Karen's Blogs

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Karen's Blogs

Life Skills and Self-Care

Life Skills and Self-Care

Being Okay No Matter What

Karen R. Koenig
Being-Okay-No-Matter-What
Most of us spend our lives stressing to make everything work out okay. We want our children to be happy and successful, friends to like us, employers to value us and our work, romantic partners to love us and live forever, and for various and sundry other endeavors to turn out swimmingly. And in so doing, we engage in a fool’s errand. For example, my middle-aged client Josephina is divorcing her husband of many decades to live alone for the first time in her life. Tending toward anxious, she worries about feeling lonely, being able to pay her rent, and managing by herself when she’s used to depending on her husband. She told me, “I just want it all to be okay.” Another client, Alan, studying to be a paralegal, gets frantic when he receives anything less than a B due to his scholarship requirements. He works two jobs and throws...
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Words to Measure Progress

Karen R. Koenig
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The words you use to describe your progress are key, so you’ll want to know which ones will move you forward and which will keep you stuck. Here are ways to think and talk about how well you’re doing. I’m guessing they might be quite different than the thoughts and self-talk you’re using now. Small steps. Describe progress as modest changes rather than looking for success in one fell swoop. The discussion of how to phrase progress came up with a client who said that she’s not doing any big things differently but is making small changes which are adding up. She’s going to the gym when she can, pacing her work to be less stressful, encouraging her children to be more active, not keeping juice easily accessible to them, and giving them more responsibility for thinking about consequences and taking care of themselves. Recognize success. I’ve written how the word...
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So What If It’s the Truth

Karen R. Koenig
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I sometimes know what clients will say before the words are out of their mouths. This happened with my client Antoinette. After doing well in many ways, she succumbed to an urge to binge which led to a “medical” diet, weight loss, and rebound eating. After discussing what she’d learned, she lamented, “But, I’m fat again. It’s the truth.” The phrase, “but it’s the truth” is the one I want to call your attention to as I did to her. I believed her. It was the truth: she had regained a portion of the weight she’d lost and now her clothes were tight again. I couldn’t argue with her, but—here’s the point—since when does something being true mean we need to dwell on and obsess about it? I reminded her it also was no lie that there’s a horrible war going on in Ukraine; poverty, guns and COVID continue to kill...
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Mistakes Help You Win, Not Lose

Karen R. Koenig
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I recently read a great quote which had no attribution, “I’d rather make mistakes than do nothing, I’d rather mess up than miss out completely.” How true, how true. It seems that people are either on one side of this divide or the other: willing to mess up in order to win or succeed or, at the other extreme, living in fear of erring and surrendering a chance to reach their goals. Sad, huh? Whether we’re talking missteps or major failures, what’s the secret the person quoted above knows that people who fear messing up don’t? It’s really no secret at all, just an entirely different mindset than believing you must do everything right that causes you to live in terror of doing things wrong. The idea is to accept that missteps are an essential part of life that we can’t escape and not be ashamed when you do something that...
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Who Takes Care of You?

Karen R. Koenig
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The other day I read a phrase that virtually begged to be blogged about: “Okay, I’m over self-care. Everyone else can take care of me now.” How wonderful is that? We hear so much about self-care in the media (and in therapy) that the other half of the equation, having others take care of us, often gets lost in the shuffle. The truth is that life is exponentially better when we care well for ourselves and also have others care for us. You might be wondering what kind of care I mean. Most people think of doing things for people who are sick or have a disability and can’t fend for themselves. That’s one kind of caring, but there are more. I think of caring for people as falling into three categories: emotional, physical and social, but there may be other ways to think about the subject. In emotional care-taking, people...
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New You, New Thoughts

Karen R. Koenig
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Rather than start a diet at the beginning of this year, think about January as a good time to evaluate and improve not just your thoughts, but the way you think. Change it, and your feelings and behavior will be transformed, automatically shifting you in the direction you want to go for health, fitness and higher self-esteem. Let me explain a simple tool for measuring how take in and process information. I’ve been using it since I learned about it in social work school back in the late 1980s. Be careful not to judge yourself as you’re learning about this new concept. Just take note of your habits and how you might change them. Consider what you do with new information. When you’re presented with a different way of looking at something than your usual way—for example, trying intuitive or mindful eating versus dieting—how do you decide whether to hold onto...
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The Best Way to Set Boundaries

Karen R. Koenig
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Many dysregulated eaters have difficulty setting boundaries. All/nothing thinking leads them to accept everyone into their lives and allow people to walk all over them or keeps them emotionally defended and alone. This is known as having loose or tight boundaries. One is not better than the other. Boundaries need to be set according to what’s necessary. Like doors, boundaries can be open, closed or swing back and forth.  We learn about boundaries from parents and other adults who take care of themselves and others and say yes and no appropriately on a case-by-case basis. Boundaries are fluid—like swinging doors—set according to varying people and situations. Wise parents are sometimes available to their children and sometimes not. They watch out for them and themselves and are clear about what they will and won’t do for others. Alternately, parents with poor boundary setting provide unhealthy models for their children. Maybe they feel...
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Taking Care Of versus Caring About

Karen R. Koenig
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A conflict that comes up a good deal in therapy is whether we can care about someone but no longer want to be responsible for taking care of them. Discussion of this topic arises more often with people who are co-dependent than with those who aren’t. In fact, it’s often a tip off of their over-focusing on other’s needs.  Here are two examples. A client broke off a long-term relationship with her boyfriend in another state. They hadn’t lived together for a while and slowly became more friends than lovers. My client made great strides in therapy, more or less leaving her ex in the dust, while he continued to be jobless, live with his parents, and do drugs. They’d been each other’s support for decades and she still had deep feelings for him, but she was tired of him calling to complain and always make himself out to be a...
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Want to Defeat Narcissists?

Karen R. Koenig
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Clients often complain about the narcissists in their lives and I’ve written several blogs about coping with them. I was thinking about them when I was waiting for someone in a doctor’s office and clocked fellow A talking non-stop to fellow B for 40 minutes! I couldn’t believe fellow B sat patiently, injecting only a few questions. Nor could I suppress a silent cheer when fellow A finally stopped talking and fellow B said, “But, you never answered my original question.”  We needn’t become captive to narcissists, especially the ones who drone on and on (and on and on) talking about themselves. I recently read about a technique called “gray rocking” which is one tool to try out. According to Deborah Ashway, LMHC, the term describes the person on the receiving end of an interaction trying “to make themselves as boring and nonreactive as possible to decrease the amount of provoking...
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The Limits of Your Powers

Karen R. Koenig
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It’s time to accept that you have tremendous power to manage your behaviors, thoughts and feelings and very little to govern the lives of others. Unfortunately, too many people have this paradigm backward: they feel and act powerless and believe they’re responsible for others’ actions. Here are two examples, one clinical and one personal.  A client described how a neighbor had been harassing her for months when she was walking her dog. He seemed to pop up wherever she went, even when she changed her route to avoid him. A gentle soul, she only hinted that she didn’t want his company on her walks and didn’t want to date him. One session she came in all upset. “He got hit by a car,” she exclaimed, referring to her neighbor, “and died!” Then she went on to explain how it was all her fault because he was probably out trying to find...
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Pleasure Minus Pressure

Karen R. Koenig
Pleasure-Minus-Pressure
Once more a similar issue keeps cropping up in sessions, which got me thinking about a sticking point in growing and healing. This time it was how little pleasure many dysregulated eaters have in their lives, while exhibiting a seemingly infinite capacity for pressuring themselves. Here’s what I mean. We all have activities or chores we’d like to get done today, tomorrow or this week. We have formal and informal deadlines and requests and demands that others rightfully make of us. Mostly, if we want to get paid, work is required. If we have children, they come with the need to be taken care of. It’s natural to feel mild pressure about getting things done. Pressure gets us up and moving. However, if we never stop feeling pressure—because there will always be more to do—it will drive us mad. Those relentless “gotta do, gotta do” thoughts can ruin our lives if...
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I Promise I’ll Stop

Karen R. Koenig
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I was reading an “advice” column letter from a woman saying that her actively alcoholic boyfriend “promised to stop drinking.” I sighed when I read his words, thinking about all the times they were my words about food and all the times I’d heard clients make the same promise. Famous last words or maybe we should call them famous lost words, because somehow their meaning and importance gets lost in the shuffle of life. Let’s take a closer look, or as they say these days, a deeper dive into the meaning of this promise and what prompts us to say it. I know what I was feeling when I swore to myself that I would stop noshing and overeating, turning to food when I was upset or bored, and living my life for my next meal. I was beyond frustrated with my terrible relationship with food. I was exasperated, in dire...
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Make Self-care a Given

Karen R. Koenig
Make-Self-care-a-Given
Talking with a client we’ll call Essie about maintaining self-care, I chuckled when she said she usually stopped taking care of herself when things were going poorly in life—at work, as a single parent, and caring for her elderly mother. I realized that this is true of many clients: paradoxically, they give up self-care just when they need it most.  I asked if she didn’t walk or feed her dog when things weren’t going well in life, and she looked at me like I was nuts. “Of course not,” she insisted. “If I don’t take care of him, who will?” When I was silent and looked right at her with a “Duh?” expression, she got my point. But, the truth is, she really did think that a person only did self-care when they were up to it and when things were going well. To her, it was normal to stop certain...
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The Benefits of Becoming a People Observer

Karen R. Koenig
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More often than I’d like, I’m saddened at clients getting themselves into nasty situations because they’ve ignored obvious red flags in people. Understandable, as many are trauma survivors who have difficulty interpreting danger. The way to grow more astute is to develop the habit of tuning up your emotional antennae around everyone. The skills of observing and assessing should not be confused with making judgments, though that is part of the process I’m encouraging. The goal is not to judge people as “bad,” but as not appropriate for you. This means watching people like a hawk, noticing everything they say and do, learning their histories, recognizing their patterns and, most importantly, paying attention to how you feel when you’re around them. I suppose I’ve always been an observer, or why become a therapist, the ultimate observer and processor? I do know that my noticing skills have improved immensely as my clinical...
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What Is Toxic Stress?

Karen R. Koenig
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You may suffer from toxic stress and not know it. Eating disorders and substance abuse problems, chronic depression or anxiety, difficulty in relationships, and sleep issues all may be symptoms of toxic stress. Because I know the childhoods of all my clients, I’d wager that many of them suffer from it, but don’t know it because they think what they feel is normal though it’s anything but. Here’s an excellent description of toxic stress and its causes from “What Does “I Feel Fat!” Really Mean? by Carolyn Coker Ross, MD, MPH, CEDS (2/224/222, Gürze-Salucore Eating Disorders Resource Catalogue). “Abuse or neglect or any other negative experiences in childhood can lead to what is called toxic stress. Toxic stress causes an overproduction of stress hormones: cortisol, adrenaline, and noradrenaline. This leads to physical changes in the brain. The brain of a traumatized child resets itself to be in fight-or-flight—regardless of whether there...
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Do Affirmations Really Work

Karen R. Koenig
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I began as a therapist when affirmations were all the rage, but I never bought into them, used them myself or encouraged clients to do so. Why? Because I thought it was weird that people were trying so hard to convince themselves of their positive attributes. I had a friend back then who said affirmations a lot—not only said but wrote them down and reread them daily. She hadn’t had a great childhood and certainly needed to do something to raise her self-esteem. When you walked into her bathroom, straight ahead of you was a towel cabinet whose front was covered with her affirmations. You could even see them reflected in the mirror above the sink when you washed your hands. I don’t recall exactly what hers said, something like, “You are a worthy person, You are lovable, People love you just the way you are, You are deserving of good...
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How Positive Self-talk Improves Your Relationship with Food

Karen R. Koenig
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I had a wonderful session with a client we’ll call Ava in which she described how she’d missed a work deadline, refused to berate herself over it, but continued to feel okay about herself, and didn’t end up turning to food after the incident. She’d been practicing self-compassion and it’s taken a while, but she’s definitely gotten the hang of it. Here’s what we figured out about the process she experienced. When she was a child and made mistakes, her father was cruel to her, so Ava grew up thinking he knew better than she did and became as hard on herself as he was on her. She mentally beat herself up every time she made an error or failed to live up to her perfectionist standards. She said the unkind things to herself that her father said to her which made her feel miserable. And feeling bad drove her to...
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The Joy of Universality

Karen R. Koenig
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I recall first hearing the term universality while taking a group therapy class in social work school. The APA defines it as “the tendency to assume that one’s personal qualities and characteristics, including attitudes and values, are common in the general social group or culture” and adds that it is “in self-help and psychotherapy groups, a curative factor fostered by members’ recognition that their problems and difficulties are not unique to them but instead are experienced by many of the group members.” In my three-plus decades running therapy and support groups, I had one client who absolutely insisted that what he felt no one had ever felt before, though I tried explaining that there are no new feelings under the sun. He was an anomaly. All my other clients felt enormous relief and even joy that others shared their thoughts and feelings because it meant that were not alone or abnormal....
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Self-care is Your Right

Karen R. Koenig
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A client sent me this quote: “Self-care is not self-indulgence, it is self-preservation” by Audre Lorde, feminist and civil rights leader. It got me thinking about how self-care is a right and about how many people don’t know that. It’s not about being selfish or thinking only of yourself. It’s knowing that your primary job in this world is to care for yourself. But, what about taking care of others, you might ask. Isn’t that a must? Aren’t we our brothers’ (and sisters’) keepers? Well, yes, it’s important to help and support others, but not at the expense of not taking care of ourselves. How you think about self-care is rooted in your upbringing. I’ve had many clients who were treated poorly and others who were made to take care of others and punished when they tried to tend to their own needs. In either case, they were never taught that...
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What Is Flow and Why Does It Feel So Damned Good?

Karen R. Koenig
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A client asked me a while ago what activities I enjoy and why and I explained that, whenever I can, I choose those that put me in a state of flow. If you don’t have enough of these minutes in a day or hours in a week, your well-being will suffer, so here’s an explanation of what flow is and how you can find more of it.  In Why Does Experiencing ‘Flow’ Feel So Good? A Communication Scientist Explains, flow is called “the secret to happiness” and an “optimal experience” . . . “characterized by immense joy that makes a life worth living.” I’m in a state of flow when I’m writing (like now) or dancing or reading an engrossing book. I used to feel it while skiing. I think of it as being so lost in the pleasure of an experience that all else in life falls away. The article...
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