Categories
Blog Everyday Thriving Thrive at Work

Creating workplaces where “care” matters

The month of October is Mental Health Month, and this year we are focusing on how to build workplaces that embody wellbeing. To learn more about our ongoing work with organizations to create these cultures of care in their workplaces, stay tuned for our upcoming activity Leading with Care: The Neuroscience and Practice of Leading a Culture of Care in the Workplace on 07 November 2023.

In We Thrive, we look at mental health as the coming together of many different factors which determine the capacity of a person to live in a way that allows them to reach their fullest potentials. Of course, our individual exercise of our faculties is critical: how we cope with difficult experiences and savor positive ones; how we pay attention to how we feel and think about ourselves and the world; how we interact with others and take part in their lives; and so on. Nowadays, we refer to things like this using the umbrella term “self-care” (ISF, 2023). But as we probably already know, individual efforts are sometimes not enough to reach. We don’t always cope particularly well; we aren’t always able to stop and smell the roses; we aren’t always able to pay attention to what’s happening; and our ability to be part of other people’s lives, or let them be part of ours, is not always at its best. Sometimes, you need help. “The ability to ask for and obtain help is a valuable life skill,” as psychologist Debbie Sorensen puts it, partly as a comment to our culturally-ingrained hyper-focus on independence (Sorensen, 2022). So besides “self-care”, realizing our potentials includes the essential component of togetherness, where interdependence is just as prized as independence, and where reaching one’s potentials is not simply an individual effort. We can call this “community care”: as author and psychotherapist Minaa B. defines as “[using] our power, privilege, and resources to better the people who are both in and out of our scope of reach” (Minaa B., 2021). 

The idea that “our wellbeing is contagious” gives us a sense of how embedded the impulses of community care actually is in our human makeup, and how our own health and flourishing depends as much on others as it does on our own efforts in ways that sometimes surprises us (Suttie, 2020). And in relation to workplace stress and one of the primary mental health challenges of “[managing] the pressures so that life is productive and enjoyable” (Teasedale, 2006), the idea of community care can provide a more integrative approach to ensuring the wellbeing of people in the context of groups and institutions. We know for example the consequences of a lack of consideration of wellbeing can be, with losses in the millions whether we’re referring to potential profits or working days lost to attrition or sick leaves (Graveling et al., 2008). Conversely, we know about the even greater benefits taking wellbeing seriously has to all kinds of organizational and business outcomes (Sears, Shi, Coberley, & Pope, 2013). But where do you begin? In this article, we want to share some advice about how to apply the concept of “community care” to thinking about how organizations can build up its practices towards creating workplaces where “care” is integral rather than supplemental to the overall business strategy.

Thanks to some clever analysis of the literature, researchers were able to offer a more condensed definition of this widely and wildly defined idea of self-care: “The ability to care for oneself through awareness, self-control, and self-reliance in order to achieve, maintain, or promote optimal health and well-being” (Martínez, Connelly, Pérez, & Calero, 2021). Using these three concepts, we can organize our thinking about wellbeing along these lines and how they might apply to community care. How can workplaces create spaces and relationships where people can support each-other’s capacities for awareness, self-control, and self-reliance?

  1. Awareness. This is about the ability to monitor, measure, and interpret one’s experiences (or “symptoms”, as used in their paper). This awareness is the natural first step to achieving wellbeing: after all, you cannot act wisely without the appropriate information. Applied to community care, this means helping each-other bring attention to our concerns, whether this means identifying specific forms of support or simply articulating some difficulty in or out of work in order to have some much-needed emotional release. Besides this, it also means helping each-other bring attention to our wins, allowing us to become more present to moments worth celebrating and appreciating. And building on the idea of interpretation, awareness is about bringing attention to the “meaning” of experiences, and helping each-other discern how our experiences at work match up with our values, beliefs, goals, and how we want life to be in general.

Reflection: Are employees afforded the necessary resources, opportunities, and structures to cultivate greater awareness? Do the relationships between peers and between team members and team leaders foster a sense of safety and security where people are not only able but encouraged to work together to identify, articulate, and respond to their experiences as a community?

  1. Self-control. In the words of Martínez and colleagues, self-control is the “product of a person acting as a unitary being and engaging in regulation and control of their self and emotions”. Achieving wellbeing, whether we like it or not, requires perseverance, sustained effort, and more than a little strategizing. Applied to community care, this means helping each-other initiate and build on the habits necessary for regulation, maximizing our individual abilities to contain and ground ourselves. It also means creating relationships and systems within the workplace that don’t unnecessarily tax these abilities. Borrowing the researchers’ use of the term, self-control in the context of community care means thinking of the community as a “unitary being”, where each person must in some ways exercise responsibility for another’s capacity to recover and return to states of calm and ease.

Reflection: Are employees afforded the necessary resources, opportunities, and structures to cultivate greater self-control? Do the relationships between peers and between team members and team leaders foster that sense of trust that, to the extent possible, we can rely on one-another as a means of regulating when things get tough? 

  1. Self-reliance. Though not defined directly in the study, the researchers offered a case study about a man who “sustained a wound to his right leg when he slipped in a canyon” but that, while he “was aware of the injury”, the man “did not treat the wound, and his entire leg became swollen, red, and hot”. So while taking consideration of the case study’s particular context, we can think of self-reliance as our ability to initiate the appropriate actions by ourselves, which requires a level of self-efficacy, self-trust, and a general belief that we can do something with our circumstances. Applied to community care, this means helping each-other create the necessary cognitive and behavioral scaffolding in our work to both have the appropriate level of trust in our own abilities (remember: asking for help is an important skill) and the necessary skills for acting on that self-confidence in productive and meaningful ways. Using the case study, self-reliance is both about trusting that your team will help you with the wound and also about your team trusting you enough to at least clean and dress the wound first.

Reflection: Are employees afforded the necessary resources, opportunities, and structures to cultivate greater self-reliance? Do the relationships between peers and between team members and team leaders create an environment that is not only challenging but also encouraging? 

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

References (in order of appearance)

  1. https://isfglobal.org/what-is-self-care/ 
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488814/ 
  3. https://psyche.co/guides/how-to-ask-for-help-without-discomfort-or-apology 
  4. https://www.wellandgood.com/what-is-community-care/ 
  5. https://greatergood.berkeley.edu/article/item/why_taking_care_of_your_own_well_being_helps_others 
  6. https://www.sciencedirect.com/science/article/abs/pii/S1476179306000188 
  7. https://www.ncbi.nlm.nih.gov/books/NBK75294/ 
https://www.liebertpub.com/doi/full/10.1089/pop.2012.0114
Categories
Blog Everyday Thriving Thrive at Work Thrive in School Wellbeing Practices

To hear and be heard: ideas for meaningful conversations for nurturing life

The month of September is celebrated globally as Suicide Prevention and Awareness Month. To learn more about suicide and how we can support each-other, see this article. If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or proceed to the end of this article for the contact numbers of various local 24/7 crisis lines.

Stereotypes aside, as an organization providing psychological care, We Thrive’s work admittedly has a lot to do with conversations. It is something we take for granted, not always realizing that this very peculiar human capacity is one of the building blocks of human civilization (Crystal et al., 2023). Conversations are also one of the building blocks of human life: as psychologist Lucy Foulkes puts it, when conversations “allow us to learn something important about ourselves, about the other person, or about the world” (Foulkes, 2021), truly remarkable things happen. Such conversations, when they are “meaningful”, can turn even otherwise mundane chatter (what we label “small talk”) into subtle gateways for deeper interactions (Macquire, 2023). They make possible the flourishing of all those aspects of being human: sensing and holding our emotions (Lieberman et al., 2007), articulating the various aspects of the self (McLean and Morrison-Cohen, 2013), developing new behaviors and perspectives (Albright et al., 2016), relieving and easing painful experiences (Kardas, Kumar, and Epley, 2021), making sense of life as a whole (Tarbi et al., 2021), and much more. Speech of this kind has a literal healing effect, hence the well-earned stereotypical predominance of “talk therapy” methods in clinical psychological practice (Lindberg, 2023).  As social beings, as author Arthur Dobrin puts it: “With conversation, we find a place where we belong” (Dobrin, 2011).

In our ongoing observance of Suicide Prevention and Awareness Month, we want to offer some practical points for reflection for having meaningful conversations, particularly those you want to check in on and support through difficult experiences.

The look and feel of a meaningful conversation

The main feature of a meaningful conversation is the experience of being “heard” — an experience which is, without exaggeration, “one of the most basic, yet potent needs we have as social beings” (Fowler, 2022). Most of us know from personal experience how painful not being heard can be, and how influential it can affect our own ability to hear others. Not being heard can have many precipitating factors: maybe there are basic differences in communication style (Khiron Clinic, 2021); or maybe the capacities of one or both people in the conversation to hold big or uncomfortable feelings are limited (Brosch, 2015). It could be some other factor, like adverse childhood experiences (Zlate, 2020), which are not within our present control. Whatever the case, when we are not heard, some of our most fundamental needs — the needs to feel that “we are taken seriously, that our ideas and feelings are acknowledged, and that we have something to share” (Nichols, 1995) — cannot be met.

So how do we get to meaningful conversations where we feel taken seriously, acknowledged, and feel that what we share has value? We may be tempted to offer advice right away or resort to offering affirmation.

But “problem-solving” is not the same as “hearing”, and our impulse to give instructions or shoo away difficult feelings with aspirations of pleasantness, while usually very well-intentioned, may not reflect the other person’s true needs. This is what is often meant by “toxic positivity”: when the resolution to be quote-unquote “happy” is not grounded in the present reality which might demand more emotional complexity.

So having said that, what does “hearing” actually look like? Thankfully, a few scholars have looked into this. In a series of studies, the concept of being “heard” — described by the authors succinctly as “a key variable of our time”, given our modern propensities for distractions — was operationalized according to five components (Roos, Postmes, and Koudenburg, 2021). Here, we will present how these were understood and some points for reflection to guide how we apply these to making our conversations truly meaningful. 

  1. Recognizing our “voice”. This is about “being able to express myself freely, that is, being able to say what I want to say.” In meaningful conversations, there must be that sense that, while some social filters might be appropriate in any given situation, we are able to say what we think or feel without fear of being criticized, demeaned, or thought poorly of. It is the sense that, right or wrong aside, what we say is welcomed.

Reflection: In our conversations, do we offer a sense of security that allows the other person to say what they need to say, and that we are willing and able to welcome what they say — even if they’re about something difficult and uncertain?

  1. Receiving “attention”. This is about feeling that the other person “focused their attention on what I said”. In meaningful conversations, there is a conscious effort to home in on the details, verbal or otherwise. It is the sense that what we say merits curiosity, and that there is a richness in what is being said that is worth patiently drawing out.

Reflection: In our conversations, do we offer expressions of interest that communicate to the other person that what they have to say is important, and that we really want to understand them?

  1. Receiving “empathy”. This is the perception that “the other tried to take my perspective and emotionally understand me.” In meaningful conversations, the affective contents of what we say — not just the words, but the conditions that led us to say what we say — are appreciated. It is the sense that the other person is resonating with us at a level that is deeper than the dictionary definitions of our statements, and that we are allowed to speak with more vulnerability, confident that, at the minimum, our vulnerability will be cared for.

Reflection: In our conversations, does our presence invite the other person to let their guard down, even a little, so that what they say communicates more truthfully what their hearts dictate? (At least to the extent possible, given the circumstance. Emotions are complex, after all!)

  1. Receiving “respect”. This is the feeling that the other person “valued what I said (my voice) and me as a person”. In meaningful conversations, while all human activity is prone to human errors of misunderstanding, we are taken and honored as we are. It is the sense that whatever prejudices there may be are set aside — or at least owned up to, honestly — and that the interaction is grounded in a commitment to the fact that we are human beings deserving of compassion.

Reflection: In our conversations, does our approach show the other person that we accept and honor them as they are, however and whatever they may be?

  1. Experiencing “common ground”. This is the perception that we can “understand each other’s point of view”. In meaningful conversations, there is a kind of exchange that allows both people’s perspectives to be influenced in a constructive way, allowing not just greater understanding of the nuances of these differences, but a greater appreciation of how such differences can lead to the same goals of cultivating a more meaningful life. While there may be significant divergences in the way we come to our conclusions, these conclusions are ultimately grounded on a desire for the greatest good — and that our conception of the “good” can be deepened and strengthened by one-another.

Reflection: In our conversations, do we communicate an openness to hearing the other person’s views, and an openness for our own views to be positively influenced by them?

Being able to initiate and sustain such a potent human activity is one of our best means for promoting healing for ourselves and one-another. By cultivating these five components, we can be better placed to leverage the power of conversations to cultivate human flourishing both within and beyond our difficult experiences.

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or call these 24/7 crisis lines:

DOH-NCMH Hotline

0917-899-USAP (8727)

0966-351-4518

0908-639-2672

(02) 7-989-USAP (8727)

1553

Hopeline PH

0917-558-HOPE (4673)

0918-873-4673 (HOPE)

(02) 8-804-HOPE (4673)

2919

In Touch Crisis Line

0917-800-1123

0922-893-8944

(02) 8-8937603

References (in order of appearance):

  1. https://wethrivewellbeing.com/world-suicide-prevention-day-responding-to-suicide-with-resilience-and-compassion/ 
  2. https://www.britannica.com/topic/language 
  3. https://psyche.co/guides/how-to-have-more-meaningful-conversations 
  4. https://carolinemaguireauthor.com/how-to-make-small-talk/ 
  5. https://www.healthline.com/health/mental-health/talk-therapy#how-effective 
  6. https://pubmed.ncbi.nlm.nih.gov/17576282/ 
  7. https://www.tandfonline.com/doi/abs/10.1080/15283488.2013.776498 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344154/ 
  9. https://www.apa.org/pubs/journals/releases/psp-pspa0000281.pdf 
  10. https://www.sciencedirect.com/science/article/abs/pii/S0738399121003335 
  11. https://www.psychologytoday.com/intl/blog/am-i-right/201112/conversation-makes-us-human 
  12. https://thedmcclinic.ie/blog-the-importance-of-being-heard/ 
  13. https://www.goodtherapy.org/blog/listen-up-why-you-dont-feel-heard-in-your-relationship-0810154  
  14. https://www.pacesconnection.com/blog/adverse-childhood-experiences-and-interpersonal-relationships 
  15. https://www.compassionate.center/docs/Why-listening-is-so-important.pdf 
https://psyarxiv.com/73jgn/
Categories
General

World Suicide Prevention Day: Responding to suicide with resilience and compassion

Trigger warning: this article discusses sensitive topics related to self-harm, suicide, and other similar experiences. If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or proceed to the end of this article for the contact numbers of various local 24/7 crisis lines.

In We Thrive, our work is embedded with the assumption that life is inherently meaningful and worthwhile. In the process of learning to regulate, relate, and reflect, we also develop a sensitivity to at least three underlying intuitions about our lives: first, that it “make sense and has continuity”, and that the logic of life, while not always completely clear, eventually unfolds; second, that it is “directed and motivated by meaningful goals”, whether or not we have fully grasped these goals; and third, that it “matters to others” — saying not just that the outcomes of our life’s work has value, but that the presence of our life in and of itself is valuable (DeAngelis, 2018).

Sadly, this intuition of life’s purposefulness is not always immediately apparent nor secure. We can be met by challenges so intense that they disturb or even completely discredit it. For many, how life unfolds can lead to the perception that life simply may not be worth it, and can lead further to the conclusion that the only way out is to take one’s own life. And the great tragedy of human experience is that these conclusions are acted on too often. Among young people in particular, suicide is the fourth leading cause of death globally (WHO, 2023). And based on recent national studies, Filipinos are not exempted from this pain: as deeply worrying data from the Young Adult Fertility Survey 5 (YAFS5) has recently shown, 17% of young Filipinos reported suicidal ideation, 7% have attempted suicide, and more than half reported that they have not reached out to anyone about these experiences (UPPI, 2022).

To honor World Suicide Prevention Day on September 10, we wish to briefly discuss some facts about the nature of suicide, and to raise awareness about how we can effectively respond to this issue with greater wisdom and compassion.

First, let’s address some MISCONCEPTIONS  about suicide:

  1. People with diagnosed mental health conditions are NOT the only ones who think about attempting, or try to attempt, suicide (Fuller, 2020). It is true that psychiatric illnesses such as depression, substance use disorders, and related conditions are found in a large number of cases (Brådvik, 2018). That said, estimates of people living with such conditions who actually attempt suicide quite low, with one study putting lifetime risk at just 4% (Bostwick and Pankratz, 2000). Even in the case of depression, the most commonly assumed cause in the popular imagination, “a large percentage of severely depressed patients never think about suicide” (Pompili, 2019). Non-psychiatric health problems (e.g. type 2 diabetes, see Gómez-Peralta et al., 2018), socioeconomic inequalities such as poverty (Bantjes et al., 2016) and immigrant status (Forte et al., 2018), or experiences of discrimination such as on the basis of sexual orientation and gender identity (Henry et al., 2021) are also well-known risk factors.
  2. Talking about suicide does NOT make someone more like to attempt suicide (Dye, 2022). This idea draws from a phenomenon commonly called “suicide contagion”: the uptick in cases after a report of suicide in mainstream media, such as of a celebrity figure; or in one’s immediate communities, such as of a friend (Poland, Lieberman, and Niznik, 2019). There is ongoing work towards reducing these risks, such as through evidence-based guidelines for responsible suicide reporting (Gould and Lake, 2013). But we know that simply talking to someone about it does not make it more likely that they will do it (Dazzi, Gribble, Wessely, and Fear, 2014). And the key word here is “responsible”: suicide contagion emerges when conversations about suicide are mishandled, such as excessive focus on the means of death, or failing to include accessible resources for seeking help (Utterson, Daoud, and Dutta, 2017).
  3. Thinking of, or attempting, suicide is NOT a sign of weakness or of moral failure (Sharma, 2021). One of the most difficult things about responding to suicide is that, while there is an abundance of knowledge about potential vulnerabilities, “no risk factor, including classification of diagnostic subtype, has been reliably shown to predict suicide” (Bostwick and Pankratz, 2000). So when we hear about suicide, what we are witnessing is an ultimately incomplete picture of a long and difficult journey, whose roads could have led to any other path, and whose particular tragic conclusion we can only ever speculate. To make assumptions about personal integrity, ulterior motive (e.g. seeking attention), or anything else about a person’s suicide assumes a level of understanding that we simply don’t have. If we want to be of any help, the first step would be to exercise some restraint on our own personal prejudices, so we can approach the question with more humility, curiosity, and kindness.

Misconceptions aside, the next question is about what we actually know can alert us to the risk of suicide. Of course, any such “warning signs” must be understood within a person’s context of adversity, and why they might experience such adversities as unbearable or insurmountable. Such contexts can be individual (e.g. a debilitating physical or mental conditions), relational (e.g. serious family conflicts), communal (e.g. unstable access to basic needs), or cultural and systemic (e.g. discriminatory attitudes towards particular groups) (CDC, 2022). Keeping these in mind, there are some potential warning signs which can alert us to such intense distress:

  1. Taking more interest in suicide than what would normally be expected (e.g. looking up information about different methods of ending one’s life), or making preparations as if one’s life will end (e.g. giving away prized possessions) (Sharma, 2021).
  2. Increased withdrawal or isolation from one’s significant relationships such as loved ones and other social groups (Dye, 2022).
  3. Increased statements which are self-deprecating (e.g. “I am useless”), express a serious sense of hopelessness (e.g. “There is just no way out”), and/or explicitly concern ending one’s life (e.g. “It would be better if I were gone”) (AFSP, 2023).
  4. Negative changes in one’s routines, such as reduced enthusiasm or commitment to hobbies or other interests; as well as disruption of regular bodily functions, such as eating habits, sleep, and hygiene practices (Ellis, 2019).
  5. Intense and unusual dysregulations in mood (e.g. increased agitation, lethargy, sadness) and accompanying shifts towards more dangerous and reckless behavior (e.g. substance use, violence, risky sexual activity, and self-harm) (Cleveland Clinic, 2021).

Lastly, whether you are someone whose loved one has attempted suicide, or perhaps you yourself live with thoughts of suicide, what is important is not just the apparent “causes”, but the “capacities” we have cultivating resilience in such difficult and complex situations. This can include ensuring access to urgent care after an attempted suicide (BeyondBlue.Org, 2022); creating a “safety plan” to help recognize triggers and coping techniques (Samaritans, 2023); and understanding the unique recovery process with the help of a professional (Raypole, 2019). Admittedly, this process of building resilience, with all its steps and caveats, can be confusing and overwhelming. But we can organize our approach within the framework commonly referred to as “suicide resilience”, described by five defining attributes (Wang, Lu, and Dong, 2022):

  1. Social support. Who can be trusted and turned to in times when life seems too much to handle, and when life seems to have no other reasonable options? Who can provide the necessary guidance, presence, and sense of security so that responding to life’s immense difficulties can be done with more efficacy, more compassion, and less crisis? 
  2. Coping strategies. What can be done, as an individual and with others, that allows for building up the ability not just to more effectively tolerate distress, but also more effectively relish and take pleasure in life? What allows for more awareness of, and more compassionate responses to, the experiences that heighten the risk for suicide? 
  3. Psychological capital. What resources are available, within oneself and within one’s many different roles and relationships, which can help grow one’s inner resources of optimism, hope, gratitude, and even forgiveness? Within one’s limitations, and doing the best one can given these harsh circumstances, how can wellbeing be strengthened?
  4. Meaning in life. One’s experiences can lead, with a terrible but clear logic, to the conclusion that suicide is the best solution. But what else might there be in the experience of life that might allow a person to seriously reconsider the possibility that living is also a viable option — not just viable, but even necessary, for pursuing one’s ideals, values, and goals? If one chose to live, what sense of purpose can encourage a person to persevere, and even joyfully accept, what life has to offer?
  5. Sense of responsibility. What obligations would a person leave behind, not just to loved ones but to themselves, if suicide is chosen? And is the person willing, given the things that are important to them, to give up on such obligations?

For mental health support services, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians.

If you need to talk to someone or if you are in need of urgent help, please proceed to the nearest hospital emergency room, or call these 24/7 crisis lines:

DOH-NCMH Hotline

0917-899-USAP (8727)

0966-351-4518

0908-639-2672

(02) 7-989-USAP (8727)

1553

Hopeline PH

0917-558-HOPE (4673)

0918-873-4673 (HOPE)

(02) 8-804-HOPE (4673)

2919

In Touch Crisis Line

0917-800-1123

0922-893-8944

(02) 8-8937603

References (in order of appearance)

  1. https://www.apa.org/monitor/2018/10/cover-search-meaning 
  2. https://www.who.int/news-room/fact-sheets/detail/suicide 
  3. https://www.uppi.upd.edu.ph/sites/default/files/pdf/YAFS5_National_Dissemination_Slides_FINAL.pdf 
  4. https://www.nami.org/Blogs/NAMI-Blog/September-2020/5-Common-Myths-About-Suicide-Debunked 
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165520/ 
  6. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.157.12.1925
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025580/ 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454768/ 
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068754/ 
  10. https://www.mdpi.com/2673-866X/1/3/13 
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543655/ 
  12. https://heartlandhealth.org/2022/09/suicide-fact-vs-fiction/ 
  13. https://www.nasponline.org/publications/periodicals/communique/issues/volume-47-issue-5/suicide-contagion-and-clusters%E2%80%94part-1-what-school-psychologists-should-know 
  14. https://www.ncbi.nlm.nih.gov/books/NBK207262/ 
  15. https://pubmed.ncbi.nlm.nih.gov/24998511/ 
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376723/ 
  17. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/8-common-myths-about-suicide 
  18. https://www.cdc.gov/suicide/factors/index.html 
  19. https://afsp.org/risk-factors-protective-factors-and-warning-signs/ 
  20. https://www.bridgestorecovery.com/blog/5-warning-signs-of-suicidal-behavior-that-are-easy-to-miss/ 
  21. https://my.clevelandclinic.org/health/articles/11352-recognizing-suicidal-behavior 
  22. https://www.beyondblue.org.au/mental-health/suicide-prevention/after-a-suicide-attempt 
  23. https://www.samaritans.org/how-we-can-help/if-youre-worried-about-someone-else/supporting-someone-suicidal-thoughts/creating-safety-plan/ 
  24. https://www.goodtherapy.org/blog/when-life-continues-recovering-from-suicide-attempt-0215197 
  25. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.984922/full
Categories
Blog Everyday Thriving

Pag-unawa sa ating layunin: mga ideya mula sa Sikolohiyang Pilipino

Isa sa mga pinakaimportanteng aspeto ng trabaho namin sa We Thrive ay ang

pagsuporta sa sa mga indibidwal at mga organisasyon para mas mabuo ang kanilang kakayahang intindihin, himayin, at isakatuparan ang kanilang mga layunin.

Lahat tayo ay may sarili nating layunin, at lahat tayo ay may sarili nating paglalakbay patungo kung saan-man tayo pinapadala ng layunin na ‘to. Ang pagtuklas nito ay pwedeng mangyayari sa pagsusuri sa kung ano ba talaga ang mahalaga sa sarili nating buhay; sa pag-unawa ng ating mga kakayahan natin, at kung para saan ba talaga yung mga nasasabing “skills” and “talents” na ‘yon; at sa pagbibigay ng oras at lakas sa serbisyo ng tinatawag na “greater cause”, katulad ng relihyon, kabansaan, at iba pa (Suttie, 2020). Kung anuman yan, alam natin na yung pagkilala ng ating layunin sa buhay — or sa ibang salita, “sense of purpose” — ay nakabuti sa ating kabuoang kalusugan (Whitbourne, 2023). Sa sarili nating salita: ang “sense of purpose” ay nakakabuti sa ating “pagkatao”, o ang pagkakila at pag-isabuhay ng ating “shared humanity”; at ang ating “pakikipagkapwatao”, o ang pagpapakita ng ating pag-unawa ng pagkatao ng iba sa ating pakikipag-ugnayan sa kanila (Lagdameo-Santillan, 2018). Sa ating kultura, importante ang dalawang aspeto na ito sa ating pang-araw-araw na pagbubunyag ng ating layunin sa buhay.

Ang kagandahan sa ating wika ay pwede pa nating mas laliman ang ideya na ito. Sa mga pag-aaral sa Sikolohiyang Pilipino, isa sa mga natunan natin ay kayang ibuod ang usapan tungkol sa layunin sa buhay sa ating karanasan ng pagkatao at pakikipagkapwatao. Sa kulturang Pilipino, ang “shared humanity” — ang ideya na nakasalalay ang ating karanasan bilang indibidwal sa konsepto na tayo ay isang bahagi na bumubuo sa isang mas malaking nilalang — ay hindi lamang natutunan pero sinasabuhay. Isa pang tawag sa oryentasyon ng isang kultura tungo sa pangkalahatan ay “collectivist” (Suh and Lee, 2020). At kitang-kita ito sa wika natin mismo. Sa isang pag-aaral na sinulat ng propesor ng pilosopiya na si Jacklyn Cleofas: “The focus on kápuwâ is so important that it is a central feature of the language; the prefix ka- specifically derives from kápuwâ and is used to form nouns that denote companion or fellow in some specific domain or activity” (Cleofas, 2016). Ka-patid, ka-klase, ka-biyak, ka-irog, — ang aspeto ng “kapwa” o “kapuwa” ay isa sa mga nagbubuo ng konsepto natin ng ating mga kaugnayan sa iba at sa ating sarili. Karagdagan sa puntong ito, sinipi ni propesor Jacklyn Cleofas sa kanyang pag-aral ang iba pang mga sikolohista na umakda sa librong “Social Psychology in the Philippine Context”, kung saan sinabi na: “the core descriptive concept for Filipino psychology is relational rather than personality or value-laden” (Macapagal et al. 2013, 13). Sa ibang salita: ang puso ng sikolohiya ng Pilipino ay nasa ating pakikipag-ugnayan sa iba.

Maliban sa paghatid at pagtanggap ng impormasyon, isa sa mga pinakaimportanteng tungkulin ng wika ay bilang instrumento sa pagkikilala sa ating sarili at sa ibang tao — sa ating pagkatao at sa pagkatao ng iba (Britannica, 2023). Kung makikinig tayo sa bigat na binibigay nito sa konsepto at karanasan ng “kapwa”, ano kaya ang pwede natin matunan sa sarili nating wika tungkol sa ating layunin sa buhay at yung bumubuo sa ating “pagkatao”? Para sa Buwan ng Wika, magbibigay tayo ng tatlong maiikling pagninilayan ukol sa ating mga “paninindigan” o “convictions” na inilista ng tinatawag na “Father of Filipino Psychology” na si Dr. Virgilio Enriquez sa isang papel na pinamagatan “Filipino Psychology in the Third World” na inilathala nuong 1977 (Enriquez, 1977):

Paggalang” o respect

Sa pang-araw-araw, tayo ay nagbibigay-galang sa mga iba’t ibang mga tao (katulad sa mga mas nakakatanda sa atin sa pamilya), mga bagay (katulad ng mga mana’t manang gamit o “heirloom”), at mga pinaniniwalaan (katulad ng relihiyon). Ginagalang natin ang mga ito kasi, sa iba’t ibang paraan, importante sila. Kaya gusto natin siyang ingatan, ayaw natin siyang sayangin, at iba pa. Pwede natin tanungin ang ating mga sarili kung bakit nga ba natin ginagalang ang mga ito. Bakit nga ba sila importante? Paano ba natin ito ginagalang? At ang paggalang ba natin sa mga ito ay nakakabuti sa ating buhay, o kaya’y ang ating paggalang ay posibleng humahadlang sa ating tunay na layunin sa buhay?

Pagdamay” o helping

Sa orihinal na papel ni Enriquez, ang pagsasalin sa “pagdamay” ay “helping”. At totoo naman na ang pagtulong ay isang aspeto ng pakikiramay. Pero sa ating wika, pag sinasabi na “damay” tayo sa isang tao o sitwasyon, hindi lang ibig-sabihin na nagbibigay tayo ng suporta sa usapan ng pera o gamit lamang. Ang pagdamay ay mas malalim pa dun, sapagkat ang binibigay natin ay ang ating oras at lakas — ang ating pagkatao. Pwede natin tanungin ang ating mga sarili kung paano ba tayo nakikiramay. Bakit ba tayo nakikiramay, at paano ba natin pinagdedesisyunan kung kanino tayo makikiramay? At anong mga aspeto ng ating pagkatao ba yung ating inaalok pag tayo ay nakikiramay?

Pagpuno sa kakulangan” o understanding limitations

Isa sa mga punto ng ating pagkatao ay meron tayong mga limitasyon. May mga limitasyon tayo sa ating mga kakayahan, kaalaman, at kagalawan. Meron din tayong mga limitasyon sa atin kaisipan, karamdaman, at kiling. At siguro ang pinakaimportanteng limitasyon: balang araw, magtatapos ang ating buhay. May hangganan hindi lamang ang mga bagay na kaya nating baguhin o likhain, pero pati na rin ang ating oras mismo sa mundo. Pwede natin tanungin ang ating mga sarili kung paano ba natin nauunawan ang ating mga kakulangan. Ano ang mga kakulangan sa ating buhay na pwede nating asikasuhin tungo sa ating layunin? Paano natin malalaman kung anong mga kakulangan sa atin ay dapat sikapin nating ibago, o dapat sikapin nating tanggapin? At ano nga ba ang kailangan nating maranasan at matupad sa buhay nating may hangganan?

Para sa mga serbisyo ukol sa ating mental health at pangkabuoang kalusugan, mag-email sa resilientteams@wethrivewellbeing.com at kausapin para makilahok sa aming mga aktibidad kasama ang aming mga mental health clinicians.

References (in order of appearance)

  1. https://greatergood.berkeley.edu/article/item/seven_ways_to_find_your_purpose_in_life 
  2. https://www.psychologytoday.com/intl/blog/fulfillment-at-any-age/202305/what-gives-your-life-a-sense-of-purpose 
  3. https://www.pressenza.com/2018/07/roots-of-filipino-humanism-1kapwa/ 
  4. https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1012&context=philo-faculty-pubs 
  5. https://link.springer.com/referenceworkentry/10.1007/978-3-319-24612-3_2017 
  6. https://www.britannica.com/topic/language 
  7. https://www.pssc.org.ph/wp-content/pssc-archives/Philippine%20Journal%20of%20Psychology/2002/07_Filipino%20Psychology%20in%20the%20Third%20World.pdf
Categories
Blog Everyday Thriving Wellbeing Practices

Eating to enrich life: understanding and responding to emotional eating

In We Thrive, we work with people becoming their best selves by working with different aspects of who they are. There are the big-picture things: our sense of purpose, for example, which in Dr. Gabrielle Pfund’s research is composed of things such as how our future plans match our interests, how engaging we feel life is as a whole, and so on (Psychology Today, 2023). But there are also the big things when you zoom into that picture: the finer details of life, emerging from moment to moment, which compose the movements towards what we want life to be. These include the patterns of our thoughts, emotions, and behaviors, but also the things which give us the energy to, well, move. Specifically, we get this energy through food, “a fundamental human need that influences both physiological and emotional states” (Hamburg, Finkenauer, & Schuengel, 2014). Nutrition looks different from person to person, but generally speaking, the task of ascertaining life’s movement can be more difficult than it has to be when our bodies aren’t getting the food and drink it needs (MSD Manual, 2023). And as we’ve probably all experienced, those aforementioned patterns of thought, emotion, and behavior can lead us into patterns of eating that can deprive rather than enrich us. In this article, we will talk a bit about what such a pattern of eating is; how we might end up moving in this direction; and what we can do to direct, rather than be directed by, our eating habits.

What is “emotional eating”?

Eating is, as nutritionist Amelia R. Sherry puts it, “an intrinsically emotional experience” (Psychology Today, 2022). Hamburg, Finkenauer, & Schuengel expressed this intuition in concrete terms: “eating behavior goes beyond nutrition and alleviating hunger; family, friends, and cultural heritage shape individual food preferences” (Hamburg, Finkenauer, & Schuengel, 2014). All of life, both the pleasant and the unpleasant, is threaded with the experience of eating. So the term “emotional eating”, while widely used, does not necessarily give us the clearest idea, and might also give the wrong impression that eating in response to our feelings is necessarily a bad thing. Choosing to eat can be a perfectly reasonable way of grounding us, whether by supplementing our present positive emotional states, reliving a positive memory associated with certain foods, or dealing with the occasional difficulty (Rachael Hartley Nutrition, 2016).

The difference between “good” or “bad” emotional eating is in the word “choice”. Whether responding to our emotions by eating deprives or nourishes us depends on the intentions we have (or haven’t) set when we eat. Besides determining how nutrient-dense our diets are, how do we clarify our intentions with eating? Here are some helpful guide questions:

  • How aware are we of the reasons why we choose a particular food at a particular time?
  • Are we eating in a way that aligns with a particular goal we have, such as a health goal?
  • When faced with stressful situations, have we considered whether there may be better ways of coping or resolving these situations other than with food? 
  • To what extent do we actually savor or enjoy the food we are eating, when we do choose to eat at that moment?
  • As a whole, does our experience of eating delight us, or leave us with a lingering sense that something is not quite right?

What moves us towards “eating emotionally”?

“Emotional eating” is also known by at least two other names: “stress eating”, and “comfort eating”. These terms might be preferable, because it gives a better sense of the context in which these patterns of eating emerge. At the minimum, when people use the term “emotional eating”, they are generally referring to food intake as a means of grounding us when we feel overwhelmed, disrupted, or out-of-balance — in other words, eating as self-soothing (Psychology Today, 2023). If, while going through the guide questions, you realize that the intent of your emotional eating appears to be mostly about self-soothing, then you may be emotional eating in a way that might not be serving your best interests long-term. But this happens to almost everyone, and it is not necessarily about willpower. The research of Dr. Tatjana Van Strien found at least three determinants for emotional eating (van Strien, 2018):

  • Poor interoceptive awareness. This means a person has difficulty distinguishing feelings of hunger and satiety, which can lead to difficulties with determining whether one has eaten too little or too much. For example, this can be due to dietary factors such as regularly eating foods that are high in sugar, which can exacerbate hunger because of the rapid increases in blood glucose (Penaforte et al., 2013).
  • Poor emotion regulation strategies. This means, for example, that a person becomes over-reliant on a particular coping mechanism (in this case, food) to deal with stressful situations. It can also mean that emotional eating becomes the result of an inappropriate coping mechanism, such as when avoidance of stressful situations ultimately leads to more of the stress occurring later on, making one more likely to rely on emotional eating.
  • Disruption of the hypothalamic-pituitary-adrenal (HPA) axis. Among other things, the HPA axis is responsible for regulating appetite. Under normal circumstances, the stress response would be a loss of appetite, but due to various factors (e.g. incredibly stressful experiences, childhood trauma, abuse, or other underlying health conditions affecting the HPA axis), this is reversed and the stress response instead leads to increased appetite.

Keeping these three in mind, we can reflect on a few more questions:

  • What might be causing your urge to eat at a particular time? Is it because of what or how you may be used to eating? 
  • What difficult or stressful situations are you currently experiencing that may be better served by something other than food?
  • Aside from providing nutrition or sustenance, in what ways has food been present in your life growing up? Did you have an abundance of food or a scarcity of it? 
  • When you think of food, what memories are usually associated with it? Were there certain negative and possibly intense experiences in your life which food used to help you get through?

How do we direct our eating?

Eating plays a vital role, not just in the maintenance of regular bodily functioning, but in our journey towards living a purpose-driven life. But eating can either deprive us or enrich us with the energies, both physiological and psychological, necessary to live out such a life. So how do we eat in a way that is more enriching? Depending on your answers to the questions mentioned earlier, co-authors Dr. Gia Marson and Dr. Danielle Keenan-Miller offers some ideas for how best you can set the direction for the way food moves your life (Psychology Today, 2023):

  • Acceptance. This means becoming more accepting of your body and how it reacts to food. This means less judgment, which often leads to guilt and shame, and more kindness, which can lead you to a better sense of how the food actually feels for you.
  • Awareness. This means tuning into the emotional nature of eating and noticing what kinds of emotions emerge alongside the desire to eat.
  • Avoid reacting impulsively. This means when difficult and negative emotions emerge, as they do in emotional eating, we take a pause rather than immediately reaching out to food as we have habituated ourselves. This will give you some room to consider how else you might be able to respond to these emotions.

For mental health support services, email us at resilientteams@wethrivewellbeing.com or sign-up for sessions with our mental health clinicians.

References:

  1. https://www.psychologytoday.com/us/blog/fulfillment-at-any-age/202305/what-gives-your-life-a-sense-of-purpose 
  2. https://www.msdmanuals.com/home/disorders-of-nutrition/overview-of-nutrition/overview-of-nutrition 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907771/ 
  4. https://www.psychologytoday.com/intl/blog/positive-food-parenting/202212/when-emotional-eating-can-be-normal-and-even-healthy 
  5. https://www.rachaelhartleynutrition.com/blog/2016/11/emotional-eating-is-okay 
  6. https://www.psychologytoday.com/us/blog/the-binge-eating-prevention-plan/202301/emotional-eating-is-all-about-emotions-or-is-it 
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918520/ 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627933/
Categories
Blog

Coming out as a starting point for authenticity

In We Thrive, cultivating “authenticity” is a core component of our work. That said, there is vibrant debate across various disciplines over what exactly it is: for example, is authenticity something that is always there and waiting to be “discovered”, something that “emerges” through our various experiences, or some magnificent combination of both? (Psychology Today, 2023) But as a working definition, we can think of authenticity as a process of making the “whats” and “hows” of life work in tandem with the “whys” of life. Adding some specificity, it is the extent to which we are “consistent” (i.e. ensuring “external characteristics” and “internal values” match); are in “conformity” (i.e. ensuring life’s broad strokes meet whatever standards we set for ourselves); are able to “connect” (i.e. how our relationships to a place, a community, or historical milieu align with our sense of self); and have “continuity” (i.e. how much of our sense of self changes or is retained over time) (Dammann, Friederichs, Lebedinski, and Liesenfeld, 2020). Put more succinctly, authenticity “requires us to embrace the reality of our freedom and be responsible for how we choose to live” (Sutton, 2021). To be able to live a life that is consistent, in conformity, is connected, and has continuity, we must exercise an awareness of life’s movements and, to the extent possible, ensure that these movements work in harmony.

Whenever Pride Month rolls in every June, the idea of “authenticity” inevitably comes up. For LGBTQ people, one marker often used to evaluate whether we are living authentically is disclosure of one’s sexual orientation and gender identity (SOGI) — that is, “coming out”. Many LGBTQ people see coming out as a cornerstone to the lifelong task of embracing this responsibility over life and maintaining the harmony of life’s hows and whys. And wonderful as it might be, and as important as it is in our collective imaginations, it needs to be said that it is not the end-all and be-all of authenticity as an LGBTQ person. You do not have to be “out” in order to be true to yourself. So the intention here is not to give undue privilege to coming out, but to ask what coming out might contribute to our own journeys of living authentically. 

Ultimately, it is on each of us to pay attention to what life is specifically asking from us — to “listen to those messages”, as the therapist Andrea Matthews explains, “listening long enough and deeply enough to really suss out the most essential parts and then begin to act as needed” (Matthews, 2023). Whether coming out is what life demands of us in the present is on us to ascertain, and with much necessary struggle. But thankfully, that difficulty is at least a good sign: as the professor of psychology Dr. Stephen Joseph puts it: “the most authentic people, because they know themselves so well, recognize their struggles in living authentically” (Joseph, 2020).

Even if life does ask this from us, coming out can be deeply frustrating. We may have to come out in bits and pieces: to one friend but not another, with a sibling but not necessarily with a parent, and so on. In these scenarios, LGBTQ people can be caught up in an exhausting balancing act of shifting between one’s “personas” from one context to the next.

We may feel unable to come out at all because of what may be real risks to our wellbeing and safety, whether that be threats of violence or serious disruptions of important relationships such as those in our families or religious communities. We may even struggle with “coming in” — that is, recognizing and accepting oneself as LGBTQ — whether because of internalized negative ideas about being LGBTQ (e.g. “LGBTQ people are promiscuous”), perceived conflicts with core beliefs (e.g. “same-sex relationships are sinful”), and any number of barriers to our ability to embrace our unique experience of SOGI.

Whatever the case, our response to our circumstances must have at least two features: a loving-kindness; and a gentle recognition that these struggles allow us opportunities for renewal that can surprise us in the way it moves us closer to authenticity than our preconceived notions of coming out ever could.

Speaking of renewal, like other aspects of life, our experience of SOGI is always undergoing this process: we learn more about the nature of our attraction to others; who we are as men, women, or some other gender category; and what influences how we respond to relationships. For example, while the rule of thumb is that sexual orientation is generally stable over a lifetime, some very clever research has shown it can also display a good deal of fluidity, such as in studies that looked at differences in its expression based on birth sexes (Mock and Eibach, 2012) or specific timescales (Diamond, Dickenson, and Blair, 2016). This fluidity is also the case for gender identity (Katz-Wise, 2020), and is readily seen both historically and in the present time both in our own culture and in the surrounding cultures of Southeast Asia (Peletz, 2006). Such fluidity is undoubtedly fascinating in and of itself. But more importantly, it raises many points of reflection: for example, how much of our experience of authenticity is invested in our experience of SOGI, given its potential fluidity? (This question certainly applies to many other areas of life!) Applying this question to coming out: how much of the movements of life — our aspirations, beliefs, talents, interests, and capacities for truth in our relationships — is invested in our coming out, given how fluid coming out can also be?

There are many ways we can break this question down further. But as a starting point for what is ultimately a lifelong process, we can briefly apply some practical points of reflection on authenticity offered by the clinical social worker Zahara Williams:

  • Does coming out allow you to be “in tune with your values and passions”? For example, is being more open about your SOGI directed towards your personal commitment to the principle of honesty? Or does being more open about your SOGI also translate to being more open to embracing interests and desires which norms surrounding gender and sexuality would otherwise stop you from pursuing?
  • Does coming out contribute to a feeling of “being fulfilled?” For example, would being more open about your SOGI open up avenues in your life that allow you and others a fuller experience of who you are and what your life has to offer?
  • Does coming out help you “navigate life with purpose?” For example, would greater honesty about your experience of being an LGBTQ person allow you to act with more honesty about what you want out of life?
  • Is coming out for you “prioritizing what brings you peace”? For example, would disclosing your SOGI, whether or not this is initially difficult or distressing, ultimately give you the peace of mind you need to move through life with more ease and without so many considerations of people’s responses?
  • Does coming out give you more “tenacity and flexibility?” For example, would facing the challenge of coming out as LGBTQ embolden you to face courageously all the other challenges life offers you? (Psych Central, 2022)

To emphasize a previous point, coming out is a “lifelong process”, and our answers to the questions like what gives us a sense of fulfillment or peace are themselves very fluid. You may have also discovered that there were just as many other questions as there were answers which emerged. Perhaps while looking back at your own experience, as I did while writing this article, you realized that there was a time before coming out where the various affections of life came less naturally then than it does now. You may also have noticed that, despite the very real difficulties that entered into life as a result of coming out, there also came very real joys. And perhaps there were things which you would not expect to be at all related to disclosing one’s SOGI — in my case, these were my renewed religious pieties and an enthusiasm for sports — which now have such a profound influence on the movements of your life after coming out.

If these questions seem difficult, that is because they are. But as we see from some of these questions, coming out can be a starting point for a fuller experience of life’s truths. Using the components of authenticity identified earlier on: does coming out allow us to direct the movements of life in ways that allow us to live a life that manifests consistency, conformity, connection, and continuity? Whether or not we choose to come out, what is important is that we are able to exercise that sensitivity to the movements of life so that we are able to be true to ourselves in the present moment.

Whatever the case, We Thrive aspires to be your ally. Whether it’s about coming out, navigating your relationships with others, and figuring out how your SOGI fits into other aspects of life in a beautiful way, we want to be with you in your journeys.

To learn more about how our different activities and programs can contribute to your wellbeing as an LGBTQ person, email us at resilientteams@wethrivewellbeing.com.

References:

  • https://www.psychologytoday.com/us/basics/authenticity
  • https://www.frontiersin.org/articles/10.3389/fpsyg.2020.629654/full
  • https://positivepsychology.com/authentic-living/
  • https://www.psychologytoday.com/us/blog/traversing-the-inner-terrain/202305/how-to-live-an-authentic-life
  • https://www.psychologytoday.com/us/blog/what-doesnt-kill-us/202007/are-authentic-people-more-mindful
  • https://pubmed.ncbi.nlm.nih.gov/21584828/
  • https://www.health.harvard.edu/blog/gender-fluidity-what-it-means-and-why-support-matters-2020120321544
  • https://psych.utah.edu/_resources/documents/people/diamond/Stability%20of%20sexual%20attractions%20across%20different%20timescales.pdf
  • https://www.jstor.org/stable/10.1086/498947
  • https://psychcentral.com/lib/ways-of-living-an-authentic-life
Categories
Blog Thrive at Work Wellbeing Practices

Help at Work: Identifying workplace stress and the support you need

In We Thrive, we understand work as vital to the whole person. In the course of work, we learn to “regulate” by meeting challenges and its accompanying pressures head-on; to “relate” by working together with different people with different histories and perspectives; and to “reflect towards wise action” by considering how our work aligns with what is truly important to us. When pursued with mindfulness and compassion, work helps us grow not just in our careers but in our ability to live out lives as well-rounded human beings.

But of course, work has its issues.

Despite the lessons which the COVID-19 pandemic should have taught us about self-care and self-compassion, we remain tangled with a work ethic that prioritizes “productivity” at the expense of everything else. Unfortunately, this work ethic also bred a resistance to, and even fear of, seeking help, so used are we to the idea of “toughing it out”.

Despite increasing visibility of the importance of mental health, we are still uncertain about how this might play out within companies and industries. And on the level of the individual, we are still working  out, in the aftermath of a global health crisis, something as basic as what constitutes a legitimate need for assistance.

Here, we will look at one way to think about the kind of pressure you experience in the workplace, and the kind of help that you (and your workplace) may consider. Throughout this discussion, we will also be directed by this question: “Is my work nurturing my growth, or impeding it?”

Defining the pressure you need help for

There are sources of pressure, or “stress”, that are common across organizations and industries. The finer details may differ across fields, but these can be categorized into two broad categories:

  1. Work content, which are the various tasks involved and its accompanying costs in time, effort, and expertise. Some potential stressors under this category can include inappropriate workloads, where there may be too much or too little demands; the meaningfulness of the work, or the extent to which the job is aligned with the person’s values or sense of purpose; and autonomy, or the extent to which a person can exercise control over the work they do.
  2. Work context, which are the environmental and socio-cultural aspects of the job. These can include thing like the nature of relationships between colleagues, which can vary in levels of support, transparency, and general good humor; organizational culture, which can refer to policy structures and management styles that buttress the organization; and the sense of belonging within the larger work community, which refers to the extent to which a person might feel included or excluded from one’s peers or the extent to which one feels that their presence and contributions are actually valued. (WHO, 2020; Mental Help, 2015)

The response to these stressors is unique to each person, dependent not just on how intense or persistent the stressful experience is, but also on a person’s particular condition. A stressful event that might be considered “mild” for one person, which may improve functioning, might be “severe” to another, and disrupt functioning (Yaribeygi et al., 2017). But how do we tell the difference? We can do this by using two distinct categories of stress: “eustress” and “distress”.

Working with “eu-stress”

The first category of stress is eustress: the kind of stress which motivates us to face challenges successfully, learn new skills and perspectives, and provides opportunities to direct their actions towards our goals and our values. (Albort-Morant et al., 2020).

Broadly speaking, while there is definitely pressure, there is vitality. This can look like the following:

  • You feel energized;
  • You feel more focused;
  • You feel confident you know what you’re doing (or at least you’re confident you can learn);
  • You are excited by what you do; and
  • You sense your productivity increasing (Shafir, 2020; Tocino-Smith, 2019).

The work may be more difficult, but the movement towards accomplishing the task elicits feelings of pleasure and a sense that one is both working well and working towards something worthwhile for themselves and for the organization.

In a phrase: eustress nurtures growth.

The help we might need here would be less about relieving pressure and more about maximizing it: how can we maximize this opportunity for growth?

In the workplace, this might mean strengthening the following areas:

  • Ensuring access to mentors or peers who can offer emotional support or concrete advice for effectively addressing a challenge;
  • Providing appropriate flexibility to accommodate people’s particular work needs, such as work schedules, deadlines, or work spaces;
  • Building relationships between employees that ensure that people are not afraid of making mistakes or speaking up about their needs;
  • Setting clear work expectations so people know exactly what they’re working towards; and so on (Peart, 2019).

Working with “di-stress”

The second general category of stress that you may (unfortunately) be more familiar with is called distress. This is the opposite of eustress: instead of motivation, energy, and a sense of purpose, there may instead be dissatisfaction, fatigue, and a lack of direction. In this situation, the strain has either fallen too short of, or more often has far surpassed, the person’s threshold. Too little stress leads to boredom, lethargy, and a propensity for catastrophizing challenges faced because there has been inadequate opportunity to learn ways to cope with and savor challenges (Szalavitz, 2011). Too much stress though and the system can be overwhelmed, unable to effectively keep up, leading to disruptions in basic life functions such as sleep and a whole host of diseases (LeBlanc and Marques, 2019).

Again speaking broadly, in contrast to eustress, distress can be understood as being sapped of vitality. This can look like the following:

In this scenario, greater attention needs to be placed on relieving the pressure and addressing the manifestations of the distress: how do we return to a condition conducive for growth?

Going back to the workplace, this might mean the following:

  • Ensure that any changes to job demands are made to ensure employees actually have the time and the opportunity to practice self-care; 
  • Address the actual sources of the distress at work, including but not limited to lack of career advancement, conflicting work demands, workloads and timelines that force employees to go over and beyond their supposed job schedules, inadequate salaries and benefits, and so on;
  • Provide mental health support is both available and accessible to employees; and
  • Ensure adequate support from mentors, management, and other peers (APA, 2018; CCOHS, 2023).

When do I (and my workplace) need more help?

Returning to our first question, we understand that growth is nurtured when there is both adequate pressure (“eustress”) and adequate rest. Considering the latter, we can ask ourselves whether we are getting the rest we need — and whether our workplaces allow us to engage in such without reprisal or penalty. One useful model for understanding “rest” comprehensively, in its active and passive forms, looks at seven different kinds:

  1. Physical Rest, such as sleep, good eating habits, and exercise;
  2. Mental Rest, such as engagement with non-work-related intellectually-stimulating activities such as reading and games;
  3. Spiritual Rest, such as activities which respond to your religious callings or other callings to a higher purpose, including prayer, charitable works, and so on;
  4. Emotional Rest, such as being able to express our emotions authentically in safe and compassionate environments;
  5. Sensory Rest, such as relieving ourselves from over-stimulation by keeping away our mobile and other computer devices;
  6. Social Rest, such as by engaging in pleasurable social activities or in pleasurable solitude; and
  7. Creative Rest, such as through different artistic endeavors (Skowron, 2022).

A rule of thumb is to check in with ourselves and if in the past two weeks that if we are either a) we are unable to get adequate rest or b) if our best efforts at getting adequate rest is insufficient to relieve our present experience of distress, then this would be a signal to start seeking help. Similarly, if an organization finds itself unable to adequately and promptly support their employees’ wellbeing needs needs for rest, then the organization itself may want to consider getting help as well.

As a final point, despite what our present culture of work tells us, seeking professional help is not a sign of weakness. Speaking to organizations, to seek help rather than to just allow our employees to “tough it out” is a sign not only of courage and strength, but a sign that we are truly taking mental health seriously — and that despite the pressures, our workplaces are places where people’s growth can be nurtured.

For mental health support services for organizations, email us at resilientteams@wethrivewellbeing.com or contact us to sign-up for sessions with our mental health clinicians. 

References:

  1. https://www.who.int/news-room/questions-and-answers/item/ccupational-health-stress-at-the-workplace 
  2. https://www.mentalhelp.net/stress/types-of-stressors-eustress-vs-distress/ 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013452/ 
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/
  5. https://www.choosingtherapy.com/eustress-vs-distress/ 
  6. https://positivepsychology.com/what-is-eustress/ 
  7. https://hbr.org/2019/11/making-work-less-stressful-and-more-engaging-for-your-employees
  8. https://healthland.time.com/2011/12/20/the-goldilocks-principle-of-stress-too-little-is-almost-as-bad-as-too-much/ 
  9. https://www.health.harvard.edu/blog/how-to-handle-stress-at-work-2019041716436
  10. https://health.clevelandclinic.org/effects-of-working-too-much/
  11. https://www.betterhealth.vic.gov.au/health/healthyliving/work-related-stress#rpl-skip-link  
  12. https://www.apa.org/topics/healthy-workplaces/work-stress 
  13. https://www.ccohs.ca/oshanswers/psychosocial/stress.html 
  14. https://www.psychologytoday.com/intl/blog/a-different-kind-of-therapy/202212/the-7-kinds-of-rest-you-need-to-actually-feel-rejuvenated
Categories
Blog General Wellbeing Practices

Three questions for cultivating a compassionate conscience

Compassion, which we can understand as the sharing in and a desire to relieve the suffering of others, comes naturally to us as human beings. It is one of our most potent qualities, and is a cornerstone of human societies and the dream for every person to have a conscience formed and directed by aspirations of justice, peace, and cooperation. However, this precious resource has many facilitators and inhibitors, and like all human potentials can be broadened or restricted. Drawing from our clinical work and inspired by the UN’s recognition of the International Day of Conscience last 5th of April, this article will describe what it means to have a “compassionate conscience” and offer three general questions to help direct us towards cultivating our capacities for compassion: whether we are “aware” of suffering; whether we are “moved” by suffering; and whether we “desire” to relieve suffering.

Defining Compassion

Compassion can be understood simply as “the feeling that arises when you are confronted with another’s suffering and feel motivated to relieve that suffering.”1 Emphasizing its action-oriented nature, compassion is distinguishable from the related emotion of “empathy”, defined as the “mirroring or understanding of another’s emotion”.2 Despite the cynicism of mainstream conversations (and sadly much of modern psychology until fairly recently), it is deeply rooted in the human condition: as professor and author Dr. Dacher Keltner puts it, compassion is “an innate human response embedded into the folds of our brains”, the “evolved instinct to help other people is a reflex”.3 And it does appear that human minds evolved the neural hardwiring for this sharing in another’s pain in some way.4 We’ve even seen how exercising “self-compassion” — the directing of kindness and understanding inwards, to our own suffering — can literally ease the experience of pain in the context of chronic illnesses.5 It has rightly provoked intense interest among scientists, hence the growing body of work focusing on its clinical application along with related practices such as “loving-kindness” and “mindfulness”.6 All this to say is that compassion comes naturally to us, and is one of our most potent qualities.


But as the clinical psychologist and founder of Compassion-Focused Therapy (CFT) Dr. Paul Gilbert puts it: “Compassion too has its facilitators and inhibitors.”7

Many factors can affect our capacities for compassion: whether we were encouraged growing up to engage in compassionate works; our own personal resources; whether our own beliefs about specific compassionate acts (e.g. giving change to a poor stranger) aligned with the moral value we assign to social questions (e.g. poverty determined mainly by individual effort or systemic factors); whether, because of formative experiences, we safe enough in our own bodies to handle the compassionate impulse and the potency of its accompanying emotions; and many others.

For the frontliners of the pandemic, without whom our entire country may have simply collapsed, there was “compassion fatigue”: a deep physical and emotional exhaustion that sets in as a response to an overwhelming loss of human life and livelihood, when there is an accumulation of the suffering of those they serve and not enough space and resources to process and recover.8 Given how helpless we all were in many instances, we might relate to the very unpleasant feelings that came when our compassion was unable to express itself in ways we desired, including shame, doubt, guilt, and even anger.9 Like all human potentials, our potential for compassion can also be disturbed.

Compassion, whether it’s the capacity to offer it to others or accept it for ourselves, is a precious resource. It is the cornerstone of the well-formed conscience and the bedrock of the dream of a “culture of peace”, which the United Nations described as “a positive, dynamic, participatory process linked intrinsically to democracy, justice and development for all by which differences are respected, dialogue is encouraged and conflicts are constantly transformed by non-violent means into new avenues of cooperation.”10 If compassion ought to come naturally, which appears to be what the research is currently telling us, then how might we build on it? What kind of questions can we ask to direct us, especially when our capacities for compassion are obstructed in some way? 

Three questions for cultivating compassion

For the former Buddhist monk and scholar of religious studies Dr. Thupten Jinpa, compassion is made up of different components, three of which we will look at here.11 While these components overlap in actual human experience, making some distinctions can help us generate useful reflections.

1. “Are we aware of suffering?”

The cognitive aspect of compassion requires that we recognize that pain exists, both in ourselves and in others. But recognition cannot remain an abstraction; compassion is directed and active. Our ability to know suffering can be hampered by ignorance: we may not have an understanding that a person experiences pain in some way because we are unaware of their context and needs. It can also be hampered by prejudice: we might assume we understand a person even if we have not really begun to enter into a real knowledge of who they are. It may not have anything to do with the other person at all: something in our conditioning, past or present, may be keeping us from seeing suffering for what it really is. So what is keeping us from being really aware? Are we really paying attention to what that person is going through? Do our assumptions about that person take up too much headspace? And are there ways of doing things we learned growing up that have left gaps in our perception?

“Are we moved by suffering?”

The affective aspect of compassion requires that this recognition of pain reaches the heart. Put another way, the experience must be felt bodily, and not just at the level of the thought. But like our ability to see, our ability to feel can also be hampered. It may be physical or emotional fatigue: as such, our energy might be directed at conserving energy and towards the things that offer rest or familiar comforts.Our beliefs about suffering might also become like gatekeepers to our emotions: values inherited from our families and communities might have led us to believe that our suffering is somehow correlated with notions of merit or of what people do or do not deserve. Perhaps these same values do not adequately accommodate the fact that suffering is inevitable. It may also be that our bodies may have too much or too little sensitivity to pain, and the effort we put into trying to regulate how much we expose ourselves diverts these emotional resources away from compassion. So what is keeping us from being really present to these feelings? Are our bodies getting enough rest? Do some of our beliefs create barriers rather than openings for feelings of compassion? And do our bodies, whether it has become accustomed to too much or too little pain, allow for these feelings to be felt?

“Do we want to relieve suffering?”

The intent aspect of compassion requires that this experience of the pain of others has an outlet. From the head to the heart, it must then travel outward through speech and action. After all, that is exactly what the etymology of compassion means: to suffer with others. But this suffering with others is not about the passive taking in of pain, but an active partaking in it towards some kind of resolution. We might express this compassion by contributing time and resources to charitable works. We might also express this by becoming a kind of reference point for compassion, whose presence communicates safety and love, so that others might feel safe enough to approach for consolation. We also manifest this intention by directing it inward, at our own pains, and practicing on ourselves what others might ask of us: forgiveness, understanding, and openness to our own failings as human beings with as many flaws as gifts. So what is keeping us from expressing our compassionate impulses as concrete actions? Are we paying attention to the logistics of these compassionate impulses, so that we know what we have to offer? Are we paying attention to how we respond to others, so that we know whether our actions communicate an invitation of safety and warmth? And are we paying attention to how we react to our own experiences, so that we know that we give first to ourselves the compassion we offer others?

As we pass through what we hope to be the worst that the pandemic has to offer, it is important to recognize how our capacities for compassion have been tested and what this might mean for us moving forward. By reflecting on the things which expand or contract the depth and breadth of our compassionate impulses, we can continue to exercise this precious human instinct with less dread about how little we have been able to offer and more hope about how much we can do for ourselves and others within our own spaces.

Sources:

  1. (n.d.). “What Is Compassion?” Great Good Science Center, UC Berkeley. Retrieved from: https://greatergood.berkeley.edu/topic/compassion/definition/.
  2. Smith, J.A. (08 May 2009). “What Happens When Compassion Hurts?” Great Good Science Center, UC Berkeley. Retrieved from: https://greatergood.berkeley.edu/article/item/what_happens_when_compassion_hurts/.
  3. Keltner, D. (01 March 2004). “The Compassion Instinct.” Great Good Science Center, UC Berkeley. Retrieved from: https://greatergood.berkeley.edu/article/item/the_compassionate_instinct/
  4. Lamm, C., Decety, J., and Singer, T. (2011). dMeta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain. NeuroImage, (54), 2492-2502. DOI: 10.1016/j.neuroimage.2010.10.014.
  5. Wren, A.A., Somers, T.J., Wright, M.A., Goetz, M.C., Leary, M.R., Fras, A.M., Huh, B.K., Rogers, L.L., and Keefe, F.J. (2012). Self-Compassion in Patients With Persistent Musculoskeletal Pain: Relationship of Self-Compassion to Adjustment to Persistent Pain. Journal of Pain and Symptom Management, (43)4, 759-770, DOI: 10.1016/j.jpainsymman.2011.04.014.
  6.  Hofmann, S. G., Grossman, P., & Hinton, D. E. (2011). Loving-kindness and compassion meditation: potential for psychological interventions. Clinical psychology review, 31(7), 1126–1132. DOI: 10.1016/j.cpr.2011.07.003.
  7. Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53, 6-41. DOI: 10.1111/bjc.12043.
  8. Clay, R.A. (11 June 2020). “Are you experiencing compassion fatigue?” American Psychological Association. Retrieved from: https://www.apa.org/topics/covid-19/compassion-fatigue/.
  9.  Culliford, L. (07 June 2011). “Compassion really hurts.” Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/spiritual-wisdom-secular-times/201106/compassion-really-hurts/.
  10. United Nation (n.d.). “International Day of Conscience: 5 April”. Retrieved from: https://www.un.org/en/observances/conscience-day/.
  11. Jazaieri, H. (24 April 2018). “Six Habits of Highly Compassionate People.” Great Good Science Center, UC Berkeley. Retrieved from:  https://greatergood.berkeley.edu/article/item/six_habits_of_highly_compassionate_people/.

Categories
Blog Everyday Thriving

COVID-19 and the Crisis of Happiness: Knowing what we are (not) responsible for

With COVID-19 restrictions in public life easing, there is an excitement for a return to “happiness.” The desire surely comes from intense feelings. Many of us struggled to meet our daily needs, endured prolonged states of helplessness, faced sickness or death every other week, and confronted deep-seated hurts and longings which we only managed to avoid through the daily routines the pandemic stole away. And yet somehow, according to the latest World Happiness Report, the Philippines ranked 60 out of 146 countries in levels of happiness in terms of overall life evaluation.1 How is this so? And what can this experience of a global health crisis offer in our ongoing struggles to recreate and reimagine happiness?

Drawing from our clinical work, this article will briefly look at discerning the factors we can exercise responsibility over, and what questions we can ask ourselves to exercise “psychological flexibility” in response to these feelings of accountability and helplessness.

Not every variable affecting happiness is our responsibility. While this fact does not imply a disregard of personal liability, a fuller experience of happiness requires that this sense of responsibility be exercised with restraint. This can be done through the practice of “psychological flexibility”, and we offer two basic questions to start. First, are you actually responsible for the things you hold yourself responsible for? And second, can you be kinder to yourself for what you are actually responsible for?

Not every variable affecting happiness is our responsibility.

Consider three of the six general predictors used by the World Happiness Report: “social support”, “perception of corruption”, and “Gross Domestic Product (GDP) per capita”. 2What you notice almost immediately is that these factors affecting happiness have little to do with individual willpower. For example, a person’s ability to access social support can be affected by cultural environments that create “social handicaps” (i.e. anything from a person’s physical and psychiatric disabilities to their membership in a stigmatized group which communities consciously or implicitly act upon in ways which impair a person’s ability to access goods, services, or privileges).3 Similarly, how rampant corruption is or how high the average household income might be is grounded in systemic issues of policy and governance rather than simple personal will. Other predictors alluding to personal decisions, such as “generosity”, “healthy life expectancy”, and “freedom to make life choices”, are influenced by things outside the conscientious exercise of personal agency. Our decision to donate to a cause might be affected by something as arbitrary as gender norms or whether you are told someone else gave a donation.4 You may be predisposed to chronic illnesses regardless of how hard you try to stay healthy.5 The choices we are “free” can hardly be called “free”, such as when systemic discrimination on the basis of sexual orientation or gender identity creates barriers to “choosing” to seek out healthcare services.6 There are other examples, but the fact that these were the variables used by a major global study tells us something about to what extent we can claim responsibility for the happiness we feel at any given time.

None of this implies a disregard of personal liability, and it is still true that we must exercise accountability for our choices. Accountability to legitimate social expectations (e.g. others expecting you not to steal from them) and to personal principles (e.g. valuing honesty) is critical not only to a functioning society but to living authentically. Having a sense of responsibility over our lives means we can exert influence over our lives, and by extension flourish in ways that are authentically ours – a capacity that is essential to happiness.7 But not everything is your responsibility. Contracting the COVID-19 virus can happen no matter how cautious you are. Being stuck in homes that hurt you because of quarantine restrictions, and the lack of feasible alternatives, is often more about circumstances outside your control. Sticking to a job that is making you sick is still less risky than seeking a new job elsewhere, especially when even short-term joblessness puts you and your dependents at so much risk. Happiness requires that this sensibility be exercised with restraint – and this, at least, we can always do.

Psychological flexibility is a key variable to happiness.

What does “exercising restraint” look like? This starts with discerning what is and isn’t within our control.

It means identifying what we can reasonably be accountable for, a part of a lifelong effort of balancing between our desire to live authentically and the reality of living in contexts of less-than-ideal choices.

This balance is achieved, among other things, by what is called “psychological flexibility”. In the most basic sense, this means “the ability to adapt in response to changes in external or internal circumstances”.8 It has been rightly called “a fundamental aspect of health” and involves a process where a person “adapts to fluctuating situational demands … reconfigures mental resources … shifts perspective … [and] balances competing desires, needs, and life domains.”9 Here, this means allowing for more nuance in understanding and implementing our sense of responsibility in situations fraught with ambiguity. We can start with two questions.

1. Are you actually responsible for the things you hold yourself accountable?

We have all had to face disturbing situations. To use a personal experience, it may have been losing a loved one to COVID-19. You may believe you did not get them the care they needed in time, or could not get them care at all because you had no means to do so. True, what they received may have been too little or too late. But to indulge in self-blame is problematic in at least three ways. First, it assumes that their wellbeing was your sole responsibility. Contributing to another’s wellbeing is not the same as taking ownership of their wellbeing. Second, it assumes that the failure is your own. As a public health issue, this cannot be stressed enough: our social institutions are governed along the system of the nation-state, and things such as providing comprehensive healthcare is the obligation of the state and not of any one person. Third, the blame assumes that you should have been better prepared. Speaking again from personal experience, there is no way to adequately prepare for something like this, not financially (given the country’s serious problems with labor and privatized healthcare) and certainly not emotionally. It is true they didn’t receive the care they needed. But it is equally true that it wasn’t entirely yours to give.

The blame can be subtler. You may blame yourself for failing in a career task, or some personal goal. Maybe you were unable to maintain important bonds, like a romantic partner. Anyway, the underlying assumptions are the same. You may be taking ownership for something that isn’t yours alone. Relationships, for example, evidently involve more than one person, and responsibility is shared as such. You may believe that the failure of the situation was entirely on you. Within businesses and organizations, there is actually only so much an individual can rightfully be held responsible for: an individual’s failure to complete can also be an organization’s failure to consider what a task really entails under these extraordinary circumstances. Or you may believe that you could have prepared more. While that might be true, remember that hindsight is 20-20, and also that the psychological strain of a global crisis has had a real effect on the decisions we made.10

2. Can you be kinder to yourself for not succeeding in what you were responsible for?

Strange as it sounds, it is easier to blame ourselves. Personal failure assumes the possibility of its opposite: personal success. If only the circumstances were different! There is some pleasure in considering alternative outcomes where you come out with a strong finish. But that pleasure is not the same as happiness. The circumstances were as they were; it can never be anything other than what it was. More fundamentally, it is difficult to accept that such a “success”, however we envisioned it, was not possible given what you had and what you knew at the time. Not finishing strong, and barely making it, may have been the only logical outcome. It may have even been the best outcome, as even bigger failures may have been more likely than even smaller successes. This is not a fun thing to realize.

Responding to a clear personal failure – the kind which not only cuts deep and could not have been anything else – is no small pleasure. But taking a position of kindness in response to these failures, called “self-compassion”, is fundamental to happiness.

So consider: can you be kinder to yourself for not living up to your expectations? Can you be kinder to yourself for not succeeding in what you were responsible for?

As we enter a phase which foresees an “end” to the pandemic’s sudden and major upheavals, it is important to exercise as much of this flexibility as possible, so we might carry with us a sense of our capacities unburdened by a sense of responsibility that is kinder and more understanding.

Sources:

  1. See Table 2.1 in Helliwell, J.H., Layard, R., Sachs, J.D., De Neve, J., Aknin, L.B., and Wang, S. (2022). World Happiness Report 2022. Sustainable Development Solutions Network. Retrieved from: https://worldhappiness.report/.
  2. Ibid
  3. Koukouli, S., Vlachonikolis, I. and Philalithis, A. (2002). Socio-demographic factors and self-reported funtional status: the significance of social support. In BMC Health Services Research, 2(20). DOI: 10.1186/1472-6963-2-20.
  4. Allen, S. (2018). The Science of Generosity. Great Good Science Center, UC Berkeley. Retrieved from:  https://ggsc.berkeley.edu/images/uploads/GGSC-JTF_White_Paper-Generosity-FINAL.pdf.
  5. Wehby, G.L., Domingue, B.W., and Wolinsky, F.D. (2018). Genetic Risks for Chronic Conditions: Implications for Long-term Wellbeing. In Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 73(4), 477-483. DOI: 10.1093/gerona/glx154.
  6.  See Subsection on “Barriers to Accessing Healthcare” in Chapter 2 of Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities (2011). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. DOI: 10.17226/13128. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK64806
  7.  Koydemir, S., Şimşek, Ö.F., Kuzgun, T.B., and Schütz, A. (2020). Feeling special, feeling happy: Authenticity mediates the relationship between sense of uniqueness and happiness. In Current Psychology, 39, 1589–1599. DOI: 10.1007/s12144-018-9865-z.
  8. Stange, J. P., Alloy, L. B., & Fresco, D. M. (2017). Inflexibility as a Vulnerability to Depression: A Systematic Qualitative Review. In Clinical psychology: a publication of the Division of Clinical Psychology of the American Psychological Association, 24(3), 245–276. DOI: 10.1111/cpsp.12201.
  9.  Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. In Clinical Psychology Review, 30(7), 865–878. DOI: 10.1016/j.cpr.2010.03.001.
  10. Tarantino, V., Tasca, I., Giannetto, N., Mangano, G.R., Turriziani, P., and Oliveri, M. (2021). Impact of Perceived Stress and Immune Status on Decision-Making Abilities during COVID-19 Pandemic Lockdown. In Behavioral Sciences, 11(12), 167. DOI: 10.3390/bs11120167.
  11. Neff, K.D., Rude, S.S., and Kirkpatrick, K.L. (2007). An examination of self-compassion in relation to positive psychological functioning and personality traits. In Journal of Research in Personality, 41, 908-916. DOI: 10.1016/j.jrp.2006.08.002.