Dr. Catalina Lawsin: “Sit with your feelings, try not to run away from them”

There’s often a lot of “talk” about embracing individuality in the work place, however in my experience and my clients — that is rarely the case. When employers hire individuals, I think they need to be aware of the strengths that they are hiring in an employee has different sides to them. Leaders need to foster these […]

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There’s often a lot of “talk” about embracing individuality in the work place, however in my experience and my clients — that is rarely the case. When employers hire individuals, I think they need to be aware of the strengths that they are hiring in an employee has different sides to them. Leaders need to foster these sides, rather than try to control and ultimately suffocate the sides that may not be a ‘part of the culture’.

As a part of my series about the the things we can do to develop serenity and support each other during anxious times, I had the pleasure of interviewing Dr. Catalina Lawsin, PhD.

Over the last two decades, Dr Catalina Lawsin, PhD has been a clinical psychologist, researcher, and professor addressing cancer’s impact on relationships and sexual wellbeing. Through this experience she has learned that intimate connection is essential for and a key marker of our overall wellness. The single question she asks to gain a holistic assessment of overall health and wellbeing is, “How sexually satisfied are you?” Because the truth is sex is more about the mind and emotion than the body. And she’s gotten really good at helping people align the three for overall satisfaction and health. Dr Catalina supports individuals and couples in her private practice in Beverly Hills, Santa Monica and online for clients living in California, New York and Illinois at www.DrCatalina.org.

Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

Aside from always being my sister’s tag-along, I’ve never been a follower. I’m naturally loud, proud, outspoken, and full of personality. Yet consistently throughout my life there were rules on how I should be, who I should be, what was expected of me. My big personality wasn’t welcome in most of my educational or career environments. And quite honestly, I learned that in order to get what I wanted in life, I needed to disconnect from who I truly was. Being a first-generation immigrant and the minority in every social circle I was ever part of played into this behavior. Who was I to complain or disrupt the status quo? I was lucky enough. I, after all, was completely privileged. What more could I possibly want? And what type of person was I to actually want something different?

My parents grew up on dirt floors in the Philippines, yet I was the one who bore witness to and experienced the abundant results of their hard work and risk. As the recipient of this life of freedom, there was a lot of self-imposed pressure to appreciate what I had, and what that appreciation should look like. And because of this, I learned the hard truth about conditional love. Results mattered. Status mattered. Judgements mattered. I had to do the most research, work the hardest, get the accolades, prove to myself (and in my mind — to others) that I was worthy of the privileged life I was given, prove I was worthy of love. My own desires didn’t matter. And even my basic human needs didn’t matter unless I was pleasing others.

Being a clinical psychologist, researcher, and professor in the field of psycho-oncology over the last 2 decades, I’ve learned that true, authentic, pure intimacy and connection is not only what we all long for, it’s essential for our overall wellness. It is a basic human need. Connecting to our own primal needs and desires, and allowing ourselves to be everything of ourselves with another person ultimately deepens our knowing of self and who we are at the most genuine level. Yet somehow expressing this basic need has become shameful. For something so essential to our existence as a species, it is unsettling that such a sacred topic be considered too taboo to speak of openly. I believe that by embracing and prioritizing our sexuality we can break free from expectation and experience the transformation of holistic healing. It’s time we got real about the reality of sexuality. Because I believe that regardless of who we love or where we came from, exponential bliss is our absolute birthright.

Can you share the most interesting story that happened to you since you started your career?

Much of my research and teaching has explored socio-culture factors impacting health, including sexual wellbeing and relationships. I appreciate the socio-cultural barriers that inhibit individuals from speaking openly about sex. While I’m not surprised, I’m still taken aback when I witness healthcare providers fostering this inhibition and blocking informative dialogue about sexual wellbeing. I’m particularly surprised by this when I’ve been asked to come in and speak specifically about sexual and relationship wellbeing.

I’ve worked in South East Asia training clinicians in the psychosocial aspects of cancer including communications skills, working with families, pain management and palliative care. In one of my work trips to Vietnam, I was asked to give a talk to a group of Vietnamese breast cancer patients on the impact of cancer on relationships and sexual wellbeing. This was at one of the busiest hospitals where patients were sharing beds and families were sleeping on floors to help care for them. Needless to say, I appreciated that sex might not be on the top of their priority list.

I was reminded by the physician who helped organize my talk, that the women were ‘very modest’ and won’t want to talk about sex. I was further instructed to limit how much I would talk about sex in my presentation and Q & A. I did what I was told and saved the sex part of my presentation to the last 5–10 minutes of a 40 minute talk. The audience, of 40 women or so, was polite, but as I asked questions throughout my talk, they were fairly shy and didn’t say much…until I finished the last part of my presentation about sex. A soft-spoken women in her early 40’s with a stylish doo-rag out of an old shirt hairless head, raised her hand. I walked closer to her and she asked, “so does this mean I can have sex with my husband?” To which I emphatically replied, ‘Yes!!! If you want to.” Then the chatter and questions overflowed. This presumed shy, sexually conservative, voiceless group of women who were fighting for their lives indeed cared about sex!!! Other women asked “do I have to have sex with my husband”, “I’m so dry, it hurts to have sex”, and “I don’t feel pretty without my breast.” These questions and fears revealed the universality of our sexual concerns. Furthermore, this experience highlighted the importance and need to foster dialogue about sexual wellbeing in healthcare. We just have to start the conversation. That’s what I was so fortunate to do that day. I was able to just talk with these women about their sexual and relationship wellbeing. I didn’t tell them what to do. Instead, I fostered a space where they could express their fears and desires — so that they could act on them the way they wanted to.

What advice would you suggest to your colleagues in your industry to thrive and avoid burnout?

As a psychologist my job is to hold space for my clients. While I interject things about me occasionally, the primary focus is on the client. That’s partly why I love therapy myself- it’s like a massage, where the focus is all on me!

A work hazard is shutting this off. I used to think I was good at this. Since I worked in cancer, people used to always ask “how can you do that, doesn’t that get depressing?” The reality is that it doesn’t I really enjoy it, but when I’m off the clock, the psychologist in me doesn’t just stop. It’s not that I bring work home with me. It’s more I can’t socialize with friends or family, without communicating like a psychologist. My holding space for others seems to never stop, so I actually have to force myself to just listen- not focus and follow, expand on their thoughts, and not always have a deep and meaningful conversation. This may seem silly, but I think this is one of the leading causes of burnout amongst psychologists and therapists. My advice to other psychologists and therapists is: stop being a psychologist when you’re off the clock- or at least limit it to one or two extra sessions a week.

What advice would you give to other leaders about how to create a fantastic work culture?

There’s often a lot of “talk” about embracing individuality in the work place, however in my experience and my clients — that is rarely the case. When employers hire individuals, I think they need to be aware of the strengths that they are hiring in an employee has different sides to them. Leaders need to foster these sides, rather than try to control and ultimately suffocate the sides that may not be a ‘part of the culture’. Systems need to be in place to offer safe spaces for employees to express their concerns, because these concerns always (and I literally mean always) impact productivity. Rather than perceiving employees concerns as complaints or weaknesses — these need to be understood and integrated into the work culture. Work organizations are relationships. Like any healthy relationships it’s dynamic. Roles need to evolve with employees as they grow, not the other way around. Negotiation and re-negotiation is key!

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

When Things Fall Apart by Pema Chödrön. I was familiar with Pema and heard her meditations and talks. In July of 2008 I had many transitions at once. After 9 years of post-graduate training, I finally finished and was starting my first ‘real job’ as a professor at Baruch College in NYC. My sister’s youngest daughter Estelle was born 2 and a half months early and I was thousands of miles away in Cambodia unable to help. While over there, the main love of my life and man I thought I’d marry, broke up with me over the phone a week before returning to NY and locked me out of our apartment. I had nowhere to live, a new job to start in a week, 200 dollars to my name (as I was a postdoc and already paid rent until my new job started) and had to find a new home in Manhattan, new furniture, be there for my family and start my career. Pema was my guide. I started reading this book the night of the break up and finished it when I landed in JFK. Her words normalized my heart ache, while also reminding me of its importance. I cried most of the 13 hour flight back to NY, but felt her by my side. She was my guide. I’ll be forever grateful.

Ok, thank you for all that. Now let’s move to the main focus of our interview. Many people have become anxious just from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have only heightened a sense of uncertainty, fear, and loneliness. From your experience or research what are five steps that each of us can take to develop serenity during such uncertain times? Can you please share a story or example for each.

In the midst of uncertainty, our brain and body wants control, predictability, consistency. Therefore, the keys to coping amidst this existential crisis is to find ways to provide these things to your body.

Here are 5 concrete steps you can take to develop serenity during these uncertain times:

  1. Firstly, acknowledge that feelings of fear, anxiety, and loneliness are natural, subjective and ever-changing. As humans we experience a variety of emotions and none of them are neither good nor bad — they’re just emotions. Emotions are subjective, meaning that everyone experiences emotions differently, through the lens of their perceptions and life experience. How we experience emotions evolves as we evolve. It’s common to feel weak when we feel these powerful emotions, however this is us judging ourselves. Try being gentle with yourself by simply acknowledging your feelings. I recommend voicing your feelings internally or out loud. Speaking your emotions out loud can also calm your body by the sound of your voice.
  2. Sit with your feelings, try not to run away from them. Your body will instinctively want to fight, flight, or freeze when experiencing these strong emotions. This is where you can begin to teach your body a different way to react. Sitting allows your emotions to move through you, building your body’s tolerance of this distress or discomfort. It’s like lifting weights for your brain, the more you can sit through distress, the more tolerant your brain becomes to experience these difficult emotions. After consistent, predictable, and controlled practice — your distress tolerance will increase. Just remember, it will be uncomfortable at first, like working out.
  3. Begin to notice any negative thoughts you’re having and begin to challenge them. Some automatic thoughts such as “I’m weak”, “I’m worthless”, “nobody cares about me”, “I’m not good enough to love.” These are all harsh, but fairly common, negative statements that get too much play time in our heads and maintain loneliness. When faced with chronic stress, our brain is constantly on the look-out for threat. Imagine a lion in tall grass, on the look-out for its next prey. This is what your brain’s doing — looking for its next threat to pounce on. Challenge these thoughts by balancing the evidence that supports and contradicts these thoughts. The goal of not spinning negative thoughts positive, but instead neutralizing and controlling them. This sounds easier than it is and requires practice- regular practice. The negative self-talk in your head is a habit which now requires intentional practice to shift.
  4. Make one small promise to yourself every day, that’s realistically achievable, and keep it. Remember, your body wants to control, predictability and consistency. During the uncertainty of this lock down, your body may feel out of control and has lost trust in your ability to protect it. You can regain this trust by making promises and keeping them. Your body and brain will learn to trust that you can protect it and it won’t need to react with fight, flight or freeze. Start small and simple- like taking a shower each day, applying facial moisturizer, or putting on deodorant. Let’s keep it real, many of us working from home have stopped these daily habits. Even though you may have nowhere to go, try to do these simple self-care strategies to begin to take back control of your body and reactions.
  5. Lean in on your relationships — family, friends, lovers, neighbors and new connections. This likely seems easier said than done, when all you may want to do is hide in a hole. Humans are social mammals which crave connection. When distressed our bodies can heal by connecting with others. From a neuroscience perspective, our nervous systems co-regulate with other nervous systems to cope effectively through distress together. Therefore, by engaging our social networks we inhibit our fight/flight/freeze responses and will experience distress more smoothly. When it comes to social support, quality is better than quantity. Be mindful of who you seek support from and be mindful of your boundaries in relationship, trying not to take on too much of the emotional heavy lifting of others when you’re barely staying afloat yourself. Know that it’s ok if you choose not to connect with certain close relationships. Begin to notice who you are resonating towards or distancing from. Relationships evolve and the COVID crisis may be a litmus testing your relationships. Considering the number of virtual opportunities, the lock down can be an opportunity to forge new connections. It can be hard, intimidating and daunting to forge new relationships (particularly the older we get). So, take it slow, start small, and be selective of who you choose to befriend. Take the time to explore new ways of interacting with others and building connections.

From your experience or research what are five steps that each of us can take to effectively offer support to those around us who are feeling anxious? Can you explain?

Keep in mind that focusing on others takes the focus off ourselves. Giving, truly giving, to a loved one, friend, or stranger can be a powerful strategy that lifts how you perceive yourself and how you feel. So begin with small everyday acts of kindness in your everyday life- your generosity and kindness doesn’t have to be life changing as long as it’s authentic.

To better support others around you feeling anxious try:

  1. Not to fix their problems or say ‘calm down’ or ‘relax’. You can’t make anyone feel better, no matter how hard you try. While you may be well intentioned, when others come to you for support, the first and foremost need emotional support. While you may be able to offer concrete support (e.g. finances, daycare), at first this is not what someone feeling anxious needs. Secondly, statements like ‘calm down’ or ‘relax’ tend to minimize feelings and have the opposite effect than intended. Think about how you feel when your nervous or anxious and someone says these things to you. It doesn’t feel good- at all. These statements can invalidate someone’s emotions and their body will tend to go into fight/flight/freeze reaction mode even more.
  2. Hold space for them. What does this actually mean? Sit there with them. Listen, actively. Focus and follow. Listen and make simple reflections, repeating back what they say. For example, if someone says “I’m so anxious that I’m going to lose my job, I can’t sleep” you can repeat back to them, “I hear you feeling anxious that you may lose your job.” You don’t need to interpret or make up new words, begin by just mirroring back to them what they just said. This allows them to feel heard while also checking to make sure you understood them correctly. They can then expand on their feelings without judgement. Remember, you don’t need to fix anything. You just need to show up. Just be there.
  3. Slow your breathe: Co-regulate your nervous system with theirs. Remember, humans are social. Our nervous systems co-regulate with others. If you’ve ever noticed that when you’re around someone anxious, you start to feel restless or fidgety. This is their nervous system co-regulating with yours. When supporting someone anxious, your nervous system can co-regulate or calm theirs by you beginning to slow your breathe, speak slowly in a medium tone, maintain eye-contact, and calm your body. These are all signals of safety to your nervous system and will communicate safety to the other, regulating their nervous system. This is a beautiful phenomenon that can be highly supportive and effective to support someone you care about. The reciprocal benefits are amazing as well.
  4. Empathize. Place yourself in the other’s shoes and imagine how you would feel. The goal is not to compare, but rather to connect. While holding space someone, connect to your own experiences that have elicited fear, anxiety or loneliness. These shared memories will allow you to provide the support perhaps you wished you wanted. It will also normalize their feelings, so they don’t feel so alone feeling how they do. You don’t have to have been in the exact same situation to empathize. We all have felt fear, anxiety or loneliness at some time or another. Connect with the emotion more than the specifics of the situation.
  5. Have boundaries for how you support others. While supporting others can be mutually beneficial, it can also be draining and overwhelming if we take on too much of someone else’s distress. Think about what the flight attendant says at the start of the flight. “Place your oxygen mask on yourself, before placing it on your child.” You have to take care of yourself first and foremost, otherwise you won’t be able to support others. Be clear about what you need and don’t want in a relationship. Boundaries are lines that you don’t want crossed in a relationship. If these lines are crossed, it’s up to you to enforce them. Examples of boundaries while supporting someone can include: not allowing them to yell at you because they’re frustrated about their situation, them asking for something (e.g. money) you don’t feel comfortable giving and them becoming upset with you. It’s up to you to identify your boundaries and assert these by communicating and enforcing with your actions.

What are the best resources you would suggest to a person who is feeling anxious?

When feeling anxious your mind takes on a scarcity mindset. Therefore, it’s effective to identify multiple resources so that your mind perceives it has options to choose from, rather than feeling trapped. Here’s a few resources to consider:

  • Lean in on your relationships with family, friends, lovers, co-workers and strangers. As mentioned above, our social brains want to connect.
  • Mindfulness apps like Headspace and Calm or online classes offer tools that can calm the nervous system and begin to train it to regulate emotions and increase your window of tolerance
  • Therapy helps and is now more accessible than ever. Psychotherapy has proven effective in treating anxiety for over 30 years. Building on what I described above, therapy offers a new relationship through which your nervous system can heal and co-regulate. Remember, it is in relationship that we heal. During the COVID crisis most therapists, including myself, are offering virtual therapy where you can meet them anywhere you are. Online therapy has been proven as, and in many cases more, effective than face-to-face therapy, due to its accesibility.
  • Online support groups for anxiety are now available much more than before. Do a Google search, check Psychology Today and FaceBook. Message or speak to the group facilitator to see if this would be a good match for what you’re looking for.
  • Self-help books for anxiety are increasing everyday. Memoire’s, how to’s and even theoretical books (e.g. The Traumatized Brain) can provide you information about anxiety to better understand and normalize your experience, while also providing a nice activity to focus on rather than worry.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

“How we stay in the middle between Indulging and repressing is by acknowledging whatever arises without judgement, letting the thoughts simply dissolve, and then going back to the openness of this very moment. That’s what we’re actually doing in mediation. Up com all these thoughts, but rather than squelch them or obsess with them, new acknowledge them and let them go. Then we come back to just being here. As Sogyal Rinpoche puts it, we simply “bring our mind back home.” Pema Chodron, When Things Fall Apart

Referring back to the story when I read this book above, in my heart break I noted in the margins

“I’ve always been validated for voicing my opinions. But, somewhere along the way my opinions became judgements. I knew all along I was judging myself — Please stop judging yourself.”

This was the turning point in my story where I really made efforts towards not projecting my harsh inner voice onto others. I believed that I needed to push myself to be a better person, when in fact I was just judging myself and developing more and more shame. This shame was projected onto others and kept me detached. This self-judgement was my body’s way of protecting itself when I felt hurt or threatened. This was my constant state of being. What my body thought was protecting me, pushed others away and kept me disconnected — from myself and others. My self-worth also suffered. Pema’s words woke me up. This flight, this heartbreak, this book changed the direction of my life. I just picked it up again and see it as my Bible. My foundation.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Sex Marks the Spot. I believe that sexual wellbeing is a holistic indicator of health. My aim is to shift healthcare to bring sexual satisfaction as a primary outcome and target for health.

Improved sexual satisfaction has been shown to be a positive side effect to every healthy lifestyle change including weight loss, smoking, controlling substance use, managing depression and anxiety, improving cardiac health after heart attacks. Alternatively, decreased sexual function and satisfaction is a symptom of unhealthy lifestyles, physical and mental illness.

Most research has looked at sexual wellbeing as a secondary outcome, or an after-thought in analyzing the data, showing that sexual wellbeing, satisfaction and frequency improves with improvements in health. For example, obesity often leads to sexual decline (e.g. decreased satisfaction, activity and function). Most obesity interventions focus on outcomes including BMI, mood, activity level and rarely sex. More and more studies are showing improved sexual wellbeing as a secondary outcome when weight reduces, however sex is rarely the primary target of therapy.

It should be. Rather than focusing on weight loss as the primary outcome, when individuals focus on aspects of their sexuality as markers of progress (e.g. increased libido, increased sexual satisfaction, increased pleasure during sexual activity), this offers a more holistic and pleasurable outcome on which to focus.

By focusing habits/behaviors on feeling sexually energized, connecting with your body, being aware of your sexual energy- eating, exercising and mood all improve. This isn’t by accident. The processes that lead to all of these improvements in lifestyle require individuals to gain control, make alternative choices and focus on themselves. Focus on your sexuality is the most efficient pathway to self-care.

I am trying to start a movement that opens up the conversation about sexuality. Too much shame and embarrassment maintain the gap between healthcare providers and potential patients to improve their health by enhancing their sexual wellbeing. Therefore, I train doctors and allied healthcare providers on how to integrate sexual wellbeing into their assessments to improve rapport with patients while completing a holistic and more efficient assessment. Through my psychotherapy private practice, talks, podcast and online courses — my goal is to empower individuals to embrace their sexuality and claim their birthright of exponential bliss.

What is the best way our readers can follow you online?

I’m always available at www.TheIntimacyDoc.com, on Instagram @The.Intimacy.Doc my YouTube channel, Facebook group The Intimacy Doc and LinkedIn. Come say Hi, follow me and let me know how I can help!

Thank you for these fantastic insights. We wish you only continued success in your great work!

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