Thursday, November 30, 2017

De-Stress this Holiday!



Holiday season is here!

Unfortunately, that can also trigger pressure and unwanted stress!

A common reason we find ourselves overwhelmed and feeling less than jolly can be pressures that come from family, friends, and media. We often have childhood memories of the holidays that seem unattainable today. Those expectations can lead to unrealistic pressures to re-create the magical and perfect holiday for ourselves and our families.

Other sources of stress can come from managing finances, staying healthy, and comparing ourselves to others. If we have suffered a loss or a difficult time this year, the holidays amplify our sorrow, grief and stress.

So what can we do to de-stress this holiday?


Let's start by changing our relationship to stress itself! We often see stressful events as bad or harmful, but the reality is that our interpretation of stress can be the key to managing it. Researcher and stress expert Kelly McGonigal talks about how to make stress your friend in this excellent video from TedX. She explains the importance of changing our perspective on stress and some tips on how to increase protective factors like socialization and helping others.

When we start feeling overwhelmed with our to do list, take a step back and ask how important is everything on my list. Where can I set realistic boundaries? When can I say no?

Make self-care a priority.


Be realistic with yourself. Recognize that it is not an all or nothing situation. We don't need to do everything perfect and we definitely don't need to believe those negative messages that we "should" be a certain way. Focus more on your blessings and less on what you believe may be missing. Take some time to build relationships instead of stressing about the perfect gift or the ideal picture for your holiday card. Remember that it is okay to be okay... Sounds silly, but it is important. Savor the good and the positive in your life, connect with people you love, and let go of the worry of what other's may believe about you. Make your health and happiness a priority. 

When it comes to your physical health, recognize you may indulge more this time of the year and pay attention to healthier eating and exercising when you can. Budget time for exercise to stay on track. Allow down time to call a friend, take a walk, practice yoga, meditate, and continue with a healthy lifestyle that can easily be forgotten about when life gets busy. When you are out celebrating, focus more on the social aspect of a party and less on indulging. For example, eat a meal before going to a party so that you can spend your time connecting with loved ones and less time indulging.  


In the end it comes down to expectations. 

Identify what is important to you this holiday season. Stay focused on what you truly value and less on outside pressure and unrealistic expectations of perfection and you will find yourself having a much happier holiday! 

Tuesday, October 24, 2017

#metoo, what next?

Photo by Cristian Newman on Unsplash

If you have Facebook, twitter, or have listened to any news media outlet in the last week, you would have heard someone say #metoo.

In response to the allegations against Harvey Weinstein, Alyssa Milano tweeted the following:
If you've been sexually harassed or assaulted write 'me too' as a reply to this tweet.
Within 48 hours #metoo was posted about one million times. Think about the impact of one million people publicly acknowledging having been sexually harassed or assaulted!   

I have heard a lot of people commenting that this in not new. That is true, sexual harassment and sexual assault being pushed under the rug or people turning a blind eye, leaving victims to feel ashamed, embarrassed and at fault, has been going on forever.  Why now are women (and some men) coming forward?

Perhaps it is because there is a safety in numbers. Much of the sexual assault cases that are coming out publically now, were well known secrets. It was considered to be part of the territory and a necessary evil. Sexual assault is seen as a part of our culture. Think about the Access Hollywood tapes of Donald Trump. Even after admitting to groping and forcibly kissing women, he was elected to be President of the United States.  How is that possible? The response from many was “that’s just locker room talk.” Rape culture is normalized and excused. So much so that statistics show that 85% of all rapes go unreported. Sometimes we hear the counterargument about a risk of false accusations, however the reality is that accounts for only about 2% of all accusations. Take a look at this data from the website www.rainn.org


There is very little accountability.
No wonder so many women blame themselves for what happened to them.
It is important to point out that sexual assault is not just a problem for women. Men are also victims of sexual assault and women can be perpetrators as well.

Too often we dismiss perpetrators and make excuses like “boys will be boys.” There are so many examples in our culture where we romanticize behaviors where men “don’t’ take no for an answer.”  Just look at the most popular movies and shows where male characters persist and persist despite being told no. Movies like, Say Anything make us believe it is cute for a guy to stand outside of a girls house in the middle of the night with a radio to get her attention after she has repeatedly said she is not interested. Subtle messages like these can be confusing and contribute to a culture where it is acceptable for a man to be elected President of the United States after admitting that he sexually assaulted women and gets away with it because he is wealthy. Ask anyone connected to the media industry and they would tell you they knew of these “open secrets” about Harvey Weinstein or about Bill Cosby before it became the center of media attention.

Statistics show that one in five women are sexually assaulted by the time they get to college. The FBI Uniform Crime Report of 2013 reports (with a very narrow definition of rape) that one person is raped approximately every six minutes.

So what do we do? 


Right now, we teach our girls how not to be victims. We tell them to not put their drink down in a bar, be aware of their surroundings, don’t dress provocatively or get “too drunk”, make sure they don’t walk alone in the dark, etc.

The majority of the attention, accountability and responsibility fall on the victim. No wonder so may sexual assault victims blame themselves for things that happen to them? That is a big part of why they don’t come forward. That was the case for me almost thirty years ago. 

That is not ok.


An expert in treating sexual assault victims, Psychologist, Charity Truong, PsyD describes a “just world myth” that perpetuates the guilt and blame following a sexual assault. We believe on some level that good things happen to good people and bad things happen to bad people. When bad things happen, we start to think we must have done something wrong. We also have what is called a “rape script” in our mind of what an assault looks like. It’s a stranger, in a dark alley, late at night. That is different from the experience of many people. That discrepancy between what we think constitutes assault and what we actually experienced leads to self-blame and guilt.  We rationalize away what happened.  We make excuses for the perpetrator and we bury the emotional pain, shame and hurt.

Again, that is not ok.  So what now?

As a therapist and as a parent, it is important to me to be a part of a changing culture and here are three thoughts I have on how to begin:

  • Recognize this is a problem. A problem not isolated to a select few perpetrators but a culture that condones, romanticizes, and rationalizes inappropriate behavior. Most of us can agree and publically agree that Harvey Weinstein, Brock Turner or Bill Cosby cases are unacceptable, but what about the smaller, sexist micro aggressions that happen every day? Can we call out sexist language, harassment, slut shaming, mom shaming, stereotyping, and objectification of women?  Do we step in and challenge our friends, coworkers, or family members when they say and do things that perpetuate a culture of sexism? Can we stop condoning a culture of entitlement that makes excuses for “locker-room-talk?" Take a stand and speak out against the notion that “boys will be boys,” or that the way someone dresses or acts means they were “asking for it?” One of my favorite social workers and authors, Brene Brown, writes about having the courage to speak truth to bullshit in her newest book, Braving the Wilderness. Silence around these issues is a form of condoning. I get that it isn’t easy. If it were easy, this would not be as big of a problem. Speak up and step in.
  •  Get really clear on what sexual assault looks like, not the extreme “rape script” we imagine. Understanding the definition of sexual assault can help to better clarify what is happening. It allows people to know clearly what is and is not assault and create more accountability and less victim blaming. The Department of Justice defines sexual assault as:
 Any type of sexual contact or behavior that occurs without the explicit consent of the recipient. Falling under the definition of sexual assault are sexual activities as forced sexual intercourse, forcible sodomy, child molestation, incest, fondling, and attempted rape.
  •  The responsibility of preventing sexual assault does not fall on would-be-victim; the responsibility falls on the would-be perpetrator. We need to spend more time teaching our girls AND our boys about respecting boundaries, accountability and what IS and WHAT IS NOT consent.
Changing our culture starts with changing ourselves.


Friday, September 29, 2017

Practice what I preach...

Glossophobia or speech anxiety is the fear of public speaking or of speaking in general. So many people have it. The idea of presenting in front of a group and being the center of attention can be overwhelming, especially for people prone to anxiety. I have had symptoms of anxiety my entire life and yet speaking in front of a group is something that I find exciting and motivating.  I worked for years in a training role for a major pharmaceutical company and currently I teach classes and workshops on mental health, optimism, and resiliency as part of my clinical social work practice. Although I get a bit nervous just before a presentation, within seconds I begin to feel the positive energy of the group and find my flow.  I pride myself on the ability to handle negative and challenging audiences and can keep calm even when things go horribly wrong.  

So, if all of that is true, why did one workshop throw me into a panic last month?

It all began after finishing up a three-week class I teach several times a year for the local adult school. It is called: Get Happy: The Science Behind the Smile. The next session starts October 2017 (here’s link if you would like to join me).  Two women from the last class contacted me to see if I would put together a program with the information we covered in class, specifically to reinforce resiliency and a positive mindset in their teenage daughters. They thought that the information presented would be best received coming from an expert instead of from mom. Excited by the idea, I agreed.

Having a 13-year-old daughter, I had a pretty good idea how to create a version of my course that would be appealing to young teenagers. I could easily re-package the information with relatable stories to create an hour-long program that would fit the needs of the parents and keep the kids engaged. After creating the content and going back and forth on dates and times, we settled on a date for me to come to the home of one of the women. The plan was for her to host a party of 8th graders after school where I could present my information and lead a discussion style workshop.

After I agreed to do it and was all ready to go, I panicked. What the heck? Why was I feeling so anxious about this? My internal voice kept reminding me that I am better with adults than I am with kids. I began my career as a therapist working with children and families but after taking a 13 year detour into a corporate job, my current my current clinical therapy practice is much more focused on working with older teens and adults, especially around work/life balance stressors and triggers.  All of a sudden I felt completely unprepared for what I had signed up to do.  My negative self-talk had me feeling overwhelmed and insecure about doing something that really should be a no brainer for me.

So what did I do? I am not proud to admit it, but I tried to get out of it. I was not exactly sure why I was so fearful of doing this workshop, I just knew I wanted to bail. The mom hosting the workshop emailed to say that her daughter told her that this was going to be the lamest party ever. That was all I needed to hear, I was convinced that it was a bad idea. My 13-year-old daughter reminds me on a daily basis just how “uncool” I really am. I thought, “How could I possibly think I could do this?”

I tried to remind myself that teachers do this every single day, but that did not really help. Teachers have special gift and type of patience I don’t believe I have. As much as I love to teach, adult learning is where I thrive.

Nothing worked. I couldn’t find a way out. So there I was, sitting in someone else’s home with a room full of young teenagers whose parents paid money to have them come learn from me how to be more resilient and optimistic, when I myself was feeling overwhelmed and pessimistic. Before getting started one boy said to me, “I don’t think I want to stay, I don’t really like psychology type stuff.”  Ugh, I just kept thinking, “This is going to be a complete shit-show.”

So, I just took a deep breath and started anyway.  A few minutes in and I was shocked to see that I held their attention. Most of the teens were engaged and were began participating in the discussion. Hmmm, I thought “Maybe this would not be so bad after all.”

As I went through the material it hit me. The key points I was trying to teach these kids were the very messages I needed to tell myself at that very moment. I was not practicing what I preach. I was doing, in my own mind, exactly what I was trying to teach these kids not to do.  My panic, fear and insecurity around doing that program were in my mind, not reflective of situation.  I believed my irrational thoughts, personalization, pervasiveness, and perfectionism that had driven me into a panic. All of these were topics of this workshop.

When the obvious light bulb went off and I gained insight into the unhelpful thoughts I was having, I was able to use more adaptive thinking strategies, reframe my thoughts and adjust my perspective to allow my fear to dissipate. As I listened to the kids sharing examples of growth mindset thinking it clicked how much I was operating from a fixed mindset and sabotaging myself over irrational and unhealthy assumptions. I was stuck believing my thoughts that “I just don’t work well with kids” or “I can’t really relate to a room full of 13-year-olds.” Those beliefs weren’t based in facts or evidence but in my own maladaptive thoughts. I had to remind myself that just because I think it, does not make it true. Something I say to other people several times a day.

During the hour together, the kids shared stories of social comparisons and how those emotions have had negative affects on their self-worth.  We identified examples of situations where emotions were triggered by unhelpful and unrealistic negative thinking, labeled and reframed those negative thoughts. The kids showed insight and eagerness to understand their own triggers and even the kid who said he didn’t want to stay, shared with the group a challenging time when negative thoughts led to feeling depressed and hopeless.  

It is funny how sometimes the things we fear can become valuable lessons. In preparing to teach other people how to be more resilient and operate from a growth mindset, I really reminded myself to practice what I preach.

Thank you to the families who trusted me to teach their children, and for the opportunity to step outside my comfort zone and continue to grow.


If you are interested in attending an upcoming workshop or setting one up, please reach out any time, you can contact me through my website Maximize Wellness or via cfmaksimow@maximize-wellness.com

Thursday, August 31, 2017

Price of Perfection

This summer I had an opportunity to put a small dent in my never-ending pile of books I want to read. One in particular that motivated me to write this blog is, “What Made Maddy Run, the Secret Struggles and TragicDeath of an All-American Teen” by Kate Fagan. This particular book popped up on my Facebook feed from a friend connected to the Author and I immediately was drawn to the story as both a parent and as a therapist. I wanted to better understand Madison Holleran's story, having remembered hearing about her suicide on the local NJ news a few years ago. At the time it was shocking and hard to image what could be going on with such a talented, beautiful and seemingly "perfect" young girl.

Thinking about what could have been going on in her life through my experiences as a therapist, I can see how warning signs can be missed and how depression can look different then we expect it to look. However, as a mom of two highly driven kids, her story triggered my fears about just how much I really know about the pressures my children are facing, as compared to pressures I may have faced a kid. Just as I started to read this book an acquaintance lost her 12-year-old daughter, Mallory, to suicide as a result of relentless middle school bullying. It is impossible for me to fully comprehend the pain Mallory, Maddy and their families have, and still are, experiencing. This book, “What Made Maddy Run” helped to remind me the importance of talking about this subject with my children and better understand life from their perspectives.

Maddy's situation wasn't about external bullying or social media however social media did play a part in her story. The author, Kate, talks about Maddy's carefully crafted social media profiles and the contrast between that image she put out into the world with the internal pain and conflict she experienced. Kate Fagan also bravely shares about her own experiences with the pressure to be "perfect" on the outside while having doubts on the inside. It reminds me of the term “imposter syndrome” which I see almost every day in my work as a therapist. Highly accomplished people report feel as if they have been fooling everyone and that someone will find out they don't really belong. Those feelings come from distorted thinking and self-doubt with very little truth behind them. I have struggled at varying times in my life with challenges related to self-esteem, self-doubt, and perfectionism and it is easy to understand how negative thoughts like “I am not good enough” and “someone will see I don’t really know what I am doing” can increase fear and anxiety and feed unrealistic expectations. Much of my personal struggles were before social media. I had no Instagram or Facebook to compare myself to others and I could shut off social comparisons when I needed to. That is not the case today.

In this book, Kate describes how social media leads people to believe they connected and that they know about other's lives when really they only know the very carefully constructed ideal image they want others to see. That magnifies the feeling of “I’m not good enough” for so many people. Although on some level people are aware that others' reality is far different from the Instagram or social media persona, it is still very difficult to not compare and ultimately feel less than.

For athletes, that contrast can be even more pronounced. The book describes the pedestal that athletes are placed on and expectations of success that are different from everyone else’s. Kate talked openly about her years as a college athlete and the pressure she felt. She writes

"Our culture celebrates harder, faster, stronger. Vulnerability, it would seem, undermines that pursuit. And within sports culture, continuing to practice of play, no matter what your mind and body says, is romanticized: T-shirts are emblazoned with quotes, inspirational sayings are stenciled on the locker room wall, epic speeches are given At Colorado, a saying above one doorway read "Pain is weakness leaving the body."

Defining athletes by sports performance is not new. My husband and I went to the same high school in the late 1980's, yet our experiences were vastly different.  I was more insecure and awkward and he was confident, popular and well-liked. I was on the swim team, however swimming was not looked at the same way as other sports. My swimming career was mediocre at best and ended with high school. My husband, on the other hand, was a football player and received a full scholarship to play football at Boston University. His experience and “social status” in high school was far different from mine and so much of what people knew about him was defined by his place on the football team. We never would have dated back in high school and only became a couple at our ten year reunion. We joked it was because ten years later, “I got more cool and he got less cool.”

The message that success is linear and defined by accomplishment is ingrained in our kids from a very young age. For athletes, like Maddy and Kate, it meant winning, being strong, and working through any pain or doubt without letting anyone see imperfections. For academics it means getting the best grades and achieving the most prestigious college acceptances. Society praises and rewards good grades instead of praising the journey and learning experience overall. Is an A in a class where very little effort was put into it better than the C that took time and perseverance to earn? For me it is not, but most people says it’s the “A” that matters. That’s how we are judged, by the outcome and not the effort.

As a parent I try to be more mindful. Being a self-proclaimed “recovering perfectionist” I am careful of the messages I send my children. Both of my children play team sports and I remind them that it is about having fun and not just about the win. I tell them that success is defined by being better today than they were yesterday and not about being the best or better than anyone else. I believe accomplishments are important in the sense that they reflect effort, motivation, and drive, however those accomplishments do not define us, they are a part of a much more complex and full sense of self. My daughter has said to me that I am the only mom who doesn't care about grades. I reply by telling her I care about her happiness first and foremost, grades are a byproduct of learning. 

Another message I have tried to convey is that mental health and physical health are not much different despite the stigma associated with mental health or emotional health. My children both know relatives and friends who have struggled with depression and anxiety and I am open about things I do to manage my own anxiety levels. They understand diseases affecting mental health can be treated just like other medical issues such as a broken leg, diabetes, or strep throat. Mental health struggles are not personality flaws, personal weakness or something to hide or be ashamed of.

Even though I try my best, sometimes things slip through the cracks. For example recently I had an eye opening conversation with my 10-year-old son. He had been really busy with travel sports and summer camps and increasingly irritable and angry at home and I wondered if maybe he wanted to talk to someone other than his mom. He sometimes will meditate with me and uses some cognitive skills I have taught him but I thought it was important to ask if he needed more support.  I asked him if he wanted to talk with a counselor or as we call it “feelings teacher.” To my surprise he immediately became angry. He said, “I’m not stupid, why would you say that!” 

What? What did he mean, “stupid?” Is that really what he thinks? I was completely blindsided by his reaction. I approached him with curiosity and tried to understand what he was feeling. He expressed being embarrassment at a sports camp that was new to him and he wasn’t performing well and falling behind his friends. He had internalized his performance from a negative and fixed mindset instead of seeing potential to learn and grow and enjoy the opportunity take on a new challenge.

The take away I want to share today is for all of us to be aware of the messages we send our kids, whether consciously or not. Take time to understand how they are feeling and show them they are valued for who they are and not just what they accomplish. Recognize that pressures today are increased with social media and many of us just can’t fully appreciate what it is like for kids today compared to how it was for us when we were that age.  Not only should we tell them they don’t need to be perfect, but show them by modeling our own self-care, acceptance, and self-compassion.

Maddy’s story is heartbreaking and my hope is that by sharing it in her book, Kate has opened up dialogue for others who are struggling and can make progress toward reducing the stigma that contributed to Maddy’s death.


If you or a loved one are in need of help, please reach out to the Suicide Prevention Lifeline at: http://www.suicidepreventionlifeline.org/ or call 1800-273-8255.

Friday, July 21, 2017

Why a mental health day is so important...

Photo by Tim Gouw on Unsplash
A few weeks ago a 26 year old web developer’s twitter post about taking sick time for mental health reasons went viral. Her message to her boss was:
"I'm taking today and tomorrow to focus on my mental health. Hopefully I'll be back next week refreshed and back to 100%,"
The company CEO, Ben Congleton, read her note, he sent the following a supportive reply back.
"Hey Madalyn, I just wanted to personally thank you for sending emails like this. Every time you do, I use it as a reminder of the importance of using sick days for mental health – I can't believe this is not standard practice at all organizations. You are an example to us all, and help cut through the stigma so we can all bring our whole selves to work,"
As a therapist, I see a huge significance in that response. The stigma around mental health and behavioral health continues to be a barrier toward effective treatment and proper self-care. Taking the viewpoint that mental health and physical health are equally important can go a long way to more effective prevention and increasing health and well-being.
When we are sick we stay home from work for three main reasons:
1.    Working while sick with a cold, cough, fever, stomach virus or any other medical condition can exacerbate symptoms and ultimately make us sicker. For those of us who go to our jobs despite feeling sick because we don’t want to get behind in our work, we can wind up getting even sicker and missing more days than if we just rested when our symptoms started.
2.    Productivity goes down when we are feeling sick. Being tired, in pain or suffering through illness can interfere with our ability to do our job effectively. It’s tougher to concentrate, more difficult communicating and slows down our productivity.
3.    We can get other people sick. Coming into the office or workplace while sneezing, coughing or with other contagious symptoms can affect those around us. Whether it’s our coworkers or clients, it creates a larger problem for the office.
Let’s look at the same three reasons and apply them to taking a mental health day and as you can see, they still apply:
1.    Coming to work and ignoring warning signs of stress, depression or anxiety can increase symptoms. Knowing yourself and how to reduce emotional reactivity and/or unhealthy responses to stress by taking appropriate breaks can go a long way to maintaining healthy mental and emotional wellness.
2.    Productivity is also negatively affected. When we are overly stressed out, depressed, or anxious it can be very challenging to stay on task, stay focused or communicate effectively with others.
3.    You may think that getting other people sick in traditional terms may not apply, but that's not exactly true. We as human beings are affected by the mood, attitude and emotions of those around us. Going to work when feeling depressed, negative, or with poor emotional regulation absolutely affects the mood and productivity of those around us. Have you ever found yourself feeling down after spending time or working with someone who was in a bad place emotionally? What about smiling when you see someone smiling? New research in the area of “mirror neurons” is starting to explain why we sometimes experience emotions as contagious. Here’s a great video with more details: https://youtu.be/HTFdMwCXpMw   
Taking care of our physical health has now become mainstream and part of our daily routine. We all know how healthy foods, exercise, drinking more water, using sunscreen, getting sleep (whether we do them or not) can positively affect our physical health. These things also have an impact on our mental and emotional health as well as other practices that are slowly getting attention. Having a healthier work/life balance, increasing time with loved ones, as well as practices such as mindful meditation, are all becoming more important as we better understand a more integrative and holistic approach to health and wellness. 
That being said, taking a sick day for emotional or mental health reasons is as important as taking one for physical illness.  
It is all part of a effective self-care for better health and wellness.  Thank you to Madalyn and her boss Ben for getting the conversation going!