Getting A Second Wind: Revisiting Your 2018 Goals

It’s February 28th, which means we are 59 days into 2018 and for some (myself included) - the New Year's resolutions that looked promising and hopeful on January 1st may feel considerably less so. Whether or not you set yearly resolutions, we all have some practice of goal-setting, whether it is in career, school, relationships, or personal life. While reaching goals often feels rewarding, unmet goals can elicit frustration, self-doubt, or self-criticism. These thoughts and feelings can often be enough for us to call it quits. However, this does not need to be the case. If the adage “experience is the best teacher” is true (and I think it is!) goal-setting (and striving positively) can always be an instructive and productive process.

First of all, let’s acknowledge that goal-setting itself can activate a whole range of automatic thoughts and emotions. For some, identifying goals can be motivating and exciting, whereas for others it may feel overwhelming and induce anxiety. We may experience optimistic thoughts, like “I think this will be a great experience” or possess skepticism and think “Well, any progress isn’t going to last”. As cognitive-behavioral therapists, we believe that identifying how we are thinking about a situation is just as important as the thought itself. Observing how we think and feel about goal-setting is a first step towards honest self-reflection, challenging unfair expectations of ourselves, and recognizing inaccurate beliefs about our ability that get in the way of goal-setting. It may be helpful to ask yourself:

  • What thoughts or emotions did/do I have about setting this goal?

  • What information or experiences have I had already that supports that my thought is true? Is there any information that contradicts my thought as true?

Onto the act of goal-setting:  While there are many ways to set goals, I have found the S.M.A.R.T. acronym a helpful guideline (Doran, 1981).   Is your goal Specific, Measurable, Achievable, Realistic, and Time-based?

Let me provide a specific example from my own life:  I’d like to be more environmentally conscious in 2018, and in my goal-setting process, I have broken down my goal into a bite-sized chunk. For example, I decided: S - I want to reduce my material footprint on a daily basis, M - I will take my daily coffee in a reusable thermos, A - Yes, I have multiple reusable options in my home/workplace, R - I can make coffee at home or request that a barista fill my thermos when purchasing it, T - I commit to this every morning. I will continue for 3 months and then reevaluate how things are going. Although it can be tempting to set goals that represent the ideal life we’d want, identifying reasonable and smaller goals goals that account for your present reality is essential. In fact, choosing goals that seem to be smaller than you think you should choose is a good first step. Why? Because being successful in smaller goals allows us to begin building a foundation to support more complex goals (e.g. if I can bring my thermos to work regularly, then I can add the goal next of always carrying reusable shopping bags with me, scaffolding on the same habit I’ve already created). Making our goals overly ambitious sets us up for quick setbacks that typically result in a barrage of self-criticism which pulls us off track of problem-solving and habit building.

Importantly, there are always setbacks in meeting goals. How we respond to the setback is critical.  Do we shame ourselves or over-personalize the setback (e.g., I forgot my coffee thermos twice this week, so this week is a wash; How could I forget my thermos-am I just an irresponsible person?!). Instead, we can “take the shame out of the game” and get curious about what happened and do some fact-finding. Here at CTWPS, we are very invested in staying curious and supporting your problem-solving. Reach out to us if we can help!




Doran, G. T. (1981). There’s a S.M.A.R.T. way to write managements’ goals and objectives. Management Review, 70, 35–36. Dörnyei, Z. (2001). Motivational strategies in the language classroom. Cambridge: Cambridge Language Teaching Library.


Dating Challenges

While dating can be a fun and exciting period of a woman’s life, many women find it difficult to maintain optimism while seeking a committed relationship, especially when she has been working at it for some time.  While dating can certainly be challenging at times, at CTWPS we aim to help women reduce any feelings of distress or hopelessness that might arise. The first step on that path is to help women examine their thinking and behavior when it comes to dating, and this involves identifying any thinking traps that a woman may fall into as she works toward her goal.

One common cognitive distortion that can be provoked by dating is the “fortune telling” error. The fortune telling error takes place when one assumes a negative outcome will occur without fully evaluating the probability of that outcome. It acts as a mental shortcut, allowing conclusions to be drawn using limited available information. Often, the negative predictions made by the fortune telling error can lead to a woman feeling sad, resentful, or anxious. Consider the following beliefs:

“I’ve been on so many bad dates, this one will be no different.”

“Nobody will want a woman who looks like me.”

“I’m never going to meet someone who will be okay with my commitment to my job.”

“I want to end my unsatisfying relationship, but I don’t think I’ll meet anyone better.”

If this kind of thinking feels familiar to you, you are far from alone! When a woman tells herself one of the statements above, she believes it and feels it, most probably because she has actually experienced it in some way. However, while our past experience is important, it does not allow us to make perfect predictions of future dating partners or relationship outcomes. And when we engage in fortune telling and assume a negative outcome, we risk impacting our mood negatively, as well as our behavior.

For example, consider a woman who tells herself that if she isn’t married by age 35, all hope is lost and she will never find someone. This woman may find herself feeling increasingly depressed as she nears the dreaded age, which may cause her to spend less time socializing and going on dates. While nothing has actually changed about her, and there is no evidence that she has “expired” as a potential romantic partner, her mood and her behavior have changed, fulfilling her belief that she is out of the game. This woman’s fortune telling about her prospects ends up encouraging the feared scenario. Another example might be a woman who tells herself that all dates that she goes on are terrible, and so she’s not going to bother putting herself out there with this one because it will turn out just as badly. She goes into the date unenthused, resentful, or withdrawn, and the date ends up being a bust. Unintentionally, this cognitive shortcut is resulting in the opposite outcome of what she really wants, and it confirms her belief. She comes out of the date fulfilling her faulty prophecy that all dates are bad.

Here at CTWPS we work with women to influence what they can do to maximize their experience of dating. We would determine together whether “mental shortcuts” or thinking habits are inhibiting her dating life or expanding it.  We would also consider ways to align her dating behaviors so that they are consistent with her long term goals of partnership.  Dating and finding a partner are similar to other goals, and can definitely benefit from an approach of positivity and flexibility.

Surviving Infertility with Your Mental Health Intact

Women struggling to conceive often express how frustrating it is to be unable to get pregnant once they’ve decided the timing is right - after years spent trying to to avoid untimed pregnancy. Many women lament the fact that friends and family members appear to become pregnant when their husband or partner “simply looks their direction;” while they may spend months peeing onto ovulation sticks, tracking basal body temperatures, and timing sexual intercourse. A friend’s pregnancy announcement on Facebook may trigger an acute sorrow for the woman who has been injecting hormones into her stomach, waking at 5:00 am for monitoring appointments, and experiencing repeated disappointments for months on end. There is no doubt, a feeling of utter unfairness accompanies one’s (unwelcome) membership to the community of women who struggle with infertility. To add salt to the wound, oftentimes “membership” is granted only after a year (or several years) of failure, after many invasive medical exams, and, in the case of repeated miscarriage, after enduring heartbreaking losses.

Managing the myriad of emotions that come with infertility can be incredibly taxing, on both male and female partners. Anger, sadness, jealousy, fear and disappointment are just a few of the emotions that may arise when struggling with infertility. Depending on an individual’s unique personality traits, history, vulnerabilities, and life stressors, sometimes these emotions become truly impairing and develop into clinical depression and/or anxiety. At CTWPS, we are attuned to these issues – we understand the emotional toll of infertility on you and your relationships, and we honor the psychological anguish that often comes with this journey. While we cannot wave a magic wand and make you pregnant, we can help you cope with the negative emotions you may be experiencing about your body, your partner, and the process of conception. We can help you develop tools for managing depression and anxiety in the face of disappointment and loss. And, through it all, we can support you by providing a safe, judgment-free space to express the full range of emotions you may experience.

When addressing infertility-related mood concerns, cognitive-behavioral therapy functions in the same way it does for many other mental health concerns. CBT aims to help the individual 1) see the relation between her thinking, mood and behavior; 2) develop skills to evaluate her thinking in order to view their life circumstances as accurately and helpfully as possible; 3) engage in healthy behaviors that promote optimum mental health; and 4) develop the ability to tolerate uncertainty, discomfort and adversity that we all invariably experience in life.

One of the primary goals of treatment at CTWPS is to increase hopefulness. To do so, we first need to acknowledge the intense fears that underlie catastrophic or fearful thoughts. These thoughts are real and significant, and yes, there is almost always a kernel of truth to our greatest fears. However, while the worst case is possible, it is almost always unlikely – and living in that place of “worst case scenarios” before it is a reality, is unproductive.

Oftentimes, our minds jump to worst case scenarios out of an innate desire for certainty: “If I know the worst is going to happen, then at least I don’t have to wonder, wait, and worry.” However, living in this dark place of hopeless negativity is counterproductive to our mental wellbeing, and may leave us feeling sad, depressed and helpless. Thus, the work of CBT is to increase our tolerance of uncertainty (and adversity), such that we can properly assess the opportunities we do have to improve or change the situation. Taking action – rather than catastrophizing – provides a sense of self-efficacy, hopefulness, and the opportunity for positive change.

Infertility can be extremely stressful and overwhelming, heartbreaking and painful. For couples who are ready to conceive, the disappointment of unrealized expectations can become emotionally disheartening or even debilitating.  At CTWPS, we recognize how lonely this struggle can be. Our goal is to support you during this difficult time by providing emotional support, by teaching you strategies for managing maladaptive thought processes, and by offering practical strategies for navigating your life and relationships in the face of infertility. Our goal is to help you live a full and balanced emotional life, whereby a set-back like infertility is a challenge, but is not life-defining.

Braking News: Slowing Down Our Relationship with the News

Like many – I have a love-hate relationship with keeping up with the news. While I believe it is important to be informed, sometimes the information can feel overwhelming; it is easy to go from reading countless updates on a breaking story to avoiding the news entirely. With today’s unfettered access to the news, our contact with breaking stories may be more frequent, immediate, visual, and perhaps for some, intrusive.  News websites, apps, notifications on our phones, and social media are only a few ways we access current events, intentionally or not. For most of us, this increasing exposure may be major shift in our relationship with news media. How might these changes affect our thinking, emotions, and actions?

Research suggests that the way people consume the news can significantly impact their well-being. On the one hand, watching the news has been associated with emotional distress and negative attitudes; on the other hand it has also been linked with increases in knowledge, one’s likelihood to vote, and civic participation (Bodas, Siman-Tov, Peleg, & Solomon, 2015; Hao, Wen, & George, 2014; McNaughton-Cassill, 2001, Roche, Pickett, & Gertz, 2016). How then, can we develop a healthy way of thinking about and engaging with the news? Below are a few suggestions.

1.  Be proactive, not passive, in your news consumption:

It is easy to go on autopilot when it comes to news consumption, allowing information to come to you unfiltered.  But remember, you are the primary curator of the information you receive and this is an important job. Take stock and record your news consumption patterns over the span of a week. If you do not have established habits that feel good, make a decision based on your personal values about how much time you’d like to spend daily on conscious news consumption.

One way to do this might be by identifying times that are less than ideal to engage with the news (e.g., after a stressful day, when you are feeling unwell, right before bed), and times of day that are most ideal (e.g. “I will look at the news around 8:30 and at 4:30”).  Turning off social media notifications may be helpful. Limiting content that may be emotionally taxing or personally triggering because of your own history and not re-watching videos with disturbing images are simple ways to also create intention around your routine.

As psychologists here at CTWPS, we encourage our patients to test out both the utility and validity of their thoughts. We help women identify evidence in their daily lives that challenge thought patterns that may in fact be inaccurate, incomplete, or unhelpful. In the spirit of encouraging critical thinking, we suggest reading the news from multiple sources. Media outlets often report from a specific lens. Gathering a range of perspectives on a single story may help create a more balanced perspective.

2.  Consume news thoughtfully.

Negative news cycles can affect our thinking.  It may seem like every breaking headline on a given day features the latest act of terror, injustice, natural disaster, or sexism.   It is a cynical fact that negative news cycles grab the attention of the public more quickly, via anxiety, than stories about puppy rescues. The media industry is rewarded by presenting negativity more than positivity, and we should always factor that bias into our experience. Expanding the content range of your news consumption (e.g., a brief Google search on “advances in medical research this year”) is one way to challenge the negative bias built into how the news is often packaged.

If, after watching the news, you notice your mood lowering, you may be engaging in some distorted thought patterns that were triggered by negative news.  An example of this might be the catastrophic thought “The world is falling apart”, which has some truth in it (some parts of the world are in great dysfunction), but does not acknowledge all of the functional and joyous aspects of the world - and your personal world - as well.

3. Prioritize self-care.

There is a lot happening in New York City and the world. Given our busy lives and responsibilities, it can be easy to delay self-care or overlook its importance in how we consume news. Yet research exists pointing to a greater need for self-care if we are frequently exposed to stories that include multiple traumatic events and images (Holman, Garfin, & Silver, 2014). Some self-care practices we would recommend at CTWPS are using relaxation techniques to reduce stress and manage your sleep. Talk with friends and colleagues so you are not isolated in your experience. Explore your own spiritual beliefs or supports as a way to address larger questions that may come up around news stories about injustice and suffering. Get in touch with your personal values which may help you narrow what types of stories to pay attention to and empower your news consumption. If you are able and interested, get actively involved in a cause or organization to help feel empowered and part of a positive story.

However, if you are finding yourself significantly distressed because exposure to particular events may be personally triggering or preoccupying, please seek out professional support. We are happy to support you and your mood by finding ways to boundary your news exposure with you, and teaching you more skills for coping in our modern age.


  • Bodas, M., Siman-Tov, M., Peleg, K., & Solomon, Z. (2015). Anxiety-inducing media: the effect of constant news broadcasting on the well-being of Israeli television viewers. Psychiatry, 78(3), 265-276.

  • Hao, X., Wen, N., & George, C. (2014). News consumption and political and civic engagement among young people. Journal of Youth Studies, 17(9), 1221-1238.

  • Holman, E. A., Garfin, D. R., & Silver, R. C. (2014). Media’s role in broadcasting acute stress following the Boston Marathon bombings. Proceedings of the National Academy of Sciences, 111(1), 93-98.

  • McNaughton-Cassill, M. E. (2001). The news media and psychological distress. Anxiety, Stress and Coping, 14(2), 193-211.

  • Roche, S. P., Pickett, J. T., & Gertz, M. (2016). The scary world of online news? Internet news exposure and public attitudes toward crime and justice. Journal of Quantitative Criminology, 32(2), 215-236.


Beyond Love: How Our Thinking Impacts Our Relationships

All couples experience periods of difficulty in their relationships. Occasional disagreements, disappointments, and frustrations are a part of every long-term committed relationship. When things get complicated many women find themselves trying to improve things, but they may discover their efforts are met with resistance from their partners, or are simply ineffective. This can prove immensely frustrating, and women and their partners run the risk of falling into a cycle of misunderstanding and distance.

One challenge in communication with our partners is the belief that the onus is solely on our partner to change. When things are rocky, it is natural and understandable to assign blame to one’s partner.   And sometimes in frustration with our partner, we employ maladaptive strategies to the conflict -  giving the silent treatment, picking fights, or engaging in sarcasm or manipulation to get our partner to change. Not only do these strategies typically not work, they further disconnect us in relationship. 

The good news is that there are strategies that can be implemented to create more connection, and it starts with our own thinking. The somewhat radical first step toward the goal of a closer relationship is to start with ourselves! At CTWPS, we work with women to identify and address difficulties in their relationships, with a special focus on both the thinking and the behaviors that can perpetuate problems of disconnection. Below are three of the most common distortions in thinking that come up for women in relationships: 

1.  Negative bias

Negative bias occurs when the positive aspects of our relationships are washed away by overemphasizing the negative qualities of the relationship, or “reading negative”. Addressing this requires really taking stock of how you view your partner. Idealization vs. devaluation is one kind of biased thinking: imagine a woman when she is most in love with her partner. He is perfect! The kindest, most attractive, smartest, most considerate partner; she wonders how she ever get so lucky to have him! But when her mood changes and she is angry or frustrated with her partner, the picture quickly darkens. She views him as selfish, inconsiderate, inattentive, and far worse than her friends’ partners. She feels foolish for having ended up with him. This kind of black and white thinking conceptualizes our partners as being either all good or all bad. At CTWPS, we help women create an honest accounting of how they view their partner, and provide specific training on how to create a balanced perspective of their partner (even in conflict!).  

2.  Rigid expectations and rules: the power of “shoulds” in your relationship. 

We learn about what relationships are “supposed” to look like from many sources - observing our parents’ partnership when we are children, hearing about friends’ relationships, even experiencing fictional characters’ love in books and movies. The lessons we learn are internalized deeply as a set of “shoulds”: i.e., if my partner loves me, he should do a certain behavior every day, or verbalize certain things, or spend a certain amount of time with me. These “should” beliefs are so closely held that when our partners do not live up to them, we can feel deeply unloved and hopeless about the relationship. However, these “shoulds” vary across individuals, and many times a woman’s partner is simply unaware of what hers might be. Adherence to a set of “shoulds” can get relationships into trouble when our partner’s benign behavior is interpreted as malicious or rejecting because it does not align with our “should” beliefs. In therapy at CTWPS, we take a close look at a client’s “shoulds”. Sometimes these beliefs run so deep that we see them as fact, and so acknowledging them as beliefs rather than facts is the first step toward developing flexibility internally and with our partners. We’ll search together for opportunities for perspective taking, communication, and behavioral adjustments that can make all the difference in the level of comfort and ease you feel with your partner.

3.  Wanting to win

We all like to win! But sometimes a woman’s desire to protect her position prevents her from engaging in effective communication. When it comes to having critical conversations with a partner or asking for what we need, many women find themselves thinking about it as a zero-sum game in which there is a “winner” and a “loser”. The assumption here is that someone in the discussion is right and someone is wrong, when in fact often both partners see the same set of circumstances in different ways, both feeling and being “right” from their perspective. Women can find themselves stuck between two tough options: I can be honest and true to myself and attack my partner (“winning”, being right), or I can be peacekeeping and swallow my needs by withholding the truth (“losing”, being wrong).   At CTWPS, we work with women to increase cognitive flexibility, to move beyond a winning-and-losing style of communication, and to increase the number of options a woman has for maintaining closeness with her partner. 

Conflict is hard, and it is easy for any of us to fall into some distorted patterns of thinking when stressed. At CTWPS, we will support you in your relationship goals by teaching you strategies to manage your thinking process and keep your perspective as clear as it can be (even when you are in conflict with your partner).  These steps start with your perspective and are the beginning steps to creating healthier communication and relationship.

Part I: Catching the Thinking Traps of Perfectionism

Many of our patients here at CTWPS struggle with perfectionism in one way or another.  By perfectionism, we mean holding high standards for herself in any area of her life and then becoming overly self-critical or anxious if she does not meet that high standard.  While many women consider perfectionism to be a positive characteristic, we as therapists see the darker side of perfectionism - when the experience of imperfection results in distress, depression or anxiety for a patient.   

In our practice, we find that women can develop evaluations of themselves that are contingent upon personally demanding, self-imposed standards. For example, consider a woman who believes that she must deliver her presentation flawlessly in order to be considered competent in her work, or a woman who is overly self-punishing if she falls a few pounds short of her target weight, despite consistent dedication to her new diet and major health improvements.  Whether it be the constant striving to meet perfectionistic ideals, or the idea that imperfection on the path towards achieving reasonable goals should result in major (often self-imposed) consequences, perfectionism can be an unhealthy mindset for women.  Perfectionism has been linked with such negative consequences as anxiety and low mood, poor nutrition from excessive exercise or dieting, poor concentration, or even procrastination at work to avoid feeling imperfect.  

There are certain cognitive biases, or thinking styles, that are most prominent among women who hold themselves to perfectionistic standards.  Do you find that you go beyond setting high standards, such that your sense of self feels contingent upon how well you live up to these standards?  If so, it may be helpful to examine the impact that your thinking has on your mood. Below are three common thinking biases to consider:

1.  Selective Attention

Do you find that you’re really skilled at noticing the negative aspects of your performance and discounting the positive?  Consider a woman who has recently been promoted to a more senior position in her organization for her stellar performance, but who constantly feels as if she is failing at work, and who worries tremendously about making mistakes.  When this woman makes a minor mistake, such as a typo in a memo, she automatically discounts the positive aspects of her performance, such as her promotion and praise from her boss.  Even more, because of her style of thinking, she concludes that she’s a failure.  In this instance, this woman actually confirmed her negative belief about herself as “failure” by attending disproportionately to negative information.  

In therapy, we would work to help this woman recognize her pattern of scrutinizing her own performance.  We may invite this woman to keep a record of provocative situations (e.g., her typo), her corresponding negative thoughts (e.g., “I’m a failure”), and ways to broaden her attention in the moment so as to notice actual evidence of her performance, ultimately arriving at a more balanced view of herself (e.g., “When I consider the evidence, the memo was well-written and effective overall”).  We may also invite this woman to keep a record of her positive achievements, so as to become more balanced in the attention she devotes to her view of herself. 

2.  Double Standards

Are the rules you set for yourself stricter than your rules for others?  It’s quite common for overly perfectionistic women to hold themselves to strict, difficult-to-achieve standards, but to adapt a more flexible set of standards for others.  For example, let’s imagine that, when asked, the woman described above explains that she believes it’s reasonable for other people to make occasional grammatical errors in their memos without discounting their intelligence, and yet, believes it’s unacceptable for her to make such a mistake.  In expecting more of herself than she does of others, this woman becomes quite vulnerable to self-criticism.  For example, she may tell herself, “Because I’ve made this mistake, I’m a failure at my job.”  This critical self-talk likely has a cascade of consequences for her, such as over-compensating by spending exaggerated amounts of time checking over her memos before sending them to her team, or beating herself up such that it becomes difficult to concentrate and meet future deadlines.  

In therapy, we would work with this woman to consider whether it’s fair to have harsher rules for herself than for others.  We would work together to track instances wherein her double standards are activated, and together, we would explore the impact of holding double standards on her self-esteem and mood.  

3.  “Should” and “Must” Statements

What do you tell yourself to get motivated when you have to get something done?  Often, perfectionistic women attempt to motivate themselves, and to protect against poor performance, with “should” statements, such as “I shouldn’t make any mistakes at work” or “I should always work harder.”  At CTWPS, we work with women to think of this type of self-talk as overly rigid, and to recognize that it can have potentially destructive emotional consequences.  For example, let’s imagine you have a friend who wants to exercise more regularly, and she says to you, “My goal is to exercise 7 days a week.”  How might this pressure make her feel?  Likely, she would feel highly stressed because she inevitably cannot live up to this goal consistently! 

In therapy, we invite women to self-monitor, and keep track of how often throughout the day or week they use “should” or “must” language, as a way to highlight how ingrained this style of self-talk may be. We also work with women to log their absolutist thinking, and to replace such statements with flexible preferences, such as: “I would like to exercise more regularly.”  We know as psychologists that setting more readily attainable goals actually results in better outcomes than setting extremely high goals.   With practice, women find that their performance actually improves when they set more flexible and reasonable goals for themselves.  This is most likely because imperfection and setbacks are part of every goal that has ever been achieved.   

For so many women, a sense of striving for perfection can be a consuming thread in their lives.  Here at CTWPS, we believe that every woman has within her the potential to achieve her goals while living a balanced life that includes time to relax, socialize, and pursue varied interests.  In fact, those factors are known to enhance performance overall.  In our practice, we actively work to help women to identify and challenge the thinking biases that keep their perfectionism in place, to experiment with more flexible behaviors, and to cultivate more realistic and compassionate expectations of themselves - not because we don’t want to encourage ambition, but because we actually want our patients to be highly successful.

This post is Part I in a series on cognitive-behavioral approaches for perfectionism.  Check back for more posts in this series coming soon.  

Overlooked and Under-treated: Postpartum PTSD

Pregnancy and childbirth can be a joyous and exhilarating time. However, for some women, fertility struggles, high-risk pregnancies and unexpected childbirth experiences result in psychological trauma. Throughout the past quarter-century, research examining the impact of childbirth on maternal mental health has yielded valuable insights for understanding Postpartum Depression (PPD). Thankfully, PPD has become increasingly well-documented and recognized by the obstetric and psychiatric communities, and (for better or worse) has been much-publicized by the celebrity set. Worryingly though, less is known about another, equally troubling postpartum occurrence: the development of Posttraumatic Stress Disorder (PTSD) following childbirth. 

Women suffering from postpartum PTSD present with a set of symptoms similar to that of other traumas – symptoms of avoidance, re-experiencing, and hyperarousal. For example, ‘avoidance’ may take the form of requesting a tubal ligation to prevent subsequent conception, abstaining from sexual intercourse, using multiple forms of birth control simultaneously, terminating subsequent pregnancies, or requesting an elective C-section for subsequent deliveries.  Symptoms of ‘re-experiencing’ may include intrusive flashbacks of the birth, nightmares of dying during childbirth, experiencing birth-associated pain during intercourse, and re-living the traumatic birth on anniversary dates. ‘Hyperarousal’ may take the form of chronic muscle tension, a hyperactive startle response, or the experience of panic symptoms when faced with reminders of the delivery – particularly during gynecological exams and visits to doctors’ offices or hospitals. Further, the physiological arousal of posttraumatic stress may also intensify postpartum sleep disturbance and fatigue, and cause a mother to be overly anxious about the health and safety of her baby.

At Cognitive Therapy for Women Psychological Services (CTWPS), we comprehensively assess and monitor women for all forms of psychological distress as they navigate the journey through pre-pregnancy, pregnancy and the postpartum period. We seek to provide a safe place where you are free to explore your personal experience (be it traumatic or fantastic), without fear of shame or judgment. 

Through our work together, we will help you identify your thoughts and beliefs about your experiences that may contribute to increased feelings of sadness, fear, anxiety or depression.  Trauma naturally creates distortion in our thinking and in our emotional life. We support and challenge you to untangle and dismantle the parts of your personal narrative that do not currently support you well. While it may be natural for your mind to be pulled toward negative thoughts as a form of protection - we will help you master skills to shift these negative thoughts, and to move you away from fears and anxieties. It takes time and commitment to do this work – no doubt – but at CTWPS, we are committed to being your witness, your guide and your biggest cheerleader as you navigate the emotional complexities of your reproductive experience.  

Work-Life Balance

Women are receiving more encouragement than ever to fulfill their potential in the workplace. But paid work doesn’t always support a rich personal or family life.  Often, ambitious (and exhausted!) women find themselves over-extending in order to juggle all of their responsibilities. Some women even contemplate leaving the workforce entirely because they believe that their needs for flexibility at work, and for shared-responsibility at home, are impossible to achieve. 

We recognize that women continue to carry a disproportionate burden of labor across their work and family lives as compared with men.  Our goal here at CTWPS is to help women create more options so that they don’t have to choose between a career identity and a fulfilling private life.  If you’re seeking to cultivate a fulfilling work-life balance, consider these three tips:

1. Collect Data About YOUR Workplace: 

Many women are too fearful to negotiate for flexibility in the workplace because of the belief that they will be unsupported or penalized for vocalizing their needs.  Sometimes this belief reflects a woman’s workplace accurately; other times, however, this belief may represent the deprivational way a woman already experiences the world.    

Let’s consider a new mother who is debating whether to stay at her job with demanding hours and travel requirements that are currently incompatible with her caretaking responsibilities.  How is this working mother likely to advocate for herself if she believes that negotiating for more flexibility would be met with a lack of support, or even a penalty? The odds are that she will either over-extend herself in all of her roles, or she might even quit her paid work altogether if that is a possibility.  

In our practice here at CTWPS, we would ask this woman to collect real information about her workplace in order to prepare her appropriately for a renegotiation of her role. What kind of information should she collect?  We would encourage her to consider whether anyone else in her workplace takes advantage of flextime, part-time, or the kinds of hours she would prefer.  If so, at what level of the organization are they?  Does anyone else acknowledge outside responsibilities as they leave work early?  What does the organization say they support in terms of work/life flexibility (even if no one takes advantage of it)?  Can she make a financial argument to the organization about why she should work differently?  What kind of changes in her pay and position can she afford to make?  Are there trusted individuals she can speak to who can guide her in her negotiation?

Ultimately, we encourage every woman seeking work-life balance to ask herself: How would my work need to change to meets the demands of my private life?  Alternatively, we may encourage her to consider the reverse - does something need to change in my personal life to better support my career?

2. Be Your Own Communications Director 

Once you’ve identified a specific way you’d like to shift your role at work, it’s time to manage your own public relations. After all, no one will ever advocate for you as passionately, or in such detail, as you can for yourself.  You can begin by creating a plan regarding with whom you will speak and how you will frame your concerns. Women working with us would likely create a thorough strategy about how they might assert their needs, as well as their value and commitment to their work.  

From an organizational perspective, women who experience their job as being compatible with their private lives are generally more confident in their roles and tend to stay in their job longer. This adds tremendous value not just for the individual woman and her family, but also for her company. 

3. Be an Active Manager of your Private Life  

Sometimes the biggest area of conflict for a woman is not in the workplace, but rather at home.  Outside of the workplace, women tend to devote many hours each week to managing their home-based responsibilities.  One of the most stressful issues women face is the unexpected excess of home-based work, regardless of their work situation.  We encourage our clients to develop skills in seeking support from their partners at home (if they have one) to lessen that burden.

At CTWPS, we fundamentally believe that there are extensive benefits to her work and family systems when a woman cares for herself well and seeks appropriate supports.  Conversely, the risk of a woman not accessing support is high – increased couple stress, mood problems, a lack of joy in mothering, or a tendency to “check out” at work (just to name a few).  In our work with clients, we take the long view, and encourage women to approach the management of their home-based work with the same level of attention and care that they devote to their paid work.  

We recognize that it takes courage and effort for women to experiment with establishing greater flexibility and balance in the workplace or in their home lives.  We can’t always guarantee that the organizations for which we work, or our partners at home, will be receptive to all of the changes we seek.  But without our engagement, we can assume that the status quo (whatever that looks like) will remain unchanged.    



New Year's Resolutions: Myths that Interfere with Action

We all seem to be compelled to set New Year’s resolutions on January 1st.  For many of us, January 1st provides an opportunity to reflect back over the previous year, and to set new intentions for the year ahead.  While nearly half of women making New Year’s Resolutions, remarkably few – only 8% of women – are actually successful in achieving them.

As cognitive-behavioral psychologists, we want to dispel the myth of willpower when it comes to setting and achieving resolutions.  After all, our willpower, or ability to “white knuckle” changing our behaviors with intense focus, may typically last a few weeks (because, let’s be honest, life interferes, we get distracted, and we may not continue to highly prioritize the original goal).  When this happens, we must rely on other mental and behavioral strategies to keep us on track.   We believe that most women are simply not set up for success with the strategies and skills necessary to persevere as they pursue their goals.  If you’re thinking of setting a resolution for yourself in the New Year, below are 7 ideas we encourage you to consider.

1.  Is my goal specific enough? It’s no surprise that driven, motivated women tend to set highly ambitious goals, such as losing weight, increasing their productivity at work, or saving money.  However, one of the most common reasons that these kinds of resolutions tend to remain unmet is that they are actually not specific enough. So, our first task to select one goal and ensure that it is highly specific.  For example, a woman may refine her goal of “losing weight” by deciding that she will lose 5 pounds this year. 

2. Do I really want to commit to this goal? Once we’ve identified a specific goal, it’s critical that we evaluate our readiness to commit.  This process often begins by first acknowledging that not meeting our goal does have advantages.  For example, the woman described above may note that committing to weight loss triggers anxiety or fears of failure (I’ve joined the gym before, only to waste my money).  She may also note that committing to the behaviors of weight loss may result in less time to do other activities that she believes are more enjoyable.  By contrast, in exploring positive ramifications of moving towards her goal, she may recognize that consistent exercise may increase her self-esteem and mood, which, in turn, may serve to increase her motivation towards weight loss.  In therapy, we would work with this client to realistically examine the pros and cons of committing to her goal at this time. 

3. How do I develop a plan? Once we’ve identified our readiness to commit to a goal, we need a detailed action plan.  For example, the woman above interested in losing 5 pounds is now ready to break down that goal into specific actions.  In therapy, we would encourage this woman to step back and consider which specific days, at what specific times, and for how long, she can realistically expect herself to exercise, determine a weight loss plan, purchase and organize food, and so forth.  This longer-term goal can now be activated.  Additionally, we would encourage this woman to consider solutions to potential obstacles prior to implementing her action plan. For example, perhaps this woman walks by a tempting bakery on a daily basis.  One of her actions may be to commit to an alternate route so that she is not so easily triggered.

4.  The all-too-common problem of over-ambition in goal setting:  Ironically, being too ambitious is likely to short-circuit our action plans.  It is our experience as clinicians that setting the bar low enough so that we are experience just enough of a stretch is the key to successful goal-setting in the long runWhy? Because the negative and self-critical thinking that occurs when people inevitably disappoint themselves on occasion is the number one culprit interfering with our ability to stay on task with our goals.  The good news is that over time, we can expand that stretch, as new, helpful habits are formed that are congruent with our goal.

5. How do I stay positive and motivated? The psychology of goal setting is just as important as the behaviors of goal setting. Whenever we try to change our behaviors, we may have negative self-talk that interrupts our process emotionally and behaviorally. In therapy, we teach women strategies to identify their negative thoughts in the moment, so that their thinking isn’t allowed to interfere with the incredible investment they are making in achieving their goals.  We help our clients to replace their “task-interfering” thoughts with beliefs that are more “task-oriented,” positive, and realistic.  For example a client might admit, “I was thinking about how unmotivated I was to go for a run, so I ended up blowing it off that day.”  We might help her reframe those thoughts going forward by saying, “Even though I TOTALLY don’t feel like going for a jog, once I get moving, I will probably have more energy and feel proud that I did it and it will have been worth it.” Reframing our thinking helps us keep on track behaviorally, which in turn, helps us eventually meet our goals.

6. Expect and welcome bumps in the road!  Perhaps our greatest task as cognitive-behavioral psychologists is to help our clients debunk the myth of perfect linear progress in goal setting. We know that challenges and setbacks are to be expected, and that no change happens without a few bumps in the road. In fact, these “bumps” often help us learn more about situations that are particularly challenging, and force us to solve important problems around a specific goal.  So, it’s actually in our best interest to welcome these challenges for the critical information they provide.

7.  Success is not about being good!  Women are so tough on themselves. As clinicians who work exclusively with women, our biggest concern is how often we see clients conflate success in meeting their goal with a type of moral goodness (and therefore, setbacks in goal setting are interpreted as a type of moral badness).  

Please keep in mind that reaching our goals has very little to do with the goodness of our character, and far more to do with our motivation for change, the specificity of our goal, and a thoughtful action plan.  

We wish you Happy Holidays and a Wonderful New Year!





Managing the "Mansplain" at Work

Rebecca Solnit aptly captured the essence of the “Mansplain” experience in her essay entitled, “Men Explain Things to Me” (2008).  Solnit described a time when she had been mansplained, or interrupted by a man, who then went on to explain the meaning of a book to her without acknowledging that she, in fact, had written it.  In response to her essay, the “mansplain” quickly became a cultural phenomenon, as it resonated with the experiences of women throughout the country who were frequently interrupted or condescended to by their male colleagues.

So how can we, as women, respond effectively to the mansplain?  As cognitive behavioral psychologists, we recognize that a woman’s internal experience of the “mansplain” has the power to exert tremendous influence over what she believes, says, and does, therefore impacting her professional identity. Let’s imagine, for example, that you’ve just begun to share an innovative idea during a weekly brainstorming meeting, only to be interrupted by a male colleague, who goes on to expand upon the same idea and take credit for it.  Although there are many possible reactions to this experience, below are three possible thought processes that may emerge for a woman in the face of this “mansplain:”

1. “I can’t challenge him, because the fact that he did that probably means I AM inferior.”

The gravest risk to a woman’s professional identity occurs when, in the moment she has been interrupted or dismissed, she becomes silenced beneath the chatter of her own self-doubt. This woman tends to personalize her colleague’s behavior because it resonates with an underlying fear of incompetence or failure that she harbors about herself. After all, she might think: why else would my colleague have had the audacity to mansplain to me? Behaviorally, the repercussions may be significant, as she may silence herself in meetings going forward, becoming complicit in the mansplain.  One way to address these kinds of issues in therapy may be to support this woman in challenging the unhelpful beliefs and fears that she carries about herself.  In turn, this woman may begin to experiment with advocating for herself at work, thereby utilizing more self-affirming strategies for collaborating effectively with colleagues on group projects. 

2. “I want to challenge him, but is it worth risking my professional reputation?”

A different woman may be able to depersonalize her male colleague’s behavior because she recognizes the validity of her ideas (and how important they are to the work itself).   However, this woman may still feel silenced by the sense of professional risk she experiences while using her voice.  In fact, research indicates that when women are assertive and advocate for their ideas, they are often labeled as more “aggressive” as compared to their male colleagues displaying the same behavior.   In the face of what has been termed the “likability penalty,” a woman may be apt to objectively examine the possible outcomes of speaking her mind. For example, if her colleagues do begin to see her as aggressive – or even bossy (oh no!) – can she tolerate their perspectives?  When, where, and by whom does being perceived as sometimes aggressive become problematic? One way we might address this issue therapeutically is by helping a woman develop cognitive strategies to tolerate that some colleagues will perceive her as aggressive some times (if she is indeed doing her work well), and that usually it is not catastrophic to her professional reputation.    

3. “I am going to respond because this man’s approach is not helpful to the completion of our work together or to my professional identity.”

A third woman may experience herself as competent, and as such, may recognize that her male colleague’s behavior is more reflective of his desire to be seen as confident and strong in the workplace than it is a conscious devaluing of her.  This woman, whose professional identity remains intact, is likely to feel empowered by the desire for her ideas to be recognized as having value, and for the work itself to be done well.  The challenge for this woman – and what could be reinforced in therapy – is to develop the facility in the moment to empathetically correct her colleague’s behavior, while also appearing collaborative.   However, what may be distinctive about his woman is her positive and accurate belief that she is already a relevant participant in the meeting and that her opinion matters (whether her colleague approves of it or not).  

The importance of depersonalization

As we can see from these examples, the more we can learn to depersonalize a colleague’s negative behaviors – that is, to truly understand that his inappropriate behavior has little to do with us and more to do with his issues – the more we are able to actively participate in group-based work projects without distraction.  Focused participation in the workplace is integral to a woman’s career success, and it begins with the assumption that her added value in the workplace is not dependent on constant approval by her colleagues.