Dr. Constant Mouton | How professionals can build community and stay mentally healthy during the pandemic

The benefits of building community have been well proven, but often, we feel we don’t have time to do so outside our work and family obligations.

But there are serious mental health risks associated with not-disconnecting from work according to psychiatrist and addiction recovery specialist Dr. Constant Mouton. 

 "If work and/or family are your only community, then you get into trouble with things like burnouts," Mouton says. Family and work are important but they can't meet all of our social needs. If we rely too much on family or colleagues, we will miss out on opportunities for personal and professional growth. 

Burnout occurs when the feeling of overwhelm, emotional drain, inability to meet constant demands continues for six months or more and we begin to lose interest and motivation in certain roles that we took on in the first place. 

In the Netherlands, where Mouton works, people who have been experiencing serious stress for less than six months can apply for sick leave and are asked to participate in various coaching activities, including finding activities in communities.

“In the Netherlands, much is focused on self care, wellbeing, finding balance and finding communities that lighten your spirits and lighten your burden - like a counterforce to work,” he says.

Mouton’s lectures on the neurobiology of addiction and burnout are quite similar. "I can just as well use that same lecture for burnout because the biological ways and the roots are very similar to burnout. It's all sympathetic overload, you have to work with your parasympathetic nervous system. You have to do a lot of winding down and calming down, mindfulness."

Community outside of work and family is a choice and it provides us with—what Mouton refers to as—collective resilience. 

“The real difference is that family is a group of people who are closely related to one another by blood or marriage or adoption, or nowadays also by choice,” he says. “Community is often a choice.”

“By building these communities, in the same way that we build family relationships, we can actually access that collective resilience and strength in everything we do and all the work we do to overcome adversity, trauma, loss, discrimination, all of those things,” he says. “Both families and communities have a lot in common. They support us in finding connection with others and that helps us grow and develop and also heal. Families and communities are really an abundant resource for stories and shared beliefs. And that makes us understand our process in a current situation.”

Dr. Mouton is certified in a unique kind of interventions, working long-term and with total transparency, with families whose members suffer from addictions and various mental health issues. In his work, he uses a "5 to 1" ratio. It takes five care professionals to replace one family member. And the equivalent of a minimum of 3.3 family members are needed for successful outcomes during such interventions.

"If you help people find communities that can support them, that will help them process things and aid the recovery as well,” he says.

“The function of a community is about that connection, mutual support, social participation, cooperation, and it’s usually towards a certain goal,” Mouton says. 

“I just love the African proverb: ‘If you want to go fast, go alone. If you want to go far, go together” says the South African native.

Mouton recommends joining three different types of communities that are aimed at higher goals. "In finding them, look for groups that meet up with your core beliefs, but that also add something to your life in terms of what you like or what you aspire to be." Do something for your body, your mind, and your soul.

• Body-wise: running club, a gym or fitness or a judo, karate or whatever you're into.

• Mind: take up a hobby that kind of sparks your imagination, like art class or writing or something creative

• Spiritual: like yoga or meditation

“This way you cover all bases. It’s quite nice because you combine self-development with community,” he says. The rest and relaxation helps to disconnect from work and other obligations.

What if it feels like no one in your area has your interests, goals, norms, and values? 

A traditional community would be referred to as a collection of people within a geographical area, but Mouton says there that today thanks to technology, the community can be online.

"The community doesn't have to be local. You can also find things online. There's also more out there than you think. The first step is to always dare to be vulnerable and to look for the others that don't fit the mold. The internet is a wonderful resource for those kinds of things. Nowadays with modern technology, things like Zoom and platforms, you don't need to be limited by your geography.” 

Does one start with interests or values?

"You might start with interests and then work out the norms and values amongst each other. I think if you're an outsider who wants to join a community that's already there because the community has a life of its own. It's also an entity of its own. The norms and the values are there already.

"You find communities that have a common goal. It can be one that is trying to overcome a potential threat, like discrimination, "which is in the media of late." 

What if we are expats?

If you live in a foreign country, and depending on the cultural boundaries, you could ask for recommendations at work. “If you're an expat, it is best to start with expat communities and branch off from there.”

What if we are older than 29?

The older we get the more difficult it seems to make friends. When we are young we are "less inhibited" and that's got to do with the brain and prefrontal cortex development. "In our 40s, we become more reserved as we get older. We know ourselves better... So in a way, we get more particular with whom we want to be friends or not."

What if we are single?

Single people need not despair. It is a good thing to be individualistic and do your own thing whether you are single or in a relationship. 

"In the Netherlands, people often go out with friends and leave their partners at home and say, well, this is a friends' evening and I'll see you later. This is quite acceptable."

So join a running or a yoga club, take up a hobby, and something creative that you can do. All of this can help you live a richer, more resilient life and help you in both burnout prevention and cure. The basic resilience is there already. 

Dr. Judith Landau and Daria Tolstoy | 5 compassionate strategies any leader can use to to combat family challenges

Dr. Judith Landau

Drama at home can derail any leader in his or her effort to be present, aware, selfless, and compassionate at work and in life.

Take the following two case studies, for example.

Daria Tolstoy

A congresswoman—working on key legislation—learns that her drug-addicted brother has conned their elderly father into loaning him yet another sum. Or, the CEO—closing a deal while on a business trip—learns that his 11-year old son used a hammer to destroy the kitchen countertops and now threatens his mother, because she confiscated the video game controls and sweets.

Whether biological or chosen, our families are important. They provide a sense of belonging and of being loved. Research shows that people in strong families are healthier, get their needs met and express their values more often than people in struggling families. People in strong families are less likely to be filled with self-doubt. Knowing our family is there gives us the courage to take calculated risks needed to succeed professionally and personally. 

 During difficult times, such as when there is illness, estrangement, abuse, divorce or death, the whole family suffers.

For any leader who wants to address the family challenges that may be holding them back, personally and professionally, here are five strategies that can help.  

1. Find our own meaning

 The best way to deal with a difficult family member who may have hurt us, says Dr. Judith Landau, world-renowned child, family and community neuropsychiatrist, is “by finding our own meaning and purpose in life, and by resolving whatever it is.”

The work of restoring—if possible—any relationships with our spouse, our parents, or our relatives and fixing anything unresolved or negative with our children is only possible if we focus on our purpose.

There are many forms of purpose besides the altruistic kind, including survival, religion, accumulating wealth and fame, personal and spiritual development and creativity. 

 Holocaust survivor Viktor Frankl wrote about purpose in his book Man’s Search for Meaning and observed that those fellow inmates who survived were those who felt they had a purpose. He concluded that meaning or purpose can be found in three different ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering" and that "everything can be taken from a man but one thing: the last of the human freedoms—to choose one's attitude in any given set of circumstances".

 To do the work of finding one’s purpose, Laudau advises asking the help of a therapist, a pastor, a philosopher, or a spiritual guide. 

2. Choose our language wisely

Words matter. They can be wise, or they can be weaponized. And within the family, diplomacy is preferable to warfare. When talking about family members and other people, it is crucial that we choose our language wisely.

Landau says:

“Negative words are static, not mobile. When one uses the word ‘toxic,’ how do you recover from that? Isn’t it better to use ‘someone who’s survived trauma’? This gives room for change. Even ‘dysfunctional’ is better as it implies that that person has the capacity to drop the ‘dys’ under different circumstances.”

Landau is weary of the popular use of the term narcissist. “People usually use those terms because they don’t like somebody or they don’t like their behavior. It’s a diagnosis and shouldn’t be used loosely. Some people who behave in a narcissistic way are simply deeply injured. Their maturity may have been compromised. They are acting as smaller children, or more immature people,” she says. 

3. Understand where they’re coming from

Restoring difficult family relationships can be hard. Family members are human beings who are, by their nature, imperfect. Coming to terms may just be enough.

“It may require taking a broader perspective and understanding why that person became abusive,” Landau says. 

Understanding the origin of the abusive behavior is necessary.

“Sometimes the origin of behavior is just sheer wicked. I am thinking of people who are really egocentric… Every bully and liar I have ever treated has had to lie to an unforgiving parent because they did not accept them as they were, which could have been because they didn’t have the intellectual capacity or they weren’t able to play a sport or they had learning challenges. They learned to cover up and to bully to gain control and to lie to please the parent. If we can get to the core meaning of that behavior and it’s there, rather than a sociopath with horrible intentions, for the most part one can understand and forgive. Forgiveness is so much at the heart of moving forward.”

But what if we’ve got someone in the family who is a sociopath? 

“You have to get to a point of acceptance and distancing,” Landau advises. “Find whether there is anything of meaning within the relationship and if it’s a family member, do they have any redeeming qualities that you can enjoy or not?” 

Does it mean cutting them out entirely? 

“It’s not realistic with family,” Landau says. “We can’t move beyond. We have to find a way of coming to terms, even if it’s just forgiveness. Yes, he’s a sociopath; he behaves abominably. I make a choice. I will not participate in bad behavior. I will not participate in wrongdoing, but there is a blood connection. There is a part of him that still cares for his mother or his child, and I will only interact with him around this good quality. It’s not even forgiveness. It’s developing the capacity for tolerance and understanding.” 

According to Landau, we need to separate the person from the behavior, and we need to start doing it with our children when they are young. For instance, saying the following is crucial: “I love you, but I do not like what you just did.”

“We start with our kids when they are very little to separate out the core of the human from the behavior. We have to do this with ‘badly behaved’ family members,” Landau says.

How do we support and love a family member who is struggling? 

“You just love and support them. It’s a huge question. That’s all you can do! Let them know you love them but you don’t love their behavior,” she says. 

4. Set boundaries

Setting boundaries “is absolutely essential to being able to live with other people,” says Landau.“We need boundaries at every level of our lives to feel safe.”

Landau often sees young children who become increasingly violent due to over-permissive parenting and lack of boundaries. Examples she gives are the 10-14-year old patients she has treated who have done thousands of dollars of damage to their homes because they were never told: “This is the limit.” 

“We all have to know what is our limit,” Landau says. “If you think of a cardboard box, and little kids start pushing against those walls, if they fall down, they will feel unsafe and they will push further and further.”

Landau sees this in people who occupy positions of power, such as dictators or CEOs, who continue unchallenged and unstopped.

 5. Pass on the right behaviors to our kids

For any leader who has had a difficult upbringing, a central question emerges when they decide to have kids of their own: how can we avoid replicating past patterns and passing on dysfunction to our own children? 

“When there is conflict, it's never in isolation, says Daria Tolstoy, a systemic therapist and executive coach working in Lausanne, Switzerland. “When something in the family is not functioning right, the child will show it. Children are often stigmatized. If the couple has problems, the child will start to act out." 

According to Tolstoy, fixing things and making sure that we are passing the right behaviors on to our kids requires an attitude of choice rather than obligation.

 “Otherwise our kids will doubt our love,” Tolstoy says.

“Give the children love, more love and still more love – and the common sense will come by itself,” says Tolstoy, quoting author Astrid Lingreen, author of Pippi Longstocking.  “I really like that. Often, parents love their children, but struggle to show it. Often there are double binds. Kids start to ask themselves, ‘do my parents really love me?’ It is more important to love for just being, rather than doing. Parents can be too anxious. Let children live. There's a balance. Constantly have a natural connection with your children. I don't agree with the quality over quantity. You can't squeeze quality into a small amount of time. Parents need to walk the talk.”

Being the loving parent and the disciplinarian is key. Landau adds that if discipline is part of loving in child raising, “you never have the dichotomy and the extreme discipline needed.”  

But what if discipline didn’t begin when they were young? “You need family therapy and parenting classes,” Landau says.

Disciplining children is about being assertive. Tolstoy advises saying: “You know the rules in the family. This is what I want." (Don't focus on what you don't want.)

How do we deal with distractions and detractors, such as kids playing too many video games? Tolstoy says: “Gaming addiction is linked to pleasure. There are other pleasures. Young girls, who are anorexic, are another example. There is no pleasure in their lives. Invite them to come along to something else that gives pleasure.”

“Take things step-by-step over a long time and think long term,” Tolstoy says. “We are so tired and fed-up, we want to fix things now, but just because you've dealt with something for 10 years, doesn’t mean it will go away overnight but it will not take 10 years to fix it.”

In order to be effective, leaders need to be mindful of their personal relationship dynamics and how that is shaping them. Seeking out the help of experts is key if one is to strengthen one’s family.  

Dr. Paul Hokemeyer | What are the 3 barriers to living a ‘good life’ for the rich and powerful?

Each and every one of us has thought about what we would do if we were to win the lottery. Would we quit work? Would we give most of it away to charity? Would we build a house for our parents? Would we hang out on beaches and drink pina coladas all day?

There are many stories of individuals who—after a windfall—have either piddled away their fortunes or continued working, amassing even more money. Interestingly, both of these groups have similarities as you will read ahead.

We know that money doesn’t bring happiness, but a certain amount does. A few years ago, researchers at Purdue University and the University of Virginia did a study that concluded that $95,000 was the ideal income for individuals, and $60,000 to $75,000 was necessary for emotional well-being. 

So why aren’t those richer than $95,000 happier with the added cash? 

We asked psychotherapist Dr. Paul Hokemeyer, aka “Dr. Paul,” what he thinks, as he is specialized in treating people on both ends of the economic and power spectrum. 

Dr Paul started off his career working in a free clinic in Los Angeles, where he treated marginalized populations, including the underprivileged and LGBT. He moved to NYC, where he began working with a polar opposite folk: the rich and famous. Soon, he saw a commonality in the extremes. Both the very poor and the very rich were stigmatized and held in contempt by society. He witnessed how this attitude permeated even the helping professions, impacting the neutrality of clinicians treating both “cultural” groups.

In his recent book Fragile Power: Why Having Everything is Never Enough, Dr. Paul shows examples of clinicians who lack the knowledge and compassion to help the moneyed and powerful cultural group. He also identifies three cultural “markers” or things that all individuals in this group have in common.

These are: 1) isolation, 2) suspiciousness of strangers, and 3) hyper-agency. Dr. Paul defines hyper-agency as the “mastery in manipulating one’s life to avoid discomfort.”

So if avoiding discomfort isn’t good or healthy in life, then what is? We sent Dr. Paul some questions and the following are his answers.

Q: Why is breaking out of isolation and trusting strangers so important for healing?

Human beings are built for connection. It’s hard wired into our DNA. We come out of the womb completely dependent on another human being's love, nurturance and protection for our survival. While this complete dependence wanes over time, we remain dependent on other people’s emotional support our entire lives. I don’t, however, believe in trusting strangers absolutely. To be healing, our vulnerability must be given to people who are worthy of our trust. In my work, I refer to this as ‘strategic vulnerability’. It involves pushing ourselves through our resistance to be intimate, but intentionally and with supports in place to protect us. This is especially true for people who have experienced any type of trauma in their developmental path. Through the practice of strategic vulnerability, we are able to challenge ourselves to connect our humanness with the humanness of others and in the process evolve and repair.  

Q: Could using one’s wealth to avoid discomfort lead to a life void of meaning and hence, less “happiness”?

We’ve been taught that money is a panacea for any challenges that may come our way. While certainly, money is important, it’s not a panacea and believing it is can lead to a host of challenges and limitations to our evolution and repair. The purpose of life is to learn and grow. We must adapt to the constant changes that are at the heart of life. If we don’t, we will stagnate and drown in toxicity. Money—its worship, its stewardship and its pursuit—cannot be the primary focus of our lives. They need to be secondary considerations of a life that is dynamic, constantly changing and in search of meaning and purpose. 

Q: It has often been said that it takes one generation to make money and one to lose it. What do you think about the theory that perhaps the generation that made money indulged its progeny, making it weak and unable to cope with discomfort?

Money is an energetic. It’s like electricity. It can create wonderful things when properly channeled but if misapplied, it can lead to destruction, destitution and death. In cases where I’ve been called in to help alter a family course following the later trajectory, I observe family dynamics where money has come to be used as a vehicle of expression. In these families money is used to convey approval or disapproval, respect or rejection, control or permission. To alter this relational dynamic, I help families see how they are using money to communicate and interact, what meaning it holds for them and what messages they are conveying to their family members. Once these messages become clear, we then create strategies to communicate and interact more effectively.   

Q: How do we grow as individuals, if we can learn to cope with our discomfort?

Human beings are genetically wired to move in a healing direction. Because we are possessed of the most developed, rational brains of any mammals, we have the gift of reflection. We analyze the past and strategize for the future. Discomfort is an integral part of this process. Through it, we find the motivation to push ourselves towards higher, more evolved, reparative states of being.  

Q: So what is “living a good life” then, if avoiding discomfort isn’t such a good thing?

Living a good life means living a life that’s intentional and diversified. Intentional means we pursue opportunities that reflect our individual values, add value to our families and the communities, and respect and steward the planet we have the privilege of occupying. Diversification means we need to strive for balance between the quantitative and qualitative aspects of our lives. We must work to find security in the quantitative, material realms of life while simultaneously striving to maximize the qualitative, relational aspects of it. 

Christophe Sauerwein | 7 brave helpful dating tips for every woman over 40

Why are women—especially those over 40—finding it so difficult to find a committed relationship? In my role as coach, I hear that they feel overwhelmed, scared and disappointed by a world of Tinder and Match.com. So what is the cause? Are we women too accessible? 

Some women practice the “three date rule,” which is a widely accepted number of dates that people go on before sex. British writer Kira Cochrane, writes about this rule after she moved to the U.S: “I also learned of the third-date rule - the most central and widely recognized of all dating rules - which decrees that there should be no sex until the third date, however much you might actually desire sex before this point.”

So, how many dates are women going on before they have sex with their new partners?

Statistics show that it’s not just the Americans who accept the three dates as a rule. Time Out’s Global Dating Survey 2015 states the average is 3.53. But, the Brits may be more conservative. According to a 2014 Daily Mail survey, women are opting for five dates instead of the traditional three. A survey by yougov.co.uk found that “one in five (18%) people would take the plunge after seeing someone for the first time and one in eight (12%) follow the classic ‘three date rule.’” So one third of people have sex on or before the third date.

So how long should women wait before sex?

Over the past years, I have asked therapists this question but few are willing to give me a number. They say it depends how you feel about it. My friend Christophe Sauerwein, a London-based psychotherapist—with whom I have been having an ongoing conversation about this—has a straightforward answer.

“I would stick to 10 dates, especially if you are middle-aged,” he says, “10-12 dates is the suggestion for people in recovery. Everyone struggles with vulnerability as it concerns attachment. If the aim is to build a long-term relationship, the aim is to connect and bond emotionally first. If sex is in the equation and it happens too early, there is a risk. The problem with sex is that it creates a very strong bond, but it is not enough to make the relationship exist. It’s not a proof of the relationship. It’s one-dimensional only.”

This bond is something he calls “the sexlock”, comparable to wedlock or the state of being married. Once you have offered something of yourself--the symbolism of giving of the body, the close proximity, the hormones, the pheromones--it is very difficult to undo the bonding.

Furthermore, sex is a blinder.

“We fool ourselves,” he says. “We convince ourselves the relationship will work and feel compelled to continue, but it’s the wrong assumption. If we decide to break up, it’s easier to do so before than after sex.”

“From a woman’s perspective, she is offering her body. From a psychoanalytic perspective, there is a defloration that takes place, much like the original first act. It should be handled with care. Only have sex once you are sure that the person in front of you is suitable. It’s all about intimacy.”

Contrary to how people use the word today, intimacy needs to include the mind, the emotions and the soul. 

“We are not speaking of one-night-stands,” he says. “If these fit into your value system, then fine, but know that the risk is huge. People pretend to themselves that they don’t want a long-term partnership, but on the basis of that one experience, they start to obsess about someone they barely know. The chance of disappointment is immense.”

But, hasn’t everyone had an obsessive crush on someone? Does this mean we are all love addicts?

“We speak a lot about sex and love addiction and this has to be handled with care,” he says. “Just because you were obsessed with a boy at 18 doesn’t mean you’re an addict. But if you are 30 years old and still repeating this, then there’s a problem. Everyone is on the spectrum, much like an eating disorder.”

Our conversation led to what constitutes sex.

“What is sex?” Sauerwein asks. “Sex is surely more complex than penetrative sex. It’s the aim, but that’s not when it starts. There is a lot that happens beforehand. It’s a very individual experience. It’s important to discover ourselves in that respect.”

A recent UK-based study shows that there exists a different understanding between men and women of when sex starts. For men, sex corresponds more to penetration and is focused on the penis; for women, however, the French kiss is often just as important to create that physical bonding. Her neuro-system or her entire body is involved.

 “So when a man kisses a woman without her permission, he may not realize that what he’s doing could be abusive. She may not have wanted it. If he forces the kiss after the date, he may see it as a preliminary, not as a sexual act. But for the woman there is a sexual component. The kiss is penetrative. There’s pleasure. The woman has the right to be clear about that and to voice her consent.”

So, based on my own experience, what I have read and learned from the experts, here are some tips:

1.  Waiting produces better sex – When we wait, we have a better sexual experience, experiencing less shame and less fear.

“We feel safe, we don’t feel exposed, and the first experience goes better,” Sauerwein says. “We know the other person so well, we feel comfortable.”

The inverse--sex too early--will negatively impact on the quality of the experience. Many people report that when they have sex with people they have just met, they bring their past into the act. The brain realizes it doesn’t know this new partner and starts to contrast or compare.

“If I do this, I’m inviting too many ex-lovers into the room: this guy is not as good as this other guy… The only answer is to get to know the partner you are touching.”

2.  Bond with the right person - Waiting 10 dates will allow you to get to know the other person and any lurking red flags and turn offs. If he stops seeing you before you get to 10, you will know he was most likely only after sex.  

Sauerwein says to be careful about love at first sight. The charming prince fairy tale is just that… a fairy tale. “Feeling passion for someone doesn’t mean you have to sleep together tonight,” he says.

3. Waiting preserves friendship - If at the end of 10 dates, you see him more as a friend than as a life partner, you still have the option of keeping him as a friend.  The chance is higher than if you had slept with him. Some of my best friends were initially dates that never went further.

4.   Ask yourself some questions – Be honest with yourself and ask yourself what you are trying to achieve.  If you have a strong belief that sex is the answer, then what is the underlying question? Am I lovable? Am I seeking love? Am I attractive? If validation is what I am looking for, then are there other ways of getting this? Why should I agree on sex without knowing the other well enough?

“Do we need to be sexual to feel loved?  If so, this could be an indicator of insecurity, fear, or low self-esteem,” Sauerwein says.

5. Beware of online dating – “It’s hugely dangerous,” says Sauerwein. “We don’t have enough information. We just have a narrative. It’s highly subjective. I had a client who found that the person she had been exchanging hundreds of emails with had lied about everything. The photo was 10 years old. People lie online. They are wearing masks. Our job before we get into sex… is to pull down the mask.”

If you do meet someone online, know that texting and exchanging emails don’t count as dates.

6. Beware of long-distance relationships – “Long-distance relationships are also dangerous,” Sauerwein says. “We make it really nice when we see each other. It’s easy to show your good side once a month. Aim for seeing each other once or twice per week. Plan to have entire days together. Go to the museum, out to lunch, out to dinner. Get to know the person over a test period.”

7. Aim for intimacy but be careful with the word – “We narrow the word intimacy too much to the physical. It’s about emotional, intellectual, spiritual, physical and sexual intimacy. Will you allow the other to see into you? It’s important to talk about sex before sex.”

For more information on intimacy, read the Intimacy Factor by Pia Melody, a therapist and author of books on codependency and sexual addiction.

Intimacy leads to pleasure.

“How do we make sex pleasurable? When we give and receive pleasure. It’s hugely interacting. We need to have enough trust, as in love trust. I know that this woman cares enough about me to say no. I can share without fear what I would prefer and not prefer about sex.”

There are many ways to express our personal preferences regarding position, oral sex, anal sex, lights or no lights, etc...  How do we say it to our partner?

“Many give pleasure but struggle to receive it,” Sauerwein says. “Take the 69. It’s a very difficult thing for many to handle. We have to hold the give and take. Many people don’t like it. It requires a lot of intimacy, being able to give and take at the same time. Joint climax is the ultimate in give and take, but it takes a lot of time and mutual understanding.”

8. If a man becomes distant after the act, run away. “Such a man will hardly change,” Sauerwein says.

9. Practice loving a man without sex as much as with sex – This addresses the spiritual self.

“It’s similar to the tantric approach, without giving it an immediate sexual dynamic. There’s a great potential for growth there.”