has striving to be your best. Perfectionism is not about healthy achievement and growth. Perfectionism is the belief that if we live perfet, look perfect, and act perfect, we can minimize or avoid the pain of blame, judgment, and shame. It’s a shield. Perfectionism is a twenty-ton shield that we lug around thinking it will protect us when, in fact, it’s the thing that’s really preventing us from taking flight.”

-Brene Brown, The Gifts of Imperfection

It’s time to change how we think about WORTH. What if you could experience a form of self-worth that did not ebb and flow with your achievement or approval? Would you step off of the “conditional self-worth” rollercoaster? Wouldn’t it be amazing to experience security in your self-worth despite successes or failures!

I want to suggest two key strategies for revolutionizing your experience of self-worth.

  1. Clarify what you really feel when you say you feel “WORTHLESS.”

I want to suggest that “WORTHLESS” is a judgment NOT a feeling. It’s a proclamation of subjective self-assessment. It is more thought than it is emotion. These judgments are similarly not feelings:

  • Bad
  • Failure
  • Fat
  • Ugly
  • Stupid
  • Crazy

But, you might argue, “I DO feel strongly when I have those thoughts!” YES! A distorted negative self-evaluation would certainly evoke a strong feeling! Let’s see if we can clarify what you are really feeling in those moments. Perhaps one of these feeling words would more accurately describe the emotion that goes with that thought:

  • Disappointment
  • Shame
  • Sadness
  • Anger
  • Fear
  • Worry
  • Guilt

This perspective shifting skill is essential: Instead of going along with the “I’m worthless” judgment, NAME WHAT YOU’RE FEELING and WHY.

For example: “I’m feeling ashamed because I yelled at my kids.” “I am feeling afraid because I lost my job.” “I am feeling sad because she broke up with me.”

2. REDEFINE WORTH.

The striking reality is that there is no standard measurement of WORTH. There is not a test you can take, a medal you can earn, or a status you must reach. The concept of what defines self-worth is unscientific, self-determined, and deeply personal. YOU HAVE THE POWER to change your self-assessment.

What if you were to intentionally choose to believe WORTH is a birthright, something inherent in your humanness? I think that’s what the founders of our country believed when they wrote these words in the Declaration of Independence:

“We hold these Truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the Pursuit of Happiness.”

WORTH does not have to be conditional. You can found your self-worth on the powerful certainty that you have sustaining value that can not be earned nor lost.


HYPOCRICY CHECK: Do you apply unconditional worth to other people better than to yourself?  For example, if you’re a parent, your child might make choices that make you lose their trust, but could they ever lose worth in your eyes? Never! You might already believe in unconditional self-worth, as it applies to others. Are you applying the same concept to yourself? If not, now’s the time. Take the leap of faith. It’s worth it!

Now, if we combine the name-your-feelings skill with the concept of unconditional self-worth, you can see how it’s possible to make mistakes, have setbacks, and receive rejection without it meaning anything at all about your worth as a human.

If you’d like help building a secure sense of self-worth (or overcoming your achievement- or approval-oriented perfectionism), a therapist at Star Meadow Counseling may be available to help.

Also check out behavioral strategies for shifting out of worthless thoughts in our latest blog: “How to Disobey ‘Worthless’ Thoughts.” 

 

 

How To Stop Beating Yourself Up

How To Stop Beating Yourself Up

When was the last time you heard from your inner critic? You know, that voice in your head that constantly judges you, puts you down and compares you to others. The one that tells you you’re not good enough or smart enough and says things you would never dream of...

Do You Know the Signs of Someone Who is Suicidal?

Do You Know the Signs of Someone Who is Suicidal?

According to the American Foundation of Suicide Prevention, over 47,000 people died by suicide in the United States in 2017. In the same year, there were an estimated 1,400,000 suicide attempts.

Knowing the signs of suicide is the primary step in preventing someone you know and love from successfully taking their own life.

The Warning Signs of Suicide

Hopelessness

Many individuals who are contemplating ending their own life experience and express feelings of hopelessness.

Other Strong Emotions

Suicidal people may also experience and express excessive anger and rage and talk about seeking some kind of revenge.

Risky Behavior

People who are thinking about ending their own life start showing signs of risky behavior. Since their lives are not valuable in their own eyes, they may engage in certain behaviors, not caring about the consequences. This can be drinking and driving, experimenting with hard drug use, and spending time in unsafe parts of town.

Isolation

Have you noticed your loved one withdrawing from friends and family and isolating themselves more?

Trouble Sleeping

Suicidal individuals often experience great anxiety that causes them to suffer from insomnia. Has your loved one been complaining of not sleeping? Are they taking medication for sleep issues?

The above are warning signs that your loved one may be experiencing a deep depression that needs attention.

The following are three signs that your loved one needs some help IMMEDIATELY:

They’ve Come Right Out and Said It

Your loved one has actually verbalized a desire to harm themselves or kill themselves.

You’ve Discovered A Plan

You have somehow come to know that your loved one is actively planning their suicide by stocking pills or getting their hands on a weapon.

They Have Become Obsessed with Death

Many suicidal people, especially teenagers, begin talking or writing more and more about death or suicide in a positive light.

How You Can Help

Talking to someone you love about suicide can feel uncomfortable. You may be worried that by merely talking about it, you will somehow inspire the act. This just isn’t so. Just opening up to someone who is supportive and non-judgmental can assist them in recognizing their need to get some help from a trained therapist.

Offer to help them make a call to schedule an appointment with a therapist.

For immediate help, please call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is available 24 hours a day, 7 days a week. All calls are confidential. The Clark County Crisis line is also available 24/7: 1-800-626-8137.

6 Suggestions for Coping with Grief at Work

6 Suggestions for Coping with Grief at Work

Losing a loved one is one of the most painful tragedies that humans suffer. The impact of this loss is often crushing, and in the aftermath of loss, we often feel like we have no control over anything. Grief is a natural response to loss. It’s perfectly normal to detach yourself from your normal existence to grieve.

 

But what happens when grief persists when it’s time to return to work? Unfortunately, life responsibilities go on, no matter how sad you feel.

 

Returning to work while grieving is quite tough! You will need to figure out how to be productive, even as your thoughts are interrupted by waves of grief and remembrance. In addition to your own feelings, you may also need to deal with your colleagues who may start to act differently around you because they don’t know how to comfort you.

 

You may not be able to control every wave of emotion, or how everyone else acts, but you can make your return to work while grieving a little easier. From dealing with awkward conversations to accomplishing tasks, here are a few tips to help you navigate your work life while grieving.

 

COPING WITH GRIEF AT WORK

  1. Have an honest conversation with your employer- Be frank with your employer, and let them know your struggles. Explain that you might not operate at an optimal level for a while. Tell them exactly what you need, so they can help you. Ask for mental health days, work from home opportunities or anything else that you need while you grieve.

  2. Focus on doing- It might be tempting to shut down and do nothing, but trying to be productive and crossing tasks off your checklists can distract you and prevent you from being consumed by painful feelings.

  3. Ask for help- People generally want to help those who are grieving but don’t know exactly how to go about it. Don’t be ashamed to ask your colleagues for help. Instead of insisting that everything is great, tell them what you need. They’d be happy to pick up your workload, so you can focus more on healing.

  4. Create a sanctuary- Find a quiet place to retreat to when things get a little too much, and you just want to have a good cry. It could be your car, or a room where people don’t go into often.

  5. Carry tissues- You might find yourself crying a lot when you least expect it. Keep tissues handy, so you can clean your tears or runny nose when you’re done.

  6. If all else fails, request leave- If you have been at your job for over a year, and your employer has 50 or more employees, you may qualify for the Family Medical Leave Act (FMLA). FMLA is a federally mandated leave for those unable to work due to a debilitating health condition (yes, at times, the depression that comes with grief can be quite disabling). Medical certification is required to qualify for this unpaid leave–a conversation you’d need to have with your doctor.

 

Always remember that grief is an important step to healing, in the wake of a loved one’s death. When you get back to work, be honest about how you feel with yourself and others. Don’t try to rush the mourning process. Everyone experiences grief differently. If you’ve lost someone in your inner circle, feelings of grief may last a long time. Be patient with yourself and the feelings that come your way.

 

It can help to see a grief counselor or therapist if you feel like you need assistance coping with your emotions. It is a sign of strength to ask for support when you are hurting. If you’d like help processing grief or deciding about your return to work, a counselor with Star Meadow Counseling is available to help.

Q & A with TMS NW: Everything You’ve Wanted to Know about Transcranial Magnetic Stimulation (TMS)

Q & A with TMS NW: Everything You’ve Wanted to Know about Transcranial Magnetic Stimulation (TMS)

Have you tried (and tried) medication management for your depression or OCD but never received full results? We invited Piper Buersmeyer, Julia Swofford, and Brendan Roe from TMS NW to provide this Q & A about Transcranial Magnetic Stimulation (TMS), a non-medication alternative for treating chronic depression and OCD. After reading the article, if you’d like more information about TMS, we encourage you to reach out to TMS NW, local in Vancouver, WA.

 

What is TMS?

TMS stands for Transcranial Magnetic Stimulation. Brainsway’s Deep TMS is a non-invasive treatment that uses an MRI strength magnet to either stimulate the part of the brain that causes depression or calm down the area of the brain that causes OCD.  TMS is a safe and evidence-based outpatient procedure that encourages rewiring and improved firing of neurons.

 

Who is eligible?

TMS is indicated by the FDA for the treatment of depressive episodes in adult patients suffering from Major Depressive Disorder who have failed to achieve satisfactory improvement from previous therapy and medication treatment. It is newly FDA cleared in 2018 for the treatment of obsessive compulsive disorder that has been resistant to treatment with therapy and medication.

TMS should NOT be used if you have metal implants in or around your head (except for standard amalgam dental fillings). These include but are not limited to a cochlear implant, implanted cardioverter defibrillator (ICD), pacemaker, deep brain stimulator, vagus nerve stimulator, or metal aneurysm clips or coils, staples, or stents. TMS should not be used in patients with an active seizure disorder.

 

How does TMS work?

In each TMS therapy session, the patient is comfortably seated in a chair and a custom cloth cap is placed onto the head followed by a cushioned helmet. The helmet houses a coil that generates brief magnetic pulses, at a similar amplitude to that used in magnetic resonance imaging (MRI) systems. The rapid magnetic pulse that runs through the coil wire produces an electric field that passes unimpeded through the brain.

During the TMS session, patients hear a tapping sound and feel a tapping sensation in the head area. The patient wears earplugs during treatment. Patients can drive to and from sessions and can immediately resume their daily routines.

 

How frequent are sessions?

TMS requires daily sessions Monday through Friday over 6-9 weeks. Treatment sessions build on one another, so it is best to follow the recommended treatment course. Some clients also benefit from maintenance or repeated treatment.

 

What are the most common side effects?

The most common side effect is temporary, mild pain or discomfort at the area of the treatment site and occurs only during the TMS session. This typically happens only during the first week of TMS  treatment. Other side effects may include muscle twitching, headache and jaw pain, and also typically resolve after the first few days.

 

How does TMS compare to ECT?

TMS and ECT are very different from one another. Brainsway Deep TMS therapy does not require hospitalization or anesthesia, and does not entail risks for memory loss, systemic side effects or an indefinite drug regimen. In contrast to electroconvulsive therapy, TMS does not induce convulsions/seizures. Seizure risk is very low with TMS.

 

How is deep TMS different than traditional TMS?

Deep TMS offers effective results in almost half the time of other treatments (19 minutes per session compared to 37 with traditional TMS). Deep TMS penetrates more deeply and broad than traditional TMS and therefore is more robust and effective.

 

Is TMS effective?

Yes. Brainsway Deep TMS therapy has been tested in over 60 clinical trials. An extensive multi-center study for treating treatment-resistant depression, with Brainsway Deep TMS, enrolling 230 patients, Brainsway Deep TMS therapy significantly reduced depressive symptoms and generated improvement. Following this study, the FDA approved Brainsway Deep TMS therapy for major depressive disorder in patients who did not benefit from any number of previous medication treatments. Approximately one out of three patients treated with TMS therapy experience complete remission of symptoms at the end of six weeks. It is important to note that some clients may experience a partial response during the initial 36 treatments followed by a robust response in the weeks following the completion of treatment.

 

What else is TMS approved for?

In the U.S. FDA approved indications include depression and OCD. TMS is considered investigational as a treatment for all other indications, including but not limited to: smoking cessation, PTSD, bipolar disorder, schizophrenia, bulimia nervosa, migraines, fibromyalgia, panic disorder, Parkinson’s disease, alcohol dependence, chronic pain, Alzheimer’s, ADHD and Autism.

 

Will I be able to stop medication?

It is possible to achieve and sustain remission from depression following TMS treatment. This can mean medication doses can be lowered or tapered off completely.  This all depends on the client’s needs. Clients are stabilized on their regimen prior to treatment medications are continued during the treatment.

 

Will my health insurance cover TMS treatment?

Health insurance companies cover TMS for patients who meet that insurance’s specific requirements. Most insurances require a diagnosis of either depression or OCD, failure of at 3-5 antidepressants, sometimes from multiple families of medications, and a history of at least six weeks of outpatient psychotherapy. If you typically have a co-pay for office visits, you will also have this for each TMS treatment. Your insurance will not cover your copay, and payment of copays is due at time of service. If TMS NW is out of network for your insurance, you may be able to contact your insurance and ask for a single case agreement.  Otherwise, it will be considered out of network and coverage from your insurance is likely minimal to no coverage at all.

Insurance TMS NW Accepts

  • Aetna
  • Blue Cross Blue Shield
  • Bridgespan
  • First Choice
  • LIfewise
  • MODA
  • Pacific Source/Reliant
  • Premera BCBS
  • Regence BCBS
  • Molina

TMS NW is not affiliated with Star Meadow Counseling. To contact TMS NW directly, you can call them at 360-719-2449 or view their website: https://tms-nw.com/