by Heidi Vermeer-Quist, PsyD
While we are preparing for Christmas, what comes to mind when I mention “good grief”? You may think more of Charlie Brown and his Christmas special than to a discussion dealing with grief and loss (remember, he says “good grief” quite frequently). Speaking of Charlie Brown, that cartoon kid was almost perpetually stuck in grief. Grief often involves the stages of Shock, Denial, Anger, Depression and Acceptance. Charlie Brown seemed to live in the first four stages. But do you remember the end of his Christmas special? Charlie accepted the most pathetic looking Christmas tree in the lot. He was able to see some good in that tree and ultimately in Christmas, even though so many things were going wrong.
Like Charlie Brown, one thing you can count on this Christmas is dealing with grief. Whether you are dealing with the loss of a loved one or every day disappointments, you are likely struggling with grief. How you work through your grief makes all the difference. Rather than getting stuck in a stage, try to work through the stages toward a place of acceptance and moving on. For example, imagine losing your car keys at a shopping mall during this Christmas season. Immediately the grief cycle will ensue:
- Shock – “Did I lose my keys?”
- Denial – “No way, they must be here somewhere!” So, you search through your purse, bags, maybe retrace your steps.
- Anger – “What did I DO with them? Ugh! Maybe someone stole them!” Watch out. If you have loved ones with you, you are likely to lash out at them.
- Depression – “What do I do now? I’m stuck. I can’t get home.” At this point you may want to hide, pout or maybe even cry.
- Acceptance – “Okay, I am not helpless here. I need to figure this out and find another solution.” You start to open yourself up to accepting the situation as it is and look for Plan “B” options. Report the loss of keys to security. Call a friend to pick you up. Find your back up keys so you can drive your car again. Pray that your keys turn up again soon.
Grief happens all the time. It occurs not just when we lose our loved ones, or go through traumatic accidents. Grief is a normal part of life. It is like the natural pruning process of life. But with pruning comes the opportunity to grow and learn to adjust. When we lose something or someone near and dear to us, we are challenged to grow in new ways. We learn lessons we may never have learned. In hindsight, though we still may not have chosen or asked for these losses, we may discover gifts of wisdom on the other side. The key to “good grief” is to go through it and not remain stuck in any of the first four stages.
Several years ago two women close to me lost their sons. One died after a yearlong battle with cancer at the tender age of 4 ½ and the other died suddenly from a fever at 19 months old. Two golden nuggets of wisdom these mothers learned in the midst of their grief and graciously shared with others include the following:
Recently one of my pastors shared this quote, “Hope for the future is the engine that creates comfort in the present.” At Christmas, we celebrate the birth of Jesus Christ. Jesus brought all of us hope for the future and His presence in our lives gives us comfort in the present. During this Christmas season, may you find comfort in the gift of the Christ’s presence. Hold onto hope, knowing that God is at work, especially in the midst of our suffering and loss.
Heidi Vermeer-Quist, Psy.D. is a licensed clinical psychologist working at the Pine Rest Des Moines Clinic since 2002. She provides psychotherapy to people struggling with depression, anxiety, relational conflicts, unresolved grief and adjustment, and personality disorders.
By Cal Meuzelaar, LISW
Why should we forgive? Because not forgiving makes us prisoners. Bitterness, rage and anger make us captive to lives of misery. We’re only hurting ourselves. Forgiving frees us from these chains. Just as we have been forgiven, we are blessed when we forgive others.
How do we forgive? First we make the very difficult decision to forgive. We don’t deny that we’ve been hurt and wronged, but we decide we no longer want to be bound to it. Then we work on the process. Sometimes delivery is immediate and sometimes it takes time.
Prayer is essential. We can say a profound but simple prayer. “Father, help me to fully forgive for I am deeply hurt.” If needed, we can repeat saying this for days. Journaling is an excellent way to release the pain and document progress. Don’t be surprised if you grow in empathy for the offender while never condoning their actions.
Forgiveness doesn’t require telling the person. Remember the person that is freed, is you.
And forgiveness doesn’t equal reconciliation. Sometimes it’s not safe to reconcile. Scripture says, as much as you are able be at peace with everyone, but it doesn’t say reconcile with everyone.
Ultimately, forgiveness frees us to grow into the people Jesus wants us to be. As it says in Ephesians 4, “Get rid of all bitterness, rage, anger, harsh words and slander, as well as all types of evil behavior. Instead, be kind to each other, tenderhearted, forgiving one another, just as God through Christ has forgiven you.”
May God bless you as you begin the journey!
Cal Meuzelaar, LISW is the Pine Rest Director of Iowa Services. He is a Licensed Independent Social Worker with 30 years of experience as a therapist, working the last 28 years with Pine Rest.
When conflicts arise, making a marriage work can seem incredibly difficult…even impossible. Though emotions become intense, heated, sad, fearful, or even avoidant, don’t despair. These are all clues that you and your spouse really care! If you didn’t care, there would be very little emotion. Many couples, however, don’t know how to work through those emotions effectively. I’d like to recommend returning to an old acronym to help you and your spouse out: KISS. You may recall this acronym as referring to Keep It Super Simple (or something like that). By just remembering to “Keep It Super Simple” in many cases, your blood pressure may lower, your heart rate may slow down, and you may begin to breathe easier. Then apply this new version of the KISS acronym as you live out your part in your marriage (the only part you can directly control):
K – Kind
“Be kind, for everyone is fighting a great battle.” This is a quote that one of my fellow mental health clinicians always kept posted in the middle of his bulletin board. Remembering this quote helps me to not take another person’s negative emotions too personally. That person’s emotion indicates that they are fighting a great battle, and I want to be an ally not an enemy. When I see my spouse struggling or even lashing out me, I need to remain focused on remaining kind, because he or she “is fighting a great battle”. Take a deep breath and remain kind. This is tough, and I’m perfectly imperfect at remaining kind myself, but when I do it helps. When my spouse remains kind toward me, it helps me tremendously. Consider the wisdom of Jesus’ Golden Rule (or second greatest commandment) to “love your neighbor as yourself”. Be kind.
I – Interested
Always remain interested in your spouse. What do they enjoy? What are they doing most days and throughout the day? What do they find most stressful? What are their priorities? The more we remain connected and interested in one another’s lives, the more likely we will feel supported when conflicts or changes arise. By remaining interested in each other, we build an ally relationship and deepen a sense of trust.
S – Seek God
In your own personal life and together with your spouse, seek God continually. He alone is the glue that holds us together. Remember Jesus greatest commandment, “Love God with all your heart, with all your soul, with all your mind and with all your strength.” He also taught us to “Seek first the kingdom of God and His righteousness.” As husband and wife, we need to continually pray, continually submit ourselves to the Lord, and then wait to see the miracle that He alone will produce in and through us working together.
S – Seek to Understand and build Safety
Intimacy with your husband or wife will only grow if they feel safe with you. If you are frequently critical or prone to debating your spouse, you may be destroying rather than building safety in your marriage. Safety is an essential foundation to trust and authentic intimacy. When we are judgmental, bossy, sarcastic and critical, we work against the marital goal of intimacy. If we reflect on why we do these marital defeating behaviors, often we realize that we ourselves are fighting a great battle. Admit your own battle to your spouse, and try to hear what battle they may be fighting. Rather than reacting to your spouse, take time to understand their perspective and value what they have to say. If you have a different take on the topic, do share it but always strive to talk with understanding and safety as your first priority.
Finally, do also remember to kiss one another…frequently. Using the new KISS acronym will help to make those actual kisses even more meaningful.
I once worked with a young lady (I’ll call her Angie – not her real name) who struggled with intense perfectionism. On the outside Angie looked like a well-adjusted, incredibly focused, and successful college graduate, but inside she was extremely anxious, riddled with worry, and constantly measuring herself up to unreasonable standards.
We embarked on the journey of reducing her perfectionism and developing the skill of mindfulness (refer to June blog). Though she was willing to slow herself down and engage in non-judgmental observation and participation in the present moment, this was very difficult work for her to do! She was bombarded constantly with automatic thoughts telling her this mindfulness stuff was a waste of time. By observing her automatic thoughts, she began to realize that her self-concept was largely dependent on her performance. While she wanted to believe that God loved her unconditionally and that she was valuable regardless of her performance, she did not love, accept or respect her own life.
During our treatment, Angie dug deep into defining who she was and learning to radically accept the precious life God gave to her, regardless of her successes. Again, this was really difficult work for a mind that was hard wired to perform in order to earn acceptance. But one day she showed up for therapy with a huge smile on her face and her eyes were dancing. It was in the middle of a cold Iowa winter that she entered my office exclaiming, “Heidi, I just noticed the snow glistening in the sun! It was so beautiful!” We spent several minutes enjoying Angie’s description of her drive to our appointment. The drive started off with her typical mental planning and worry, but as she was taking a curve in the road, she saw it. She really SAW it. The sun was shining brightly and the snow on the ground glistened in such a way that she observed it. As Angie observed it she suddenly felt JOY. At that point, our work together took a positive turn and we did not need to continue treatment much longer. Angie was beginning to connect with her own life, with nature, and with God in more positive, mindfully accepting ways. She was able to appreciate the loveliness available to her right now. In fact, Angie started to call the present moment the “precious present”. Life began to glisten for this young lady. The old mental defenses of worry, toxic comparison, and perfectionism melted away in the light of participating in the blessings of the precious present.
In the New Testament book of Matthew, Jesus tells us not to worry but to join the rest of creation trusting God and participating in the precious present. “I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?” God himself thinks you are valuable. Enjoy the precious present He has given to you.
Heidi Vermeer-Quist, Psy.D. is a licensed clinical psychologist working at the Pine Rest Des Moines Clinic since 2002. She provides psychotherapy to people struggling with depression, anxiety, relational conflicts, unresolved grief and adjustment, and personality disorders.
Mindfulness is a hot topic and tool used in psychology, spirituality and popular self-help these days. As one who often has her mind “full” of thoughts, learning mindfulness skills and helping others to practice mindfulness is joyful work. The goal of Mindfulness is to take hold of your mind; using your whole mind as fully as possible. A psychologist and guru in the study of Mindfulness, Marsha Linehan, encourages us to being aware of and use both “reasonable mind” and “emotional mind,” increasing the likelihood of better decisions. We come to a place of “wise mind” decisions when we consider both our reasonable and emotional mental processes.
From a Christian perspective, acknowledging and relying on God’s presence and His Word are enormously helpful. We acknowledge that wise mind is produced by not only reasonable and emotional minds working together, but also through dependent dialogue with God. A prayerful experience can help us feel less alone, look at a bigger picture than just their own frame of reference and discern meaning/purpose in the midst of their suffering.
God created us to love and depend on Him constantly; therefore, He guides us toward “wise mind”, a grounded place, as we converse mindfully with Him. I like the imagery by the prophet Jeremiah: “Blessed is the man who trusts in the Lord, whose confidence is in him. He will be like a tree planted by the water that sends out its roots by the stream. It does not fear when heat comes, its leaves are always green. It has no worries in a year of drought and never fails to bear fruit” (Jeremiah 17:7-8).
Linehan trains Mindfulness from a behavioral approach, teaching both the “what to do” and the “how to do it” skills. For example, if someone just tells you to “smile,” you may or may not enjoy it. However, if someone tells you to “smile” and “imagine your favorite place,” you probably will. Similarly with Mindfulness, the “what” skills tell you what to do, while the “how” skills teach you how to approach the “what” skills.
MINDFULNESS…WHAT TO DO?
First, observe the moment you are in. Turn your mind to WHATEVER is in this present moment. Focus on what is external (outside of you) or what is internal (inside yourself). Accept it just as it is (not necessarily as you would have it). Do not judge it; rather look at it as objectively as possible.
Second, describe what you are observing. Attach words to what you are experiencing. Be like a scientist observing and writing down field notes on an object or experience.
Third, participate in the moment. Be involved in whatever you are doing, like a musician who is 100% involved in a piece of music. If you are walking—walk. If you are driving—drive. If you are talking—talk. If you are typing—type….
MINDFULNESS…HOW TO DO IT?
First, take a non-judgmental stance and accept the moment just as it is. Acknowledging what is helpful and what is harmful is fine, but try not to judge.
Second, each activity is approached as one-mindfully, defined as doing one thing at a time. Let go of distractions that keep you from focusing fully on accomplishing this task. Allow yourself to use what Linehan calls, “Teflon mind,” letting unhelpful thoughts slide off your mental frying pan and then return to the present moment and the task at hand.
Third, focus on what works effectively for the moment. Use the principles, morals and values you know and trust. Use tools like journaling, prayer and social support to identify your helpful options. Consider your options, and choose what is most effective (not perfect) for the situation.
In His Sermon on the Mount, Jesus instructs us to trust God and participate in the present moment, just like the birds of air and the flowers in the fields (Matthew 6:25 -30). He also teaches us to let go of judging, especially judging one another. We are encouraged to constantly communicate with God, trusting Him to guide us, guide others and allow Him to be the judge (Matthew 7:1-5).
I love how Jesus tells us to stop our over-controlling and deal with ourselves...right now...effectively addressing the plank in our own eye and depending on Him to help us remove it.
These are the skills to use when practicing Mindfulness. Observe, describe and participate in the present moment, noticing what is going on inside of you or outside of you. Do so with slow, steady breath and enter into each moment with a non-judgmental stance, one-mindfully and effectively. As you do these steps you will likely enjoy the moment!
Above skills taken from Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan, The Guilford Press, 1993.
“Be careful how you think; your life is shaped by your thoughts.” Proverbs 4:23 (GNT)
I am a HUGE “Keep It Super Simple” (KISS) person, so I like to boil down thought processes into two major themes: Victim Thinking and Victor Thinking.
Victim Thinking is characterized by thinking from a survival perspective. We all go there at times. To some degree, we have to when we are faced with a life threatening situation, but by no means do we have to be in survival mode all the time. How many of us are truly under constant attack? When I am stuck in victim thinking, I believe that I have no options or at least no “good” options. I feel extremely anxious, hopeless, perhaps depressed, and desperate. If this is my perspective, and therefore my reality, it is likely that I will either cower in a corner or become aggressive and abusive toward others in order to survive.
There are four Fear-based survival reactions, each starting with the letter “F”. When we view ourselves as Victims it is likely that we will react with Freeze, Fight, Flight, and/or Fix behaviors. A statement that motivates me to move out of victim thinking is the statement, “Victims stuck in victim thinking will become abusers.” I know this to be true in my own life. While I may not overtly abuse someone else, it is highly likely that I will lash out at those closest to me when I’m stuck in victim thinking. How about you?
Victor (or non-victim) Thinking is largely characterized by a mentality of “I’m Okay. This situation may be bad, but I’m okay.” When we hold onto an internal sense of security we are able to think more clearly and search for options to get through difficult situations. If I embrace a victor mentality, I am able to draw more effectively from the positive resources both inside and outside of myself. Conversely, when I’m stuck in victim thinking, I perceive very few positive resources inside and outside of myself.
From a Christian perspective, we believe that God provides us with everything we need at all times. Consider with me some of the basic gifts we receive every day: from oxygen, food and water, to values and social resources, to changes and options arising in our lives and environment every moment. As we turn to God as our source of everything, we begin to hope again, to see a more positive perspective, and to take “the good” into our thought lives. We can take comfort in that moment as we notice God’s loving presence.
We may consider the supportive people that are available to us. We can choose to engage in activities we CAN do (rather than focusing on what we can’t). For example, focus on basic activities I can change, like washing dishes, self-care (healthy eating, sleeping, exercise), and exploring options while remaining grounded in the present moment. As I calm myself down (reducing my fear), I open myself up to embrace other options that are already at my disposal. Rather than being driven by fear, I’m committed to hope and finding solutions. I may even be able to experience joy in the midst of difficult times. As a result, I am more able to connect with other people honestly and respectfully, rather than reactively or fearfully.
When I was growing up, every summer my Grandma and Grandpa Vermeer took my cousins and I fishing up in Canada. Looking back, it was quite a treat, though I often did not fully appreciate it at the time. We would get up early every morning, usually before 6 a.m., which was “sleeping in” for my grandparents. Sleepy eyed and chilled, we’d shuffle to the table for a hot fisherman’s breakfast. During breakfast, we’d talk about the day, which lake we’d go to, and what Grandma would pack for our lunch. Then we’d get out onto the water as quickly as possible. Within two to five minutes of putting minnows on our hooks and letting our lines down, one of us would get a “hit”. Then the fishing frenzy would begin. We caught beautiful (well, if fish can be beautiful), big fish. Walleye and Northern Pike mostly.
Honestly, while on these over-stocked lakes, we would catch our fishing limit every day…sometimes we’d catch it within the first hour! Sickening, eh? (I always have to say “eh?” when I’m talking ‘bout Canada ). Once we caught our limit, we’d start weeding through our stringers full of fish and decide which ones we wanted to keep and which ones we wanted to release and replace. Finally, after about two whole hours of fishing we’d be just “exhausted” (remember we were kids), so we’d head back to shore for our gourmet lunch consisting of either fresh cooked fish or premade PB&J.
Catch – Release – Replace. This fishing experience serves as a great analogy for mental health. Did you know that we go fishing all the time? We cast out our attention like a fishing line, baited and hooked, trying to connect with the next great “catch”. And typically our mental ponds are stocked full. We catch something immediately. What we reel in may or may not be a “great keeper”. We are the ones judging its value. We may reel in something quite disappointing, and it is up to us to hold onto it or to let it go. Unfortunately, sometimes we get in the habit of catching and holding onto unhelpful thoughts, unhelpful expectations (for others, outcomes, or holding onto old memories – “coulda”, “woulda”, “shoulda’s”) and not releasing them. It is vitally important for us to release and replace those thoughts that are toxic to our mental health.
Try to apply the “catch – release – replace” analogy to your mental health management. What are you catching in your mental pond? Just be aware what you are “catching”. What is “hooking” your mind or thought patterns? We are all fishing…all the time. Just pay attention to your thoughts.
Now ask yourself, “do I want to keep these thoughts or let them go”? Are my habitual thoughts keepers? Or are they throwbacks? Hint: the throwbacks would definitely include the 3 O’s – others, outcomes and old stuff. In all honesty, whenever I do the above exercise many of my thoughts are throwbacks – something to do with old stuff, something about someone else, or some worry I have about the future. HOWEVER, when I catch it I realize that I can free myself by simply releasing it to God’s care and replacing it with something better. Perhaps putting my mind on something tangible in the present; focusing on gifts from God given to me in every moment; adopting an attitude of acceptance, thanksgiving, and trust. Take some time to reflect on and use this “catch – release – replace” mental health methodology. May God guide and bless your fishing expeditions.
PRAYER: “The way I see things determines how I think about them. The way I think about things determines the way I feel about them. The way I feel determines how I will act, react and choose. That will determine the results I will have to live and with. I choose to side with Your (God’s) ways in all things.” – A Daily Affirmation from Christ Life Ministries.
I grew up in the lovely little town of Pella, Iowa. People who grow up in Pella are expected to be well-put-together, responsible, hardworking, God-fearing and independent. As a good Dutch Reformed girl, I figured I had “boundaries” down pat. I grew up in a church and community with lots of clear rules. I never got in trouble. People liked me (at the least most seemed to like me). And I genuinely loved God and desired to follow His commands. So, imagine my shock and dismay, when three years into my doctoral degree, my psychologist told me that I had problems with healthy boundaries. It took me a good year or so to even consider that she might be right. She was. That same year, a chaplain who I was working with on my inpatient rotation, told me I was a “control freak”. Again, I experienced shock and dismay, not to mention major offense. She was way off…until I realized she was way on.
I carried tons of extra stuff on my shoulders that I simply could not control. I felt very responsible for keeping other people happy, succeeding in everything I did, knowing the right answers and not making mistakes. I worried constantly, planned obsessively, and struggled with a good deal of shame and “not-good-enoughness”. Developing a healthy concept of Boundaries was critical to my own well-being, and I find it to be a missing piece for almost every client who walks through the door.
From a Christian perspective, we are created in the image of God but born in sin (thinking we can actually do God’s job better than He can). As a result, we all often have problems realizing our own limits. Here is a simple overview healthy boundaries:
Basics of Healthy Boundaries
(some concepts taken from Boundaries by Cloud and Townsend)
o Attitudes or thoughts (directing or redirecting them)
o Behaviors (choosing and acting with them)
Watch Out for the “O” Zone and Garden Your Life with God.
We naturally let the three O’s into our minds and dupe ourselves into believing that we can control them. Focusing on the “O’s” of others, outcomes and old stuff, and trying to change or control them is a losing battle. Instead, catch yourself when you are in the “O” zone, commit your “O’s” to prayer, and focus on managing your own Feelings, Attitudes, and Behaviors one moment at a time. Ask God, your Master Gardener, to guide you and provide you with His wisdom and grace. Ask supportive others to help you as you adjust your boundaries and garden your life. As we manage our own FAB-ulous treasures, we are energized to connect well with others. We are able to live and give freely.
I did an exercise with a depression support group a few years ago. I encouraged participants to turn to one another and take turns asking the question, “Who are you?” One of the ladies graciously agreed to demonstrate the “Who are you?” dialogue with me. Instead of having her ask me first (which I should have done, so as not to put her on the spot), I asked her first, “Who are you?” She responded immediately with a laugh and the statement, “I am fat!” She then continued a litany of other things about herself that were wrong. I don’t remember any of them because I wanted to stop and redirect her ASAP. I encouraged her to focus on more simple, factual (less negative and judgmental) self-statements.
Now, some of you may be wondering, “Well, was she fat?” She was overweight but not morbidly obese. Still, isn’t it sad that her first self-statement was “I am fat!”? What does that tell you about how she sees herself?
Is this woman alone in her automatic perceptions of herself? By no means! I frequently have automatic thoughts that are self demeaning. I’m pretty sure you have those types of automatic thoughts too. Certainly we all seem to struggle with “I’m not good enough” or “not acceptable” thoughts.
Take note right now, however, that those descriptions are simply not true! They are more likely statements of a negative self-concept or an expression of negative feelings. If I confuse “Who I am” with “How I am feeling”, then the “worlds” I create with my words will be very dramatic, unstable and probably dark. Who I am is NOT a negative perception or judgment. Who I am and who you are is amazing and well designed. We are more unique than anything else in all of God’s creation. As far as I can tell, we are the highest functioning beings on the planet…and likely in the universe!
Who am I? I am a human being. I am created by God and in God’s own image. I am also a person created to be utterly dependent on God for all things. He made me female. I am a wife, mother, daughter, sister, cousin, friend, co-worker, psychologist, and musician. I love pumpkin spice lattes (with half the syrup) along with most hot drinks; critters like dogs and horses; crisp fall days; wearing blue jeans, colorful socks, comfy shoes and cozy shirts; going to hang out in a coffee shop with nearly anybody; making music; laughing at and with my husband; marveling at the growth all around me (especially with my kids) but also within me. When I turn my mind to all these things, I’m compelled to say, “Praise God from Whom All Blessings Flow” and I’m much more okay with myself.
How about you? Who are you? Remember, your life is a gift to you. You are not to judge it, but to embrace it, unwrap it, and value it. Take time this day to write out who you are. Perhaps do the “Who are You?” exercise with a friend or family member. It will make your world a brighter place.
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