Ready to Expand? 3 Things to Consider When Growing Your Practice

A natural next step for an established clinician in private practice is to consider bringing on other professionals as part of their growth opportunity. Therapists may consider this option for a variety of reasons, including a desire to address their growing list of referrals, utilize office space more fully, or reinforce their brand. Moving to a group practice model is a process that is not for the faint of heart, so let’s take a look at some important things to consider before embarking on the process.

1.     Do you wish to take on Independent Contractors or Employees?

This is a vital first question because it dictates how you go forward with the process. If you were to take on Independent Contractors (ICs) for example, your hiring process and formal contract would emphasize their defined commitment to the practice, payment schedule, and marketing or referral expectations that fall within IC guidelines at both the Federal and State levels. In contrast, if you were to go with an employee model, you would need to be prepared to pay salaries, maintain office space and supplies, and offer retirement or healthcare packages based on recommendations by your attorney and CPA for this model. By asking this question first as it applies to your vision for practice growth, you will be able to refine your plan of action when taking on professionals for hire.

2.     Have you set up a business name with tax ID and group NPI?

Another piece to the puzzle of private practice growth is moving from a solo practitioner to a small business model. This includes having a business name and TAX ID form which to operate from, most likely established when you started your practice as a sole proprietor. A next step for group practice designation includes applying for a free group NPI which will link back to your business for billing and insurance paneling if that is part of your larger plan and working towards updating your records to reflect both TAX ID and NPI going forward.

3.     Do you have plans to take insurance in your group practice?

Speaking of bigger plans, are you hoping to credential your new hires with insurance panels for the services you provide? Identifying the process of adding clinicians to your existing contracts for each insurance panel could impact your timeline for new hire on-boarding and adaptation. Some insurance panels may take 1-2 weeks to update their records with your new hire information whereas others may take longer, which could impact your launch date or growth opportunity overall if too many obstacles exist.

These are just three of many questions to consider when exploring if a group practice model is right for you. There are dozens of things to consider including office space, health insurance, contracts, fee schedule, staff, and billing needs. Lots of moving parts that feel rewarding to owners who have made the move to group practice. Consider investing in training, consultation, or group practice conferences to learn more about the pros and cons of group practice ownership and leadership as they fit with your future goals. 

Self-Harm vs. Suicidal Behavior: What Clinicians Need to Know

A common question in our community is about the connection between self-harm and suicide. Self-harm, also known as Non-Suicidal Self Injury (NSSI), is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as relational and coping. Self-harm as a means for suicide can be described as one of eight possible reasons for engaging in self-harming behaviors. Dr. Jack Klott discusses the eight reasons in detail in his online series, Suicide and Self-Harm: Stopping the Pain as:

1.     Emotion regulation or coping-i.e. to calm the senses  

2.     Self-punishment- i.e. “I deserve to hurt.”

3.     Psychosis-i.e. command hallucinations to harm self

4.     Response to anxiety and depression- i.e. to bring back into body, to feel something, to express internal pain

5.     Peer influence- i.e. they said it worked for them

6.     Body dysphoria- i.e. I need to alter my body to feel more like myself

7.     Isolation and abandonment- i.e. expressing pain

8.     Suicide rehearsal- i.e. intention to die

For teens today, any of these eight possibilities could apply. Although each person has their reasons for engaging in self harm, more and more teens are going to their peers and the internet for answers on how to handle the stress they face in academics, relationships, and more. 

For 12-year-old Savannah, for example, self-harm patterns in her life are the result of a friend saying it helped them cope, therefore encouraging Savannah to explore if self-harm would have the same results for her as a coping strategy. 

What and Where?

 So what does self-harm look like for today’s youth? In the clinical arena, we are tracking trends in behaviors that have been socialized and publicized to some degree, like the Tide Pod Challenge of 2018 and the Salt-Ice Challenge of 2012. According to the Mayo Clinic, self-harm can be defined as any behavior that is self-inflicted, deliberate, and results in injury. Examples could be scratching, cutting, burning, hitting, and rubbing the skin until it’s damaged, as is the result of using an eraser on the skin. As more awareness is built around self-harm, the once typical locations of arms and legs may be seen as too noticeable to the public eye by individuals who feel a sense of judgement or shame after having engaged in self-harm behaviors. Therefore the clinical community is now tracking self-harm that appears more subtle when expressed on the human body, such as locations that are easier to cover up or hide from others, including but not limited to armpits, torso, upper thighs, and between toes. 

Curiosity and Compassion

Engaging youth in exploration as to what purpose the behavior serves can bring context and understanding to their reasons for engaging in repeat self-harming behaviors. It can also help professionals, family, and friends identify appropriate responses to self-harm in order to best support of the person they are trying to help. Asking questions from a neutral, curious place can clarify a youth’s choice for self-harm as it relates to risks for suicide. 

 Examples of how to ask:

“What purpose does this serve for you?” 

“What do you get from engaging in self-harm?” 

“What was your intention when engaging in self-harm?” 

For example, after being encouraged by her peers, 12-year-old Savannah states that she scratched her arm repeatedly in trying to cope with an internal, painful experience. This disclosure may feel very different in how a professional would respond to safety needs in comparison to the experience of 22-year-old Taylor, who reports he was hoping he would get an infection as the result of self-harm and die.

Harm-Reduction Model

Self-harm can be considered a precursor and risk factor for suicide, which is why it is important to explore a person’s experience and purpose for engaging in self-harm behaviors. Best practice continues to be a Harm Reduction Model when it comes to addressing self-harm behaviors, which means working alongside the person to identify other coping skills that could be utilized prior to self-harm with the hope of the urge dissipating as time passes and other strategies are utilized. The peak of strong emotions and stress is best described as the bell curve, where once a person in distress reaches the peak and start moving back to baseline—possibly out of fatigue or exhaustion—individuals who have historically engaged in self-harm report they are less likely to engage in the behavior in feeling less of a pull to do so.

Coping skills that can reduce the intensity and frequency of self-harm should be unique and individualized to each person. Returning to 12-year-old Savannah, for example, with therapeutic support, she has identified that she is looking for external expression of internal pain. Therefore, the primary theme for Savannahs’ safety plan would be to support her in identifying other ways to express that pain. For some youth, just the sight of damaged skin or blood is sufficient to shift or alleviate their current state of pain. For these individuals, a mental health professional might work with them to try fake blood applied to their body where they feel the urge to self-harm, or other expressions such as henna tattooing or doodling. 

For individuals who report that the pain response is the key element that quiets their internal system, other means can be introduced that reduce the risk of injury or infection. For example, perhaps a mental health counselor introduces a rubber band for youth to snap their own wrist, a frozen washcloth to pull apart that results in intense cold and stinging without injury, or introduces Icy-Hot for the tingling sensation on their skin. Again, each person’s Harm Reduction Plan should be catered to their needs in support of reducing self-harm behavior by means of how often they engage in the behavior and reducing methods that increase suicide risk.

Avoidance and Attendance: Advocating for yourself

It’s that time of year. The time where you might feel the urge to disengage from therapy in response to the season, holidays, or stress.  The time when you may need an appointment the most in order to support you through trauma, family conflict, isolation, and loneliness. For some, the crises seem to intensify during the holidays. Perhaps you are experiencing depression symptoms due to the winter weather or maybe you are battling loneliness in spending the holidays away from your loved ones. Perhaps you are attempting to navigate the unwanted memories of trauma during your family’s holiday dinner or are experiencing high anxiety because of money stress and holiday shopping. You on your journey to sobriety and anticipate having to navigate holiday parties around family and friends where temptation may lead to relapse. Combine these stressful situations with your ability to cope and you may feel you can engage in therapy fully to receive support, or in some cases, desire to disengage in response to the overwhelming feeling of all that is weighing you down. It can feel like a balancing act to engage your supports when feeling stressed, but rest assured, it can be an empowering experience to engage in through the holiday season in support of your personal and relationship goals.

Avoiding Appointments

The more easily measured type of avoidance when overwhelmed is a change in attendance in your scheduled sessions. Perhaps you find yourself canceling sessions when in the past, you’ve been consistent in attending each week. Or maybe you find yourself cancelling last minute due to feeling like you need to use that time or money for another task? How do you explore your needs when you haven’t been able to justify spending the time or money on your own mental health? Depending on how your therapist structures sessions, you may want to consider advocating for yourself in exploring the following:

• Completing a phone call with your therapist to communicate what is going on in your world and attempt to re-engage in sessions to support managing your stress.

• Engaging in a phone session instead of a face-to-face to explore and address present stressors if you are unable to attend in person.

• Identifying a different appointment time that encourages attendance such as an early morning before work or later evening if appropriate and depending on if your therapist has openings at those times.

• Identifying biweekly or monthly sessions for the holiday season to account for financial constraints and time management.

• Reviewing your attendance contract with your therapist to explore opportunities and restrictions, such as possibly placing scheduled appointments on hold and resuming at a later time if appropriate.

Emotionally checking out

The hope is that with ongoing rapport, the conversations with your therapist above can support you with healthy communication and accountability when experiencing increased distress. Your relationship with your therapist, or rapport, becomes even more important when you find yourself engaged by your therapist around a lack of emotional participation in session. Perhaps you begin to notice that you struggle to arrive on time to your scheduled appointments, jumping into sessions with details unrelated to yourself or changing subjects rapidly throughout the scheduled time. Or maybe you remain surface-level in your processing, not dropping down into emotions and deeper meaning in session because you are avoiding the stress or have worries that it will become unbearable when talking about it. With healthy communication, you can name what’s going on for you and process the outcomes with your therapist. Here are some examples of how you might start the conversation:

• In response to running late: “I’m struggling to get here on time and it feels rushed lately, like we have to fit it all in. Can I talk to you more about what that’s like for me?”

• In response to staying surface-level: “I have to admit, it’s easier to talk about the lighter things than the deeper, more stressful stuff. I think I’m worried that if we talk about it, it will just make me feel worse.”

• To encourage connection: “I feel very disconnected from my body, like my head is fuzzy and floating and I just want to be numb rather than this stressed all the time. Can you help me feel more like myself?”

• To encourage feedback: “I’m needing something different in our sessions to help me. Can I talk to you more about that?”

• To name fears: “I’m afraid that if we talk about these things, I won’t be able to function or get things done afterwards,” or “I’m reluctant to talk about this now because we won’t have our next appointment until after the holiday.”

Any of these statements can lead to a supportive conversation with your therapist to further identify and explore your needs. These sessions can prove to be some of the most impactful and fruitful in not only holding space for emotion and processing of stress, but also supporting vulnerability and self-advocacy in exploring how you can engage all of your supports in ways that feel beneficial to you.

Hear me

Vulnerability is hard. Yet for many of us, the power of being seen, heard, and understood makes engaging in vulnerability worthwhile. Your therapist, engaging you from a place of compassion and empathy, can better understand your needs when you speak of them. Your therapist can offer a neutral curiosity with ongoing optimism conveys the message that, together, you can find relief. Whether it be concrete tools for coping or holding space for your emotions, your therapist can create a safety net to address any fear, guilt, or shame you may be harboring in these moments of distress. Engaging in holiday travel, consider your therapy sessions a roadmap to relief! With direction and insight, you can address avoidance and attendance from an authentic, supportive place to best serve you during the hustle and bustle of the holiday season.

“You are as amazing as you let yourself be. Let me repeat that, you are as amazing as you let yourself be.” Elizabeth Alraune

Failure to Launch: Fostering Confidence and Freedom

You may recall the American Romantic Comedy “Failure to Launch” in 2006 that describes a 30-something man struggling to leave the nest. This concept isn’t foreign when describing young adults’ struggle with achieving the next milestone of independence: moving out of their parents’ house. Dr. Jean Twenge writes extensively on the trends of stagnation and delayed pursuit of independence in both the Millennial and iGen generations.  But what can we do to support confidence and the pursuit of autonomy and freedom in our young adults?

An Uphill Battle

For many young adults, American society has given them expectations that they can do anything they want, be anything they want, follow their dreams, and thus, never settle for mediocre in their identity, career, or relationships. For the adult child, this becomes a rude awakening when facing competitive college admissions, fighting for quality jobs, and budgeting to live on their own with the rising cost of living. Dr. Twenge speaks extensively about the ways young adults are set up to fail—highlighting loneliness, a lack of self-esteem, and elevated anxiety and depression as some of the challenges of our 18-35-year-olds.

Recognizing that these challenges may lead to stagnation and loss of confidence, it is important to foster hope for these generations, both in themselves and the communities they cultivate that can help them achieve success. Below are some ideas for young adults to support their transition to independence from their parent’s home:

1. Identify communities of support-By finding and strengthening connection to communities that feel like-minded and relatable, you can shift from family of origin focus to relating to others and developing other spheres of connection outside the home.

2. Explore other's experience-Knowing that you are not alone in how you feel and the struggles you face can make the transition less lonely and more hopeful by learning form other’s experience and strategizing your next move.

3. Build confidence-Engage in self-discovery by identifying areas where you have strengths. Identify what’s most important to you through values exercises at Lifevaluesinventory.org and explore career strengths and direction at youscience.com.

4. Positive reframes-Practicing your ability to rewrite negative thoughts or experiences can be a powerful tool in creating confidence and hope of independence. Reframing negative thoughts as temporary or your best effort can inspire movement and hope. To learn more, consider individual therapy where a professional can teach you these skills through Cognitive-Behavioral Therapy or identify a gratitude practice that can shift negative thoughts daily.

Parenting Parameters

Fostering hope and confidence is not exclusively the job of professionals. The support of parents can also be crucial to the confidence of a young adult. Here are some ideas for parents to encourage the exit from the nest:

1. Support structure-parents’ ability to provide rules and expectations in the home can be an important incentive for young adults to exit and live on their own. When we think of the movie “Failure to Launch,” the parents made it too easy and convenient to stay in the home, thus stifling any urge in their son to leave. Structure can support expectations of a young adult’s transition from the house in a supportive way.

2. Remain consistent-being consistent and true to your word as a parent is just as important now as it was when your young adult was a child. Predictability can support your young adult in building respect for your position in their exit from the home by identifying a timeline for your young adult to move towards independence and freedom.

3. Provide encouragement-with change comes anxiety. Remember to be encouraging, positive, and reassuring towards your young adult that you are still a part of their lives and care about them as they make this transition. This will allow them to feel comfort rather than anxiety or grief at the loss of daily contact and connection offered in your household.

In whatever ways one accesses the confidence to pursue independence, knowing there are loving, caring connections between the person and others is a vital component of their success. There is no rule book for how to move from failure to launch to thriving in freedom. In a generation that feels more lonely and anxious than ever, community connection and meaningful interactions can help. We can support the next generations in their success though encouragement and kindness, and in this effort, we all win.

 “Change is hardest at the beginning, messiest in the middle, and best at the end.” Robin Sharma

Exploring the Enneagram: Relationship Reinforcement

I can’t handle it when others are upset. I throw myself into work to avoid emotions. I want to be left alone. No one understands me. I want everyone around me to be happy. Can you relate to any of these statements when it comes to how you operate in your world? Does this describe your reactions when relating to others? If so, there is good news! The Enneagram is a personality test that not only looks at your strengths and weaknesses, but also allows insight into relationships with others in order to strengthen compassion and connection.

Personality Test Popularity

For many of us, we’ve been exposed to personality tests in the past, whether it was part of high school psychology class, a component of starting a new job, or a viral quiz on social media. Myers-Briggs Type Indicator (MBTI) was the go-to personality test for several decades starting in the 1940s when exploring a person’s extraversion, intuition, and decision-making skills. The Enneagram has been around almost as long, making an introduction in America in the 1950s. Praised as a tool for deeper awareness, self-understanding, and self-discovery, The Enneagram classifies personality into 9 categories or types, identified below by The Enneagram Institute as:

• Type 1: The Reformer

• Type 2: The Helper

• Type 3: The Achiever

• Type 4: The Individualist

• Type 5: The Investigator

• Type 6: The Loyalist

• Type 7: The Enthusiast

• Type 8: The Challenger

• Type 9: The Peacemaker

The Enneagram also claims that a person’s designation as one of the nine types is solidified in childhood based on traumatic or impactful experiences that reinforce behaviors that support feelings of safety and security.  For example, someone who tests at Type 2, The Helper, may have a core belief that “I am good and ok if I help others.” The authors of several Enneagram books, Don Richard Riso and Russ Hudson further describe each person’s capacity to equally develop into any one type, however the type that ultimately defines us is reinforced by our environment at a very young age. Another example that can highlight this concept is the child who is praised for every positive performance or good grade, allowing them to feel pride when sharing their accomplishments at a young age. In continuing to seek that valuable praise to feel positively about themselves, they might find themselves pursuing various accomplishments throughout their life in a series of patterns of achievement, categorizing them as Personality Type 3, The Achiever.

Put it to the Test

So now that your curiosity is peaked, why not put it to the test and see for yourself? You might have an idea of your type just from the names above, however there are several options that can clarify your results.  The Enneagram Institute (enneagraminsitute.com) has an online test that can define your type and any other connections to other types based on your responses to a series of questions. A faster option can also be found in a free App called EnneaApp, that can allow you to explore your type and read more about what the results mean in shortened form, ideal for those who want family members and loved ones to also test and identify their personality types. The Enneagram has risen in popularity due to its use in various contexts to help people better understand themselves and others.

• Premarital Counseling

• Individual and Family Therapy

• Workplace Efficacy & Human Resources

As you can imagine, clarity about your type and The Enneagram type of others around you can help you rise to your fullest potential, including strategizing on projects in the workplace or connecting at a deeper level interpersonally. Therapists value the Enneagram due to its ability to start conversations about similarities and differences between people, as well as its ability to provide opportunities for growth and self-discovery.

Discovering Depth

Self-discovery with the Enneagram reflects the effort you put in the results and your ability to have an open mind. Designation of your personality type includes implications for balance and wellness by looking at the positive characteristics (which will please you) and the negative characteristics (which will make you want to hide). In other words, you will have positive traits that you feel fit your personality very well, and negative traits you will want to reject due to the painful accuracy of things you want to keep hidden from others due to embarrassment or shame.

Allow me to illustrate. If you are found to be a Type 8, The Challenger, you, like all the types, have both positive and negative characteristics. Some of your positive characteristics include having a powerful vision of your future, being vocal about your goals to get results, getting others cooperation in those goals, and being described as passionate.  So far so good right? You sound like a force to be reckoned with. On the other hand, your negative traits include speaking over others, a ‘my way or the highway’ mentality when challenged, being described as bossy and overbearing, and being intimidating when expressing anger. As you can imagine, balance between positive and negative characteristics is important in exploring shifts to support connection with others both personally and professionally as well as workplace success.

Enneagram Enhanced

The Enneagram can go much deeper into passions, difficulties, relationships, team work, and more. Just look for trainings in your community and online to move into further discovery after you identify your type or the type of those you value. By beginning your journey into The Enneagram starting with your own reflection, you will uncover unlimited possibilities regarding how to successfully connect with strengths in yourself and with others! 

 “The point of it isn’t to just be a type, but to use the awareness of our type as a kind of entry into a more full-bodied humanity and a greater and greater capacity to embody and flow with all the different qualities of our humanness.” Russ Hudson

Upper Limit Problem: Smashing Through our Self-imposed Glass Ceiling

Remember when we explored if we’d quit something before it could go wrong? How you’ve ended a relationship before you could get hurt? We identified these as examples of self-sabotage, which can strike at any moment when we feel that things are gaining momentum in a positive way.  But what happens when you achieve the success you’ve always wanted and now, instead of joy, you feel doubt and dread, fearing it is too good to last?  Because of this fear, perhaps you desire to remain safe in your career trajectory, creating your own glass ceiling because it pays the bills and supports stability.  You choose comfort rather than taking risks that would allow you to reach your fullest potential.  Gay Hendricks calls putting on the breaks when our success has exceeded what we thought it could as The Upper Limit Problem, described in detail in his book “The Big Leap.”

Signs you have an Upper Limit Problem

It’s understandable that we struggle with success in thinking it’s too good to be true. Awareness of our reactions to success and the resulting negative thoughts and unconscious self-sabotaging behaviors can be considered a first step in recognizing the problem and identifying viable solutions!  Here are some signs that you might be experiencing an Upper Limit Problem:

• You avoid taking risks

• You can’t slow down

• You can’t enjoy your successes due to fear and doubt

• You prevent change in wanting stability

• You love your comfort zone

• You feel uncomfortable with too many successes at once

• You get stressed and sick when experiencing rapid growth

Smashing through your Upper Limit Problem

For many, illness in response to stressors or fear of success in a big part of their Upper Limit Problem. So now that you know what you are experiencing, what can you do about it? Here are some ideas that might help:

• Identify positive affirmations such as “I’m right where I should be.” “I’ve worked hard for this success.” “I deserve good things.”

• Engage your supports. Talk to others you trust about the stress you are feeling in the face of your achievements.

• Practice mindfulness. Engage in mindfulness and meditation practices to reinforce positive vibes and refocus.

• Slow down. Take breaks for self-care and rest up to prevent illness.

By recognizing the signs of your Upper Limit Problem and exploring possible responses, you can remove self-sabotaging behaviors and fully surrender to your success, allowing yourself to enjoy your accomplishments and continue to thrive in the possibilities of your future.

“The goal in life is not to attain some imaginary ideal; it is to find and fully use our own gifts.” Gay Hendricks

Imposter Syndrome: Sabotaging Success

Have you ever quit something before it could go wrong? Ended a relationship before you could get hurt? Stirred things up out of boredom? These are all examples of self-sabotage, which can manifest when we don’t feel we deserve good things or when we fatalistically think all good things must come to an end. With Imposter Syndrome, you may experience all of these thoughts and feelings in response to having an internal battle with yourself and have a fear of success! More specifically, when achieving success, your doubt in yourself may show up as a fear of being exposed as a fraud to others.

Image courtesy of caitlinhudon.com

The image above captures the perception that others know more than us, which can lead to self-sabotaging behaviors or crippling self-doubt, resulting in delayed or stunted progress towards your goals and creating unnecessary anxiety in various areas of our lives. So, what can we do about it? How do we embrace our knowledge base, success, and self-worth?

Discovering Strengths

For many of us, it’s a fine balance between self-confidence and ego.  Our society has taught the youngest generations to not speak too highly of themselves out of concern of being called cocky, egotistical, entitled, or self-centered. When celebrating strengths, it is important to break down some of these barriers and embrace what we do well.  Some ways you can do this include:

1. Asking Family and Friends: By engaging in rewarding conversations with those that know you well, you can listen for language that describes your strengths.

2. Floating Back: Recalling compliments or positive feedback from others in the past, including work situations, can help pinpoint times when you were recognized for your strengths.

3. Take a Test: The popularity of personality tests and other self-assessments continue in helping people find their strengths. Consider the following tests in your self-exploration:

• Myers Briggs Type Indicator (MBTI) – looks at how you interact with others, thinking vs. feeling, and more.

• Enneagram – Explores how you relate to others and what you contribute to relationships when balanced or unbalanced. Check out the free EnneaApp quiz in the App store!

• Big Five Factor Personality Test – explores your openness, agreeableness, neuroticism and more.

• Locus of Control – take the self-assessment to explore how you are internally or externally motivated to do things in your life.

• Values Inventory – explore what is most important to you with a values inventory. A free, online version can be found at http://www.lifevaluesinventory.org

Encouraging Growth

Now that you’ve found your language and skills that demonstrate your strengths, it will be important to continue learning about yourself to silence the Imposter Syndrome’s little, nagging voice that states you are a fraud. Perhaps you challenge yourself to grow through additional schooling or training. Or measure your progress through achievement of short-term goals. Or perhaps you identify a professional who can serve as an accountability partner in your quest for confidence. Such professionals include:

• Coaches

• Consultants

• Therapists

Celebrating Successes

By engaging a trusted professional or other support person who know you well, you can also feel encouraged to slow down and celebrate the little successes in life. Maybe you had a goal to feel more comfortable talking about what you do with others and you celebrate attending a network event where you had to describe it to multiple people in a matter of minutes. Perhaps you have a goal of conquering your fear of public speaking and find yourself in front of a community audience talking about a project you are involved in. Whatever the achievement, slowing down to celebrate it with those you love can reduce the experience of Imposter Syndrome, making is less of a barrier and instead, serving as fuel for your fire of drive and purpose!

“Think about all the crazy ways you feel different from everyone else. And now take the judgment out of that. And what you are left with is such a wholly dynamic, inspiring character who could lead an epic story.” Jennifer Lee

Mirroring in Relationships: Manifesting and Maintaining Connection

What does it mean to feel connection with another person? How do you know when you are building rapport in your interactions with others? For many of us, connection starts with body language and conversation when determining relatability and ongoing engagement. Engagement can lead to belongingness and belongingness is a crucial element of positive mental health and overall wellness. So why wouldn’t we want to pursue belongingness and connection in our relationships and throughout our lives in support of optimal wellbeing?

Monkey See Monkey Do

Connection can be measured externally in how we interact with one another, but also internally through brain activity. Mimicking one another, often described as mirroring, was first discovered by Giacomo Rizzolatti, MD and his colleagues when studying monkeys.  Rizzolatti recognized that there was similar, observable brain activity indicating pleasure when a monkey consumed a banana as when the monkey observed a researcher consuming a banana. This brain activity involving neurons, called Mirror Neurons, provided implications that our brain activity responds in relation to others, thus encouraging development of an empathetic response. A more recent article was published in the UK on research involving infants and their mothers. With eye contact, the brain waves in the infant responded and attempted to synchronize with their mother, implying efforts at deeper connection and communication, according to scientists at the University of Cambridge.

Bonding in Business

Mirror neurons are important for close relationships; however, they can be influential in working relationships as well. Business gurus have developed interpersonal programs to support connection and reciprocity in business interactions, including awareness of body language, eye contact, and mannerisms. These programs can teach a person to be more aware of cues in social interactions and introduce subtle mirroring behaviors to increase engagement, likeability, and reciprocity. 

Mirroring behavior in conversations is adaptive, such as noticing when one party begins to unconsciously mimic the other in their posture, speech, and/or gestures during an interaction. As you can see from the picture we’ve chosen above, several members of the group are mirroring one another in their hand gestures, indicating connection or attempted connection in the moment. When learning these interpersonal skills for yourself, you may experiment with subtly shifting your posture to mimic the other party, exploring any observable differences in the interaction, including how you each feel towards one another. Mirroring research shows that when you make subtle attempts to mirror another person, they will find you more approachable, likeable, and connected, all which can be valuable when conducting working interactions or achieving rapport.

Generational Gaps

Engagement in working and personal relationships can support successful interactions, and it can also change how a person feels about themselves, including shifts in self-confidence and self-worth. Jean Twenge, a Psychologist researching generational differences including mental health, substance use, technology, and social engagement, speaks of this in depth in her book iGen. Her book highlights the dramatic shift in social interaction away from face to face contact to more technology-based connection. Her book also highlights a possible correlation between technology and lack of belongingness, even when those surveyed reported, on average, more than three hours per day of technology use including social media. Twenge’s research identifies some concerns about connection, including individuals reporting minimal person to person engagement, low self-confidence or preparedness in social situations, and thus identifies questions needing to be answered around technology and mental health.

Regardless of how we measure it, connection is important. One way of encouraging connection is getting out in the world and finding people who have things in common. This can be a pleasant opportunity to engage over shared interests and build relationships. Identifying activities you enjoy can be a starting point to engaging others around shared interests, with organizations like Meetup.com bringing groups of people together around enjoyable experiences. Pushing yourself to get out and meet people can have a positive result, as belongingness and social interaction continue to be vital parts of what it means to be human.

“You're imperfect, and you're wired for struggle, but you are worthy of love and belonging.” Brene Brown

Pursuing Purpose: What Feels Worthwhile

Purpose. Impact. Fulfillment. All are meaningful words for a desired way of living we want to maintain in pursuit of a quality life. Society may tell us to find what we love to do and do it for the rest of our life. Individuals tell us to never settle and keep pursuing our dreams. Regardless of how it’s described, pursuit of purpose, passion, or fulfillment can be seen as the driving force behind our behaviors and identity within the world. Influential author and speaker Simon Sinek calls this quest for meaning, “finding your why.”

Learning Through Literature

So how does one start the journey in finding their why? For some, it’s engaging in reading material such as Simon Sinek and David Mead’s book, Find Your Why: A Practical Guide for Discovering Purpose for You and Your Team, or exploring your leadership style with Tom Rath and Barry Conchie’s Strengths Based Leadership. Perhaps you explore your personality through the Enneagram, which is increasing in popularity over the Myers Briggs Personality Test in its ability to develop insight into how we interact relationally with others from reinforcement in our childhood experiences. Any of these sources could support increased awareness not only of our strengths, but awareness of the psychological driving forces behind our motivation and resulting behaviors. A free version of the Enneagram quiz called EnneaApp can be found through the App Store with additional information and the formal assessment can found at the Enneagram Institute (enneagraminstitute.com).

Vetting Values

In addition to read and written assessment, another low-risk option for exploration of purpose and self-discovery can occur through values exercises. Ranking a series of values by level of importance can allow further insight of what motivates a person. By engaging in a values exercise, it allows one to check in on how important values are being experienced both in the present moment and how they can be improved in the future to support feelings of fulfillment.  A free, online resource to engage in exploration of your values can be found by completing the Life Values Inventory (lifevaluesinventory.org).

Core Beliefs and Cognitions

Engaging in the progressive work of processing behavior patterns and values can also be explored through therapeutic work. Identifying negative thoughts or core beliefs can create new connections and awareness between actions and reactions. Core beliefs can be described as our deepest, sometimes darkest fears or beliefs about ourselves, usually focusing on negative traits such as feelings of unworthiness, being unlovable, or feelings of failure.  When experienced, core beliefs can engage visceral reactions in the body including intense feelings of shame and fear. When explored through trauma therapy modalities such as Eye Movement Desensitization and Reprocessing (EMDR), healing can be accelerated and supported to re-write our views of negative beliefs to something more positive, thus improving self-esteem, functioning, and relationships with others.

Whether you engage in the above-mentioned exercises to improve self-esteem, discover your purpose, or develop new insight, know that self-discovery is an exciting, sometimes lengthy process to uncover passion and motivation.  However you go about engaging in “finding your why,” enjoy the process and be gentle with yourself as you uncover your recipe for success to achieve feelings of fulfillment and keep your passions alive!

“When you find your why, you find a way to make it happen.” Eric Thomas

Mandatory: Making it Worthwhile

“I don’t want to be here. I’m not going to say anything. I don’t know. Why should I talk to you?” You may find yourself thinking or saying thoughts like these in response to pressures to engage from a program, family, or friends. Perhaps you aren’t ready to share what’s brought you here, or what the challenges are that you are facing in this moment. Perhaps you feel like your personal freedom has been taken away, your choice to participate of your own free will. Understanding that you may feel angry, resentful, or withdrawn, please consider the following in support of getting the most out of something that is identified as mandatory.

Blocking or Belonging

You may come from a different background or hold different values from those you come into contact with, so what brings people together in this process? Shared experience around homelessness, financial instability, substance abuse, conflict in relationships, or a lack support can help one feel less isolated and alone in their experience. Although each person’s story is their own, the feeling of connection to others and belonging can go a long way in having an experience feel less mandatory and more voluntary. When you observe others engaging in the program or group, you may find yourself asking:

• Do I feel I can relate to others in the group?

• Do I feel this community is healthy, approachable, supportive, and willing to engage me in this process?

• Do I feel supported by staff and helping professionals to achieve my goals?

• Do I feel comfortable opening up and working on myself in the presence of others?

For many involved in Alcoholics Anonymous (AA), they speak of the community as an equally powerful element as the 12 Steps in to their ability to actively participate in their own sobriety. Due to the friendships they make, they feel they have a connection to others in ways that feel encouraging and uplifting in moments of challenge or struggle.

Building Perspective

In addition to identifying a supportive community, how you approach the experience for yourself matters. Do you have realistic expectations of what you can accomplish both short and long term? Can you set yourself up for success in your work with others? When starting this process, it is helpful to understand basic needs as the foundation for progress. Educating yourself on how basic needs such as food, safety, and shelter provide the foundation of stability gives you permission to organize goals for success. Abraham Maslow, who identified this relationship in the Maslow Hierarchy of Needs, emphasizes that only when basic needs are met can one focus on higher work around self-esteem, sobriety, and relationships.

Relational Rapport

When exploring relationships, research tells us that therapeutic rapport accounts for more than any other factor when measuring progress towards goals set in therapy. In other words, the therapeutic relationship, unconditional positive regard, and power of feeling seen, heard, understood, and supported has positive results on goal progression. If your past experience involves trust or mistrust, being aware of how therapy and/or relationships have helped or hindered you in the past can put current resistance and reluctance in perspective. A few questions that you may find helpful at ask at the first meeting with a helping professional include:

• What kinds of clients have you worked with before?

• How do you work with people who are uncomfortable with therapy?

• What do you do with feedback from clients?

• What can I expect from working with you?

All of these questions encourage healthy discussion around the therapeutic process and can provide insight into expectations and measurable goals when engaging a helping professional in your own growth process. 

Mandatory can feel restrictive and stressful when viewed as a loss of control or freedom. What better way to reframe it than to ask yourself, what can make it worthwhile? 

“If you change the way you look at things, the things you look at change.” Dr. Wayne Dyer