Coping with Challenges During the Holidays

Holidays can be a special time when there is joy in spending time with friends and family. It can be a time of joy with giving and gratitude. Unfortunately, for many people, the holidays can be a challenging time that can be a struggle to get through. These struggles can include dealing with the loss of an ideal or loved one, dealing with difficult people, and dealing with loneliness. However, there are ways to cope with challenges during the holidays.

The Loss of an Ideal

Holidays can be hard for people who see holidays as a time of year for family gatherings. People may have family gatherings but are enduring ruptures. Therefore, their family may feel incomplete and there can be struggles with the feelings that come up from that.

Others may have people missing from their family gatherings due to changes in life circumstances. For example, adult children who move away after getting their first job after university often don’t have the time off or funds to return home for Christmas. This is not due to an interpersonal relationship rupture but does take getting used to for people who have the ideal that family is together for the holidays.

It can be challenging to see what you wanted but never got, such as people who wanted a family or children, but it never came to be for various circumstances. The loss of an ideal is one of the challenges you can learn to cope with during the holidays.

Coping with the Loss of an Ideal During the Holidays

Identify at least one reliable coping mechanism you can use when negative emotions bubble up. It’s important to figure out what will help you before you need it. Some ideas of coping:

Manage Expectations

You are likely to feel some sadness and possibly other emotions. The holidays won’t be the same as you wish they were and that’s okay. Try to figure out what you want from the holidays considering what is going on. Figure out how you can make the most out of the holidays. Don’t feel like you have to do everything you’ve done in the past.

Be Honest with Yourself

It’s okay to feel angry or hurt about separations between you and close friends or family. It’s okay to protect yourself by creating separation from family that has hurt you.

Be Flexible

Don’t schedule your way through the holidays. Make sure you have room to take care of yourself. Make sure you have the flexibility to change your plans if they don’t feel right.

Be Kind to Yourself

Make a physical list of all your positive attributes that you can use to make yourself to feel better when you are feeling down. Engage in activities that soothe you.

Plan ahead of how you are going to spend the days that are the most important to you. This can be going for a walk, doing a puzzle, or something else that calms your spirit.

Be Aware of What Your Triggers Are

Take a break from social media if you need to. Limit your time with people who are triggering or activities that are challenging for you.

Educate Others on How to be Supportive

Sometimes people don’t know how to help you, they want to help you but don’t know how. When you let them know how to support you, it makes supporting you easier.

Find Ways to Connect During the Holidays

This can be getting together with friends, family, or engaging in volunteer work.

Coping with Challenges During the Holidays

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Dealing with Difficult People

Often during the holidays, you end up having to spend time with people you find challenging. Whether they are family or work acquaintances. It can be due to different political opinions, people who tend to engage in gaslighting, or others who just rub you the wrong way. Dealing with difficult people is one of the challenges you can learn to cope with during the holidays.

Ways to Cope with Difficult People

Make Boundaries

Set time limits for conversations with difficult people (bathroom breaks or helping in the kitchen) or time at a gathering with difficult people. Don’t be afraid to say no to events or activities that can trigger excessive stress or resentment.

Re-evaluate Your Expectations

We are only let down or disappointed when our expectation is not met. Disappointment can lead to further negative emotions that can dampen our spirits. The key is not to have much expectation, especially if there is a history of disappointment attached.

Choose Your Battles Wisely

You don’t have to voice your opinion on every topic that comes up. It’s okay to know and not tell. Choosing your battles wisely is one of the best ways to manage holiday stress. Avoid too much time with that one person who always stirs up problems.

Avoid Comparisons Around the Holidays

Although it is difficult to avoid comparisons, it is very rewarding to not engage in it. It helps if you give yourself a pep talk and are confident in your phase of life. Good for them if they are doing well, things will happen for you when it is meant for you.

Take a Backseat

Don’t be afraid to sit back and observe as if you are a spectator. You don’t have to engage in conversations that can become heated or stressful. Don’t pay attention to what everyone has to say about you or your choices. Their opinions don’t have to dictate your life.

Worst Case Scenario

Think about the worst thing that could happen, and plan on how you will deal with it.

Keep Yourself Busy

An effective and possibly least offensive ways of avoiding any uncomfortable conversations is to be busy or at least pretend to be busy.

Take Some Time Out for Yourself

Now and then, we need to step away and just unwind. You might feel the need to do so more if you are dealing with toxic people around holidays. Plan fun games and even topics in advance so you can divert any uncomfortable questions or maybe avoid them altogether.

Ground Yourself

Focus on yourself and what you can control. You can only control how you react to what they say or do. Plan on what coping strategies you will use when dealing with difficult people.

Listen to Your Body

Listen to your body. Often you may start to get a headache or feel some discomfort in your body when it is becoming too much. You may also use that discomfort as a reason to leave.

Ride the Wave

Know that any emotion or anxiety that come from dealing with difficult people are temporary. Imagine yourself surfing the wave of emotion, knowing it will decrease over time.

Memories of a Deceased Loved One

Holidays can be a time when memories of loved ones you lost come back up. It is a time where often special memories occurred and you are likely to be reminded of those memories. This is a normal part of the grief process. Dealing with memories of a deceased loved one is one of the challenges you can learn to cope with during the holidays.

Coping with Grief of a Loved One During the Holidays

Create Boundaries

Create boundaries when you are going to events that you don’t feel like or may feel challenged by. Some of these boundaries can involve picking an endpoint when you are going to leave or avoiding certain aspects of gatherings.

Honor Your Loved One

Find a way to honor your loved one, some ideas are:

  • displaying a photograph where everyone can see it.
  • an empty seat at the table.
  • a moment of silence before a meal.
  • donations made in your loved one’s name.
  • volunteering somewhere that would mean something to them.
  • get creative with personalized ideas.
  • Share memories

Practice Self-Compassion and Self-Care

Be gentle with yourself and make sure you take the time to take care of yourself.

Decide What You Can Handle

This may mean going to fewer events or skipping events you used to attend.

Make New Traditions

Figure out new ways to celebrate the holidays.

Find Connection

Find ways to connect with others, even if it is different than previous years.

Coping with Challenges During the Holidays

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Loneliness Intensified

The holidays can seem lonely for people who have a small social circle can suffer from their loneliness as they see other people getting together with close loved ones but they don’t have people to gather with. Loneliness is one of the challenges you can learn to cope with during the holidays.

Coping with Loneliness During the Holidays

Remember that You’re Not Alone

It’s OK to feel isolated during the holidays, and you are not alone. Talking to others who share similar experiences (either via the Internet or in person) can make you feel less alone in your situation.

Reach Out to People Around You

If you feel isolated, make it a priority to work on your relationships with others. Whether it means exchanging friendly words with people you come across or connecting with friends or family. Connecting with others strengthens bonds and can help you feel less lonely.

Practice Self-Care

Focus on taking special care of yourself. Take time to engage in healthy habits like physical activity, getting enough sleep, and eating nutritiously. Engage in activities that you enjoy. Good self-care habits will keep you entertained and boost your mood.

Redefine Your Expectations

Many people have high expectations for this time of year. Popular culture portrays the holiday season as synonymous with spending time with close family, friends, and romantic partners. Focus on the good things you have in your life instead of comparing yourself to how you think others are spending the holidays.

Give Back to Your Community

Volunteering to support a cause you believe in is a great way to feel less lonely during the holidays (or any other time). Helping others who are less fortunate can remind you of all you have to be grateful for and leave you with a sense of love and appreciation for yourself.


The holidays can be hard and challenging when you have challenges that run counter to the general emotions of the season. There are ways to cope with challenges during the holidays. The most important part is to find the strategies and tools that work best for you.

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The Grief of Chronic Pain

Unfortunately, grief usually ends up being a part of the chronic pain experience. It’s the grief of things you lost to the pain and the process of moving through life within your new circumstance. As you move through the grief process and gain acceptance of your pain, it can get easier, and you can start to find purpose and identity within your new circumstances.

The Grief of Chronic Pain

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What is Grief?

Grief is a normal response to loss. Grief is a process of adapting or reconciling to change. It can be a rollercoaster of thought and emotion. Each person has an individual grief response, even if they experience the same loss. The grief process is about integrating the loss into a new life.

Symptoms of Grief

Some of the symptoms of grief include:

  • Fatigue /exhaustion/lack of energy /lethargy
  • Lack of concentration/confusion
  • Memory issues/forgetting stuff you normally wouldn’t
  • Emotional rollercoaster – volatility/irritability
  • Depression and anxiety, including lack of motivation/interest, changes in appetite, changes in sleep (too little/much), and/or numbness/detachment.
  • Physical symptoms: headaches, nausea/upset stomach, restlessness, and/or tightness in chest/throat.
  • Existential crisis (Who am I now? What’s important to me now?)

Common Thoughts with Grief

  • Why is this happening? I can’t believe this happened.
  • When will this ever end?
  • This isn’t fair!
  • How will I manage?
  • What will become of me?
  • Who am I now?

Common Feelings with Grief

  • Lost/Bewildered
  • Confused/Perplexed/Disoriented
  • Anger/Irritability/Frustration
  • Fear/Despair
  • Sadness/sorrow

Our Society Discourages Grief and Mourning

Unfortunately, we live in a grief-adverse society that is often uncomfortable with external expressions of grief. This can be communicated to you in the following comments or ones similar to them:

  • Don’t cry.
  • Buck up – Stiff upper lip – Be positive!
  • Everything happens for a reason.
  • Just Grin and Bear it.
  • Don’t whine/complain.
  • Encouraged to mourn in isolation.
  • Choose to be happy.
  • You’ll get through it, be strong.
  • Aren’t you over it yet?
  • Stay busy. Don’t think about it.
  • Change your mindset.

These statements tend to be more about how they are uncomfortable with grief, distress, and strong emotions and trying to avoid those things, including in other people.

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What Are Some of the Losses with Chronic Pain?

Grief comes from loss. Chronic pain often comes with multiple losses, such as loss of ability, social connections, ease in life, and identity. You may also have other losses along the way.

Loss of Ability

The first loss from chronic pain involves the loss of ability. Chronic pain can take away the things we used to do due to the limitations caused by pain. This can involve the loss of careers, hobbies, and other roles in life. There can be grief around the things you no longer can do.

Loss of Potential

A subset of the loss of ability is the loss of potential. For youth and young adults who develop chronic pain, the losses are often of potential. Where they grieve what could have been and the things that they won’t be able to do in their life due to their chronic pain. Their chronic pain could have them questioning about potential careers, ability to parent well, and potential hobbies and activities.

Loss of Social Connections

The second loss of chronic pain comes from the loss of social connections due to the inability to keep up with the social engagements that you used to do. Social engagements are often one of the first things you drop when chronic pain starts to interfere with your life. We often want to hide our pain and that also can lead to isolating ourselves.

The loss of social connections can be hard because some of these people that we have lost could have been part of the support network that can make your chronic pain journey easier.

Loss of Ease in Life

The third loss is the loss of ease of life. Living with chronic pain is exhausting and distressing. It often requires pacing and planning on how to get the most out of your life with chronic pain. It may mean passing on activities with friends because you can no longer do those activities. You may also feel a loss of control due to the potential of missing planned activities due to flare-ups.

Loss of Identity

The fourth loss is the loss of identity. Living with chronic pain can force you to change your self-identity. If you were athletic and found part of your identity in sports, you may no longer be able to participate in the same sports that were part of your identity. As a mother, you may be limited in some of the activities you used to do with your children. These losses can be difficult to cope with because you feel like you lost a part of yourself. You may have to grieve the old you before you can accept the new you.

What May Be Involved in the Process of Grief with Chronic Pain?

There are multiple phases of grief with chronic pain, these are based off a modified set of stages of grief by Amanda Pratt. Not everyone goes through all the phases of grief with chronic pain and the process is not linear. You may experience jumping between the phases and experience more than one phase simultaneously. You are dealing with grief at the same time as your chronic pain symptoms and this can be especially emotionally and mentally exhausting.


Denial is something that helps us cope. You may not be ready to face what is before you and denial is a way you are coping with that. While you’re in the denial phase, you may not take the steps you need to, to prevent your condition from getting worse. Some of the things you may find yourself doing include:

  • Thinking the pain will resolve itself.
  • Pretending that the pain is not happening.
  • Trying to do everything you were doing before.

Bargaining, Pleading, and Desperation

Bargaining is the phase of the grieving process in which you fight what has occurred and the circumstances you find yourself in with your chronic pain. It often shows itself in:

  • Trying to find some medical magic bullet or some answer that will make it better.
  • Asking your doctor for a bunch of tests, searching for a reason for the pain.
  • Keep trying new treatments in the hope they will work despite the fact that some of them are unlikely to work.
  • Feel desperate for answers for the pain.

This is a phase of trying to bargain and fight with the reality you find yourself in. You may feel guilt or blame and wonder if you did it to yourself.


Anger is often the stage that starts the healing process. It also can be exhibited as frustration and irritability. The anger can be aimed at:

  • The pain and the things lost to the pain.
  • The unfairness of your experience.  
  • The support system around you, including doctors, caregivers, family and friends.

Anger often comes with the recognition that your life will change.

Anxiety and Depression

Anxiety and depression are a normal part of adjusting to a major life stressor. They may set in as you realize how your life is going to change due to your chronic pain. You may question about what your future is going to look like. You may not know how to deal with all these stressors.

Loss of Self and Confusion

You may struggle with your identity and feel that you lost a part of yourself to the chronic pain. There may have been parts of your identity that you can no longer do due to the pain. You may be confused with who you are and struggle to define what makes you who you are. This is a phase of losing your old self and figuring out who the new you are.

Reevaluating Your Life, Role and Goals

This is the phase of figuring out what your life is about, what your role is, and what are your goals for a life with chronic pain. This can be a trying time of adjusting your life to the limitations of your pain but trying to get the most out of what is important to you. You may be asking questions like:

  • Where am I going to go now?
  • What is my new normal?
  • How am I going to be … (a mother, a professional, etc.)?


Acceptance is the acknowledgement of where you are at this moment. It is recognition that your current circumstances are what they are. You realize that you can’t change the current facts about your chronic pain and how it is affecting you. Acceptance does not mean you like it because you probably don’t like your pain.

Acceptance allows you to come to terms with things that are out of your control and prevents you from becoming stuck in feelings of happiness, bitterness, anger, sadness, and suffering. You can accept something is painful and challenging. It is at this point that you aren’t fighting the pain anymore. You don’t like it, but you accept that it’s a part of your life. This is about learning to integrate your chronic pain into your life.

Acceptance frees up the energy you were using to fight reality and instead refocuses it on coping and taking care of yourself.

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What is the Benefit of Moving Through the Grief of Chronic Pain?

Through moving through the grief, you may find yourself moving through a lot of the emotional turmoil that can really increase your suffering with chronic pain. When you are at a place where you are focused on making your life the best it can be with your pain, there are benefits that come with it.

Easier to Self-Manage Your Pain

Once you move through the grief, listening and taking in the strategies and suggestions for self-management is easier. It allows you to focus on yourself, how to get the most out of your life, and the ways to reduce your suffering.

Can Reduce the Tension and Lower Your Suffering

When you stop fighting or resisting the pain and gain acceptance of your situation, your body will hold less tension and that can lessen the pain. At a minimum, it will lessen your suffering.

Turn the Page Towards Purpose

With acceptance of your situation and having a new outlook on your life, your role, and your goals. This allows you to move past what you lost and towards meaning and purpose.

How to Cope with the Grief of Chronic Pain?

Building Your Support Network

Figure out who is part of your support network and talk to your support network about chronic pain, grief, and healing. Connecting with your friends and loved ones can help lift some of your burden with grief and chronic pain.

Learning to Say “No” to People and Things that Don’t Support You Physically or Emotionally

Developing boundaries and learning to say “no” are two of the most important skills for coping with grief and chronic pain. With the amount of energy that dealing with the pain takes out of you, you only have so much energy to invest in the things that are important to you. Grief is also emotionally and mentally draining. When you engage in things that don’t support you, they can be even more draining. This can result in missing out on the things that are important to you and help you maintain a better quality of life.

Engaging in Self-Care

With Chronic Pain, self-care and taking care of yourself is even more important than before you developed pain. When you combine that with grief, it becomes more important to attend to your emotions and stick to a routine.

Engaging in Self-Compassion

How do you communicate with yourself? Is it how you would communicate to a friend or family member going through the same thing? Engaging in self-compassion can bring positive results to how you feel about life.

Self-Compassion (Kristen Neff), includes:

  1. Mindful awareness of our suffering
  2. A recognition that we are part of a common humanity that is imperfect.
  3. A willingness to be kind to ourselves even when we are suffering or feel unsuccessful.

Self-compassion has both a soothing comforting side as well as a side that provides and protects yourself through boundaries and standing strong against things that can harm us. Additionally, self-compassion also can reduce anxiety, depression, stress, rumination, perfectionism, and shame.


Grief is a part of the suffering of chronic pain. The grief of chronic pain has its own unique challenges. It can take years to process the losses and changes to your life due to your chronic pain. There are ways to cope with the grief and take care of yourself.

How Spirituality Can Help The Healing Process in Therapy?

Spirituality can be a powerful aspect of your helping process, whether you take your form of spirituality into your therapy sessions or not. It was for me, but I know not everyone is like me.

Spirituality may have a vital place in your life, or you may not have a place for spirituality in your life. I work with both ends of the spectrum. I want you to be able to bring your whole self to our therapy sessions and use all the resources you have. Utmost, I want you to be comfortable with what you are bringing into therapy and for us to work in a way that works best for you. The amount and ways of bringing spirituality into therapy are up to you.

Spirituality in Therapy

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From My Personal Experience to Serving You

How My Faith Helped Me Heal

I realise the importance of spirituality in healing because my faith helped me to find healing and benefited me in some of my struggles. It was my Christian faith that helped me believe that I had a greater purpose and that I was more than the struggles I was facing at the time. There were times that I felt loved and cared for despite not feeling that from the people around me. In my darkest times, it was my faith that helped me to hold on.

Through my own healing, I found prayer to help me in distressing times. I found that my spirituality was coming through during trauma processing with EMDR and that helped my recovery. I found that making coping statements that included my faith helped me accept my own worth. For me, spirituality was a blessing that enhanced my healing journey from chronic pain and trauma. Similarly, I would not want to take the possibility of that type of healing away from you.

My Respect for Your Form of Spirituality

Because of my experiences with my faith, I know how important your form of spirituality may be in your life. I will respect your faith and the place it has in your life. If you wish, we can work together to figure out how to use aspects of your faith to enhance your healing and find ways of healing that work with your faith.

Respecting Your Autonomy

It is up to you how much your spirituality comes up in therapy, if at all. We can explore its place in your struggles, limit it so coping strategies, or avoid it altogether. I realize that your spirituality can be very personal to you and you may not want to talk about it to just anyone. Therefore, I leave it up to you to decide how much you want to involve your spirituality in therapy.

Limitations on Spirituality in Therapy

I can help you probe what your spirituality means in the circumstances. When we are discussing coping mechanisms, I can ask about ways to use your spirituality to help you find healing or cope better. We can also discuss how to make sure the psychological techniques work with your form of spirituality rather than work against it.

Unfortunately, I can’t answer the kind of spiritual questions that should be asked of spiritual leaders. Questions about whether you are saved or other questions specific to your form of spirituality belong to spiritual leaders such as pastors, rabbis, and other leaders.

The benefits listed below are based on the belief that spirituality is provides meaning, purpose, and comfort to your life. If you are facing spiritual abuse, you may not be receiving those benefits. We can also talk about that if you wish.

Spirituality in Therapy

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Spirituality’s Influence on Healing in Therapy

Influence of Spirituality on Healing in Therapy

Spirituality can:

  • enhance your sense of purpose.
  • offer you guidance and direction in life.
  • provide coping mechanisms for difficult situations.
  • provide social and emotional support through connections with other people who share your form of spirituality.
  • lower anxiety, improve self-esteem, and improve physical functioning.

Moreover, people who are more spiritual experience less distress after trauma. They often feel supported by a spiritual community that lessens grief and isolation. Additionally, they may routinely practice forgiveness, relaxation, reflection and/or meditation practices.

Post-Traumatic Growth

Positive religious coping, religious openness, readiness to face existential questions, religious participation and intrinsic religiousness are some of the factors that are typically associated with post-traumatic growth.

People who have spiritual beliefs tend to explore their core beliefs in response to changing life circumstances. This deliberate rumination can help someone find meaning in distressing circumstances and can promote post-traumatic growth. There is an even stronger link between deliberate rumination and growth if the person has average to high levels of spirituality.

Probing our beliefs about who we are and what matters to us before and after trauma helps us rebuild our personal security. People with higher levels of spirituality often expect to have their beliefs shaken occasionally and use contemplation to deal with the fallout.


I recognize that spirituality may be an important aspect of your personal identity and can be beneficial to healing from mental health challenges and other life struggles. I want to work with you and your spirituality in a way that is comfortable for you.

Related Information

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The Benefits of Gratitude Practices

Gratitude can have many benefits to your health. It can be done in many ways. There are some pitfalls that can happen with gratitude practices which can change a beneficial experience into a harmful one. Overall, gratitude practices are simple ways to bring some benefit into your life.

What is Gratitude?

Gratitude is a positive emotion that involves being thankful and appreciative and is associated with several mental and physical health benefits. It is a recognition of value independent of monetary worth. Spontaneously generated from within, it is an affirmation of goodness and warmth. This social emotion strengthens relationships, and its roots are connected to the survival value of helping others and being helped in return.

According to researchers, “Gratitude stems from the recognition that something good happened to you, accompanied by an appraisal that someone, whether another individual or an impersonal source, such as nature or a divine entity, was responsible for it.”


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How is Gratitude Beneficial?


Gratitude practices can cause lasting changes in the prefrontal cortex that heighten sensitivity to future experiences of gratitude.

Physical Health

  • Better sleep
  • Better immunity
  • Lower blood pressure
  • More likely to engage in other health-promoting behaviours
  • Feel less pain

Mental Health

  • Higher self-esteem
  • Decreased stress
  • Less anxiety and depression
  • Higher levels of optimism

Social Health

  • Can help build and maintain relationships with others, resulting in hope, life satisfaction, and more proactive behaviours toward others (Passmore & Oades, 2016).
  • If a person experiences gratitude, they are more likely to recognize the help and then later reciprocate that help (Wood et al., 2010).
  • People who are thanked are more likely to extend help to others in the future.

How Can You Practice Gratitude?

There are many ways of practising gratitude. You can try a few to figure out what feels the best for you.

Cognitive Activities

  • Spend a few moments thinking about the things in your life that you are grateful for.
  • Reframe experiences: Compare current situations to negative experiences in the past. This enables you to notice your strengths and self-growth, as well as appreciate things in the here and now.
  • Think about people who have inspired you and what about them was most significant.
  • Engage in “mental subtraction.” Imagine what your life would be like if some positive event had not occurred.

Mindfulness/Imagery Activities

  • Meditation and focusing attention on people or things you are grateful for indicates appreciation for yourself, which could help to foster even more gratitude.
  • Stopping to observe and acknowledge the beauty of wonder of something you encounter in your daily life.
  • Paying attention to the small things in your life that bring you joy and peace.
  • Meditation or prayer focused on giving thanks.
  • Observe the moment: Take a second to focus on your experience and how you are feeling. Focus on what is coming through your senses in that present moment. What are you grateful for in the present moment?
  • Savor the moment: Give yourself time to really enjoy the moment. Focus on the experience and allow yourself to absorb those good feelings.

Writing Activities

Gratitude Journal

A gratitude journal involves jotting down a few things that you are thankful for and can be done daily, weekly or any interval that works for you. Keeping a gratitude journal is a good first step toward establishing gratitude, and it will help you identify and reflect on people, things, or events for which you are thankful. It is also something that you can look back and read when you are feeling down to improve your mood.

Gratitude Letter

Writing a gratitude letter is a form of written communication that conveys an appreciation for someone in your life. These effectively communicate the impact someone has had on our lives. Although it is nice to send it to someone, you can write a gratitude letter with no intention to send it.


Write down “three good things”—identify three things that have gone well for you and identify the cause.

Write thank-you notes to others.

Interpersonal Activities

  • The gratitude visit:  Take the gratitude letter a step further by visiting the person to whom you are giving the gratitude letter and reading it aloud to him or her.
  • Thanking someone for the positive influence they have in your life.
  • Doing something kind for another person to show that you are grateful.
  • Give thanks: You might thank a person to show you are thankful for them, or you might spend a moment simply mentally appreciating what you have.


  • Create gratitude rituals: Pausing for a moment to appreciate something and giving thanks for it can help you feel a greater sense of gratitude. A meditation, prayer, or mantra are examples of rituals that can inspire a greater sense of gratitude.

Developing a sense of gratitude doesn’t have to be complex or challenging. The more you practice it, the better you will become and put yourself into a grateful state of mind that can benefit you.

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Pitfalls of Gratitude

Creates Stress

While gratitude is generally viewed as a beneficial activity, there are situations where it may have some downsides. For example, if you view it as a situation that creates a debt, it may make you feel a sense of obligation that could potentially contribute to feelings of stress.

The pressure to feel grateful, particularly around certain times of the year such as Thanksgiving and Christmas, can also contribute to feelings of stress.

Invalidating Your Emotional Experiences

Gratitude that’s done in a way that is invalidating is not good. It should not be about comparisons to others, it’s about what you appreciate in this moment. What you appreciate in the here and now. You can have things you appreciate and negative experiences. It becomes unhealthy when it is used to diminish or dismiss your own lived experiences of various stressors and harms. Gratitude can be used to gaslight you about the very reality of such stressors and harms.

Hindering Your Emotional Processing

It is important that you don’t use gratitude to avoid certain emotions or hinder your emotional processing. If you are upset, it is important to let your emotions change and run their course. If they don’t seem to be calming down, use emotion regulation skills.

Do not force gratitude when you’re feeling upset as a way to manage your emotions. Instead, allow yourself to experience your emotions while acknowledging that gratitude won’t stop or fix them.

Maintaining Harmful Systemic Issues

Avoid gratitude for things that maintain structures that need to change. Gratitude can become similar to “toxic positivity” in that it serves to sustain and reinforce injustice, exploitation, and the kinds of oppressive power relations that are at the basis of so many mental health problems.

Acknowledge the systemic issues that negatively impact you and how these issues co-exist with your feelings of gratitude.

Overdosing on Gratitude

More isn’t always better when it comes to gratitude practices. If you aim too high, your gratitude practice may become a chore and the benefits decrease. If that is happening for you, take a step back and focus on quality over quantity.

Focusing on Feeling Grateful for Someone or Something Who isn’t Worthy

Focusing on feeling grateful in an unhealthy relationship that involves physical or emotional abuse can be harmful. You may end up gaslighting yourself or convincing yourself to stay in a bad situation. If you are in a situation like that, focus on gratitude for yourself or the world outside that specific situation.

Using Gratitude to Avoid a Serious Problem

Gratitude helps you focus on what is important instead of getting caught up in the little annoyances of everyday life. However, not all problems are little annoyances, and focusing your attention on things you appreciate may provide only temporary relief from serious problems. In cases like these, a negative emotion like anger may actually be more constructive.

Downplaying Your Own Successes Through Excessive Gratitude

It’s important to recognize your role in positive things that have happened to you. Don’t let gratitude get in the way of appropriately taking credit for your part in your success.

Mistaking Gratitude for Indebtedness

Gratitude is the positive emotion you feel when someone else helps you out. Indebtedness is when someone helped you and now you feel you owe them. If you mistake feelings of gratitude for indebtedness, you may find yourself working hard to repay a favour not to express your appreciation but to take the weight of a debt off your shoulders. This can harm the closeness of the relationship.


Establishing a gratitude practice can bring you a lot of benefits. It is not a complex or challenging thing to do. It is within your control. If you avoid the pitfalls, it can bring great benefit to your life.

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My Approach to Problematic Substance Use and Behaviours

My approach to problematic substance use and behaviours starts with understanding the root cause and the role that the substance use or problematic behaviour has for you. I can work with you from either an abstinence or harm reduction model. I will focus on working with you to understand their relationship to the substance or behaviour. Additionally, I will help you add skills and strategies to increase your ability to cope and heal the trauma behind the problematic substance use or behaviours. As we go through the process of changing your behaviour patterns, we will work on building a path towards a better future for you.

What Problematic Patterns I Work With

I work with substance use patterns and problematic behaviours that may or may not reach the level of a diagnosis. More specifically, I work with problematic substance use and most problematic behaviours such as gambling problems, excessive internet/social media use, shopping addictions, impulsive spending, food and exercise addictions, and video game addictions. I do not work with sex and porn addictions.

I realize that you may have significant trauma which causes issues with restricting use when you first start therapy, so I have the expectation that when you attend our sessions that you will be sober enough to do the work. You do not have to be completely sober. I will also work with you after you have completed detox as well. It is about what works best for you.

Trauma-Focused and Root Cause

Focus on the Root Cause

I will focus on helping you with the pain behind the addiction. Usually, there is pain behind the addiction and the behaviour or drug use is used to cope with the pain or other symptoms the sufferer wants to get rid of or replace something that is missing. This can come from chronic pain, trauma, or other causes.

It is through understanding what the purpose of the substance use or behaviour is for you that we can work on things that will fill the need or heal the wound. Sometimes you may have a lack of awareness of these purposes until we bring attention to them. Through exploration of the emotions, urges, and thoughts you have prior to engaging in substance use or problematic behaviour, we can understand what is behind it better. Once the root cause(s) are dealt with it usually becomes easier to release the hold that the substance use or problematic behaviour has on you.


Trauma is common among people with addiction. Additionally, trauma can lead to addictions when you don’t have the skills and resources to cope with the traumatic triggers. Substances often provide relief that other techniques do not. Unfortunately, they also come with negative consequences that can negatively impact many aspects of your life.

Trauma-Addiction Cycle

Often what happens with people with trauma symptoms who try to overcome their addictions without addressing their trauma is that they end up relapsing when the trauma symptoms increase due to lack of management.

They start with good intentions getting off the substance or breaking away from the problematic behaviour. However, as time goes on the trauma symptoms increase until they reach a breaking point. When they reach that breaking point, they end up using the substance or engaging in the problem behaviour to deal with the trauma symptoms and they feel shame that they weren’t able to break their habit. They end up using the substance for a time until they try to break free of the behaviour again, but the same thing happens because the trauma symptoms are too big of an obstacle to overcome.

The way to break this cycle is to get treatment for the trauma and gain skills so that the obstacle to overcome is not as large.

Often through the healing of trauma you will find that you are better able to reduce your reliance on the  substances and behaviours. As the trauma symptoms reduce you are better able to ride the waves of the urges to break the pattern of substance use or problematic behaviour.

Influences on the Brain

The problematic substance use and behavioural patterns are embedded in neural networks in the brain. Your brain is used to going down the same path, so it is harder to get your brain to choose a different path. This is also why people who are trying to quit their substance use end up using after a stressful event.

When someone has an addiction, the brain starts to associate specific sensations or feelings with the urge to use a substance. When that association is broken it becomes easier to avoid the substance or the behaviour.

We will work together to change those patterns so that you are less likely to repeat those patterns. There are psychological techniques that can help to rewrite the neural networks to reduce the associated habits and meanings.

These substances and behaviours can hijack the dopamine response system. Dopamine is the neurotransmitter that is responsible for the feeling of pleasure and is part of the reward system in the brain. With problematic substance use and behaviour patterns, a person may start to only feel pleasure with certain drugs or behaviours and not feel pleasure with other substances and activities. We can work together to prepare you for the experience of being without a sense of pleasure for a period of time while your brain readjusts to being without those substances and behaviours that trigger pleasure and help you start to discover new ways to feel pleasure that are more beneficial and have fewer consequences.

Managing Life and Preventing Relapse from Problematic Substance Use and Behaviours

Understanding the Impact on Your Life and How It’s Working for You

We will work around understanding the role that addiction has in your life and how you use it. Most of the substance use and behaviours that end up in addictions are because the substance or behaviour is providing some benefit for you, even though you may not be conscious of the reason. Unfortunately, substance use and behaviours also have negative consequences. These negative consequences can have really damaging effects on your life, relationships, and quality of life.

Learning Skills to Deal with Cravings and Triggers

There are skills that you can use to deal with cravings and triggers, so you are better able to ride those experiences. We will work with skills and strategies that come from Dialectical Behaviour Therapy (DBT), Cognitive Behaviour Therapy (CBT), mindfulness, somatic theories, and EMDR to help you deal with your cravings and triggers.

Planning for Urges

We will create plans for when you experience urges, so you are able to ride the urge and come out of it without bad consequences. These plans will focus on your preferences, values and what is important to you. We will also consider when those urges often happen so we can lessen the chance of it happening in the first place.

Problematic Substance Use and Behaviours

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Building a New Life After Problematic Substance Use and Behaviour

Building a Plan for What You Want from Your Life

We will focus on what is important to you and respect what you value. We will build a plan based on your values, interests, and goals for your life. This can involve repairing family relationships, reconciling with friends lost due to the addiction, pursuing a career, returning to school, or something else. This can also involve exploring what you want from your life.

Learning Skills to Enhance Different Aspects of Your Life

Based on what you want from your life we will work on skills that will help you get the most out of your life. We can work together to bring you from a life of pain to a life of purpose. We will work together to enhance your skills so that you are more effective with different aspects of your life.


I want to work with you on where you are in your journey with your problematic substance use or behaviour pattern. I want to work in a way that will work for you to help you overcome your struggles and start to build a better life.

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The Connection Between Trauma and Chronic Pain

Trauma and Chronic Pain are difficult to live with; they often occur together and exacerbate each other. This can make recovery more difficult and your experience with each condition worse. Some treatments can bring healing and reduce your suffering for both conditions.

How Trauma Can Influence Chronic Pain

Trauma and Chronic Pain can influence each other. Chronic pain is reported in 20 to 80% of individuals with a history of trauma. Additionally, 10 to 50% of individuals with PTSD report chronic pain.

People with chronic pain and a history of trauma tend to have worse functional status, report greater distress, and demonstrate worse responses to medical intervention. Similarly, worse PTSD symptoms in people with chronic pain are associated with higher levels of pain, disability, and psychological distress raising the possibility that the conditions may negatively influence each other. The presence of chronic pain and PTSD increases symptom severity in both conditions.

What Can Cause Chronic Pain and PTSD-like Symptoms?

The types of events and experiences that negatively affect chronic pain and PTSD-like symptoms are not confined to the traumatic events that meet the Criterion A qualification of the PTSD diagnosis. For a traumatic event to qualify for Criterion A there needs to be exposure to actual or threatened death, serious injury, or sexual violence and there are some qualifications for that exposure, such as directly experiencing or witnessing the event as well as some other qualifications around exposure of a traumatic event happening to a close family member or friend or exposure through a non-optional situation such as employment (such as dealing with human remains, crime scene photos). Individuals who react with fear, a perceived threat to survival, or react with horror to events below the Criterion A Threshold may still develop PTSD-like symptoms and have effects on their chronic pain or the development of chronic pain.

Adverse Childhood Experiences (ACEs)

When we are threatened, our bodies have what is called a stress response, which prepares our bodies to fight or flee. If an adult does not provide a calming influence to a child after an adverse experience (also called co-regulation), toxic stress can occur and damage crucial neural connections in the developing brain. This is because children often have not developed the skills to self-regulate and are reliant on adults for protection and to fulfil their needs. When children start to question if their parents are able to protect them or provide for them it can cause uncertainty that stresses their system in multiple ways.

What are Adverse Childhood Experiences?

These Adverse Childhood Experiences (ACEs) are damaging to adult mental and physical well-being, with lifelong consequences. Adverse Childhood Experiences may be defined as traumatic experiences occurring before the age of 18, and include (but are not limited to):

  • Physical, emotional, and/or sexual abuse
  • Physical and/or emotional neglect
  • Familial or household dysfunction, such as parental incarceration, parental mental health disorder, and/or parental separation.
  • Witnessing domestic violence or substance use

People rarely only experience one of these types of adversities as they usually experience more than one.

People with chronic pain often have high levels of adverse childhood experiences (4 or more). These types of early trauma seem to bring an increased risk of 2 to 3 times of later development of chronic pain. People with adverse childhood experiences can have a worse experience with chronic pain. Their experience of chronic pain is often more severe, more extensive, and more difficult to treat.  The greater number of adversities a person experiences the worse this effect is. The more types of adverse childhood experiences, the greater the negative impact on development and pain experience in adult life.

Poor mental health can also be a contributory factor to chronic pain. Moreover, the negative impact of childhood adversity on mental health is well documented.  People with more Adverse Childhood Experiences experience a greater mental health impact of anxiety and depression as well as fear of pain itself.

Specific Types of Trauma

Different types of trauma can affect the development of chronic pain in different ways. Research has shown that different patterns of pain can come from different types of trauma:

  • Physical and/or sexual abuse tends to result in physical pain.
  • Emotional abuse tends to result in widespread pain.
  • Women develop pain from all forms of mistreatment (emotional abuse, physical abuse, physical neglect, bullying).
  • Men tend to develop pain from physical and sexual abuse.
  • Fibromyalgia is associated with prior psychological or physical trauma.
  • Sexual abuse was linked to non-specific chronic pain and chronic pelvis pain.

Stress Response System

People with a history of childhood trauma and chronic pain have been shown to have a dysregulation of the central stress response system (hypothalamic pituitary adrenal [HPA] axis), which regulates the body’s response to stress. Unfortunately, in the event of significant traumatic exposures like adverse childhood experiences, this system may be chronically activated which results in increased “wear and tear” on the body. Over time, this chronic activation can negatively affect brain development, and impact learning, behaviours, and emotional functioning. Through these mechanisms, childhood trauma and ACES can result in poor physical and mental health in adulthood. Through the development of various chronic conditions, such as diabetes, heart disease, depression, and chronic pain.

People with PTSD often have the most extreme cases of HPA dysregulation. Notably, among those with increasing PTSD symptoms, rates of musculoskeletal and less understood pain conditions (e.g., fibromyalgia, pelvic pain, irritable bowel) increase appreciably.

Mental Illness

When people have a mental illness or emotional distress, they are twice as likely to develop chronic pain. Mental distress is often more predictive than the severity of pain in establishing chronic pain and driving negative outcomes such as disability and healthcare costs.

Trauma and Chronic Pain

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Similarities Between Trauma and Chronic Pain

Similar Predispositions

Negative affect and anxiety vulnerability are two personality features that may predispose individuals to chronic pain and PTSD symptoms and may be partially responsible for their comorbidity. Anxiety vulnerability is the tendency to respond with fear due to the assumption that certain symptoms are harmful. It may amplify the intensity of the initial emotional response to a traumatic event, thereby increasing the risk of developing either condition.

Common Symptoms

The symptom overlap between chronic pain and PTSD suggests that they may share underlying causes. Some of the symptoms they share include:

  • Hyperarousal, which is increased alertness, anxiety, heart rate, and/or respiration.
  • Avoidance
  • Anxiety
  • Emotional liability, which is sudden and intense changes in mood or affect.
  • Somatic focus, which is a tendency to notice, focus on, and report physical symptoms.
  • Biases in attention toward threatening stimuli, which is when someone has to tendency to perceive things as threatening or dangerous that may not be dangerous.
  • Appraisal tendencies, which are patterns of appraisal such as always seeing things in a negative light (opposite of rose-coloured glasses).
  • Heightened startle reaction,
  •  Trait fear, which is the tendency to experience fear in response to specific stimuli.
  • Hypervigilance, which is being highly or abnormally alert to potential danger or threat (always being on-guard or on edge)
  • Emotional numbing, which is being in a state of not feeling or expressing emotions.
  • Stress response dysregulation

These conditions often involve a lowered physiological threshold for alarm responses and feelings of loss of control and unpredictability.

Impacts on the Brain

Both chronic pain and PTSD have similar activity in the hypothalamic-pituitary-adrenal (HPA) axis and the amygdala (involved in emotional control, memory, and learning), as well as structural and functional alterations in the anterior cingulate cortex, a brain region involved in attention and emotion.

Similarities in the Experience of PTSD and Chronic Pain

  • Increased sensitivity to perceived threats
  • Processed through and influenced by the Nervous system.
  • Takes time and energy to cope with the symptoms.
  • Becomes the focus of attention and energy and takes away from other tasks.
  • Changes the relationship we have with our bodies.
  • Affects the mind, heart, relationships, and work life.
  • Engage in activities to protect or brace oneself.
  • The environment and support system can affect how one deals with these conditions and how large the suffering is.
  • Thoughts, feelings, and actions can affect how significant the pain and suffering are.
  • Common human experiences of these conditions involve fear and lack of control.
  • They are both incredibly demanding teachers who force sufferers to create boundaries, carefully manage themselves, and control their surroundings.

Cognitive Biases

Both trauma and chronic pain involve attentional and reasoning biases toward potentially threatening stimuli. These biases can increase the suffering of the person. Catastrophizing, which can involve imagining the worst-case scenario, believing that you’re in a worse situation than you are or exaggerating your difficulties, is common with trauma and chronic pain and can increase the intensity of your pain or suffering. Often trauma and chronic pain sufferers can end up having selective and negative interpretations of things that evoke pain or fear.

Often people with trauma and chronic pain have heightened expectations or overestimations of how their condition has impacted them and the losses due to their condition. Furthermore, pain may serve as a traumatic cue, evoking fear and PTSD intrusion and hyperarousal, and vice versa.


Avoidant coping style, depressive symptoms, and fatigue are could lead to physical deconditioning, inactivity, and disability – all preventing fear extinction. This can prevent recovery as fear can maintain both conditions. PTSD-related anxiety may also directly influence pain perception.

Cognitive Overload

Cognitive overload is a situation where one is given too much information at once, or too many simultaneous tasks, resulting in not being able to perform or process the information as it would otherwise happen if the amount was instead sustainable. It characterizes both conditions, and it leads limited capacity to employ adaptive coping strategies. Both trauma and chronic pain can lower your cognitive load capacity because of your pain and other symptoms.

How Trauma Can Complicate Chronic Pain Recovery

Effect on Conditions

Several vulnerabilities and processes may make an individual more prone to developing chronic pain following trauma. These vulnerabilities with the circumstances of the traumatic event can:

  • Affect the emotional responses in the encounter, such as fear, anger, or disgust.
  • Initiate cascades of cognitive bias, a systematic error in thinking that occurs when people are processing and interpreting information in the world around them and affects the decisions and judgments they make.
  • Hypervigilance,
  • Avoidance behaviour
  • Autonomic responses, such as fight, flight, or freeze
  • Muscular responsivity, which involves when muscles over- or under-respond to sensory input.

PTSD hyperarousal is associated with increased pain perception and dissociation with decreased pain perception. Combat-related PTSD is associated with increased pain thresholds, whereas accident-related PTSD is associated with decreased pain thresholds. Accident-related trauma is linked to an anxious and sensitizing reaction. Whereas combat-related trauma may lead to a dissociative and habituative reaction. Subjective pain reporting most often points in the direction of a more severe symptoms profile concerning pain, disability, and distress when comorbid PTSD and pain persist.

Effect on Treatment

Trauma can have negative consequences on the common treatments and relationships that are important for healing. Some of these challenges include:

  • Trauma can affect a person’s capacity to trust healthcare professionals.
  • Pain can impact access to coping strategies, such as coping strategies that involve positions or movements that increase pain.
  • Common pain management strategies such as relaxation and mindfulness exercises can bring back trauma memories or trigger aspects of trauma.
    • Often these strategies can make people with trauma feel uncomfortable relaxing a protective state. Generally, a sense of safety needs to be established before these strategies can be effective.
  • May be hard to apply pacing strategies, due to a sense of worthlessness unless productive and feeling distress for taking breaks.
  • May be hard to set boundaries if hyperaware of others’ displeasure, such as people who have people-pleasing tendencies.

Biological Mechanisms

The biological mechanisms behind pain sensitization and the development of chronic pain are complex but include regulatory mechanisms in the hypothalamic-pituitary-adrenal axis, inflammatory processes, immune system suppression, and fatigue. More complex interpersonal traumas such as physical and emotional abuse associated with war or sexual assault are of such a pervasive nature that the ability to trust others can be severely damaged, resulting in attachment insecurities that further increase the risk of developing long-term pain problems.

Chronic Pain and Trauma

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Treatment of Co-Occurring Trauma and Chronic Pain

Having knowledge and understanding of trauma and chronic pain can benefit sufferers and promote recovery. These conditions are both very complex and understanding how different things you think and do can have an impact on these conditions can help you reduce your pain and suffering from them.

Therapies Beneficial for Both Trauma and Chronic Pain

EMDR and Cognitive Processing Therapy are two evidenced-based PTSD therapies that can also be effective with chronic pain. EMDR also has chronic pain-focused protocols, which can make it easier for a therapist to move between the two conditions. Cognitive Processing Therapy (CPT) teaches the client a skill that can be applied to both thoughts relating to PTSD and chronic pain. Since trauma and chronic pain have similar mechanisms the treatment of trauma is likely to result in benefits with the chronic pain.

Most trauma therapies can be effective with chronic pain if the therapist is knowledgeable about chronic pain and can figure out how to make changes and bring aspects of chronic pain into the treatment. Integrating CBT techniques in the treatment of comorbid PTSD and chronic pain can also be effective.

What to Look for in a Therapist

When seeking treatment with a therapist for both trauma and chronic pain, it is important that the therapist is knowledgeable about chronic pain. Also, that the therapist knows the complexities of suffering with chronic pain including space for fatigue, challenges with pain, and challenges with the medical system. Unfortunately, some therapists who don’t have this knowledge can end up unintentionally gaslighting their clients through a lack of understanding and expectations of their clients.

The therapist may need to be flexible enough to adjust trauma treatment plans to incorporate aspects of chronic pain. Some therapists who are trained in chronic pain-specific treatments and therapies may be able to combine them with trauma therapies to give you the best possible outcome.


Trauma and chronic pain are difficult conditions to deal with and suffering from both can make the experience of each worse. There is hope and there are treatments that can improve the condition of both conditions.

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What is the Default Mode Network (DMN)?

The Default Mode Network (DMN) is a system of connected brain areas that influences what you think about when you are not focused on a specific task. It can influence your pattern of reactions to social situations and what you think about yourself. It can be behind problems with rumination. There are ways to calm down your Default Mode Network.

What is the Default Mode Network?

The default mode network (DMN) is a system of connected brain areas that show increased activity when a person is not focused on something else. The DMN is especially active when one engages in introspective activities such as daydreaming, contemplating the past or the future, or thinking about the perspective of another person. It is the default state that your brain goes to when you are not focused on a particular task.

When your default mode network kicks in you may start with daydreaming. However, you may start to ruminate over what happened the day before and what will happen in the days to come. If you tend to be anxious about past and future performance, then the default mode network can hijack the mind to mull over worries when it does not have something else to focus on.

Brain Regions Involved with the Default Mode Network

The default mode network (DMN) spans a number of brain regions, incorporating parts of the prefrontal, parietal, and temporal cortices that show joint activation, or deactivation, in connection with particular mental functions. The DMN is distributed across three major subdivisions (Raichle, 2015):

  • Ventromedial prefrontal cortex (vmPFC), which plays an important modulatory role when coping with adverse conditions, and regulates motivational drive in favour of goal-oriented behaviours.
  • Dorsomedial prefrontal cortex (dmPFC), which often has been associated with self-referential judgments in the present and is activated by attention-demanding tasks that require the subject to reflect on their own psychological state or those of others (Denny et al., 2012).
  • Posterior hub including the posterior cingulate cortex (PCC), adjacent precuneus and angular gyrus, are thought to support the recollection of past experiences, including autobiographical information and previously studied items.

This process is mediated by functional coupling with the medial temporal lobe and hippocampus, which are known to be sensitive to the temporary accumulation of daily experiences and are recruited in the memory-based construction of future scenarios (Andrews-Hanna et al., 2010; Shannon et al., 2013).

Default Mode Network

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How is the Default Mode Network Connected to Mental Processes and Suffering?

The default mode network is about self-focus and mental time travel, and its inactivity appears to be related to varied forms of mental illness. The DMN is involved in episodic memory processing, with introspection and autobiographic memory as important cognitive processes.

The default mode network is more connected in the brains of lonely people. There is more activity in the DMN in the brains of lonely people. These people often spend a lot of time thinking about what happened in the past and what will happen in the future, all with feelings of worry, anxiety, and dread.


Humans spend nearly half of their time engaged in thoughts related to their plans, everyday concerns, and experiences.  “Daydreaming” or “mind-wandering,” has been shown to utilize areas in the DMN (Fox et al., 2015). Planning involves an increased engagement of the DMN around future-oriented thoughts.

Self-Referential Judgments

The Default Mode Network is an integrative system for sustaining inner narratives. This means the way we think of ourselves, our expectations of ourselves, and our relationships of with aspects of our world are influenced by the DMN. It influences how we see ourselves in the world. These inner narratives can push us towards perfectionistic, timid, and polite tendencies.

Social Evaluations

DMN regions are activated in tasks requiring understanding and interacting with others, including interpretation of others’ mental states, inference of intentions and beliefs, and subjective evaluation of their behaviour. This means if you tend to think of others’ intentions in a certain way, that is through the lens you will see the world. It is also involved in reasoning about one-self in the context of social interactions with others.

Chronic Pain

The default mode network is involved in the pain experience and that chronic pain can reorganize “the dynamics of the DMN and as such reflect the maladaptive physiology of different types of chronic pain” (Baliki et al., 2008). Pain rumination in chronic pain patients can lead to strengthen the connectivity within the DMN (Kucyi et al., 2014). Strengthened connectivity between the DMN and insular cortex has a relationship to ongoing pain intensity and duration in individuals with chronic lower back pain (Loggia et al., 2013) and fibromyalgia (Napadow et al., 2012). Chronic pain sufferers can get caught in continuous loops at the cortical level which can turn into developing more persistent states of pain.

Alzheimer’s Disease

Alzheimer’s disease (AD) is a progressive condition primarily associated with memory loss. The regions affected by AD also support DMN functionality, changes in DMN activity are thought to be seen in people affected by the disease.


Schizophrenia is a complex psychiatric disorder characterized by altered perception, delusions, cognitive deficits, and abnormal emotion regulation.  There is an altered functional connectivity of the DMN with other brain areas in people with schizophrenia, that is associated with both positive and negative symptoms (Hu et al., 2017).


Clinical deficits in ADHD, including issues with attention and impulsivity, have been reported in association with delayed maturation of the DMN. Specifically, ADHD studies have consistently displayed increased functional connectivity within the DMN and across the whole brain.


One of the defining features of depression is brooding rumination, characterized by a passive and recurrent focus on depressed mood and its consequences (Treynor, Gonzalez, and Nolen-Hoeksema, 2003). The Default Mode Network seems to be critically involved in these ruminative processes.

Default Mode Network

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How Can I Change My Default Mode Network?

Relaxation techniques, mindfulness, meditation, and even deep breathing can quiet the default mode network.


Meditators learn how to become aware of self-related thoughts, emotions, and body sensations, trying to separate the experience of these feelings from self-identifying with them.  Reduced DMN activity has been found across different styles of meditation, including focused attention, mantra recitation, and loving-kindness. Furthermore, fluctuations in the activation of this network seem to correlate with the degree of focus during the practice.

Relaxation Techniques

Relaxation techniques, including mindfulness meditation and breathing exercises, can help reduce DMN activity, dampening the impact of self-reflective thoughts and resulting in increased present-moment awareness (Brewer et al., 2011).

Cognitive Techniques

Cognitive Behavioral Therapy (CBT) and other cognitive therapies can be used to retrain the brain, including the DMN through helping individuals regulate their thoughts and emotions.

EMDR Therapy

EMDR therapy can have the therapeutic benefit of achieving normalization of default mode network dysfunction.

Aerobic Exercise

Doing aerobic exercise communicates to the DMN to calm down along with the additional benefits of less self-criticism and rumination after exercising in nature.

Hobbies and Novel Activities

Engaging in hobbies and novel activities can also induce a shift in thought processes, contributing to an increase in a person’s sense of self-worth and self-efficacy.

Social Interactions

Finally, engaging in social interactions can help the person assume alternative points of view on problems and disengage from passive, ruminative problem-solving tendencies (Yeshurun, Nguyen, and Hasson, 2021).


The Default Mode Network can be a powerful influence on your mental state. However, you have the ability to change its influence from one that causes suffering to one that presents a calmer and more relaxed state.

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What is Mindfulness?

Mindfulness is the practice of fully attending to the present moment without judgment. The options of how to practice mindfulness are almost limitless. Additionally, there are many benefits to a regular mindfulness practice.

What is Mindfulness?

Mindfulness is the practice of fully attending to what’s happening, to what you’re doing, and what is happening in the space around you. However, this is often not easy at the beginning as you find your mind wandering, so you need to gently bring your focus back to what you are observing with your senses.

Mindfulness is an ability that every human being has, but you need to learn how to access it. It can involve focusing on sensations to root yourself in your body in the here and now. It is also looking at the world through a lens of simply accepting what is in your world without judgment.

Mindfulness practice is a way to gently retrain the mind to settle into the present moment. By practising mindfulness over and over with patience and compassion for yourself, you can teach the mind to be still.

How to Do Mindfulness?

Mindfulness can be done while:

  • Seated
  • Walking
  • Standing
  • Moving
  • Laying down
  • Engaging in activities of daily life (washing dishes, eating, cleaning, etc.)
  • Engaging in activities of self-care (yoga, fitness, doodling)

The easiest way to practice mindfulness is to focus on the breath, resting your attention on the inhalation and exhalation repeatedly.

  • Begin with becoming aware of the sensation of your breath. Feel the rise and fall of the belly and chest. Feel the breath moving in and out of your lungs.
  • When you notice your mind has wandered, simply bring the attention back to the breath without judging yourself or “rating” your performance. You are simply being with and observing the breath.
  • You can practice for a set amount of time or moments throughout your day.

Ultimately, you’ll be better able to maintain your practice if it is meaningful and enjoyable for you.


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What Does It Help?

When engaging in mindfulness just do the practice. If you focus on the benefits you may nullify them.

When you’re mindful, you can reduce stress, enhance performance, gain insight and awareness through observing your mind, and increase your attention to others’ well-being. Mindfulness meditation gives us a time in our lives when we can suspend judgment and unleash our natural curiosity about the workings of the mind, approaching our experience with warmth and kindness—to ourselves and others.

Benefits of Mindfulness include:

  • improving cognitive ability
  • slowing brain ageing
  • reducing stress, anxiety, and depression symptoms
  • increasing a sense of well-being
  • helping with pain management
  • improving quality of life for those living with chronic conditions
  • increasing well-being
  • reducing perceived stress,
  • increasing job satisfaction in the workplace
  • reducing anxiety
  • reducing depression symptoms
  • reducing fatigue
  • providing relief from digestive disorders
  • improving symptoms of sleep disorders
  • improving immune response


There are many benefits and few costs to establishing and maintaining a regular mindfulness practice. Once you retrain your brain, you are able to take mindfulness breaks from all the thinking you do. That is when you will find the real benefits.

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What is Gaslighting?

Gaslighting is a form of manipulation and psychological abuse that can be very damaging to the victim. It can appear in many aspects of life and can really affect your health and well-being. There are ways to recover from gaslighting.

What is Gaslighting?

Gaslighting is a form of psychological or emotional abuse that manipulates someone into questioning their own sanity, memories, or perception of reality. They do this by questioning your authority, denying the evidence you have or doing everything they can to make you feel like you’re wrong. Sometimes on the surface, it may appear as a difference of opinion, but the purpose if to undermine or control you.

Gaslighting may be subtle at the beginning with the gaslighter changing small details in stories or memories and eventually the details get bigger and bigger until the person being gaslit starts to question their own intuition and the ability to trust themselves. This leaves the gaslighter with the opportunity to gain dominance in the relationship as the misinformation beats down your self-image.


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Types of Gaslighting


Countering is when someone questions a person’s memory or aspects of a person’s memory. This is often done by saying things like “That wasn’t the way it happened.”


Withholding involves someone pretending they do not understand the conversation, or refusing to listen, to make a person doubt themselves. They may also say that they don’t understand what you’re talking about or that you’re crazy for talking the way you do. This commonly happens when you confront them about their gaslighting.


Trivializing occurs when a person belittles, disregards, or invalidates how someone else feels. They may accuse them of being “too sensitive” or “overdramatic,” or overreacting in response to what are valid and reasonable concerns. This may cause you to think that your emotions aren’t valid in any way. After experiencing this type of gaslighting, you may find yourself becoming afraid to open up your emotions or believing that everything bad that happens is entirely your fault alone.


Denial involves a person refusing to take responsibility for their actions. They may do this by pretending to forget what happened, saying they did not do it, or blaming their behaviour on someone else. It ignores events and feelings. Gaslighters often engage in denial when you try to confront them about their gaslighting behaviours.


Diverting is when they deny your emotions or what you’re trying to say, except they involve another point of view. For instance, they might say that you got that idea through your friends, or it was misinformation you read from a biased source. Additionally, they will try their best to divert your attention from the reality at hand by saying that you were influenced to think or feel that way. Unfortunately, you may end up believing them – that maybe your emotions were never real in the first place.


A gaslighter may intentionally use negative stereotypes about someone’s gender, race, ethnicity, sexuality, nationality, or age to gaslight them. For example, they may say that no one will believe a woman if she reports abuse or that you’re emotional because you are a woman. Stereotyping is similar to trivializing, except their reason is based on who you are as a person. They will use perceived flaws against you to turn things in their favour.

What Does Gaslighting Sound Like?

  • “You’re so dramatic.” “You’re too sensitive.” “You’re overreacting.” “You’re too emotional.”
  • “You’re imagining things.” “You know you sound crazy right now, right?” “You’re always making stuff up.” “You’re making a big deal out of nothing, like always.”
  • “You’re being paranoid.” “You’re not thinking clearly.”
  • “I was joking! You take everything personally.”
  • “That never even happened.” “This is what happened…” “This is what I said…”
  • “You’re making yourself the victim when I’m the one who should be mad.”

Many gaslighting statements start with the word you. This is because the gaslighter/perpetrator is an expert at identifying the supposed deficiencies in another person and hardly ever acknowledges or takes personal responsibility for the impact of their own statements or behaviour.

Why Do People Use Gaslighting?

Unfortunately, gaslighting can be more effective and successful than many people imagine. Almost anyone can be susceptible to gaslighting tactics, which are often used by domestic abusers, dictators, narcissists, and cult leaders. They use them so they can get their way and, if necessary, control other people in order to get their way.

Not everyone who engages in gaslighting realizes that they are doing it. It still involves gaining control over the mind and behaviour of the victim. Some people engage in gaslighting because it is what they observed in their family as a child. Other people may engage in gaslighting because they lack skill in communication, and it acts as a defence mechanism. Regardless of a gaslighter’s level of self-awareness, the behaviour is never acceptable, and ignorance should not be accepted as an excuse for manipulative actions. 

Gaslighting can occur in any type of interaction, but it is especially common in:

Intimate Relationships

Gaslighting is common in domestic violence situations. But it can also happen in otherwise non-abusive relationships. Anyone can gaslight another person in a relationship. It’s more likely that women will be gaslit by men in romantic relationships. However, gaslighting still happens to men by women, it’s just not as common.

In relationships, an abusive person may use gaslighting to isolate their partner, undermine their confidence, and make them easier to control. Gaslighting often starts gradually. Initially, the abusive person gains their partner’s trust through an initial honeymoon period where there is no abusive behaviour. The partner subtly starts to initiate gaslighting by suggesting that their partner is unreliable, forgetful, or mentally unstable.

Child-Parent Relationships

Abusive parents or caregivers may gaslight children to undermine them. For example, when a child cries, they may say they are “too sensitive” to shame them and make them stop. Gaslighting is also often used to control older children and adolescents towards the parent’s way of thinking. It may be used to manipulate the adolescent to do what the parent wants.

Medical Gaslighting

Medical gaslighting is when a medical professional dismisses a person’s health concerns as being the product of their imagination or downplays their legitimate medical concerns. This can refer to situations in which a medical provider may not have meant to mislead or manipulate the patient. Instead, they failed to take their concerns seriously or to pursue them in an attempt to reach a diagnosis. In addition, some physicians use gaslighting to dismiss people’s (specifically women’s) medical concerns. This is unfortunately common with people suffering from chronic pain and other chronic conditions. This may cause you to feel irrational about specific medical fears or concerns.

If you feel that your doctor is gaslighting you, it may be a good idea to switch to a new one or find a second opinion from another doctor (such as visiting a walk-in clinic or urgent care clinic). When it comes to your physical and mental health, you should feel that your concerns are being taken seriously.

Racial Gaslighting

Racial gaslighting is when people apply gaslighting techniques to an entire racial or ethnic group in order to discredit them or deny the experiences of that group. For example, the denial of the abuses of the Residential Schools would be a form of racial gaslighting.

Political Gaslighting

Political gaslighting occurs when a political group or figure lies or manipulates information to control people. For example, the person or political party may downplay things their administration has done, discredit their opponents, imply that critics are mentally unstable, or use controversy to deflect attention away from their mistakes.

Institutional Gaslighting

Institutional gaslighting occurs within a company, organization, or institution, such as a hospital. For example, they may portray whistleblowers who report problems as irrational or incompetent, deny unfair employment practices, or deceive employees about their rights.

How is Gaslighting Damaging?

Some potential signs that someone is experiencing gaslighting include:

  • Feeling incompetent, unconfident, or worthless
  • Becoming withdrawn or isolated from others
  • Constantly feeling confused or like you’re going crazy.
  • Having difficulty trusting yourself and other people.
  • Constantly assuming you did something wrong or feeling the need to apologize.
  • Making excuses for other people’s actions or rationalizing why they did something that hurt you
  • Feeling like you have to prove everything.
  • Feeling like you constantly have to back up your reasoning/views of things with an abundance of facts.
  • Sensing something is wrong but feeling like you’re not able to “put your finger on it.”
  • Regularly feeling misunderstood and alone.

Gaslighting may contribute to anxiety, depression, low self-esteem, low self-image, low self-worth and psychological trauma, especially if it is part of a wider pattern of abuse. It often targets victims at the core of their being: their sense of identity and self-worth. As the gaslighter insists that what he or she remembers, thinks, and feels is wrong, the victim may experience increased feelings of self-doubt. Eventually, the gaslighter will start to lie about more sensitive areas, attempting to disrupt and distort foundational aspects of the victim’s being, wearing them down, confusing them, and forcing them to rely on the gaslighter’s version of reality.

Gaslighting can be psychologically devastating. It violates a person’s sense of trust in themselves and others. It can change a person’s worldview from that in which people are generally good to wondering who else is out to get them. Victims of gaslighting may forget what they once valued about themselves and blame themselves for having been too trusting, vulnerable, or dependent. The experience may make a victim never want to be part of a relationship again.


Photo by Marc-Olivier Jodoin on Unsplash

How Can You Heal the Damage from Gaslighting?

Gain Awareness

Gaining awareness of this type of psychological abuse is a crucial element of healing and moving forward. Being able to discern or recognize that someone is gaslighting you is an important first step.

Find Validation

If you feel like might have been gaslighted, the answer to that is validation. Go to a trusted individual to give you feedback about what you have been going through. It is helpful to be honest about your experience (notice any urges to withhold information or lie to potentially protect the gaslighter) and to get someone else’s perspective. Realize that gaslighting is often best recognized as a pattern, but it can be clear in some one-off circumstances.

Nonetheless, if you’ve been experiencing gaslighting for a long time, it is understandable if it’s difficult for you to discern who is actually trustworthy. In this case, it is recommended to seek therapy with a therapist experienced in emotional abuse to help you navigate what you are going through. Through therapy, you can gain increased self-awareness, recover trust in yourself and your intuition, and attain practical tools to feel empowered in your relationships.

Have Space from the Other Person

Gaslighting is one of the most draining and toxic behaviours that can ever be done to you. When you have space from the other person, it helps you reflect and analyze the situation’s reality without being manipulated into their version of the truth. Sometimes, space is all you need so you can think of a logical reaction to being gaslit.

Collect Evidence

Collecting evidence to support that it’s not just all in your head, but that event took place is important. Evidence can be used to support yourself or be used to confront the gaslighter.

Set Boundaries

More often than not, gaslighting happens because of the lack of boundaries you set in certain relationships and friendships. You can’t be manipulated if you know exactly what you tolerate and what you don’t, which is why the people being gaslit are often those who don’t know how to set boundaries and stick to them.

Confront Them

This is one of the most complex parts of being gaslit because you should expect they’ll do everything to manipulate things in their favour. When you confront them, make sure you have the confidence to do so and stand your ground, even when they make you feel insane, insecure, and doubtful of your version of the truth. Trust in your instincts, believe in yourself, and confront them with how their behavior and actions are affecting you negatively. Don’t try to comfort them when they play the victim, and don’t try to lessen your version of the truth for their sake. It’s painful enough that you were gaslit, so the best thing you can do is confront them about it.

Things to Say When You’re Being Gaslighted:

–              “I realize you disagree with me, and this is how I see it.”

–              “I see that your perspective is different from mine, I’m not imagining things.”

–              “This is my experience, and these are my emotions.”

–              “I feel like I’m not being heard, and I want some space.”

–              “I’m making this decision for myself.”

–              “I’m not responding to that.”

–              “I want to figure things out for myself.”

–              “I get that you’re mad, and I’m angry too.”

Suggested Key Components of Communicating These Statements Successfully:

–              sustain eye contact (if appropriate to your culture)

–              be mindful of your posture (stand or sit straight)

–              facial expressions (serious, firm, and pleasant; refrain from using dismissive gestures)

–              body movements (balanced, relaxed, and open)

–              tone of voice (calm, soft, and firm)

This may take practice to convey these messages in a clear and assertive way. However, communicating in a passive, passive-aggressive, or aggressive manner can prevent you from asserting your rights, wants, and needs. Additionally, it can also encourage the recipient to either communicate more aggressively or become defensive and not hear you.

Ultimately, it’s very hard for others to dispute the content of what you’re saying when you stay focused on describing yourself. In contrast, describing the situation or another person are the types of statements that are much more easily disputable. Remember that your emotions are valid, and you have the right to feel and express them. You also have the right to ask for what you want and what you need.

Also, realize in your unique situation, confronting them may not be safe. If you sense that it is not safe to confront them, it may be better to hold the line and protect yourself emotionally until you are able to walk away.

Walk Away

The hardest part of being gaslit is that if they’re not going to change their behaviour, which is the common tendency, you need to walk away from that friendship or relationship. Being gaslit is highly detrimental to your mental health, so to keep your sanity, walk away from them as early as you can before they destroy you further.

Remind yourself how healthy personal and professional relationships should operate. Healthy relationships should have honesty, trust, and communication. They should also be respectful and supportive. If you realize that your relationship with the gaslighter is missing these qualities, it’s time for a change.

You then need to evaluate if the relationship is worth saving, or if you simply need to leave. A therapist may be able to help you talk about these issues, sort out your feelings, and make an action plan. Gaslighting often takes a huge toll on your mental health. It’s important that you learn to trust yourself again. Remember that this may take time, as well as the support of family, friends, or a professional. With time and the right support, you can, and will, recover.


Gaslighting can be a very damaging type of emotional and psychological abuse. There are ways to reduce the damage and find healing from the wounds caused by gaslighting.

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What is Reconciliation?

Reconciliation is the process of restoring harmony to a relationship. It is not a fast process but a slow one of renewing trust and intimacy. You may not be able to find reconciliation with every relationship as reconciliation takes two sides coming together with honesty and a willingness to work together to make the relationship work.

What is Reconciliation?

Reconciliation is the act of reconciling, which is the process of restoring harmony to a relationship, such as a marriage, a friendship, or between two people or groups. It can happen to a relationship that is broken or damaged, the people in the relationship do not have to be physically separated or have a complete rupture. Reconciliation can happen after a significant wound has happened to the relationship such as something that is seen as a betrayal.

In Canada, we often hear about reconciliation in relation to Indigenous People and the Government of Canada, but reconciliation can happen between other relationships. Reconciliation is not a fast process. It is slow and won’t happen overnight. It requires patience on both sides. Ultimately, reconciliation is a process that slowly allows trust to rebuild, forgiveness to happen, and reconciliation to emerge.

Reconiliation Comes After a Wound has Harmed a Relationship

For a broken or damaged relationship, healing needs to come to the wound that damaged the relationship in the first place. It may be a wound to one person or both people that has caused a wound to the relationship. Nevertheless, the wound has caused damage to the relationship. Both sides need to be able to set aside the anger, pain, and/or resentment that led to the damage to the relationship. This does not have to happen right away, just that it is able to happen if they feel heard by their partner.

Reconciliation involves the healing of the wound and the harm that the wound has caused. For example, the wound of one of the partners in the marriage cheating may come with multiple harms. This probably has wounded the trust of the other person on multiple levels and the belief in the cheating partner’s commitment to the relationship. Hurtful things said can also cause additional wounds.

Role for Each Person Involved in the Reconciliation

If one partner has acted badly, the other partner may want to look for the 3 “R” s: Remorse, Repentance, and Recompense in that partner’s response. The injuring partner should be emotionally present and acknowledge the pain created by their actions. There should be an apology that includes: accountability, vulnerability, and empathy. An explanation should be provided, including motivations, which makes actions more predictable to our partners. The injuring partner should respond to the injured partner’s fears and needs, change hurtful behaviour, should not dismiss or downplay hurtful behaviour, and should not resent doubts about their sincerity.

Make space for the hurt partner to speak about the pain, speak for their feelings, but not only from their feelings. It is important for them to feel like their partner is listening and to feel heard. Attention needs to be paid to the wound for it to heal.

Commitment Towards Healing Needs Language that Supports It

Reconciliation needs both sides committed to exploring the wound and how to make it better so that the wound and the harm caused doesn’t continue to fester. It is important to focus on non-confrontational “I” messages and to avoid language that may cause the other side to feel defensive.


Photo by Giang Vu on Unsplash

What is Needed for Reconciliation

Both Sides Must be Willing to Explore It

You cannot have reconciliation if only one side wants to heal the relationship. It cannot be one-sided. Neither is it where one person submits to the other. Additionally, it is important to consider if you have enough mental resources available to reconcile and build the relationship.
You need both people willing to participate in the process. This doesn’t mean that both people need to trust the other because the level of trust was likely harmed. Both people need to be honest, willing to listen, and have a desire to see if the relationship can be restored. It is important to accept the other person with where they are now. Check your ego, and stop trying to prove you are right.

Forgiveness is not needed at the beginning of the process, but the possibility is needed. Additionally, forgiveness is not the same as reconciliation. Forgiveness can happen without reconciliation. Reconciliation can start before forgiveness is given. However, reconciliation continues after forgiveness as the rebuilding of trust and the relationship continues.

Reconciliation is impossible if one side is unwilling to engage in the process. If that is the situation for you, you need to make a decision on what you are going to do with the relationship. Will you stay in it with the wounds and harm? Let it go with an open door if the person changes their mind in the future. Or let it go and move on with your life. You can forgive without reconciliation. You do not have to reconcile with an abusive partner. There may be things that have to happen before reconciliation is possible, such as addiction treatment or therapy for a mental health condition. Ultimately, the decision whether to reconcile is up to you.

Both Sides Must Acknowledge the Wounds and the Harm Done

Reconciliation starts with the acknowledgement of the wounds and harm that has been done. This requires both sides to be honest about the circumstances that led to the wounds and harm. It is important that both sides avoid defensiveness and certain aspects of what happened.

There is a need for both sides to be honest so that the other side can understand what happened from their point of view. This can be done through listening to understand instead of listening to reply.

Both Sides Must Work Together to Find Healing

This is a process where both sides are working together to find healing for the harm. At this point, it is important to leave the past behind and focus on the present and the future. Work together to seek common ground and avoid each other’s triggers. It is important to manage expectations as you may not get everything you want.

Above all, it is important that you know your boundaries, values, and beliefs within this process. It is a process of working together to figure out how to find healing for the relationship. Future wounds can come from a lack of boundaries. Boundaries are good for relationships because they let others know what your limits are and what you are comfortable with.

It is about compromise and figuring out how to make the new version of the relationship work for both. It is not a process in which you should sacrifice yourself for the other side. Both sides need to be comfortable with how much you are giving to the other person or side.

Both Sides Must Work Together to Restore Trust and the Relationship

Reconciliation is a process that leads to a place where trust can be restored as well as the relationship. The new status of the relationship should be one that both sides are comfortable with. This should include boundaries that allow both sides to feel comfortable and respected. There should be a reflection of the story of the relationship together. The end goal is the restoration of the relationship.


Reconciliation is the process of restoring a relationship between two people or two sides. It takes both sides working together to restore that relationship. Not every relationship is able to be reconciled.

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