Impact on Identity and Relationships

Identity is not static. It changes for many reasons. A few are life circumstances such as a birth, a move, or death. You may be led to re-evaluate your life, who you are, and who you may become. Even seemingly small changes can impact your larger relational systems. These shifts may also lead you to see yourself differently or to reinvent aspects of yourself.

There can be excitement and joy as well as heartache and pain. Partnerships may need to be re-examined. You may grow closer with friends and family or begin to experiment with different ways of being social. You might try different things and meet new people and connect in unpredicted and interesting ways. You may also no longer have the same interests, values, or drives. When you no longer have the same interests, you may find yourself reevaluating unexamined parts of your life. You may find that you want to learn something new, try something again, or making a big change, like changing a career. For example, if someone was an avid coffee drinker and stopped, they might not want to go to the same places, might meet different people and connect over something other than coffee. These changes, while leading to greater connection for some, may lead to the need for creating new boundaries or to disconnect from other people.

When you change people will look at you in different ways. Perhaps you were a “we” and now you are an “I”. You and your friends will have to learn how to relate to you as an individual rather than as part of a couple. After months, years, or decades of being a “we,” what does it mean to be a “me”? And, just as others will see you differently, you might look at yourself in different ways.

You may feel internal or external pressure to make difficult personal or relational decisions. Choosing change can be stressful and if you do, it’s not possible to plan for every contingency. There is discomfort with sitting with uncertainty. This can lead to having second, third, and fourth thoughts about how to proceed, and what the next steps should be. Try to remember making decisions about change may take time. You may vacillate. And it can be challenging. This is normal. During that time it is important to remember that things do not have to be all or nothing. Relationships and even identity can be renegotiated and reinvented.

Your identity and relationships can evolve as you and your circumstances change. You are not the same person you were as a toddler or a teen. We sometimes forget that. Development happens throughout the lifespan, and every shift impacts the larger systems in which we operate. Sometimes we forget that we cannot control every eventuality. However, we have all negotiated change in the past. And sometimes we might prefer that things stay just as they are. However, the one constancy of a human life is that change eventually happens.

Breathing is the most sacred of acts

We have the illusion of control

As if we could play any card we want

Yet the outcome is determined before the start

We often recognize a piece of the puzzle and then categorize to fill in the blanks. It’s sometimes like doing a Mad Lib or writing the ending to a story based on partial information, but what do the actual literal words mean? What do body language, tone of voice, or presumed intention do to making meaning? How do two or more people sit together and through interaction come to a mutual understanding about anything? And, do context and assignation of motive change things?

When you stop and really look at all of the potential places conversations can go wrong, it is really quite amazing that humans communicate as well as we do.

In school I remember being introduced to mathematical word problems. In them there was only one right answer. In conversation we often forget, that unlike with math, there can be lots of solutions and way to understand the words, body language and intentions. We see patterns, but how well do we interpret them?

Meaning can be more than literal. Take a poem for instance. There can be a literal meaning and there can be puns and all kinds of subtext and words with multiple meanings. The same is true in art. You can look at an optical illusion picture of the young woman/old woman and see more than one picture. In life you can see the glass as half empty or half full. There is a certain amount of subjectivity in meaning making.

One word with different ways to parse it: meaning/meaningful. For my brother the word “Teddy” was also meaningful. It may have meant dog, but it had special meaning to him through his relationship with his doggy. The dog has long since passed on. And, the way the dog mattered to my brother then is not the way he matters now. The way things matter change throughout the lifespan as our interpretations and connections to them change.

What are the implications for meaning making and does it matter?

What does it mean for something to matter?

How much meaning do we take for granted?

I don’t have many answers to these questions, but find these questions to be vital for happiness, for connection, for meaning.

All I know is that it matters, whatever that means.

It sometimes looks bigger
and sometimes smaller

It’s hard to see the fine points.

Is a shadow less accurate than a reflection from a mirror?
Is what I see me?

Can a shadow exist in the dark?
Can a shadow exist without a me?

When I try to shadow box, nothing really lands.
Unlike Peter Pan, I can’t catch my shadow
I’m just enjoying the glimpses

Here one moment
Gone the next

Life

Reality is sometimes complicated and I’m determined to enjoy the hell out of it.

A few months ago I hurt my arm when I tripped and grabbed a tree. I chose to ignore the injury until the pain made me go visit a doctor. Ignoring my injury and delaying care has made my life a little more complicated. This has helped me understand that sometimes we must live with realities we do not like and do not approve of. Sometimes we have to face the consequences. This experience highlighted two frequent strategies that people use in difficult circumstances: acceptance or avoidance.

People sometimes have many very good reasons to avoid what is happening. Making a choice can be confusing. There can be multiple possible solutions. And sometimes there is the desire to bargain or negotiate a different outcome. The fact that sometimes we are powerless to change life can sometimes be very painful. We may have little choice but to experience something like grief, change, lost opportunities, or lack of control.

I would argue that there are times when it may be appropriate to avoid reality, for a time. For example if one is in shock or the pain is initially too great. However, there often comes a time when we must choose to accept what is occurring in the present moment. When that happens, what is the cost of avoidance or delaying acceptance? If you are pregnant and assume you’re just gaining weight and ignore it, you will be very surprised in a few months. But this does not apply just to having a baby. There are lots of long-term hidden costs. Avoidance may provide immediate relief while quietly increasing the future costs. And sometimes it’s hard to know what to do, especially when emotions are involved. It can be difficult to know if we are seeing the situation clearly or hoping for a different outcome.

However, not making a choice can take an emotional toll. Living in non-acceptance takes energy, creates anxiety, creates sadness. It can build on an unsteady foundation. The delay may magnify challenges and the overall pain when circumstances can no longer be avoided.

Acceptance can also be exquisitely tender. Reality is sometimes beautiful and sometimes horrible or exciting or sad. Being with what is happening may mean ingesting all the many and sometimes sordid, horrible, beautiful, exciting, peaceful, and wondrous flavors of life and reality.

The choice to accept or reject reality is something that gets revisited. Sometimes life means accepting that a parent is dying or you might need surgery. It might mean aging and not being able to do things that used to bring you joy. It’s not easy. It’s not a one-time choice. Each time we accept or reject what is happening is a deeply personal and complicated decision. And each time we must ask ourselves are we relating to what is happening now or what we wish were happening? Acceptance does not mean that we have to agree that our circumstances are fair or just.

Life is like a garage sale. Everything must go, and none of us get out of it alive.

A person may want support and know the facts of their situation but may not know how to ask for what they need. They might say something like, “I am getting a promotion and have to move.” The friend might focus on the logistics of helping their friend and offer to help pack. The speaker might be thinking about leaving friends, uprooting family, and being in a new community and not yet ready to think about help. This leads to one person feeling like they were somehow unhelpful and the other feeling misunderstood. And this type of interaction can apply to many other situations such as relationships, careers, parenting, relationship status, and ordinary life.

Many people hear a problem and want to provide a solution. It is understandable that people want to solve each other’s problems. If the door is open and there is a breeze and you are cold, and you shut the door for a person – or tell them to just shut it – you are not solving the larger issue. Some people try to join or show care and support by solving problems.

However, providing solutions may not always be the best solution. Providing an answer for someone else can inhibit someone from learning that they have the capability to solve their own problems and to notice that they are cold. It could also ignore the fact that the person may have already known the door was open. The door closer might miss the point that the door was open because there was a gas leak. Additionally, closing the door closes the possibility of really getting to know another person more deeply and may miss their actual concerns. It closes the door on vulnerability, communication, and mutual care and respect.

Providing answers and solutions sometimes seems like an attempt to resolve the question of uncertainty. And, just to be clear, sometimes offering a solution may be the right answer. If there is a natural disaster people coming together to rebuild houses is absolutely the right answer. But sometimes in conversation it may just relieve the discomfort of the listener rather than the person they are with.

One of the reasons people try to solve uncertainty is that they might feel helpless and powerless. Someone might want to solve problems to take away the other person’s pain. It can be painful to see other people suffer and feel like there is nothing you can do, but ultimately it may not be what is most helpful to the other person.

Sometimes there are no right answers. Things may be outside of one’s control and circumstances really are painful.

Additionally, when people try to give solutions and it misses the mark, there is a special kind of loneliness for the person needing support. There is loneliness because one may recognize that those around them care, and care deeply, and at the same time, there may be a feeling of disconnection. It’s like shooting an arrow at the wrong target.

So what can you do to help someone and get the help you are looking for?

One example comes from the Jewish tradition of sitting Shiva. During that time it’s traditional to not initiate conversation until the mourner initiates the conversation. However, this ritual highlights a practice which is actually very helpful for many complex situations.

Wait, listen, don’t assume and provide presence. Sometimes just being with someone in their pain or worry is what they need the most. And providing that presence is powerful.

And for the one hurting, let yourself accept the gift of presence and let your feelings unfold as they do in the time that they do. As sometimes, when we are hurting, the first challenge in a complex situation is trying to figure out what kind of support we actually need.

For both the giver and receiver, true presence is the most rare and most wonderful of gifts to give and receive.

Behavioral incongruity is sometimes described by self and others as inauthenticity. However, what is often called inauthenticity may instead reflect a developmental stage in which a person is trying out new ways of being while navigating change.

Take a moment and ask yourself, why do we forgive teenagers for changing personalities like they change outfits? And why do we expect adults going through development or change to be coherent?

We recognize adolescence as a phase of growth, change, and experimentation. Adults go through similar periods throughout the lifespan and yet people are often less forgiving of adult inconsistency. Adults, like any teenagers, may have periods of awkwardness, missteps, and unanticipated discoveries.

Developmental reorganization can be confusing. It can lead to self-criticism or being judged by others. These differences in expectation can be messy, confusing, and frustrating to the one changing and those around them. This mismatch between expectation and execution will happen as people learn new skills. And like with adolescence, there are times when not everyone will like the outcome.

Additionally, the unknown may be scary or unsettling because while it brings potential opportunities it can also bring potential risks. Many of us expect ourselves and others to be predictable and can become unsettled when familiar patterns shift. It can feel like loss of control, even though change is a normal part of being human. Change often requires people to reevaluate their values, relationships, priorities, and ways of moving through the world. And, as people begin to act differently, familiar patterns shift, which can be disruptive both to themselves and to those around them. This can create a mismatch between behavior and expectation.

This is particularly painful for some people who may not realize that they are growing or changing. They or their friends and family may just notice the inconsistency. This can be particularly true for a person in addiction recovery. They may relapse. They may do something that violates their new values. They may appear to “revert” to an older behavior, and then say something along the lines of, “why am I doing this, I know better.” I have also seen this in couples counseling when partners are learning new behaviors. One may “know better” but find themselves behaving from parts of themselves in ways that are familiar and which no longer fit them. This process can also be deeply unsettling to self and others because of an underlying assumption that adults should be predictable, finished, and consistent.

When someone changes, the ripples of change can have unforeseen consequences for both the person changing and those around them. If you or someone you know are undergoing change, try to remember that no one is bad, wrong, or shameful because they are not where they or another person thinks they “should” be. The process of development is messy, it can be embarrassing, it can be a roller coaster. And everyone grows at their own pace. A whole person is not their behavior or even the part that drove the behavior. Actions are only one piece of the larger puzzle of who a person is.

Growth at any stage of life is often awkward before it is integrated. We are all larger than any behavior, mistake, or aspiration.

When someone says or refers to “attention”, you either imagine a military person standing erect in place or the attunement that you give a child or a friend. We use the same word to describe different facets of reality such as focus, awareness, attunement, support, etc. This word is interesting because it describes what one does as well as what one receives, it is reflective and reflexive. Attention can be focus. Attention can be care. Attention can be recognition. And attention can be awareness.

A lot of people come to therapy because they “want attention” from their partner, parents, friends. Or they come to therapy because they “lack attention” and want to be productive. Get a job, get a partner, get something.

Attention also drives society. It is monetized. There are apps, games, advertisers, and whole industries devoted to gaining our attention and directing what we attend to.

But, what is attention and why is it important?

Perhaps it is the orienting of awareness toward another person, object, or experience. Perhaps receiving attention is being recognized, responded to, and held in relationship? Perhaps it is both.

From a developmental and health perspective, social connection and emotional attunement are extremely important factors in human well-being. Research on children raised in severely deprived institutional settings has shown that adequate food, shelter and basic physical care are not sufficient for healthy human development. Children who experience profound deprivation show deficits in emotional and neurological development which can continue throughout their lifetime.

Across the lifespan, social isolation and loneliness are associated with increased risk of illness and premature mortality. Isolation is when people do not have connections with other people. Loneliness is the perception that one is disconnected. In both circumstances people may experience lack of adequate care as well as reduced morale. Who pays attention to them to notice their needs?

Take a moment and stop and think about your life, what do you pay attention to? How does that impact the lens through which you see yourself and others? How does it impact your relationships, happiness, and choices?

How do you feel when people pay attention to you? Are some types of attention more palatable than others?

In a way attention is like tofu. It can have different textures and flavors depending on what it is combined with.

Whatever we pay attention to is what seasons our reality. If we spend our days focused on fear, conflict, and outrage, those qualities begin to color our experience of life. If we spend time attending to kindness, beauty, or connection, our interpretation and feelings about the world may be different. What we pay attention to truly feeds us. Sometimes nourishing us and sometimes just filling us up.

In a way, we are or become what we pay attention to, and we learn who we are through the attention we receive from others.

When a child smiles at you, when you listen to a friend, when you turn your back and walk away from someone, when you pat someone’s back, something is being communicated either through the giving or withholding attention.

In that way, we really are what we eat. I think this is why it matters what media we consume and with whom we devote attention and spend our time.

Perhaps attention shapes far more of our lives than we often realize.

What do you pay attention to, and what flavor profile are you becoming?

This reflection is intended as an invitation to inquiry and is not a substitute for therapy, medical care, professional support or attention.

There are scary and potentially unsolvable events in our lives such as fires, earthquakes, and war. Life is inherently full of movement and change. Human life is full of development internally and externally, and this ongoing state of flux may sometimes feel like we have very little control.

And yet, paradoxically, the more we can accept the fact of change the more we can meet circumstances flexibly, rather than with resistance.

I think of it like surfing. The water is constantly shifting. A surfer may get pulled under and struggle against the water. The more they struggle the more difficult it becomes to find the surface and survive the waves. But, if they are able to relax into the waves, they are more likely to float, recover, and continue. The same can be true with life. The more we can release our struggle into what is, the more we can ride the waves of life rather than feel pulled under by them.

What we often have influence over is how we participate in the story unfolding around us. We help co-create the meanings we make from our circumstance even when we cannot control the events themselves. It can sometimes happen that we get lost and trapped in stories around despair or victory, as though one moment defines the plot of our entire lives. This letting the story evolve may itself be a form of resilience.

This ongoing co-writing allows us to remain in relationship with uncertainty rather than trying to eliminate it. This can help us acknowledge our reality while still remaining capable of action. We can do a controlled burn to try to prevent a forest fire, but preparation cannot guarantee that there will not be a forest fire.

And, this process can be very difficult. When one is in the middle of a hurricane, it can be hard to look beyond the storm where things may be calmer.

Things can get challenging and feel overwhelming. In those moments, it is important to remember that even if circumstances are uniquely ours, we do not have to carry them entirely alone. There are people we may or may not yet know who are capable of care. And in life, we all need to be held sometimes.

In life, you will make relational mistakes. You may be tired, overwhelmed, or accidentally say or do something “wrong.” You will hurt someone.

At a recent meditation retreat I was tired, sleep deprived, worried about a sick relative, and more than a little self-absorbed. I laughed at a situation, and it was taken as laughing at them. My actions hurt their feelings. I later apologized.

When we are hurt in an interaction, we try to make sense of what happened by creating stories about it. We may blame ourselves or another. We try to figure things out to avoid repetition, shame, and relational loss.

Human relationships have breaks, disturbances – “ruptures”. After that we sometimes try to control the situation. There may be anxiety around either losing or maintaining the relationship.

I often see this in my work with couples, actions have consequences, and sometimes there are no do-overs.

Repairing relationships requires vulnerability, openness, and the desire to understand the other person and may require more than an apology. And there are no guarantees.

Repair works best when there is accountability without self-destruction and when attempts are made without any guarantees or obligations. You may choose not to attempt to make a repair, and the other person(s) may choose not to accept or respond the way you would like them to.

Attempted repair is risky. It can be painful. This attempt is uncertain. And like a broken glass, sometimes cannot be repaired.

When all individuals in a relationship work on it, rupture can become a place of growth. New ways to communicate, shared values, and deep commitment to work together can lead to greater closeness. However, there can be no guaranteed outcomes. Keep showing up to life and relationship, even when repair is uncertain.

This is a reflection piece and not a substitute for therapy or professional support

At the same time, healthcare systems are strained—trying to remain cost-effective while providing meaningful care to growing populations.

These issues are often treated as separate problems. But they are not. They are connected expressions of a broader breakdown in how we care for and support one another, and they cannot be fully addressed in isolation.

Young people are finding it increasingly difficult to secure entry-level work as more roles become automated. Many are forced to remain at home longer than expected, delaying their entry into adulthood. Loneliness and uncertainty are common.

Parents often live far from extended family or lack access to affordable childcare. They come home tired—overworked, under-supported, and disconnected. Some relationships can weather these pressures; many struggle under the weight of them.

Others face a different kind of gap. Some people are unable to access medical care because they do not have someone to list as an emergency contact. Others lack transportation or support after a procedure. Those who need long-term care may not have friends or family available to provide it.

All of these point to a deeper gap in how we care for one another.

Care and kindness are essential parts of the relational field that sustains society. These forms of care cannot be fully automated, and the need for them exists across the lifespan.

What if, instead of organizing our society primarily around productivity or defense, we also organized around care?

We could imagine a form of national service rooted not in war, but in care. One that provides meaningful work for young adults while addressing real and growing needs for childcare, elder care, and support after illness. This kind of service could offer both purpose and connection, while helping to close the gaps many people are currently navigating alone.

This would not be simple to implement. It would require coordination, resources, and cultural shift. But the problems we are already facing are not simple either.

If disconnection and loneliness are the defining challenges of our time, then building systems of care may be among the most important responses.

As we move through a period of cultural and technological change, it may be worth remembering what has always sustained our humanity: our capacity to create community and to care for one another.

Start Here

• Take a breath

• If there is an emergency, or if you are not sure what to do:
  Call 911 → follow their instructions

• If you are in a hospital or care facility, notify medical staff

• Take another breath

If You Are Alone

• If possible, ask one person for help

• If you do not have someone:

  • Call 211 for local guidance

After Death Has Been Confirmed

• If you have religious or cultural practices, consider calling clergy or a spiritual leader (some traditions have specific requirements)

• Call a funeral home or mortuary
  → They will guide you

• Ask for death certificates (get several copies)

Important Calls

• Call the bank

• Call insurance companies

• Say: “This person has died. What do I need to do?”

• Write down what they say (or ask someone to write it down for you)

Basic Tasks (Do Slowly)

• Tell close family or friends

• Cancel or transfer:

  • phone

  • utilities

  • subscriptions

• Look for:

  • will

  • life insurance

  • important papers

Money

• Death can be expensive

• You do not have to buy everything

• Ask for:

  • lower-cost options

  • itemized prices

Support

• If possible, have someone sit with you while you make calls

• If you do not have someone:

  • SAMHSA National Helpline: 1-800-662-4357 (provides referrals to local support)

  • call 211 and ask about support groups or warmline services

  • contact a local community or religious organization

Important

It is normal to feel overwhelmed

Do one thing at a time. You do not have to do everything today!

Start Here

• You do not need to do everything at once

• This is not a checklist — it is a guide

• You can come back to this as needed

Planning Ahead (If You Have the Capacity)

• Write down your medical wishes (advance directives)

• Choose someone to make decisions on your behalf if you cannot

• Create a will if possible

• Tell someone where important documents are kept

• If you can, think about:

  • burial or cremation

    • If you have religious or cultural practices, check what is permitted (some traditions have specific requirements)

    • funeral preferences

• Tell your decision maker your wishes

• Consider support for your condition (Therapist, support groups, clergy, or other resources)

During Serious Illness

• Ask about:

  • hospice (comfort care near the end of life)

  • palliative care (support during illness)

• Ask what help is available at home

• People who may help:

  • medical social workers

  • hospice teams

  • therapists

  • clergy or spiritual leaders

  • end-of-life doulas

• If you feel overwhelmed, ask someone to help make calls

• If you do not have someone, you may still be able to get support through local resources

When Death Is Near or Has Occurred

• You do not have to remember everything

• Focus on one step at a time

• You may want to keep a simple check list nearby

• You do not have to do this perfectly

Practical Matters After Death

• A funeral home or mortuary will guide next steps

• You will likely need multiple death certificates

• Call:

  • the bank

  • insurance companies

• Be aware:

  • accounts may be temporarily frozen

• Cancel or transfer:

  • phone

  • utilities

  • subscriptions

• Look for:

  • a will

  • life insurance

  • important documents

Money and Costs

• Death or prolonged illness can involve unexpected costs

• You do not have to buy everything offered

• Ask for:

  • itemized prices

  • lower-cost options

• It is okay to take time before making decisions

Practical Resources

• · Advance directive forms (see your state – the laws may vary)

• · Hospice/palliative care directories

Support Resources

• Individual therapy

• Grief support groups

• Condition or Situation specific support groups

• If possible, ask someone to help you think through decisions

• If you do not have someone:

  • SAMHSA’s National Helpline 1-800-662-4357 (provides referrals to local support)

  • call 211 and ask about support groups or warmline services

  • reach out to local community or religious organizations

Important to Remember

Even very capable adults may feel overwhelmed or unsure what to do

This is a normal response to stress and grief

You do not have to do everything at once!

Last week a friend asked if I would write about anticipatory grief. I hesitated. Several members of my family are seriously ill, and one of them was told in 2021 that they likely had two years to live. It is now 2026, and they are still alive, although not well.

Over the past several years there have been many treatments tried, many hospitalizations, and many difficult conversations. I share this simply to say that what follows cannot be entirely clinical.

Anticipatory grief is, in some ways, exactly what it sounds like: grief that arises when we know or suspect that a significant relationship may end.

If you are caring for someone who is seriously ill, or a family member or friend of someone who is, you may already recognize parts of this experience, even if you have never heard the term anticipatory grief before.

You may find yourself imagining future conversations, worrying about decisions that may need to be made, or wondering how life might change. You may also find yourself trying not to think about any of it at all.

Similar emotional processes can also occur before other forms of loss. People may experience anticipatory grief before divorce, separation, or the dissolution of important relationships. Anticipatory grief can also occur in conditions such as dementia, where a person may still be physically present but the relationship changes over time.

When we know that a loss may be coming, parts of us may begin preparing in different ways. Some parts rehearse conversations. Some imagine what life might look like afterward. Some try to organize practical matters. Others may try not to think about it at all. We may find ourselves anticipating emotions, responsibilities, and decisions long before the loss actually occurs.

Caregivers also often face a number of logistical questions during this time: advance directives, wills, finances, Long Term Care decisions, and questions about what to do if plans are not already in place. Because these practical realities can feel overwhelming, I have written a separate short guide outlining some of the logistical issues families may encounter when preparing for death.

At the same time, anticipatory grief can bring up a wide range of emotional responses. People may experience shame, guilt, perfectionism, anxiety, sadness, or a sense that they are somehow not doing enough. Others may find themselves emotionally preparing for the loss in ways that feel confusing or even disloyal.

Many people are surprised by the range of emotions that can arise during anticipatory grief. Our relationships with family members are often complex, and it is normal for many different feelings to emerge. Some parts of us may feel sadness, while other parts may feel anger, frustration, or helplessness. People who have experienced past harm in relationships may notice parts that feel protective (of themselves or others) or angry. Others may find themselves feeling relief at the thought that suffering might eventually end, and then feel shame for having those thoughts or feelings.

Sometimes anger itself is protective; it can sometimes feel more powerful than helplessness in the face of what we cannot control.

The complexity of your feelings may also be a testament to the fact that you have had a real relationship with a real human being. Real relationships are rarely simple. The mixture of love, frustration, sadness, gratitude, and even anger can reflect the depth of a life shared together. Recognizing both yourself and the other person as fully human—with a full range of emotions and experiences—is often one of the most honest expressions of love.

Internal Family Systems would see these different emotions as parts of us trying to help in their own ways. When these feelings arise, it can be helpful to seek support from a therapist, trusted friend, spiritual teacher, or community. Talking about what is happening can help people feel less alone in an experience that can sometimes feel isolating.

Acknowledging lack of control is one of the hardest life lessons many of us encounter. And, as long as people are legally competent, they have the right to make decisions about their own lives, even decisions that others might not agree with. When those decisions affect those we love deeply, this reality can be painful.

During these times people may also discover that friends, relatives, and even strangers have strong opinions about what they should do. Advice often comes quickly, and not always with a full understanding of the complexity of your situation.

Unfortunately, high-stress situations and time-sensitive decisions can create tension even in the most loving of families. In families where communication has historically been difficult, or where there has been past conflict or abuse, those dynamics may become more visible during serious illness and caregiving.

It is also important to remember that no matter how much we rehearse, plan, or try to prepare ourselves the actual experience of loss will almost certainly be different from what we imagined.

Anticipatory grief can help us begin preparing emotionally, but it rarely removes the unpredictability of loss.

For this reason, it can be helpful to approach both ourselves and others with as much patience and compassion as possible. Many parts of us – the adult parts, younger parts, and protective parts may all be responding at the same time.

And the feelings we have are simply the feelings we have.

It may also help to remember that loss and change are experiences that every human being encounters at some point in life. Even when it feels isolating, you are not alone in this experience.

This post is intended for informational and reflective purposes only and is not a substitute for professional mental healthcare.

References:

Singer, J., Roberts, K. E., McLean, E., Fadalla, C., Coats, T., Rogers, M., Wilson, M. K., Godwin, K., & Lichtenthal, W. G. (2022). An examination and proposed definitions of family members’ grief prior to the death of individuals with a life-limiting illness: A systematic review. Palliative Medicine, 36(4), 581–608. https://pmc.ncbi.nlm.nih.gov/articles/PMC10098140/

We are living in a moment where digital interaction increasingly mediates human life. Recent estimates suggest Americans may spend between six and thirteen hours per day engaging with digital media (Deloitte, 2025; Cramer-Flood, 2026). Within this landscape, conversational AI systems such as ChatGPT and Claude AI have become normalized.

As a therapist, I’ve become interested in the psychological implications of this shift — particularly how automated responsiveness interacts with human attachment systems.

Participatory Sensemaking

Research in embodied simulation and mirror neuron systems (Gallese, 2009; Jeon & Lee, 2018) suggests that human beings are neurologically wired for resonance. We do not construct meaning alone; meaning often emerges between us.

The framework of participatory sensemaking (De Jaegher & Di Paolo) proposes that understanding develops through interaction rather than residing solely within individual minds. Sociocultural learning theory echoes this view: cognition is relational.

Conversational AI introduces a novel interactive arena. Humans bring questions, projections, tone, and emotion. AI systems generate statistically probable language responses based on training data. Meaning develops in the exchange — but the lived experience of meaning belongs to the human participant.

This distinction is critical.

What AI Is — and Is Not

Current large language models are advanced pattern-recognition systems. They predict word sequences based on probabilistic modeling. They do not possess embodiment, subjective awareness, or self-reflective consciousness.

A useful metaphor is that of a mirror. AI reflects linguistic and thematic patterns present in user input. Like a funhouse mirror, it can amplify or subtly distort perception. It does not experience what it reflects.

Yet because the reflection is coherent and responsive, human attachment systems may activate.

Clinical Implications

When responsiveness becomes automated, asymmetrical interaction can feel reciprocal. Vulnerable individuals may perceive symmetry where none exists. For clients with fragile reality testing, the distinction between simulation and mutuality may blur.

This dynamic is not entirely new. Humans have long projected meaning onto inanimate objects — from children’s attachment to transitional objects to cinematic depictions such as Wilson in Cast Away or the Ewoks’ reverence toward C-3PO in Return of the Jedi. What is new is the sophistication and apparent coherence of the response.

Unlike a ball or a doll, AI replies.

For clients experiencing loneliness, depression, or social isolation, this responsiveness may feel deeply validating. It may also reinforce withdrawal from embodied relationships if not carefully contextualized.

The Role of Therapists

Clinicians may need to begin assessing digital engagement the way we assess sleep, exercise, and substance use. Questions about AI use — frequency, purpose, emotional reliance — may become clinically relevant.

The task is not to reject emerging technologies. It is to help clients differentiate between simulated responsiveness and embodied reciprocity. Human relationships involve unpredictability, repair, and shared vulnerability, and biological responsiveness. These cannot be automated.

AI can assist with curiosity and organization. It can also amplify distortions or strengthen attachment to perceived reciprocity.

In an era marked by increasing isolation, maintaining clarity about these dynamics is essential.

The question is not whether AI will become conscious.

The question is how human attachment systems will adapt when responsiveness is increasingly automated.

That is clinically relevant and where our attention belongs.

If this reflection resonates, you’re warmly invited to connect.

Please note that this is a post expressing my feelings and is not intended as a substitute for therapy.

Selected References:

Cramer-Flood, E. (2026, February 13). US Time Spent With Media 2026. EMARKETER. https://www.emarketer.com/content/us-time-spent-with-media-2026

Deloitte. (2025, March 24). 2025 Digital Media Trends: Social platforms are becoming a dominant force in media and entertainment. Deloitte Insights; Deloitte.https://www.deloitte.com/us/en/insights/industry/technology/digital-media-trends-consumption-habits-survey/2025.html

Gallese, V. (2009). Mirror Neurons, Embodied Simulation, and the Neural Basis of Social Identification. Psychoanalytic Dialogues, 19(5), 519–536. https://doi.org/10.1080/10481880903231910

Jeon, H., & Lee, S.-H. (2018). From Neurons to Social Beings: Short Review of the Mirror Neuron System Research and Its Socio-Psychological and Psychiatric Implications. Clinical Psychopharmacology and Neuroscience, 16(1), 18–31. https://doi.org/10.9758/cpn.2018.16.1.18

Todd, R., Hanne De Jaegher, & Paolo, E. D. (2025, February 11). What is Participatory Sensemaking and Why Should We Care? Substack.com; Reaching towards an ecology of mind. http://beckettodd.substack.com/p/what-is-participatory-sensemaking

I have a number of clients who are very anxious about world events and what the future holds and have reported wanting to “numb out” and avoid reality. That is totally understandable. No one likes to feel afraid or helpless or that they have little control to affect outcomes. On the YouTube series Last Meals from Mythical Kitchen the host Josh often opens with the statement, “Everybody has exactly two things in common: we all gotta eat and we’re all gonna die”. What this powerful quote emphasizes is a simple truth: some things in life cannot be avoided or distanced.

But it’s not so simple, for if one has experienced or is experiencing trauma, these “distractor” behaviors may truly have meant or mean survival. The dilemma then becomes: how do you keep moving forward when in life there are times that pain is unavoidable.

First, let’s look at ways that people avoid and distance through use of substances like food, alcohol, cannabis, or other substances. Other ways are through activities like watching TV and movies, work, or gambling. Another way might be relationally through one-night stands or serial relationships. Other people might socially mask and just smile and say “I’m fine” although they are not. What all of these things have in common is that they serve a purpose. The purpose may not always be clear, but what Internal Family Systems teaches is that parts always have positive intentions.

To help find out about the positive intentions, it’s helpful to know a little about Internal Family Systems (IFS) and the different types of parts that may be in our systems. There are three common types:

Managers try to anticipate situations and are proactive. Just like a coach on a sports team, they want to anticipate and plan. There might be a manager that judges your actions to try to manage the system and lead to a desired outcome. Other managers might criticize, caretake, or plan. Managers are often the parts that bring clients to therapy—sometimes to try to make a behavior go away.

Firefighters are reactive and will jump in to try to help keep the anxiety, memories, emotions, and pain away. They particularly try to keep these away from exiles—parts that hold difficult memories—they are trying to protect. Firefighter parts really mean well but are often disliked by other people and parts. They are often hated by the managers and other people, and are often unsung heroes in the system.

Exiles often hold pain and memories. They are, as the name implies, exiled to both protect them and keep what they hold in place to avoid overwhelming the system.

What Managers and Firefighters have most in common is that they are both trying to protect exiles or the system from what the exiles hold. They are trying to help a person have control and agency.

In IFS, Self is our core essence—the part of us that can observe our parts with curiosity and compassion rather than being overwhelmed by them. Self is the agent for living with the good, the bad, and the not-so-great aspects of life. Self can offer calm, curiosity, compassion, confidence, courage, clarity, connectedness, and creativity. Self helps us keep going and find meaning and value even in the worst of circumstances. Self allows us to be available to help others and our younger parts. Self can help us find purpose and meaning.

Self allows us to feel deeply while maintaining enough steadiness to choose our response, rather than being driven solely by our most activated parts, so that our actions align with our values.

Self does not mean we do not experience loss and grief. Self does not mean that we do not act or express feelings. Self is that which allows us to feel deeply while maintaining our capacity to respond with wisdom and compassion.

While IFS helps us understand our internal world, practices like Tonglen help us connect with the larger human experience of suffering. Tibetan Buddhism has a practice called Tonglen, where you send compassion to yourself, to those close to you, to people you don’t like, and to the world who are in pain. This practice is beautiful because it teaches one how to offer compassion to oneself and to others. And the more compassion in the world, the better.

When pain becomes too great to handle alone, there is wisdom in seeking help. The key is learning to distinguish between healthy coping and escape, between using our resources for comfort and using them to avoid what needs to be felt. Just as doctors use anesthesia during surgery for good reason, sometimes we need professional support to navigate our most difficult moments.

If this reflection resonates, you’re warmly invited to connect.

Arielle Vale, Licensed Marriage and Family Therapist
California LMFT #98885, Maryland LCMFT #893
Internal Family Systems Level 1 & 2 Trained
(925) 726-3151
Psychology Today Profile

Please note that this is a post expressing my feelings and is not intended as a substitute for therapy.

In Internal Family Systems (IFS) there is a concept that sometimes we behave in ways we don’t like or don’t understand. This can happen when a part takes over the system and forgets that “Self” is there or online.

In therapy I often hear people say things like “I know better” or “I/he/she/they should know better.” And the kicker is that they are right. I do “know” better. He/She/They/It does know better – when they are acting from Self. The problem is that in those moments they probably were not acting from the Self but from a blended part.

Self is our essence. What we are. Self is often described in the IFS community as having qualities such as: calm, curiosity, compassion, confidence, courage, clarity, connectedness, creativity. I would argue (in a future essay) that self is more than just these characteristics. Self is also awareness and witness. Self is the throughline in our experiences. Self is more than just behaviors.

In blending, self is forgotten and a part “drives” the bus. It’s kind of like having a 6-year-old drive a bus or fly a plane in an emergency. The first time this happened a part may have had to (or believed it had to) take over the system. That first time the part acted in this way it may have been when you were young. It may have been like a child having to do an adult job. And, as such, not fully equipped to do the job and by adult standards may not be skillful. This can cause issues when you are an adult and the part is acting from a different developmental stage.

Sometimes it is unavoidable to get blended with a part. It might be because you are tired, hungry, over-worked, not having enough fun. Or maybe there is something pleasant like a yummy taste or smell that brings you into the past.

And there are other reasons to be blended. You just read a news item which makes your heartbeat faster, your stomach clench or even outright terror. Your very bones might ache from sadness. You may ascribe meaning to those sensations such as “hopeless” “helpless” or “shame” and “guilt.”

When parts in you or others come in that judge or “know” better your system may not understand “why” you behaved the way you did. This can lead to a cycle of shaming or disregarding self and others/ or guilting self or others. The focus switches to outcome and external results and harms. This is natural to reduce overall harm but can lead to either deep systemic entrenchment and feeling stuck or out and out internal civil war with parts actively fighting each other leading to greater anxiety, depression, and instances of self or other harm. Thes internal tactics may make logical sense but ultimately do not fix the problems or allow for a self-led system.

Because it is likely this part learned these skills to save you, it’s really important to assume that their intentions are positive (even if you don’t like the behavior). These parts may have truly saved our lives or sanity in the past. They may even believe they are still saving the system like soldiers at the end of WWII who did not know the war was over and kept fighting.

You may be asking yourself: “how do I change a behavior if I don’t shame or blame for blending?” The answer is to bring awareness of Self to the blended part.

There are a lot of ways to start the process. You can befriend the part and slowly introduce it to who you are. You can acknowledge what it has done for you. And you can really let your system notice when you (and those around you) have those behaviors of Self present (calm, curiosity, creativity, etc.). I might add another aspect which our society desperately needs which is true kindness, acceptance, and acknowledgement that moments of blending are part of the human experience. This creates space for repair after rupture and ultimately helps with true healing.

An internal example of this might be you are sitting in a meeting and suddenly you notice you have paused, you might have clenched your jaw, you might feel tightness in your belly. Take a moment and pause and instead of interpreting “why” you are reacting just notice “what” is occurring and ask your system if it has information. Although it might be something you “already know” take a moment and silently acknowledge your system. See how the part responds to being acknowledged. Many times just by noticing without interpretation or assigning judgement or meaning the system will relax and give you a little space. This allows your Self time to reboot and come back online and take over your Self-leadership rather than the young 6-year-old part driving alone.

This gentle awareness practice helps us remember that parts that blend are not enemies but are an aspect of being human. Blending may have helped you survive childhood and may be part of the process that allows humans to feel empathy, compassion, and love. It can lead to art, science, connection, creativity as well as to war, illness, and suffering. It allows us to enjoy movies and books, fantasy, and dreams. Can you imagine enjoying a book or movie without blending just a little bit?

If this reflection resonates, you’re warmly invited to connect.

Arielle Vale, Licensed Marriage and Family Therapist
California LMFT #98885, Maryland LCMFT #893
Internal Family Systems Level 1 & 2 Trained
(925) 726-3151
Psychology Today Profile

Please note that this is a post expressing my feelings and is not intended as a substitute for therapy.

Citations:

Wikipedia Contributors. (2019, April 1). Japanese holdout. Wikipedia; Wikimedia Foundation. https://en.wikipedia.org/wiki/Japanese_holdout.

As we approach the season of love and chocolates and pink hearts and cinnamon bears and coffee proliferate the marketplace, I start to think about love. I work with a lot of individuals, couples and families. And one of the things that clients will often say is that they want to have love, give love, and to know that they are loved.

The lack of perceived love can lead to depression, anxiety, communication issues, issues at work, home, and school, isolation, and issues of trust (among other things). Western Pop culture is quick to let us know that, “Love Makes the World Go ‘Round.” In fact much of entertainment has a throughline about love. With all these thoughts of love and with so many people literally hurting and feeling heartache, I turned to the trusty bible of all clinicians—the Diagnostic and Statistical Manual of Mental Disorders (5th-TR) (DSM for short)—for guidance and support. Alas, there is no direct diagnosis or support for issues relating to love or lovesickness in the DSM.

The DSM guideline for a diagnosis almost always says something along the lines of X “causes clinically significant impairment in social, academic, or occupational functioning.” It focuses more on the behavior than the feelings. For example, personality disorders tend to highly impact relationships. There are several different personality disorders, each with their own unique set of treatment issues. To grossly overgeneralize them as a class, they all highly impact relationships in some way or another. There are “Trauma” disorders that highlight emotional disturbance or insufficient care. There are Z codes—”Other Conditions That May Be a Focus of Clinical Attention”—covering “relational distress” and issues with partner relationships, parents and children. However, the most glaring omission of love in the DSM is around grief and loss. Love does not die when our loved ones (animal or human) die. But what all of these diagnoses lack is a consideration of “love”—what is it and how it impacts people and relationships.

Why This Matters for Clinical Treatment

This gap in the DSM has real clinical consequences. Medication is sometimes necessary and can help manage overwhelming symptoms and provide relief when someone is suffering. But, it cannot replace the need to process and honor love and loss. If you break your leg and are given only a numbing agent without proper treatment, you might walk on it and cause further damage—damage that might have been prevented if you had felt some of the pain letting you know that something needed attention and care. Similarly, numbing emotional pain without addressing its source can delay or prevent true healing.

Our society gives the message that there are “positive” and “negative” emotions. This is highly dangerous. In Internal Family Systems therapy, we understand that different “parts” of ourselves hold different emotions, memories, and protective roles. Parts which express criticism, depression, anxiety, and other symptoms are often hard-working members of our internal system, utilizing outdated strategies to try to protect us. These are often some of the most misunderstood aspects of one’s being. When clients get to learn about these parts and find out about various burdens the system has been carrying and can let go of the burden, healing can actually take place. By pathologizing normal human feelings like grief, people may bottle up feelings and can become sicker. Medication alone cannot heal the loss of love. Acknowledging the loss and helping parts learn new skills to live in a world without that significant relationship can. It’s like ignoring the fact that you have just had your left leg amputated.

Sometimes clients need to share their feelings, their memories, their stories and may need them witnessed by themselves and or another person. And sometimes feelings are complicated. People are capable of loving their parents and hating them at the same time. There may be parts that remember when a parent carried them on their shoulders. Other parts may remember when a parent was abusive and hit them. Relationships, especially with family members, are complicated. Abusers are not cartoon characters. And even the best parents sometimes make mistakes. Children do not come into the world with a textbook about how best to raise them. Other relationships are equally complicated. And losing a pet who has shared your life for over a decade can be devastating. No amount of medication can (or should) devalue those relationships. And one of the aspects of healing is helping parts to learn that they can keep the love, still feel the absence of that relationship, and still have and deserve to have a life—and that this is not disloyalty.

Love does not die when we lose what we care about, whether it be a pet, a partner, a friend, a relative, or anyone/anything significant in our lives. (This listed order is not meant to ascribe value or meaning.) What/who/how a person loves is what/who/how a person loves, and that this love is not acknowledged as a player in relationships, loss, and overall life as represented in the DSM is and should be concerning.

Parts that come up around grief and loss are often personal and unique to each individual. One size cannot fit all, as no one relationship is entirely identical. Often when people go through these experiences they feel alone, sometimes isolated. And this is valid because each experience is unique. And sometimes, to function and heal and lead lives, professional help may be needed. This help can work with different parts of a person to grieve their individual losses. It can also help people learn how to reconnect to life.

Grief and loss is something that we all have to face. As such, no matter how alone we may feel, is something that therapy is very good at helping with—you do not have to do this alone.

And really, is there anything more valuable than love?

If this reflection resonates, you’re warmly invited to connect.

Arielle Vale, Licensed Marriage and Family Therapist
California LMFT #98885, Maryland LCMFT #893
Internal Family Systems Level 1 & 2 Trained
(925) 726-3151
Psychology Today Profile

Please note that this is a post expressing my feelings and is not intended as a substitute for therapy.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425787

Personality Disorders. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/personality-disorders#part_2618

Have you ever had any of these thoughts:

· Should I change jobs or careers?

· Should I break-up?

· Why can’t I make up my mind about this or that…?

When people think about options or have indecision, they are often asking questions such as, which possible future outcome will make me the “most” happy/”least” unhappy? What will be safest course of action? What will bring the least disruption to my life? How can I get what I think I want?

Conversely, you may have parts that imagine possible pasts and work to keep a decision from being made because the part remembers a past similar circumstance and projects what happened before onto the current reality.

The Internal Family Systems (IFS) concept of polarizations (parts that want different things) can help make sense out of this. One of the many things that polarized parts might do is anticipate needs by focusing on potential futures or past occurrences. Through working with those parts that appear to be in opposition one can get to the heart of what is keeping you stuck.

Ask yourself, what story am I telling myself? Are the scenarios that come to mind directly related to what is happening in this moment or are they projections into the future or looking through the lens of the past? If they are not in the present, try to gently update them to your current reality. If you have difficulty with this, you may want to work with an IFS trained therapist.

· Check in with the parts to see what they anticipate about the future/the past rather than the present. Often just by acknowledging what they really want they can turn down the volume and allow you to be more present.

Take a slow deep breath in and feel inside (yes, even at a loud concert). Notice as many of your senses as you can (given your venue). The simple act of breathing and engaging senses often can reorient a person to the present.

Decision making is easier when it’s based on what is happening now. “When you know you don’t know, you remain open, when you know you don’t know, anything is possible.” (Wallis, Recognition Sūtras 2017, p. 354).