Judgmental Language is the Death of Productive Conversations

I have been working on something for a client that got me DEEP into the thinking about why using non-judgmental language is so important. What came out of it is a handout that will be used for peer supporters but I think is so important for all of us to keep in mind in our everyday lives and connections!

Non-Judgmental Language

We as humans have an innate desire and ability to “group” things in our minds into categories – “like me” or “not like me,” “helpful” or “harmful,” all the way to basic judgments about whether things are “good” or “bad.” This is a protective instinct that we have that is intended to sort incoming information so that we know whether or not to move closer to things that are going to nurture us or run away from things that might hurt us.

These instinctual categorizations are really judgments – interpretations or opinions formed about what we see or hear. Judgments are not inherently bad – in fact, when we make a decision or form an opinion based on objective, authoritative information or good sense or wisdom, judgments can be very helpful. At times, though, our judgments may get in the way of our being open to new information or to others’ perspectives.

When it comes to helping others, we are best served by reserving our own judgments and trying to open ourselves to that person’s perspective and situation. We want to use non-judgmental language so that we don’t shut down someone else based on our own judgments or opinions.

What is non-judgmental language?

Non-judgmental language is a way of communicating with other people that encourages them to share about their experience. Non-judgmental language is using words that do not put a negative interpretation to what the person is sharing. Instead of using words like “good,” “bad,” “right,” or “wrong,” it is using more neutral and non-judgmental words to express that you are hearing the person, rather than judging what they say.

Why is using non-judgmental language important?

Speaking out of judgment (conscious or unconscious) can shut down a conversation, while non-judgmental language keeps the communication open and allows someone in need to be more vulnerable and share more, so that you have a better understanding of their situation and will be more able to offer help and show you care.

When we are trying to help and support someone, non-judgmental language is a way to demonstrate that we are open to and focused on what they are saying, that we are not disapproving or critical of them. We want to convey that we are supportive, sympathetic, and curious – all of which make us someone they want to open up to.

How do I practice using non-judgmental language?

Watch the words you are drawn to say in conversation. How often do you rely on words like “good,” “bad,” “right,” or “wrong” (or other versions of these words)? These types of words express that you have an opinion about what the other person is saying, rather than being open to their experience and listening to what they say.

Practice listening fully, trying to understand what the other person is saying. Reflect back to them what you understand, and ask curious questions about things you don’t understand. The goal is to try to understand their perspective, rather than trying to share your own.

Respond with observations, acceptance, and encouragement, rather than with advice, opinions, or judgment about what they said. Advice and opinions mainly serve to end the conversation, not to continue it. Letting the other person know what you observe when they are talking (“You were upset by what your friend said,” or “You get tearful when you talk about that situation.”) shows them that you are paying attention, rather than trying to figure out what to say next. Using words that convey acceptance (“It’s okay,” “That makes sense,” “I hear you”) make the other person feel heard and valued, and they are likely to share more.

Substitute curiosity – The antidote to falling into judgment (about ourselves or others!) is to be curious instead. When you find yourself feeling like it’s hard to reserve judgment or get yourself out of that thinking, try to reframe the judgment into a curious question – “What does it feel like…” or “Why do you think you feel that way?” instead of “You must feel…” or “Don’t feel that way.” Asking a question instead of stating an opinion opens the conversation and allows for more understanding, which will lead to less judgment!

We all want to feel heard and understood. Using non-judgmental language allows others to see us as someone who is open to hearing and understanding what they are going through, which helps them to feel more comfortable sharing vulnerable information and being open to our assistance. Using non-judgmental language sets us up to be a presence of connection and hope for people when they need it most.

Resources:

A Simple Method to Avoid Being Judgmental - https://zenhabits.net/a-simple-method-to-avoid-being-judgmental-yes-that-means-you/

Non-Judgmental Language: Helpful Phrases - https://www.uwsp.edu/hr/Documents/Site%20Documents/Human%20Resources/Non-Judgemental%20Language%20for%20Feedback.pdf

Jessie Everts, PhD LMFT

Empowered Leadership Coaching!

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I have been in leadership positions where I felt supported, competent and qualified based on who I was as a person. I’ve also been put in leadership positions where that was not the case. Often those from non-dominant backgrounds are shown how to be leaders from a male-dominated traditional model that doesn’t feel authentic and doesn’t make it feel like our own vision or qualities are what make us good leaders.

We need empowering leadership models that help us connect to who we are, our own vision for our work, and how to bring our whole, most authentic self into leadership positions. I want to help people to explore what being a leader means to them, how they can embrace their strengths and weaknesses to be their own most authentic leader, how to find and build the support they need, and how to lead with intention.

I hope to hear from all you leaders soon!

Jessie Everts, PhD LMFT

https://www.empowermentalhealth.org/leadership-coaching

How we solve the Opioid Epidemic

I promised to follow up on my presentation on the Fear and Pain Epidemic this week. The takeaways were BIG - big picture, big ideas, and a big change from the way we have thought about solving the opioid epidemic in the past.

First, it’s important to understand the fear and avoidance cycle that can get triggered after a painful event and cause what we call chronic or persistent pain, which is pain that persists beyond the normal course of healing from an injury. Two people can have the same experience of pain after an injury. One who has low fear of pain, based on previous experience or conditioning or lower anxiety sensitivity, etc. will continue to engage in activity and will achieve recovery or rehabilitation. The other individual, who experiences higher fear and catastrophizes the fear experience, which is influenced by their proneness to negative emotions or anxiety sensitivity, distress, and has unhelpful beliefs about pain – that it means damage, that it might be permanent, that it will be very difficult to deal with – experiences more fear of pain, which leads them to avoid activities related to the injury and that might be helpful in rehabilitation, and so the injured part falls into disuse, they might identify more with disability (which is then self-perpetuating), and fall into depression, all of which perpetuate the experience of pain on and on, which becomes chronic.

So, using this model, it gives us a lot of points of intervention to make strides in treating fear and pain, other than targeting the opioids. Catastrophizing can be treated preemptively by setting reasonable and realistic expectations about the pain experience, if possible – letting people who are facing surgery or other rehabilitation from injury know what pain they might experience and that pain is a part of the recovery process. When we know pain and related fear may arise, we can teach people ways to engage their parasympathetic “rest and digest” system to counter overactivity in the “fight or flight” system. This includes mindfulness practices, relaxation, breathing exercises, and physical practices like yoga that focus the mind and cultivate feelings of safety within the body. We can help people deal with their fear cognitively as well, with acceptance and mindfulness practices that reinforce pain as a signal, not something to fear and avoid. We can also help them to engage in exposure and de-sensitization therapies, to give people manageable experiences with pain that can show them, over time, that they don’t need to engage in “fight or flight” quite so quickly or automatically and that they can do some of the activities that will ultimately help them to heal. We can help people who experience pain to identify less with pain as a core part of their being, and to identify in ways other than “disabled” or with their disease. And, throughout all courses of illness or injury, we can learn about and promote alternative ways of managing pain – because these do exist and are more and more accessible! We have to help clients who experience fear of pain to see longer-term practices as more valuable than quick fixes.

Overall, the way we will solve the opioid epidemic is by using psychological approaches for fear rather than medical interventions for pain. If people can feel they have more control over their circumstances – by having choice, information that they can understand, and a sense of autonomy, that they can do something about their own health – they will experience less of the fear about pain that is the most debilitating. This includes giving information about what to expect, reducing the unknown about pain as much as possible. It includes encouraging participation and social connection, both of which can provide relief in those opioid centers of the brain. And we can be the ones who pay attention to people’s moods and their personal experience of pain. Where physicians must be the ones who ask us to “rate our pain on a scale of 1-5,” we can be the ones who take time to talk with people about their fears about pain, beliefs, expectations, anxiety levels, and ways to empower them to disengage from the cycle as much as they can.

Lethem, J., Slade, P. D., Troup, J. D., & Bentley, G. (1983). Outline of a fear-avoidance model of exaggerated pain perception: I. Behaviour Research and Therapy, 21(4), 401-408. http://dx.doi.org/10.1016/0005-7967(83)90009-8

Jessie Everts, PhD LMFT

The Fear and Pain Epidemic

There is no question that we are coming over the peak of an opioid epidemic. We have all heard the statistics. Over 130 people a day die of opioid overdoses in our country, and the number is not coming down quickly. Overreliance on opioid pain medication by prescribers, encouraged by Big Pharma, plays a large part in this epidemic – in 2016, there were 66.5 opioid prescriptions written for every 100 Americans. Nineteen percent (19%) of the population had a prescription, and the average patient had 3.5 prescriptions for painkillers (National Safety Council, 2018).

We are making strides on these fronts. We now have widespread mandated prescriber education on the risks of opioids, implementation of prescribing guidelines that limit the amount and length of time that a patient should have an active prescription, prescription drug monitoring programs in most clinical programs, improved data collection, more opioid overdose treatments and education, and more options for treating opioid use disorder when use turns into addiction.

So, problem solved, right?

I wish. Saying the above measures “solve” the problem of opioids is like saying we “solved” car accidents when we made laws requiring people to wear seat belts. They are fixes to the system that don’t get to the root cause of why this proliferation of opioids as a cure-all happened in the first place. I think also contributing to the opioid epidemic is an increase in Americans' attention to and perhaps fear of experiencing pain - both physical and emotional.

I’ve been diving deep into the research on pain-related fear and anxiety in preparation for a presentation on Monday at the Minnesota Association of Resources for Recovery and Chemical Health (MARRCH) conference. This session will talk about how this epidemic of pain and related fear has developed, interventions and possible solutions that incorporate understanding of co-occurring disorders and the psychology of addiction, fear, and pain. I’ve been learning some awesome things about how we might focus on treating fear of pain instead of relying on medications to stop pain that also sometimes inhibit our ability to heal from it. I’ll share some of my learnings here after the session!

Jessie Everts, PhD LMFT

Ask Anyway

We’ve been away, but for good reason – we’ve been busy! Empower Mental Health has been all around the state of Minnesota, engaging with providers on how to best address mental health! We have been talking with leaders about what struggles they are seeing and what some of the barriers to addressing them are…and there are a lot of each!

Here are some things we’ve learned. “Mental health” is a buzzterm right now, but a lot of people don’t really know what it means. When we talk about mental health, we’re talking about everything from anxiety, depression, and everyday stress, all the way to more severe things like suicidal ideation and aggressive behaviors that might come from an issue like schizophrenia or a neurocognitive disorder. Anxiety, depression, and stress are by far the most common things that people see around them, and these might be just normal feelings but also might be symptoms of a bigger issue that may require some kind of treatment.

Second, people don’t like to ask about others’ mental health because A) they think it will make the other person (or themselves) uncomfortable, or B) they don’t know what to do next. Okay! That is totally fine. Ask anyway. It absolutely might be uncomfortable to ask someone if there is something bigger going on for them than just an angry outburst or seeming isolated or withdrawn. Ask anyway. I love the “Seize the Awkward” campaign I’ve seen on commercials – it’s geared toward adolescents but does a great job of saying “it’s okay to talk about it, even if it’s awkward.” In fact, it is absolutely better to say something than nothing at all! Saying nothing makes it seem like it’s not okay to be struggling, which keeps stigma high and people quiet. And even if you don’t know what to say next, just the fact that you have asked opens the conversation. You can say “Is there anything I can do to help?” or even “I’m not sure what to say, but I’m glad you told me.” And you can always suggest that they find a professional (a therapist) to talk to – we therapists love to hear that clients come to us because someone who cares about them said they should talk to someone!

Here’s another thing you can do: write to our “Ask a Therapist” page and ask how you can support someone you care about who might be struggling with mental health. We love questions and can give you a few helpful hints about bringing it up or let you know how great a job you did trying it out!

Ask anyway! Breaking down the stigma around mental health helps us all – because we’ll all feel less scared about talking about things, and the struggles we all have will become more manageable.

Jessie Everts, PhD LMFT

Ask Anyway.

Why Online Therapy Is Worth It

One of the questions I’ve been getting a lot lately is “do you think online therapy is really as effective as in-person?” My answer is this: Maybe not, but the fact that it is reaching people who might never come into an office for in-person therapy outweighs the fact that it might not be as satisfying or relational as if they were in the room with me. I think we have to get over this “ideal therapy situation” concept as therapists – that if we can’t do therapy exactly in the way in which we are most comfortable, it’s not worth it. We are excluding so many people then for our own comfort (and privilege, see this past post for the whole soapbox)!

In my brief experience with online therapy, I am noticing that I get a lot of clients who say, in one way or another, “I don’t want to bother anyone with my problems.” I am guessing that this internalized message of disregard for their own importance would normally stop them from going in to see a therapist – where there is a lot of paperwork and effort required to make and get to an appointment, all the while they are telling themselves they are not worth it. So, the ease of online therapy breaks down some of these barriers and makes the initial inquiry easier and much more likely to occur! Wonderful! If someone can get in the “door” and express to me that they don’t feel worth any time or attention, it allows me to give them some, and to at least start working on those negative messages they have been telling themselves for who knows how long.

Also, I am seeing a lot more marginalized individuals via online therapy – those who identify as LGBTQ+ or of different racial or ethnic backgrounds. Those messages of “I’m not worth it” or “I don’t want to bother anyone” are strong in these groups! Maybe these are messages they have heard from our dominant culture, or have been taught to them growing up as coping strategies to fit in or acculturate. Shame. On. Us. for making whole groups of people feel unworthy of time, love, care, and attention. This is a big part of our jobs as therapists these days – to undo as much of these self-degrading thoughts and messages as we can. (It is much the same job as parenting, a post for another day!) We can do this in our lives as well as in our work – notice where society tells us to be small, invisible, silent, not needy or emotional – and counteract those messages. Take up more space there, amplify the voice and the presence of someone told to be quiet, and feel and show our emotions instead of stifling them.

Be a disruptor out there to make voices heard and emotions felt and mental health okay to talk about!

Jessie Everts, PhD LMFT

Therapy is not Magic

Therapy options now available, see our Therapy page!

Jessie Everts, PhD LMFT

In the Tunnel

Yesterday was World Suicide Prevention day and today is the 18th anniversary of the terrorist attack of 9/11. It’s a rainy, gloomy morning in Minnesota, and sometimes it feels like sadness is all around us. This is a feeling and sentiment that I’ve been hearing often in my work and in my life – sometimes it feels hopeless, and sometimes there is more darkness than there is light. We have days like this. We all do.

The most pain I’ve felt in my life is when I tried to deny those feelings, shove them down or pretend they didn’t exist; the best I’ve felt is when I let myself feel them, and then went “through the tunnel” (as a yoga teacher of mine says) and came out the other side. Because there is always another side. No feeling lasts forever, including sadness, depression, even hopelessness. Moreover, no feeling is as painful as we let ourselves believe. Sadness is just a feeling. Hopelessness is just a feeling. It’s a body response, and a spirit response, and the best thing we can do is pay attention to it, not judge it or try to stop it, but to see what it has to tell us. And then do something about it.

The key is to keep moving forward. We can let ourselves feel our feelings, to sit in them for a while, and then the job of life is to keep going. It might mean doing something to shake up our routine or to get out of our own heads. It might mean reaching out to talk to someone. It might mean taking a mental health day from work (please, employers, make this an option for everyone! Talk to me about how to make it happen!) and doing something to take care of yourself. When we do these things for ourselves, we can create a little bit more light in the world. When we tell someone else about our struggle and they feel they can open up about their own – there is a little bit more light. This is how we combat the darkness – by creating one little spark of light at a time.

Always feel welcome to ask a question or share your experience and create a little light here!

Jessie Everts, PhD LMFT

Out of the Office

With depression, substance use, and suicide rates climbing, we need to look at new and evolving ways of providing mental health services. The people who need therapy are often not going in to the places where it is being offered – private practices, clinics, etc. One thing we can do is look at who is and isn’t going to therapy and how we can reduce the barriers for people to get in. The other thing we can do is take mental health out of the office and to the places where people ARE. Schools, workplaces, homes, doctors’ offices – these are the places where people are going, and they all need to be infused with mental health messages, information, support, and options.

When we expect people to come in to an office for therapy, we’re basically saying that we only want to treat people with privilege – those who have the privilege of transportation, of flexible work and family hours, of money to pay co-pays and big deductibles (or – could we be more entitled? – self-pay only!), and also, the privilege of being able to walk into an unknown business environment and talk to a stranger about their most vulnerable inner thoughts and feelings – without overwhelming and often historical fear. Each one of these ignored privileges discounts thousands of people, especially those who could most benefit from mental health therapy because of these very reasons.

Taking mental health to nontraditional places helps more people be aware of their and others’ mental health. We also need to offer therapy in nontraditional ways, and often this means using technology that people are already using. Therapy by text, chat, video, and email are all ways to reduce the barriers for people who need mental health support but are not going to go in to an office to get it. While many “classically trained” therapists think these modes of communication are disingenuous or don’t lead to real connection and therapeutic environment – and they may be right. But it gets therapy to more people, and to people who might not otherwise see you, so why not focus on that rather than our righteous beliefs about what therapy “should be.” We need to evolve as a profession to be where the people are, rather than expecting them to come to us. We hope you’ll join us in taking mental health out of the office, and into the world.

Mental Health Pyramid

My husband, an engineer, asked me, “Isn’t there something like the Food Pyramid for how to take care of your mental health?” WHAT A BRILLIANT IDEA! So, I created this.

I give you the Mental Health Pyramid!

Start at the bottom and work your way up:

Social Connection doesn’t mean that you have a ton of close friends or supportive family members. It means that you have some meaningful connections – people in your life that you can go to when you need help or support, want to talk things through, or just need to reach out. This can even be a person you know only virtually, if it is truly someone real that you can talk to about things. If you don’t have this, Step One to better mental health is to find it. If there truly isn’t someone in your immediate life that you can reach out to, this is what a therapist is for. Find someone today! And talk to the people you do have in your life – we all need a place to connect and relate.

Goals/Purpose are what give our lives meaning. It might be just deciding what the next thing you want to work on is, personally or professionally. It might be thinking about what is important to you, or where you want to be in 5-10 years (start with 1 day in the future – something you want to do tomorrow – if five years is too far in the future!). This can be a concrete plan or something really written down on paper, or it can be ideas and interests, or new things you want to try. You have to hold a sense that you are heading somewhere to stay motivated to keep going, even when things get difficult.

Mindfulness/Self-soothing Skills are the things we do to stay or get back on track in the moment. Hard things are going to happen. There are going to be times we don’t feel awesome. Practicing mindfulness skills and self-soothing can both prevent the negative emotions from taking up so much space, and also shorten the length of time we have to spend in them. Self-soothing skills are things that you do to soothe yourself, or make yourself feel better – things like taking a bath, listening to music, giving yourself a break or a treat. The best things you can do to self-soothe are those that are free and those that don’t have negative consequences down the road (i.e. smoking or drinking or overeating) – try to identify something free and healthy that you can build in to your self-soothing regimen. Mindfulness skills are things we do to stay in the present moment, to pull our minds out of ruminating about things that have already happened or things that might happen in the future. Staying in the present moment is grounding and soothing as well, and reduces many mental health symptoms all by itself (and it’s free and healthy). Check out the gallery of Mindfulness activities for a quick start.

Lifestyle is really about these things: Sleep, nutrition, exercise, living environment – the things that keep us physically healthy and also impact our mental health in really serious ways. Pay attention to where you have trouble with your sleep, your eating habits, and your exercise (or lack thereof). Think about how you’re doing with all three things every day. Even small improvements in these areas can really make you feel better quickly!

Therapy is really helpful for a lot of people and a lot of different issues. You can go see a therapist even if you’re not quite sure what is wrong or you don’t have a “problem” right now. It can be helpful just to talk to someone who is outside of your current situation and life and can give a different perspective. You can try different therapists to find the best fit, and you only have to go for as long as you want! Many therapists will give you a free first session, which is a great time to just let them know what is going on with your life and see if you feel good about the response. You can connect here to ask any questions you might have about what therapy is like or how to go about finding a therapist.

Medication (as needed) – Mental health medications are really important and necessary for a lot of people. If you have tried other things in the pyramid and they haven’t worked, or even if you’re just curious about whether a medication might help you, talk to a qualified prescriber right away. Your regular doctor can be a starting point – most physicians and nurse practitioners can prescribe basic antidepressant and anti-anxiety medications. For more complex issues, you’ll want to find a psychiatrist who has some more mental health training and be sure to find someone that you feel comfortable with, who really listens to you and has your goals and best interests in mind.

For more information or training on this graphic or any of the points above, please contact us!

Jessie Everts, PhD LMFT