Why I Work the Way I Work

The people who have come through my office have consistently been bright, intelligent people. Their minds are effective, often in fact overly so. This has meant that they can master handouts, articulate behavioral chains, identify healthier alternative behaviors and thoughts, and still see little to no changes. To me this occurs because all of these tasks can stay circumscribed to the intellectual realm. Clients can go through the motions of superficially recognizing their triggers, reciting more adaptive thoughts, or pausing before acting. However, the energy to actually choose something (e.g. grab a fiddle toy, go for a walk) that goes against inertia and immediate gratification continues to be absent.

To me, what is missing from usual cognitive-behavioral approaches is an appreciation that people are always divided. It is a not a matter of simply pointing out what the healthier or more logical thing to do is or BFRB folks would have done it a long time ago.

Here is some of my experience:

• I can give tracking sheets but clients quickly stop filling them out because they are too confronting
• I can elucidate problematic ways of thinking and clients can see them but still choose "indulgence"
• I can teach about boundaries but clients just cannot get themselves to frustrate or disappoint others
• Clients can see progress and then be filled with impulses to undo 
• Clients are hyperaware of others' needs and expectations but struggle to know what they really need or want
• Clients are unready to detach from the idea that they can magically stop picking/pulling/biting tomorrow or next week
• Clients cannot relax into being because they are so caught up with doing
• Clients can get frustrated but not vulnerable

Christina Pearson, founder of the TLC Foundation, has framed BFRBs as a long term relationship. So, like any long term relationship, it's complicated. Part of us wants to give up our BFRBs and part of us doesn't. This means that we can't expect to simply tell people how the "healthy" way to be and expect them to simply walk through that door. There are anxieties and there are attachments we need to speak to and honor first.

What also has become increasingly evident over time is that folks with BFRBs are tired (exhausted). They are always "on," figuring out the "right" thing to say or do in every situation. This means that (1) they are expert at assessing external scenarios but poorly motivated by internal agreement, and (2) even after absorbing therapy lessons about antecedents, mental sets, or consequences, in a moment of pulling, picking, or biting, they just don't want to think critically or correctly. There isn't enough ease or gratification in their lives in general so they are protective of and hungry for this chance to turn off and not think.

I once had a client tell me, "It's like I can't sustain the health" when her skin picking was lower. She felt impulses to attack her face. This is an important testament to how hard it is endure success. Enduring success means having to bear belief which, when you have been skin picking, hair pulling, or nail biting all your life, can feel instinctually stupid and dangerous. Staying skeptical and disbelieving has grown to feel smart and safe. I think usual, cognitive-behavioral approaches overlook the attachment clients can have to their failures and their failure mindset. Deep parts of clients have emotional reasons for resisting the belief that they are both worthy and capable.

While stopping pulling/picking/biting may technically be in clients' best interest, no one likes to have something taken from them and that's how it often feels for clients. Therapists have to appreciate that messaging from society internalized day in and day out is that BFRBers are wrong as they are and need to get right. This means it's hard for clients to look at BFRB cessation with enthusiasm or pride. Getting "treated" only means finally being able to fall in line with a way of being that other people have always been. The decision to pull or not pull doesn't and has never felt like it belonged to them. For them, the expectation was always clear and they've only been disappointing. Therefore, relinquishing their BFRBs is a reform they have been burdened with and thus can harbor resentments about too.

To me, BFRB treatment is not just about managing thoughts and behaviors, it's about becoming a whole person. And I don't think change really comes from overt knowledge, it comes from love. Individuals with BFRBs are learning to have a relationship with themselves as whole beings instead of relating to parts of themselves (hair, skin, nails) which they treat more like objects. And once they can be fully embodied, then they can relate to others and allow others to relate to them in a full and meaningful way.

2017 BFRB Group - Call for New Members!

Back in April 2015, I began a psychotherapy group for individuals with body-focused, repetitive behaviors (e.g. hair pulling, skin picking, nail biting). We reviewed the demographic backdrop to these behaviors, behavioral management strategies, and factors such as motivation that affect treatment outcomes. Members began exploring their own pulling/picking/biting profiles and uncovering the emotional and sensory factors that feed into them. I started this group so BFRB sufferers could gain understanding and, even more so, grow relationships with like individuals. Group members have worked to tackle discomfort, interdependence, self-compassion, and self-assertion experientially and through guided conversations. In the safe and controlled space of a psychotherapy group, they began to heal shame, open up, and rely on one another. The experience proved so rich and fulfilling that I launched a second BFRB group chapter in February 2016 and a third in March 2017. My conviction about the importance of this unique space for sameness, difference, sharing, and receiving with peers only continues to grow.

This brings me to now. I would like to respond to building interest by launching a third chapter with all new group members. I am aiming to begin this group in September 2017, but will adjust according to members' availability and reaching of a critical mass. The meeting time would be Thursdays from 6:00 - 7:15 pm, and meeting place would be my office at Post and Divisadero in San Francisco. The fee would be $75/session, which I can include on your monthly superbill for your insurance company.

If you have any interest in this new group, please let me know by email: dr.nmayeda@gmail.com, or by phone: 415-735-0029 in the next couple of weeks. Again, please reach out to me if you have any interest at all. Your inquiry is not a commitment, just a chance to obtain more information so we can mutually determine fit.

Wholeness over Goodness

“I would rather be whole than good.” - Carl Jung

Carl Jung’s quote pertains to a personal and collective problem: We are not good at being whole. We internalize from a young age that being anything other than “good” has no intrinsic value.

Feeling lazy is only a signal that we need to get motivated again.
Wanting to depend on another is only a sign that we need to become more independent.
Gaining weight is only a sign that we have to get back to the gym.
Being quiet at a party represents that we have to grow our social skills.

Why can’t laziness be an expression of our need to go slow sometimes?
Why can’t wanting to depend on another be a sign that maybe we are feeling securely attached?
Why can’t weight gain be because we are taking advantage of a culinarily delightful holiday season?
Why can’t quietness at a party be because we enjoy being in an observer role?

We proceed in life constantly assessing our deviation from ideal states, as if the goal of life is to make sure we never drop below imagined levels of “perfection.” Thus, we spend our time trying to manage ourselves instead of being selves. The problem is, we are not just objects to be corrected, we are people to be experienced and expressed.

I view the goal of therapy to help you get free. Not simply to help you recover passing levels of societal acceptability until the next time you experience another debilitating lapse into humanness. Even if I help you to climb out of the red (e.g. to have a productive week at work, to remit hair pulling), you will be governed by fear as long as lava is still perceived below (e.g. the threat of falling behind at work or hair pulling again). We can do more than string together moments of temporary and conditional safety. Real freedom comes with the feeling that you can exist anywhere on a spectrum at any given time. Then there is nowhere you have to run and nowhere you have to hide.

Too often people with BFRBs feel they can only be in the world when they are at or above par. Clients have reported they cannot attend a party if they are feeling lower energy, they cannot turn in their homework if it is half completed, they cannot share with their romantic partners if it will involve anger, they cannot go to work if their mind is feeling distractible, they cannot get married if their nails are short, and they cannot meet up with friends if their face features any visible blemishes.

Good is limiting. If you live according to an insistence on goodness, you have lost half the range of human experience. Did you see the movie Hitch? Do you remember this later scene?

Albert: You know, honestly, I never knew I could feel like this. You know? I swear I'm going out of my mind. It's like I want to throw myself off of every building in New York. I see a cab and I just wanna dive in front of it because then I'll stop thinking about her.
Hitch: Look, you will. Just give it time.
Albert: That's just it. I don't want to. I mean, I've waited my whole life to feel this miserable. I mean, and if this is the only way I can stay connected with her, then... well, this is who I have to be.

Albert is able to embody our opening quote through his prizing of wholeness over goodness. He is reflecting in this scene on his romantic misery when Hitch makes a very common assumption about upward mobility as the agreed upon goal. Albert then checks Hitch with his appreciation of feeling fully, not just feeling “better.” I believe this ability to embrace, hold interest in, or even simply tolerate ourselves in ALL states is critical to general and specific (i.e. BFRB) freedom.

When we give ourselves permission to be anywhere on the human spectrum, there is nowhere we cannot be. This means we do not have to get stressed and start tearing at ourselves when we are in angry moments, lazy moments, antisocial moments, made-a-mistake moments, or not-knowing moments. We get to simply go on being the variable and finite humans we were meant to be without feeling chased from behind. Success in therapy to me means that you get to live harmoniously WITH yourself, not in constant pursuit of rising above it.

Life is flexible and people are resilient, so make your only task to focus on being your most authentic self.

"Opting Out of the Self-Esteem Game"

"Having contingent self-esteem can feel like Mr. Toad's wild ride - your mood swinging from elation one moment to devastation the next. Let's say you derive your self-worth from doing well at your marketing job. You'll feel like a king when you're named salesperson of the month but a pauper when your monthly sales figures are merely average. Or maybe you tend to base your self-esteem on being liked by others. You'll get an incredible high when you receive a nice compliment but crash in the dust when someone ignores you - or worse - criticizes you." 

- Self-Compassion by Kristin Neff

Living wholeheartedly and in wonder of our complexity - our complete humanness - is not just a concept. It requires that we actively fight the temptation to live off or in retention of positive estimations EVERY. SINGLE. DAY. For many of us with BFRBs, our self-worth becomes largely contingent on our skills and performance. And our society, built on capitalism and ideas of meritocracy, reinforces this. It becomes routine to reduce ourselves to one-dimensional evaluations of "good/bad" or "success/failure" re: skin picking, hair pulling, or nail biting, and all across the board. We get feelings of pride, contentment, and security off of being "special" or "better than" others instead of being able to relax into knowing our specialness is innate to being a finite human with everyone else. To "opt out of the self-esteem game," we have to appreciate the breadth of our experiences, the returns of connection, and the sincerity of our needs. Think of how this preoccupation with performance / overreliance on self-esteem applies to your life. Does it exist broadly, or is it circumscribed to your BFRBs? Does it play into your urges to pick/pull/bite? Does it render your mood variable? Does it affect the activities you choose to undertake? Does it make you more inclined to perceive others as friend or foe? Does it ever lead you to any real or lasting satisfaction...?

Perfectionism and Control

Just like independence is often about counter-dependence, perfectionism is often about counter-imperfection. What I mean by this is that commonly we are not perfectionists out of some positive inspiration. We, especially as BFRBers, are often perfectionists because we fear or cannot stand imperfect outcomes. We tend to live our lives with this constant feeling of severity that makes us prone to pick, pull, and bite.

Clients of mine have often described that events that should be casual, such as choosing what to eat or what to wear in the mornings, can be BFRB-inducing. This is because the world is approached like there is a “right” and a “wrong” decision to everything, and thus a risk of “failure” in every move. Because our internal bullies are so high, this is also not some light feeling of, “Oh, silly me…” This is a charge of “Idiot, you should have known better!” that denigrates your entire sense of capacity.

Clients of mine commonly get stressed packing for a trip, driving a car, etc. I acknowledge there is some objective, reality basis for those stressors, but perhaps not to the same degree that our internal worlds react. If we’re headed to some other continent and don’t pack an item, there really is no going back home to swoop it up. But oftentimes we are traveling somewhere where some pretty easy solutions exist. They may not be ideal (e.g. you have to spend an extra few bucks to buy another toothbrush or pair of shorts), but it is not life or death (and if it is, you have my respect)! The issue is that the pressure we feel internally is usually not proportional to the criticalness of the actual situation. It’s not really about that $10 or $100 to replace the forgotten item; the same thing would happen over $1 if our internal bully thought the money spent was avoidable. Our internal bully will berate us out of pure contempt - out of its awareness that something unpleasant, and that it deemed unnecessary, happened. It's about principle - you were imperfect. It doesn’t matter how this situation lined up in your life personally. Nevermind that your needs were met in the end. Your only perception is that you had a task and you “failed” at it. Again, there are times with clearer “smart” or “dumb” decisions e.g. to fill up one's gas tank before heading into a long stretch of desert. However, if you are feeling stressed and picking your skin apart trying to decide which adjective to use in your text or email, the pressure may be internally produced and not objectively warranted! And if it is felt to be that serious, why? What makes you feel your relationships with people are so critically hinged on single words, expressions, or emoticons? What makes you mentally regard communication like a test of accuracy or prediction, instead of a means for self-expression? When did people start seeming so volatile or fragile? How did you lose touch with the idea that people can be casual and forgiving, and relationships flexible? 

Multiple possibilities + Perceived consequences → Expectations for control (PERFECTIONISM)!

Decision making is a common trigger for people who pick, pull, and bite. While driving, there are a million microdecisions you have to make. Same with when you write - there is an endless archive of words you can use. And when you choose what to eat for dinner, there are a ton of restaurants that your friends insist you have to try, and a ton of diets that researchers insist you have to follow. The pressure to make the “right” choice is intensified by the feeling that your choice is consequential. We are too afraid to imagine that we could get second, third, even 500th chances in our lives to make things up even if we got them wrong the first time. We are disappointed with ourselves if ever we are late. If ever we are wrong. If ever we trigger conflict. If ever we didn’t anticipate someone else’s needs. If ever we are lazy. If ever we want for ourselves. We agonize over any holes in our mind or slips in our environment no matter the size, location, or patch-ability.

In summary, it is our fears about imperfection that drive us to avoid every negative. So we aim to control all bads like they are always really bad, like we-have-to-avoid-it-at-all-costs bad, and hold ourselves to perfection as a defense. But think about how stressed (and vulnerable!) we are if our stability and sanity depend on things going perfectly all the time! We end up filled with immense and constant anxiety about avoiding the “wrong” option and picking the “right” one. When we operate off of fantasies of omnipotence, we drown in “shoulds” - we “should” have been able to find a way to not spend that money, not eat that slice of cake, not waste that food, not miss that test question, not forget that grocery list item, not miss that bus, not miss that friend’s birthday dinner, not get tired, not get lazy, not be forgetful, not have bitten that nail or pulled those hairs. But we aren’t machine. We are human. And the sooner we can accept that the sooner we can live with some real peace and freedom.

Spend more time trying to listen to, and lean into yourself. Believe in your resilience. Have faith in the flexibility of the world. Check your actual circumstances. Forgive your fear. And remember your humanness and connectedness, not just your skill and productivity. Last but not least, make sure your standards for rightness and accuracy are measured against YOURSELF - congruence with YOUR NEEDS - rather than arbitrary, societal standards.

Beyond Achievement: Knowing ourselves as more than just our performance

A common scenario I’ve encountered in my practice is individuals who, starting a day, ending a day, or returning home after an extended period away, feel compelled to “check in” on their skin. Taking this measurement feels like a grounding ritual of sorts, but this need to know how we are doing (e.g. behaviorally) has seemed to take the place of who we are and how we are. In our society, our means of knowing ourself feels dependent on and limited to who likes us, who agrees with us, how many “likes” we get, how much we are getting paid, what invites we get, etc. We all need some baseline sense that we can be successful in this world, but this was always meant to be a stepping stone in our development. “Industry vs. Inferiority” was identified as only the fourth stage in Erik Erikson’s theory of psychosocial development. This stage is all about growing feelings of competence (our ability to feel “good at” things). There are eight stages total, however our society is largely stunted here! What was supposed to come next? Development of a personal identity, which can then fuel intimate relationships and creative instincts. Achievement was never intended to sum us up, it was meant to give us the confidence to keep on exploring.

We are a society that tends to overemphasize achievement. As a result, it makes us reliant on some external marker to tell us how we “should be” doing. Why, when we wake up in the morning, do we need to know the status of our skin to know if we can feel good or bad about the day? Can that not exist on its own? Do we not have internal sources for determining this?

I think the simplistic answer is “no.” I think our sense of ourselves is impoverished, so we are constantly, frantically looking for definition. We are so out of touch with innate feelings that we seek external indications to inform our well-being. When we pick in the morning/at night/after a vacation, we are saying that we feel unbounded. We feel lost and unsecured. Knowing the state of our face gives us some reassuring feeling of knowing our place again. When we want to check in with our skin condition, this is not the same as checking in with our actual self. This is not the question of, “Am I feeling unsettled right now?” or “Am I feeling an urge to pick right now?” It is simply the need to know how we are literally doing - our relative success. It’s like we need to know our skin condition to tell us if we’re allowed to feel good about ourselves or our life at the moment - [scans face immediately upon waking up] “Oh yeah, last night was a bad night…” If you just came back from a wonderful, pick-free vacation, why is your instinct upon returning home to plant yourself in front of a mirror and assess the clarity of your skin? It’s like we can’t trust that we can keep those good feelings about us unless it is verified by our face. Even then, our sensitivity to performance makes it so that we always fear failure and often pick just to preempt potential feelings of disappointment.

It is sad that we can’t connect with or hold onto natural feelings about ourselves above and beyond external circumstances. For example, instead of determining whether we care to read that book on our shelf, we surround ourselves with acute and painful awareness that we haven’t read it yet (FAILURE). We accept a position with an organization simply because the president tells us they think we’d be great at it (SUCCESS). We feel inadequate because we can’t hold conversation about film, even though our passion is really for poetry (FAILURE). We are being depleted by our job, but feel superior because most folks couldn’t last one month (SUCCESS). It is these incongruencies that point to our difficulty hearing (and responding to) what feels personally relevant vs. reacting to suggestions of success/failure. When we believe accomplishment is the key to acceptance, we become attached to measuring ourselves. However, once we can develop a relationship to ourselves that is personal, we can go to bed peacefully even if we picked ten scabs that day. Living without the need to regularly evaluate how we are doing is to live with exponentially more room for being freely and intentionally.

Our Negative Narcissism

I once read this post which addressed our common observation that children are able to survive even situations of severe abuse. This post challenged, however, “Why is this our baseline?” Is that all we want for our children...? To merely be able to survive…?

I think we too often glorify the resilience of people, and that can come at our detriment. As a society, I think we’ve developed this ego about our ability to “survive.” And survival needs to be inextricably embedded in the context. There is a real place for survival, and often in the world of psychology, this comes up in situations of real deprivation and trauma. However, I think these attitudes become dangerous when they outsurvive their original contexts and persist in situations of expanded possibilities.

When we come from places of trauma, our security is threatened and so security becomes the primary preoccupation. When the ground we stand upon is crumbling beneath us and we know no other place to go, we begin frantically trying to glue or stitch our splitting foundation back together. Imagine days and days, years and years of having to live in this constant hypervigilant, paranoid, reactive state… and then one day being dropped into a place where the ground splits apart only once a year. This gives us windows of being able to relax, and even prepare for breakdown. We are grateful. But having to rebuild your home once a year is still a HUGE burden. And someone who comes from trauma has an extremely difficult time acting in response to what they could have because they are still internally reacting to what they haven’t had. This often shows up as all those times we remain in jobs, relationships, living situations, etc. despite objections because “the job still has good benefits...” and “we could leave him/her but what if we can’t find better…?” It’s muddled with all these doubts and judgments about what other people would be grateful for, and how we’re “expecting too much” or “being greedy and unrealistic.” Paired with our increased tolerance for suboptimal conditions, we swallow that bad haircut, that our roommate ate our leftovers, that our foot really does hurt, that our evaluation has been delayed an extra six months, and that our parents forgot to ask how our presentation went. We are always more keenly aware of the dropping floor than expansive ceiling. Of what we stand to lose than what we stand to gain. Not to mention, we "can deal with it.”

As often noted, surviving is distinct from thriving and when we are oriented towards survival, we are always looking down not up. We are always keeping an eye on our ground -  for where all the gaps, breaks, and fault lines are and not towards the sky for a rescue prince or Cloud Nine. Having to be preoccupied with safety interferes with our openness to fantasy. In healthy development, you get to exist and expect the environment to respond to you. Not the other way around. But in many cases of trauma, you are having to mold yourself to the environment and cannot expect the environment to adapt to you. Your wants, needs, and expectations do not exist independently anymore, but are carefully formed around what you’ve reasoned is feasible to have.

When resources have been scarce or unreliable, you then become invested in your ability to not need, not feel, not ache, not get. It is not that this damaged person loses their sense of worth. Their worth - rather than being inborn - gets derived from their ability to be OK with less and less. Self-abnegation becomes their identified power. (Psychologist Andre Green refers to this kind of drive for self-annihilation as "negative narcissism"). They turn their ability to take nothing into a source of pride when, in truth, to have nothing is sad.

Beyond judgments about what is or is not sad, the problem is that this leaves us vulnerable to mistreatment.  Let’s say you are in a relationship where your partner routinely fails to set plans with you and takes days to return your calls. Someone with a trauma/survival-based mind believes in the necessity or utility of tolerating discomfort. Hence, the issue is not with the partner, it is with YOU for having a reaction. You should be able to go days without hearing from him. You are too needy and should learn to be more flexible and comfortable with distance... He is the best you've ever had. Now perhaps you are able to hear how this thinking becomes dangerous, particularly when the circumstances allow for healthier strivings. People who are chronically concerned with “worse” are often problematically discouraged from seeking “better.” They are caught up with the fact that they have someone, period, and so are inclined to distort the things that aren't feeling good into supposed opportunities to toughen their character.

A person who is able to orient toward thriving would have greater ability to pursue their dreams before “fixing” their expectations. This person would be able to appreciate (1) that they are being overlooked, and (2) that they don't have to force this specific, relational fit. Given these two factors, they could feel confident in delivering a swift “Hell no!” to their partner. Being able to pursue greener pastures requires first that one is able to imagine greener pastures. But for many (our survival-oriented folks), living in some la la land of greener pastures sounds stupid. They believe learning to live off the dirt around you is sound. And it is sound... in a drought. But when the pastures are fecund and everyone else is enjoying full meals and you are still [insisting on] subsisting off of dirt, you are not taking care of yourself. You are depriving yourself disadvantageously.

Please be mindful of how you reinforce yourself to not need because of its adaptive appeal. The more we keep adjusting down our standards, the more open we leave ourselves open to accepting nothingness. Nurture your capacity to feel safer so that you can protect your ability to dream. Only then can be we strong enough to keep shooting for fulfilling situations that we may not yet know.

* NOTE: I do not presume in this article that traumas refer only to distinct events. I believe that any situation that involves having to get used to negative or uncomfortable terms can be impactful, lasting, and traumatic.

Insulated, but Isolated: Part II

Now I want to transition to thinking about what this self-contained person looks like in the context of others (because we really don’t exist in a vacuum!). Let’s continue with our vignette from the previous post...

Now imagine you get home and your partner or roommate wants to know about your day. You feel inclined to offer something and nothing else is standing out, so you start describing the dilemma over a raise. While you may feel like you’re doing a courtesy by sharing, you may not actually be available for relating (which is what this other person is really after!). By this time, you’ve already had a day’s worth of spin cycling possibilities so you’re convinced no one else can help in any way/fix anything/add any further information. AND YOU’RE RIGHT! No one else in 5 minutes is going to be able to analyze your situation further than you already have. But not because they’re inadequate (even though both of you might be thinking so at this point), but because you have left no feeling or thought for them to uncover with you. You’re bringing an issue to someone AFTER you’ve completely dissected it.

What are you going through?
You are probably frustrated. You have already found some peace with the situation and so now having to simply catch someone else up feels like a chore. There is no clear incentive for you and as this becomes increasingly apparent to you, you become increasingly irritated. Irritated at the work of explaining, irritated at yourself/the other person for putting you in this position, and irritated at the rawness of their emotions when you’ve already contained yours. This situation is probably reminding you of how much easier it is to just keep things to yourself. You instinctively did this for them but they are not even satisfied. You care about this person, but you’ve been shutting down all their suggestions (and their empathy) and now you are feeling like a jerk as they are looking shut down.

What are they going through?
They went into this conversation with a positive assumption - that is, with an assumption that you actually want to talk about the thing you are volunteering to talk about. Little do they know that you have no outstanding needs around the situation and were seemingly doing them a favor. But they haven’t asked for favors. They’re interested in connection and were expecting to be helpful. They have been offering genuine empathetic responses and racked their brains to try to come up with useful suggestions for you. But you have a swift way of denying all of it, and as it becomes clear that something’s not working out, they begin feeling frustrated with you or dejected about themselves. In their bodies they may be feeling inadequate, and in their heads they might be wondering, “Am I not smart enough?” “Am I bad at communicating?” “Maybe I’m not showing I love them enough...” “Maybe I’m not good at supporting people...”

From this example, we can see that this setup is not fulfilling for either person. It probably would have worked out better if you could have refrained from acting “as if” (i.e. as if you needed to talk about your raise) and flat out stated you needed nothing when you needed nothing, or reached out when you authentically did need something. The goal is for us to be this congruent, but the reality is that we as humans are very complicated. Why were you so immediately pulled into obeying social rules before respecting your internal truth? What were you assuming they needed? Why did that matter more than what you needed? Why were you so compelled to reject their empathy? Why were they so quick to assume they were the problem? How did that affect the outcome? What makes you so much more comfortable with pure logical analysis anyway? 

Wrapping ourselves up in reasoning may make us feel safe, but while we are wrapped up, we are also unavailable to others. It is important to be aware that we are actually exploiting our minds (and secondarily our bodies via picking, pulling, and biting) as a means of bypassing vulnerability. In this prizing of our mental selves and this process of self-containing, we pass vulnerability off onto reasoning, which takes over and stamps out emotions, and then concludes that connecting with the external world is unnecessary. We remain isolated with a distorted rationalization that the world can offer us nothing more than we can offer ourselves. We may feel that our minds contain us, but too often, we become tragically contained by them.