Practicing Skills Outside of Psychotherapy Sessions

An important part of treatment is practicing the skills we learn during psychotherapy sessions during the times between sessions. Practicing skills is like doing repetitions with weights — this strengthens the neural pathways that make our new behaviors easier to do and more automatic.

When we’re in treatment together, I’ll ask you to report:

(1) What skill did you use?

(2) How did it change the outcome?

(3) What’s easy for you?

(4) What’s still a challenge?

We tend to practice skills that are easier and more automatic, and tend to practice the hard ones less often. You’ll have to consciously decide to attend to the skills that are harder for you. Sometimes skills you ate good at also have particular applications that are more challenging. For example, making boundaries with a co-worker might be easier for you while they may be more challenging with family members or friends. We will work together to identify what skills or applications are challenging and set goals for progress in those areas. The best goals are challenging, doable, measurable and important to you.

Three Methods for Working with Chaos

Today when I was reading, “When Things Fall Apart,” by Pema Chodron, I arrived at the chapter called “Three Methods for Working with Chaos,” and wanted to share this wisdom with my readers.

Pema recommends three very practical ways to work with chaos: no struggle, poison as medicine, and regarding everything that arises as the manifestation of wisdom.

First, we can train in letting go of the story lines. We can slow down enough to be present and let go of the multitude of judgments and schemes and just stop struggling.

Second, we can use every day of our lives to take a different attitude toward suffering. Instead of pushing it away, we can breath it in, with the wish that people everywhere could experience contentment in their hearts. In this way, we could transform pain into joy.

Third, we can acknowledge that suffering exists, that darkness exists — that there is chaos in here and chaos out there — and this is basic wisdom. As stated by Pema: Whether we regard our situation as heaven or as hell depends on our perception (p. 126).

Finally, we can just relax and lighten up! When we wake in the morning, we can dedicate our day to learning how to do this. We can cultivate our sense of humor and practice giving ourselves a break. Every time we sit down to meditate, we can think of it as training to lighten up, to have a sense or humor, and to relax.

Tonglen Meditation: Connecting with Others

In her book, “When Things Fall Apart,” Pema Chodron introduces the reader to the practice of tonglen — sending and receiving — which is designed to awaken bodhichitta, or the noble and genuine heart within us. Tonglen is the practice of connecting with other people around the world who are suffering, perhaps how you are currently suffering, and breathing in pain and sending out pleasure. Pema goes on to explain that, “…whenever we encounter suffering in any form, the tonglen instruction is to breathe it in with the wish that everyone could be free of pain. Whenever we encounter happiness in any form, the instruction is to breathe it out, send it out, with the wish that everyone could feel the joy.”  This is “…a practice that allows people to feel less burdened and less cramped, and a practice that shows us how to love without conditions” (p. 88).

Try the tonglen meditation for 5 minutes. What was your experience with tonglen?

The Love That Will Not Die

In her book, “When Things Fall Apart,” Pema Chodron describes our innate ability to connect deeply with others through a basic openness, which Buddhists call shunyata. It manifests itself through basic tenderness, basic compassionate warmth. Compassion and bodhichitta, she says, are the qualities of a “love that will not die.”  She notes that “…whenever we let go of holding on to ourselves and look at the world around us, whenever we connect with sorrow, whenever we connect with joy, whenever we drop our resentment and complaint, in those moments, bohhichitta is here.” She goes on to describe how wise people know that the best thing they can do for themselves is to be there for others, which allows them to experience joy. Would you agree with this idea? If so, see my next blog on the bodhichitta and the practice of tonglen meditation.

“When Things Fall Apart”

One of my favorite books is “When Things Fall Apart,” by Pema Chodron. She is an American Buddhist who offers new insights on pain and suffering and practical tools you can try-on to see if they are effective at giving you new perspectives when life becomes difficult. I will publish nuggets of her wisdom on this blog for you, but you might consider buying this jewel and soaking up its juiciness directly! Really, it is that good!

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How Does Mindfulness Work?

Buddhist Mindfulness practice has been around for more than 2500 years. Now, revamped in a psychological and neuroscientific context, we start asking the question, how this practice actually works. Well, we are not talking about how it helps individuals to reach a state of liberation or even to move on to enlightenment, but we want to see whether some of the processes that lead to beneficial outcomes can be described in psychological and neuroscientific terminology.

Britta Hölzel with several colleagues from the Bender Institute of Neuroimaging in Giessen and from the Harvard Medical School in Boston recently published a theoretical paper that outlines their ideas of some of the main mechanisms of mindfulness meditation. Building on previous work by Shauna Shapiro, by Bishop et al, and also by Baer et al. they suggest that the interplay of four components is at the core of mindfulness meditation. These four components are: (1) Attention regulation, (2) Body awareness, (3) Emotion regulation and (4) Change in perspective on the self. The citation for this work and a link to the article are found below.

Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537-559.

Redefining What It Means to Be Successful

I’m currently reading a book called “Thrive,” by Arianna Huffington. The goals of the book is to redefine success and creating a life of well-being. One of the reasons I like this book is that Arianna helps the reader deal with stress, exhaustion, and burnout, which are problems that a lot of women suffer from in the workplace. As women, we have to take care of ourselves and this book provides steps for how to practice self-care so that stress, exhaustion, and job burnout down overwhelm us. Drawing on the latest research and science in the fields of psychology, sports, sleep, and physiology that show the profound and transformative effects of meditation, mindfulness, unplugging, and giving, Arianna shows the reader the way to a revolution in our thinking, our culture, our workplaces, and our lives. I highly recommend this book!


Dr. Karg


“It is spring again. The earth is like a child that knows poems by heart.”  ~ Rainer Maria Rilke

This year, the yearning for Spring is palpable. As my 84-year old neighbor said, “The snow was lovely…and it’s time for it to go!”

Spring is my favorite season! I love to garden and cannot wait to start digging in the dirt and planting! I’m looking forward to watching the trees and plants come back to life, seeing the gorgeous blossoms,  smelling the fresh Spring air, feeling the sun shining on my face, taking long hikes in the woods, strolling in my neighborhood, and of course, going fishing every chance I get! 🙂  What are you most looking forward to this Spring?

Sometimes Beautiful Gifts Come in Ugly Boxes

Here is one of my favorite quotes by Pema Chödrön:

“…feelings like disappointment, embarrassment, irritation, resentment, anger, jealousy, and fear, instead of being bad news, are actually very clear moments that teach us where it is that we’re holding back. They teach us to perk up and lean in when we feel we’d rather collapse and back away. They’re like messengers that show us, with terrifying clarity, exactly where we’re stuck. This very moment is the perfect teacher, and, lucky for us, it’s with us wherever we are.”

What does this mean for you?

New Year, New Leaf

Happy New Year! I’m excited by the prospects of 2015 and hope you are, too!

The New Year is a time that many of us renew our dedication to self-improvement. I’ve been studying self-change since my days at the University of Scranton, working with Dr. John Norcross, who helped develop the Stages of Change model that has been used for decades to help us understand and predict self-change. The research literature shows that you can boost your rates of success at making changes by writing down your goals, making a public commitment to change, and getting coaching! So get ready, get set, and GO!