How do I talk without feeling triggered? Part 6

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Continued from last week…

Dear Survivor,

If you want to help your partner, and your relationship, my best advice is to focus on yourself and your healing. I don’t mean this in a selfish way; I mean it in a self-care way. Your partner’s feelings are his own, and only he can own them. Taking on his feelings robs him of understanding your true feelings and prevents you from sharing your authentic self. There are developmental and valid reasons for this given your history of sexual abuse at the hands of a parent, e.g. violation of self-worth, violation of boundaries, codependency as a means of survival, etc. I imagine that adopting an agreeable, people-pleasing persona is how you coped with and survived a household of abuse. These adaptations and coping mechanisms can become entrenched patterns long after they’ve helped you to survive. Understanding this with self-compassion can help unburden you from the guilt that may come with co-opting other’s feelings in your adult life. By embracing your sovereignty, you’ll realize you are entitled to your own feelings and experiences, living unburdened from the responsibility of taking on or managing anyone else’s emotions.

Lastly, understanding your triggers is an ongoing process. Triggers are reminders of your past trauma. When a traumatic event occurs, people often dissociate from themselves to survive the event. This creates a dis-integration in our life history - oftentimes a blockage of our right and left cerebral hemispheres or brain halves. When these dissociated experiences are held in our memory, the two halves of our brain cannot communicate - the left holding our facts, time, and linear events of the memory while our right holds the self, emotions, and autobiographical memories. These unintegrated memories in the form of emotions, sensations, images, and impulses can flood the individual when triggered without any sense of time. It literally feels like they are re-experiencing the traumatic event right now. This is often why traumatized individuals' reactions may be out of proportion to the triggering event - it is because they are releasing all of their repressed and unintegrated memories at once without any control. But, through careful work, integrating these experiences back into your psyche can stop the triggers from impacting you because they will eventually have a time, place, and accurate context to separate them from the present moment. Your husband also has his own history and traumatic experiences, and along with it, his own set of triggers. My partner and I have created a safe word, “misfire,” for those moments we stumble into a trigger unintentionally. It can be very grounding to stop the flood of emotion that ensues when one of these landmines is triggered.

By no means are these answers intended to be comprehensive, complete, or to encapsulate the entirety of your story and being. There are many nuances to navigating trauma, abuse, and the multitude of obstacles layered into these complicated experiences. You are courageous and brave to be doing this work. You are offloading the guilt and shame that was unjustly put onto you as a small child. If you love your partner and your partner loves you, you can find a way to navigate this together, respectfully and gracefully. When you open yourself up intimately and vulnerably, it requires taking down your protective armor, lowering your defenses, and risk being truly seen. This is a raw place to be and it may feel scary navigating this terrain. There will be mistakes and missteps along the way. But, if you trust your partner, continue to show up and do the work. As Michael Beckwith says, “the safest place to be is in your own unfolding.” Stay open, stay curious, stay respectful, and stay kind. Your heart is meant to be wild and free. Thank you for your trust and courage to be seen and heard.

With love and light,

John Moos, MD

How do I talk without feeling triggered? Part 5

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Continued from last week…

Dear Survivor,

PART III

“How do I talk about it with him and not take on his feelings & being triggered?”

We’ve covered a lot of material and language in Parts I and II, so some of this may feel repetitious. There are two primary components to engaging in safe conversation and avoiding triggers: 1) creating a safe container to discuss these traumatic experiences openly and honestly, and 2) understanding your triggers and integrating them back into a whole concept of self.

There are many facets to the trauma created by sexual abuse, and the lasting consequences. Thus, it makes sense there are many reparations required to restore one’s integrity and personal authority. Creating a healthy container requires several factors: trust, safety, transparency, and faith. It requires each participant avoid assumptions, blame, judgments and criticisms. As Brené Brown says, “clear is kind.” If something is not clear, ask for clarification from a genuine place of curiosity and compassion. It can be extremely hurtful to diminish, negate or tell the other participants' story or their truth. If this is new or difficult, there are professionals who are available to help facilitate these intimate and deep conversations so they don’t result in processing retraumatization.

It is worth exploring the dilemma you may find yourself in when trying to create a safe container. If you are wounded and triggered, how do you trust the container? If you have been lied to repeatedly, how do you know what honesty and transparency looks like? If you have been abused and manipulated, how can you know what safety feels like? In order to offset the grooming, lying, manipulations and gaslighting required to abuse a child, survivors will have to start trusting their intuition, reconnecting and reaffirming their gut instincts, and developing their inner trust and personal authority. This is the first of many early stages to healing the injuries sustained in your childhood. Eventually, a maturation, an inner knowing will emerge to help you intuit who is trustworthy and who is not. Over time, through small, consistent, and repetitive gestures and actions, these people build trust through kindness and compassion. Invariably, there will come a time when there is a gap between trusting and knowing. That is where faith comes in. You have to trust your intuition and rely on faith that you are opening yourself up vulnerably to an individual that will hold your safety with great care. It is a scary place to be, and courageously moving through it can yield great transformation. In those raw moments, it is still possible to be hurt, for your partner to misstep and make a mistake, and it seems justified to retreat and withdraw. If you trust your partner, be open and honest with where you are so they can do better next time. As Maya Angelou once said, “Do the best you can until you know better. Then when you know better, do better.”

To be continued...check back next week for the finale of this 6 part series.

With love and light,

John Moos, MD

For More Resources:

RAINN - Rape, Abuse & Incest National Network

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

The Courage to Heal Workbook: A Guide for Women and Men Survivors of Child Sexual Abuse by Laura Davis

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.

How do I understand his experience and not feel overwhelmed? Part 4

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Continued from last week…

Dear Survivor,

If all else fails and you find yourself in a position of conversation, triggered and flooded, have an exit strategy for moments of crisis. Talk about this ahead of time. Make a sign, have a safe word, agree to take a break, but figure out what you both need in a time of crisis to remember: you are seen, supported, and loved. When the triggering event occurs, it can be hard to orient yourself and find stable ground. Making a plan is effectively tethering yourself to a safety line so you know how to find safety when you need it. A plan will not stop the bodily sensations, flooding, or danger reflex, but it can be a light in a dark tunnel when it’s difficult to find or choose a direction to safety. Remember, Noah built the ark before the storm.

Relationships can be an incredible catalyst to growth. Quoting Jim Hollis from his book Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up, “what we don’t know about ourselves is a burden to others.” I think this perfectly encapsulates your dilemma. You are not a burden to your husband and you cannot know if he would be better off without you unless he has shared such with you. If you want to show up for your husband in the best way possible, continue to focus on your healing journey. Seek out the information you don’t know about yourself, i.e. your triggers, your trauma, your experience, and do the necessary work to integrate those into your whole self. Perhaps you are feeling like a burden because there is still much to discover in your history and your traumatic experiences, but it sounds like you are courageously pursuing your truth and your integration with self-compassion and intent. Honor that! The quality of your marriage will only be as strong as your inner relationship - the inner marriage.

I would encourage you to avoid narrating your husband's story. You do not know that he would be better off without you or if he never married you, unless he has said that to you directly. If that happens to be the case, choose yourself and your safety. If not, know that he is on his own life journey and it clearly has involved meeting, befriending, dating, and inevitably marrying you. He is choosing to be with you, just as you are choosing to be with him. You have chosen him to reveal yourself and your most sacred vulnerabilities. There are three people in every relationship: me, them, and us. Together, you have consciously ventured into relationship and embarked on a courageous path of healing, both individually and collectively. Your partnership is acting as a catalyst to mature your relationship so you can hold a healthy “us”. Being in a relationship is not always easy, but the challenges offer opportunities to reflect on our choices, deepen our empathy, and understand how we are connected to ourselves and others.

To be continued...check back next week for part 5 of this 6 part series.

With love and light,

John Moos, MD

For More Resources:

RAINN - Rape, Abuse & Incest National Network

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

The Courage to Heal Workbook: A Guide for Women and Men Survivors of Child Sexual Abuse by Laura Davis

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.

How do I understand his experience and not feel overwhelmed? Part 3

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Continued from last week…

Dear Survivor,

PART II

“How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off…”

There is much repair work required to undo the trauma perpetuated against you by the individual entrusted to protect you - your father. I acknowledge and honor that this can be a long and arduous process to endure. However, the freedom, confidence and resiliency from undergoing such a journey is well worth it. I have seen the rewards firsthand with my fiance, and close friends and family.

Living in guilt or with guilt can feel like a prison. Genuine remorse and concern is a healthy component of empathy, and so is guilt. Guilt, remorse, and concern arise because you care. But, guilt can easily turn into shame if you start to believe that you are responsible for your husband's perceived unhappiness or the burdens in his life. If you find yourself in guilt or shame, you run the risk of creating false narratives and unnecessary separation from your husband. Authentic stories can bring us together, but fictional stories we tell ourselves can tear us apart. Bringing in and nurturing your self-love, self-compassion, and forgiveness can help to release any shame or guilt around these stories. Brene Brown, undoubtedly a queen of story-telling, talks about the power of this statement, “the story I am telling myself…” Tell your husband that you are telling yourself a story and see how he responds. Oftentimes, making this statement out loud and to ourselves is enough to defuse the power of these fictional stories we tell ourselves.

If you are curious about what he is experiencing, create time and space to ask him. Be willing to hear his joys and struggles. Ruminating that your husband would be better off or that his unhappiness is your fault is creating distance and separation from him. You have to trust that he will tell you if he is overwhelmed, struggling, or challenged with how to support you or be in your marriage. Trust your intuition if it is telling you that something is off, but also trust it if it is telling you that everything is okay. If you're having a hard time attuning to your inner guidance, invite him into a dialogue to explore this topic gently. Be honest about your feelings and ask the same from him.

Creating a container of safety is always a good idea when exploring the wounding around your sexual abuse, especially if there are elements that are still unprocessed. Unprocessed trauma can be nuanced and tricky because there will still be unidentified triggers that can cause re-experiencing of the past traumas, flooding and overwhelm, dysregulation, and an autonomic response that puts us into a fight, flight, freeze or submit response. If you or your husband do not know or haven’t named your triggers, you may be walking into a minefield. Even with the best intentions, once triggered, you could shut down, react, shutdown and/or create reprocessing trauma. Oftentimes it is best to incorporate a skilled professional to help with these discussions until you have built the requisite skills to navigate them on your own. Each time you name and process a trigger, integrate a piece of your abuse history, and deepen your understanding of your inner environment, the discussions become less treacherous. For your husband, if he is openly and honestly sharing his experience, or shares some raw, unfiltered thoughts, it could be triggering and render the discussion ineffective. Once the autonomic system is activated, it is difficult to regulate and bring your awareness back into the present moment without practiced skills, understanding, and support. My comments are not to suggest that you cannot do it, but rather to minimize any reprocessing trauma and hurtful misunderstandings that come from opening delicate conversations with our best intentions.

To be continued...check back next week for part 4 of this 6 part series.

With love and light,

John Moos, MD

For More Resources:

RAINN - Rape, Abuse & Incest National Network

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

The Courage to Heal Workbook: A Guide for Women and Men Survivors of Child Sexual Abuse by Laura Davis

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.

How do I support my husband after being sexually abused? Part 2

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Continued from last week…

Dear Survivor,

Young children, at a bare minimum, rely on their parents to meet their basic hierarchy of needs. These basic, i.e. survival, needs are categorized as 1) safety needs and 2) physiological needs, e.g. food, water, shelter - for more information please reference Abraham Maslow’s hierarchy of needs. When a parent abuses a child, there are multiple trust ruptures, violations, and abuses that occur.

1. Violations of trust and safety. As children, we look at our parents or parental surrogates as all-knowing, all-powerful beings. We trust that they will provide safety and security from the dangers of the world when we are most vulnerable. Safety and security are the foundation necessary to trust our world, our experiences, and the people around us. It is requisite to any healthy sense of curiosity. When this trust is violated, the integrity of your safety and security are ruptured. Life is viewed through this distorted lens of distrust and insecurity. It impacts our attachment models and how we relate to and understand people and relationships. These early traumatizations create a state of arrested development. Another way to think of this is to imagine your life as a house filled with rooms, people, memories, and experiences. Your childhood is the foundation that the home is built on. Homes built on strong foundations can withstand tremendous stress. Once the integrity of that foundation is compromised or violated, the homes can no longer withstand the normal stress of the environment. This leads to foundational and developmental instability, insecurity and dysregulation. These early and critical violations constitute the first, and major, trust rupture.

2. Violations of self-worth and healthy sexuality. Kids naturally think that everything revolves around them. This ego-centric perspective helps them to focus on growing, learning, exploring, and integrating their life experiences. It is normal and healthy. When somebody perpetrates a trauma against a child, especially a parent, it is difficult for a child to not blame themselves for the act. This inevitably erodes away at feelings of self-worth and taints their view of sexuality. It is common for abused children to think that it was their fault or that their value is inherently tied to their sexual availability and exploitation. These early and forced exposures to sexualization distorts the natural and healthy development of sexuality. Exploring sexuality in the adolescence period then becomes a minefield of triggers and compensations. For some, reclusive, fear-based behaviors (sexual anorexia) becomes the default mode. For others, reckless and risky choices prevail. In some closest to me whom have been impacted by sexual abuse, sex and sexuality became a form of leverage; an opportunity to hold power over instead of being over-powered. It is an attempt to take back the power that was lost or stolen during their childhood and reverse the power dynamic. It takes time, distance, and guidance to be able to extricate a young child's sense of worth from these traumas and restore a healthy sense of sexuality once these violations have occurred.

3. Violations of boundaries. Boundaries can be difficult to create, maintain, and enforce - even for adults. But, when traumas are perpetuated against young children, it distorts the healthy development and understanding of boundaries. Without a clear understanding of what boundaries are and how to use them, a child may grow up thinking that everyone has access to them, i.e. their time, their space, their bodies, etc. It may be difficult to separate themselves from others; fertile ground to cultivate unhealthy codependency. Boundaries are a necessary and healthy way for us to push back, to define our limits, to establish independence, and to protect ourselves from dangers. They reinforce our sense of self. The early dismantling of these boundaries can make it difficult or impossible to self-protect and separate ourselves from others.

4. Abuses of power and authority. The parent-child dynamic is a powerful one and inherently skews to regard the parent as the all-knowing authority. Power and authority can be forces applied to nurture or destroy relationships. The use of power and/or authority over instead of with is a superficial dynamic and not a spiritual one. Benevolent parents want to use their power with their kids to raise them up, grow their inner authority and nurture their development in the world. Abusive and/or manipulative parents seek to use their power over their kids, perpetuating the power disparity and suppressing their kids' growth. This has nothing to do with intent. Well-intended parents may not realize that their power over their children is actually an incredibly suppressive force. As Maya Angelou said, “if you know better, do better.” However, when abuses of power and authority are intentional, as would be for the sexual abuse of a child, the consequences are grave. The child’s inner authority diminishes, their development can become suppressed and a growing discordance and distrust can develop within themselves.

This list is not meant to be comprehensive or exhaustive, but I think it accurately highlights and encapsulates the major, life-altering impacts of a child who has survived sexual abuse. With all of this said, I still have not answered your question, “How do I support my husband's needs being the husband of a woman who was sexually abused by her father?”

You can see they myriad of obstacles that the survivor of sexual abuse must endure. Tending to your own needs and healing can be hard enough, but to factor in the needs of your husband might be overwhelming. The simplest answer I have to your question is: it’s not your responsibility to tend to your husband's needs. I believe the most important thing you can do for yourself, for your husband, and for your relationship is to tend to your healing. Your healing journey will allow you to show up in a way that your husband will notice. If your partner loves and supports you, they will be patient, compassionate, and supportive of the difficult and rewarding work that is required to heal from such abuses and violations.

To be continued...check back next week for part 3 of this 6 part series.

With love and light,

John Moos, MD

For More Resources:

RAINN - Rape, Abuse & Incest National Network

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

The Courage to Heal Workbook: A Guide for Women and Men Survivors of Child Sexual Abuse by Laura Davis

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.

How do I support my husband after being sexually abused?

TRIGGER WARNING: Sexual Abuse

Dear John,

How do I support my husband's needs being the husband of a woman who was sexually abused by her father?

How can I better understand his experience and not get overwhelmed with the feeling of guilt that it is my fault & that if he weren't married to me he wouldn't have to deal with this...feeling like it's my fault and if I removed myself from the equation, then my husband would be better off...

How do I talk about it with him and not take on his feelings & being triggered?

Dear Survivor,

Thank you for your vulnerability and willingness to share your experience. To put this into perspective, 4 out of 5 women have experienced sexual harassment or abuse at some point in their life. Your question is relatable and pertinent to the vast majority of women in the world. I am going to answer your question in parts to ensure I identify and untangle as much as possible. Thank you for your trust!

PART I

“How do I support my husband's needs being the husband of a woman who was sexually abused by her father?”

I don’t know your experience of being a woman and daughter abused by her father. However, I do have personal experience holding space for and supporting my partner who was abused by her stepfather in childhood. In a partnership, there is always going to be a mutual-supporting of each other’s needs. Fundamental to any discussion about wants and needs is the work of establishing a safe, secure, and transparent method of communicating. When my partner and I talk about delicate topics such as these, we create the time and space for it. We center ourselves, disclose any requirements we may need for the conversation, and ground ourselves in our mutual love for one another. Creating a safe container is paramount to mutually supporting each other and to work through delicate issues such as these. If you cannot create a safe space to openly explore these topics, my concern is that it will not be productive. Armor will stay up, guarding will occur, resentments will develop, and misunderstandings will prevail. Without an appropriate container, language, or support, you also run the risk of retraumatizing yourself sharing these experiences if they are not handled and received correctly despite your best intentions.

In my particular situation, I feel it is my responsibility to unburden my fiance so she doesn’t have to tend to my needs when sharing openly and vulnerably. It is my responsibility to understand and hear her as well as communicate my needs to her. This can be tricky without a delicate, guided or trauma-informed approach as there are many ways to trigger survivors of abuse. Once that occurs, it may be difficult to open back up due to the sensitive and traumatic nature of those triggers. Having the right language is imperative to being able to navigate this terrain. It is not necessarily yours or your partner’s responsibility to have this language - that is why there are professionals to help guide these conversations. For myself, I dove into educating myself about sexual abuse and trauma, understanding the coping skills required to survive such abuse, and learning how to compassionately hold space for my fiance and her healing process. I approached her with love, curiosity, and tenderness so she never felt judged, ashamed, or conflicted about what she was experiencing or sharing. I took the responsibility of tending to her needs so she could move through the healing at her pace knowing she was loved and supported along the way. At baseline, our foundation is safety, transparency, and love - even when things go wrong or we have a misfire.

I admire your sense of empathy and compassion to look after and tend to your husband's needs. Survivors of sexual abuse are often left with complex PTSD from the repeated and chronic violations of boundaries and abuses of their bodies. Sexual abuse is rarely an immediate or quick act; there are repeated trust ruptures and violations along the way that impact every dimension of the survivor. Oftentimes there are long periods of grooming of the survivor before any physical and sexual violation occurs, complicating and layering the traumatic experiences over time, making it an intricate process to untangle. However, it is possible to live free from the burden of those wounds and with a sense of abundance.

I feel it is important to name and acknowledge several things to put them into perspective and give language to a survivor's experience. As Brene Brown says, “language is a handle.” Using the correct language is important so we can get a handle on our experiences and accurately work through them. Without precise and accurate language, we are left swimming in the ambiguous, unknown, and incomprehensible. You may also notice that I have not and will not use the word, “victim” here. You are a survivor and will be honored as such!

To be continued...check back next week for part 2 of this 6 part series.

With love and light,

John Moos, MD

For More Resources:

RAINN - Rape, Abuse & Incest National Network

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

The Courage to Heal Workbook: A Guide for Women and Men Survivors of Child Sexual Abuse by Laura Davis

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.

Where did my memories go?

Dear John,

I’m wondering if you can help me. I have been to many therapists in the past….no one has been able to unlock what happened.

I remember snippets of a day when I was a small child. It was horrible and physically painful and I can’t piece together what it means.

My parents never discussed it and would never allow me to ask questions when I started remembering. I have basically no other memories of my childhood. No birthdays, christmases, special occasions…..nothing and there are approximately 3 photos that I can recall seeing in print from a camera. And I don’t remember the days. 

I believe that it has partly cost me a 27 year marriage. He told me I was broken and refused to find out why.   

I don’t have healthy relationships in my life. None.  Everyday is an emotional struggle. 

I’m asking you if you can point me in the right direction. I am 51 and alone. I feel like I can’t move forward anymore in my life until I fix what is wrong. I want peace and happiness and to find joy in life. I have snippets of it but the unknown gnaws at me. 

Can you help me?

Dear No Memories,

Let me first start off by telling you how sorry I am. And, I commend your courageousness for reaching out and starting the process. There is a quote by Rumi, “the wound is where the light enters.” I can explain a few things about trauma that may explain why you are unable to remember anything. When we encounter a physical, emotional, or psychological trauma, we dissociate to protect ourselves. It is a survival strategy when our mind is unable to process the pain of the events we are enduring. We can’t physically leave our bodies, but mentally and emotionally we are able to remove ourselves from that moment, compartmentalize it, and never revisit it again. Why? Because there is too much pain to process. Our minds are overwhelmed and flooded with emotion and thought, so we disconnect. The problem with unprocessed trauma is that it can resurface when triggered. Triggers are stimuli, known and unknown, that remind us of the event, e.g. a smell, a visual, a sound, a location, anything. It affects you in the present moment as if the trauma is recurring all over again. It can be terrifying, disorientating, and confusing.

There are therapists who can guide you into those unprocessed memories safely and help you retrieve those memories, and thus, integrate them into a congruent timeline. Understanding and naming these triggers is important to lessening their impact on your life. Processing these traumas is not comfortable, but necessary to become whole and free yourself from the automatic reactions that occur when triggered. You would be free from that automated pattern and would have the freedom of choice. There are other ways to access this trauma, and where I have decided to direct my training and healing efforts. You can access these memories oftentimes with psychedelic and somatic healing modalities. I work professionally with psychedelic and somatic healing at Greenlight Metamorphosis Center. As a physician, I work with ketamine, which is legal to prescribe and administer, but I have also worked personally with other psychedelics for my own inner healing.

There are also incredible programs, such as the Hoffman Process, which is a 7-day experiential program at the Hoffman Institute. They are incredible at defining and releasing core/root trauma and often many memories emerge as you create new space for your higher Self. I'd highly recommend their program; I am also a graduate.

This is a complicated question, but there are solutions and answers. You are definitely not alone, and even though you are 51, there is still plenty of time to heal. I am here as a resource if you need guidance. I trust you, I believe in you, and I commend you for taking this step towards your best self.

With love and light,

John Moos, MD

Finding happiness and living through love? Part 3

Dear John,

What keeps you on track to finding happiness and living through love each day? How do you avoid getting derailed with the stresses of life that surround us?

Continued from last week…

The best definition of love I’ve heard came from my experience at The Hoffman Process: love is what overflows from your cup when you decide to fill your cup first. This identifies two important principles of love. First, you have to fill yourself whole with self-love. If you are trying to serve from a cup that is not full, you will diminish yourself until your cup runs dry. Serving from an empty cup is the quickest way to resentment, martyrdom, and burnout. Second, the outward expression of your love is a reflection of how you love and treat yourself. When you authentically and wholeheartedly love yourself, you will do the same for others. You will do so from a place of abundance, needing nothing in return. You will love without conditions or expectations, which will keep you out of the roles of persecutor, victim, or savior - the three roles of the dreaded drama triangle (The Power of TED by David Emerald). You will also identify that the love you give yourself and others does not depend on others. You are your own wellspring of vitality and love.

Building a language and understanding of love, and joy, will help you to stay in alignment despite the obstacles that will come your way. There will always be obstacles and stress is inevitable. You will get derailed. There is no way around this; it is the grist of living a human life. Stress is integral to growth. You cannot have growth without stress or friction. Stress is what guides us to our growth edge, those uncomfortable places that we need to lean into and move through in order to expand our capacity and capabilities. There is always going to be stress in our lives, so learning how to deal with and lean into it is more important than practicing how to avoid it. There is a notable example of this that came from the Biosphere 2 constructed by the University of Arizona. Scientists were studying the viability of growing plants on other planets. They accounted for all variables except wind. Without wind, the trees grew taller, faster, but inevitably collapsed. Without the stress of the wind, the trees didn’t form “stress wood,” which strengthened their bases allowing them to grow taller, more resilient, and mature properly. Stress is integral to our own maturation, fortitude, and growth. The more we welcome it into our lives, instead of avoiding or resisting it, the smoother and quicker we can transition back to our abundant growth.

With the proper language to describe love, happiness, and joy, I have no doubts you can use them like stepping stones on your own personal journey. And, hopefully, by reframing stress and shifting your perspective, it will allow you to look at adversity, challenges, and obstacles in a new light. Life is always giving us opportunities - only you can choose to receive them or resist them.

With love and light,

John Moos, MD

Finding happiness and living through love? Part 2

Dear John,

What keeps you on track to finding happiness and living through love each day? How do you avoid getting derailed with the stresses of life that surround us?

Continued from last week…

Instead of trying to pursue or identify happiness, try to apply these 8 pillars of joy to your daily life:

1. Perspective

   • Our perspective is what enables us to see situations, problems, and people differently. We are often limited by our lens in those moments, crafted from our historical experiences and patterns. When we free ourselves from these narrow perspectives, we can broaden our appreciation and understanding of the world.

   • How can you look at things differently? Can you deepen your empathy for someone else’s point of view? Can you find an opportunity in your obstacle?

2. Humility

   • Humility takes us out of our own egocentrism and broadens our vision to a wider range of circumstances, possibilities, and perspectives. When we have a high self-regard or self-involvement, it disconnects us from others. Humility is the antidote to that, bringing us closer to others and away from self-aggrandizement.

   • Would the outcome change if you approached a problem or task with humility or curiosity? What would it feel like to praise others instead of yourself? How would an interaction change if you admitted you didn’t know?

3. Humor

   • Stress is inevitable and humor is one of the best ways to cope with it. It is a pressure-release valve. Bringing humor into our stressed out, frenetic lives gives us a break, a pause, to let go of it all in the moment and let our bodies release. It is joy-making, requiring our bodies to move, our lips to smile, and our lungs to respire. It is an opportunity to reset and release.

   • What can you laugh about today? Instead of getting struck in anger, sadness or fear, can you find the humor in the circumstances and laugh it off?

4. Acceptance

   • Acceptance is the conscious decision to stop resisting life’s circumstances. It is synonymous with surrender. Instead of spending our vital life force in resistance or avoidance, we can align our sails with life’s winds and go with the flow. When we are in acceptance, we have more bandwidth, energy and resources to allocate on being present and innovating solutions.

   • What would happen if you accepted the outcome instead of standing in resistance? Can you surrender and trust that life has a bigger plan for you?

5. Forgiveness

   • There is no better resource on forgiveness than Desmond Tutu’s The Book of Forgiving. In his book, he identifies four core elements to forgiving: (1) telling your story, (2) naming your hurt, (3) granting forgiveness by recognizing our shared humanity, and (4) renewing or releasing the relationship. We will all experience brokenness in ourselves and others. This is how we learn to identify the hurt and hone in on what it takes to heal. We can’t always control what may break us, but we are solely responsible for putting ourselves back together. This work, when done in the context of relationships, is what deepens our empathy and understanding of one another, i.e. our shared humanity.

   • Can you let go of your resentments, expectations, or rivalry? What would you do with the energy you reclaimed from laying down the sword? Can you lean into forgiving someone who has wronged you? Can you remember a time when someone forgave you for a wrong you committed?

6. Gratitude

   • Gratitude is a process and an emotion; it makes what you have enough. When we are grateful, we are not searching for more. Gratitude brings us into the present with reverence - it makes the mundane and ordinary sacred. There is a saying, “if you want to feel rich, want less.” Gratitude is what abates insatiable consumerism. Establishing a daily gratitude practice is linked to improved health benefits and a greater overall satisfaction with life.

   • Can you name three moments or people in the day that you are grateful for? When you find yourself wanting more, can you find gratitude for what you have?

7. Compassion

   • Compassion is empathy in action. Empathy is important to broadening our understanding of others' circumstances, pain, and suffering. Compassion takes it one step further, motivating our bodies, minds, and souls to relieve the suffering of others. When we talk about shared humanity, it is the compassionate regard that we have for our fellow humans that allows us to understand, grow, and thrive together.

   • What does it look like to put your empathy in action? What can you do to remove the pain or improve the circumstances of someone suffering? 

8. Generosity

   • Being generous means living in abundance. It is searching for opportunities to find those less fortunate than you and lifting them up. There is always someone less fortunate than you - recognizing it and acting to better their disposition is a powerful force. It is the selfless and unconditional giving from your overflowing cup. Fear is a zero-sum game; generosity is the antidote.

   • Who could benefit from any one of your gifts? Apart from material items, what else can you give? A smile? A hug? An encouraging word or gentle smile? A moment of your time? What can you give to others without expecting anything in return?

To be continued...check back next week for the finale, Part 3 of this exploration.

With love and light,

John Moos, MD

Finding happiness and living through love?

Dear John,

What keeps you on track to finding happiness and living through love each day? How do you avoid getting derailed with the stresses of life that surround us?

Dear Staying Focused,

With so many distractions in today’s busy world, this question is more pertinent than ever. The first step to moving through any obstacle is acknowledging and naming it. Your intent and commitment to finding happiness and living through love is setting you in the right direction. Knowing you can, and will, be derailed is equally important when anticipating and acknowledging the difficulties of life.

To explore this topic, I will have to deconstruct and recontextualize it. Staying on track requires many things: faith, discipline, and grit amongst other things. When challenges and obstacles arise, nurturing your resilience to persevere is pivotal. The quest to find happiness, love, fulfillment, contentment and joy is as unique a task as any. One person’s paradise may be another one’s hell. However, there are principles that can guide us along the way. This question could be expounded on to make a book, which they have, but I will try and keep my answer focused, tangible, and practical.

First, what is happiness and love? Happiness is a fleeting, ephemeral emotion and relatively superficial. For me, it evokes a materialistic pursuit, i.e. feeling happy when the latest Netflix series is released or when you try a new restaurant. Happiness is the transitional goal, a means to an end, but it is not the journey. For love, there are a multitude of definitions and interpretations that vary by person and perspective. People typically love to their greatest capacity, which can be as big or as small as your experiential basis and level of consciousness. This is evidenced by the hedonistic, earth-shattering “love” we may feel as teenagers or young adults, only to look back at a later age with disbelief. Through time, maturity, and perspective, our definitions and ideas around love grow. Sometimes with the people we choose, and sometimes without them. This is often how people grow together or grow apart.

Happiness and “love” can also have a dark twist. Finding happiness and love was a driving thirst throughout my addiction. Instead of getting derailed by stress, I avoided it entirely through distraction, numbing, and pleasure-seeking. Inevitably, stress was stockpiled away, fueling the well-spring of shame that supercharged my addictive behaviors. My finding happiness and love was not an act of moving towards, but rather a fear-based position of moving away from shame and pain. It was inauthentic, misguided, and delusional. My perspective was anchored in pain, shame, and victimization. This occurred because I was fragmented, looking for quick doses of anything that resembled happiness and/or love to fill the voids. I was a house without foundation, unsupported by anything with real strength. You cannot grow or build upward without a foundation or pillars of support.

Desmond Tutu and His Holiness the Dalai Lama wrote a book with Douglas Abrams, The Book of Joy. Joy, in my humble opinion, perfectly encapsulates the notion of finding happiness and love. The reason I love “joy” so much is because it is both the means and the end; it’s finding gratitude in the journey. According to Desmond Tutu and the Dalai Lama, joy is composed of 8 pillars: 1) perspective, 2) humility, 3) humor, 4) acceptance, 5) forgiveness, 6) gratitude, 7) compassion, and 8) generosity. There are two major influences that affect these pillars as well: community and education. Without a community, we are unable to explore consciousness or these pillars as there would be no relationship. Without education, we’d be unable to grow or change our perspective and understanding of ourselves, each other, and the world.

To be continued...check back next week for the finale, Part 2 of this exploration.

With love and light,

John Moos, MD

Is what I am doing criminal? Part 3

Dear John,

My daughter is 16, dating a boy who’s turning 20 in a month. He drives a muscle car and lives with a roommate. My daughter who is sometimes mature beyond her years, wise beyond her years, is also emotionally a 16 year old.

The thing is, I trust her!! I feel ok with it. I met him and feel she can do worse. My wife says that seeing a boy over 18 should be a hard no. I’m judged by my friends for allowing this. But I’m not actually even second guessing my decision. But I do wonder if that’s being a bad father? Should I not allow this? I know what he’s doing is technically criminal. Is what I’m doing criminal for condoning it? (Part 3)

Continued from last week…

On a much simpler level, an example of this recently came up in my own family. My fiance and I have a mixed, blended family with kids ranging from 5 to 17. My 13-year-old daughter was in a relationship - they have since broken up and gone their separate ways. My wife and I had to go out for the evening, leaving the two of them alone in our house. I trust my daughter and didn't think twice about it. My fiance also trusts my daughter, but recognized some feelings of discomfort around leaving the two alone for almost 2 hours. We acknowledged and spoke truth to our feelings and perspectives before making a joint decision. Ultimately, we decided to leave the two of them alone, but I was willing to make adjustments to make sure my partner felt seen, supported, and heard. This is a simple example, but one that highlights the differing perspectives and beliefs parents can have when it comes to raising their children. More important than the circumstances of a disagreement is the process you both agree to that integrates mutual respect, attunement, joint decision-making, and child-focused solutions. Boundaries and clear expectations help everyone to show up in the best way. There will be countless opportunities for parents to have differences of opinion when it comes to their children, which includes stepchildren, adopted children, foster children, etc., but what remains imperative throughout all of them is a process or plan to ensure everyone in the family feels seen, supported, and heard. When anyone is left voiceless, it sends a message that their voice does not matter. It is a surefire way to make somebody feel invisible and grow further resentments.

These parenting decisions, boundaries, and expectations are all deeply personal and have to be in alignment with your family, your principles and philosophies, and the culture you are trying to create. When you include your partner in your decision making, you send a message to them that they matter. When you set clear boundaries, it shows kindness. When you support your daughter’s autonomy and keep an open dialogue, it shows her that you trust her, and she can trust herself. If your daughter gets hurt during this relationship, you have an opportunity to support her back on to her feet and build her resilience. These are all opportunities to show up in meaningful ways. Life is not about black and white decisions or clear cut delineations on what you “should” and “should not” do. It is an ever-changing, always flowing dynamic. It is a dance that is conducted in the grey. When we open up to the possibility that all of this is a representation of life, and prime material to learn and grow from, we surrender to the flow of life and learn to intuit more easily on how to best support one another. I trust you - you’ve got this!

With love and light,

John Moos, MD

Resources

• Lisa Damour, Ph.D. - specializes in understanding teenage girls

• Daniel Siegel, MD - especially his book, Brainstorm

• Hold On To Your Kids by Gabor Mate, M.D., and Gordon Neufeld, Ph.D.

• Jessica Lahey, J.D. - especially her book, The Gifts of Failure

Is what I am doing criminal? Part 2

Dear John,

My daughter is 16, dating a boy who’s turning 20 in a month. He drives a muscle car and lives with a roommate. My daughter who is sometimes mature beyond her years, wise beyond her years, is also emotionally a 16 year old.

The thing is, I trust her!! I feel ok with it. I met him and feel she can do worse. My wife says that seeing a boy over 18 should be a hard no. I’m judged by my friends for allowing this. But I’m not actually even second guessing my decision. But I do wonder if that’s being a bad father? Should I not allow this? I know what he’s doing is technically criminal. Is what I’m doing criminal for condoning it? (Part 2)

Continued from last week...

The fact that you know and trust your daughter is imperative. Integrity is hard earned and easily lost. If you and your daughter have a foundation of trust and open communication, you will be able to intuit her needs and safety far better than questioning every one of her actions and choices. However, trust is not a one and done experience. Trusting your daughter and her choice to date somebody, not only older, but also at a different maturity level than her poses many challenges. An adolescent girl compared to a young man, while only 4 years apart, can be at fundamentally different places in their lives. This 4 year difference is not so significant when we are talking about adults after college, in midlife, or in their second half of life. The relative difference is actually quite small when you aggregate their total life experience on earth as we get older. At this point today, your daughter’s age difference represents a fourth of her lived experience and a fifth of this young man’s. In order to support your daughter, and by extension her relationship, it will be imperative to have frequent conversations with her so you can stay attuned to the ebb and flow of their relationship, their obstacles and joys, and make sure that this relationship provides fertile ground for her to get to know herself better. Ultimately, that is what relationship does for us. It provides a mirror and opportunity for us to better understand ourselves and how to nurture our interdependence, not codependence, in a healthy way. Regardless of the outcome of this relationship, the boundaries erected or required, and the feedback given, solicited or not, the most important thing for your daughter is to learn to trust herself. You are in a position to help her with that.

There will never be a shortage of people with opinions offering unsolicited advice on what you should or shouldn't be doing as a parent or with your own life. You will encounter - if you haven’t already - judgments about you and your choices, your parenting style and family decisions, and many other things. As important as it is for your daughter to learn to trust herself, it is most important for you to trust yourself and your parenting intuition. If something seems wrong, it likely is. If you have and/or maintain an open line of communication, honesty, and transparency with your daughter and things feel right, they likely are. However, you can only know this if you are whole yourself and come from a place of integrity. For many parents, showing up and doing your own deep inner personal work is the only way to show up as a whole, attuned parent and not project our baggage onto our kids.

The dynamic gets a little more complicated once you factor in the discord between you and your wife. I am assuming you love and trust your wife. You now have to balance the trust you have for your wife when it is in conflict with the trust you have for your daughter. It is important to know and explore what is coming up for your wife. What are her concerns? What is triggering her about the relationship or age difference? Is there something in her past that needs to be honored and acknowledged? Did she experience a relationship with an age difference that was concerning? Relationships are an incredible opportunity for us to explore and expand our consciousness, our history, and our own traumas. This is no exception.

At first glance, it may be easy to hold onto the age disparity and focus on that as the primary issue. But, I feel strongly that this is only the superficial level of the matter. Beneath her hard “no” is a story. Create time and space to honor and explore that story. It is important to be attuned to your spouse/partner; to ensure everyone feels seen, heard, and witnessed. Perhaps there is something in her past, an experience, a hurt, that needs to be spoken truth to and witnessed. Your daughter's relationship may be an incredible opportunity to deepen your own attunement and love map with your spouse. Also, if your wife has a good relationship with your daughter, I would encourage your wife to create time and space to explore this with your daughter as well. You and your wife may not see eye to eye, but it is important to have a cohesive and collaborative plan on how you want to support your daughter. You can support your daughter without creating a rift between  you and your wife. Making sure you and your partner have buy-in to the parenting decisions is extremely important. You do not have to have a consensus, and you can agree to disagree on aspects of this relationship, but nobody should feel marginalized or alienated in the family.

To be continued...check back next week for the finale, Part 3 of this exploration.

With love and light,

John Moos, MD

Is what I am doing criminal?

Dear John,

My daughter is 16, dating a boy who’s turning 20 in a month. He drives a muscle car and lives with a roommate. My daughter who is sometimes mature beyond her years, wise beyond her years, is also emotionally a 16 year old.

The thing is, I trust her!! I feel ok with it. I met him and feel she can do worse. My wife says that seeing a boy over 18 should be a hard no. I’m judged by my friends for allowing this. But I’m not actually even second guessing my decision. But I do wonder if that’s being a bad father? Should I not allow this? I know what he’s doing is technically criminal. Is what I’m doing criminal for condoning it?

Dear Trusting Dad,

I love this question on so many levels. First, an anecdote. The first time I met my fiance, she created an inaccurate impression of who I was - she thought I was a biker. I was wearing a short sleeve shirt, distressed jeans, and had tattoos covering my arms. She could have written me off then and there based on my outward appearance or circumstances, but there was enough to keep us both engaged and intrigued. Fortunately, it paid off.

I have been judged by my appearance throughout my life. I was teased and bullied as a kid for looking different - I was a Mexican-American boy living in a predominately white suburban city. As an adolescent, I was lost and confused with my identity, wearing pants too big, talking in incoherent slang English, and appropriating cultures that were not mine. Teachers, coaches, parents and peers constantly judged me. As an adult, I eventually decided to cover my body with tattoos while concomitantly working as a surgeon, one of the most conservative professions around. In love, I met and fell in love with a woman who is almost nine years older than me, highly successful, and fiercely loved and protected by her family, friends, and community. My intentions were called into question, I was looked at suspiciously, and I was dismissed and disregarded in the early days by people close to her. I have been met with preconceived notions much of my life, but have always been willing to accept that risk for the sake of my self-expression, and ultimately my self-discovery. Once people got to know me, they realized that my outward appearance was not an affront to them, but rather an extension of my personality and commitment to finding and expressing my authentic self. Getting lost is part of the journey, and I wouldn’t be where I am today without those life experiences to look back on.

With all of that being said, I don’t know your daughter’s boyfriend’s story. I can empathize with him and the judgements he likely faces. I also don’t know your daughter, but can empathize with any judgments she likely faces as well. He is 20 and she is 16, yet both of them are still subject to the developing adolescent mind. Adolescence isn’t confined to the “teen years,” but rather ranges from ages 12 to 24, and is a pivotal time for kids to separate from their parents. Separation from parents doesn’t have to look like reckless rebellion; it takes many forms. At its healthiest, it is a supported and beautiful act of individuation. At its worst, it is a hell-bent rebellion with significant personal and collateral damage. It is an art to support your child’s autonomy while also keeping and maintaining healthy boundaries and guardrails for their safety. There are incredible authors and resources for those who want to do a deep dive on parenting this age group and better understand their inner experience - see below.

To be continued...check back next week for Part 2 of this exploration.

With love and light,

John Moos, MD

Resources:

• Lisa Damour, Ph.D. - specializes in understanding teenage girls

• Daniel Siegel, MD - especially his book, Brainstorm

• Hold On To Your Kids by Gabor Mate, M.D., and Gordon Neufeld, Ph.D.

• Jessica Lahey, J.D. - especially her book, The Gifts of Failure

When is too soon to be vulnerable? Part 2

Dear John,

How do you define the difference between showing all my cards and being vulnerable?

I am an open book and share so much about myself early on when I feel like it’s a safe space to then ultimately being [sic] judged in the end. When is too soon to be vulnerable in a relationship/friendship? (Part 2)

Continued from last week...

You need to feel safe in order to trust completely. I have shared and repeated this saying time and time again, “if you are a human being, you cannot get through this life without physical or emotional scars.” You will suffer traumas and wounding, eventually erecting the necessary protections, i.e. guarding and armor to shield your heart, your vulnerabilities, and your essence. If you've been on this planet long enough, you inevitably have been around someone whom you thought was trustworthy who eventually violated your trust. It is a painful experience, but not insurmountable. I tend to believe that all human beings are inherently good with different life histories, traumas, obstacles, coping mechanisms and patterns. It takes courage, grit and discipline to work through that wounding, but it is imperative to move through it in order to live free and untethered from your past experiences and the resulting patterns. Knowing this can be helpful to deepening your empathy bridge to others, but it does not mean you need to condone hurtful behavior if you are being judged, criticized or rejected.

As I mentioned before, you need to be clear on your intentions on why you are showing your cards. Is it from a place of feeling complete and open to share? Or is it from a place of needing something in return? Only you can answer this question, and the power of self-deceit is strong if we are unwilling to look at our own patterns and life context. There is no rush and life isn’t a race. Take as much time as you need to trust yourself, to know yourself, and to love yourself before partnering with others. A question of reflection I often ask myself is, “if I do this, will I feel better or worse after?” Only you can answer those questions honestly for yourself. 

With all of this said, there may be a point when your relationship evolves, you are sharing authentically and with clear intention, and with discernment and discretion. Your love map is growing and you feel a deepening connection with that person. And then all of a sudden, you are being judged, criticized or rejected. This is another painful lesson, but ultimately a good sign. That person is telling you that they are not your person, they are not safe, and you cannot trust them. That is not the person you need to be sharing yourself with. Look back and see if there were signs, blindspots, or a growth edge to lean into. But, at the end of the day, sometimes a person is just not your person - and that’s okay!

For myself, dating after inpatient rehab for alcohol and sex addiction felt like a formidable task. I had extensive guarding around my heart from my adverse childhood experiences and self-inflicted wounding. In rehab, I was disarmed of all previous tactics and strategems. The armor I removed would have been so easy to throw back up to avoid sharing the ugliness of my past. I had to find a balance, timing, and cadence of how I shared and how much I shared about myself. This was my discernment in practice. Sometimes it was awkward, sharing the most intimate details of my past life only to be rejected. However, I refused to jeopardize my integrity by lying about my past when asked - and that was okay. I shared from a place of peace - peace with myself and forgiveness of my actions - and my intentions were pure. There were substantially more times where I shared my story and was met with acceptance, empathy, and compassion. These moments were the ones that helped reaffirm my belief that people are caring, empathetic and understanding. It is worth the risk to develop safety and trust with new people when we are whole on the inside and in a position to trust ourselves.

When I finally met my life partner, whom I am engaged to now, we set up requirements to help establish a foundation of trust and safety. They were: 1) no aggression, 2) transparency and honesty on all things, and 3) planning how we would fight, if we did. When we made this agreement, we accepted each other's ground rules and could show up whole and complete. Every time we reinforced this commitment, we strengthened our container of trust and security. It is from this foundation that we’ve been able to co-create a love far beyond our wildest dreams. And, that is possible for you, too!

With love and light,

John Moos, MD

When is too soon to be vulnerable?

Dear John,

How do you define the difference between showing all my cards and being vulnerable?

I am an open book and share so much about myself early on when I feel like it’s a safe space to then ultimately being [sic] judged in the end. When is too soon to be vulnerable in a relationship/friendship?

Dear Open Book,

Thank you for sharing! I can relate to this predicament on so many levels. For decades I’ve used alcohol and sex as tools to validate and affirm my existence, my sexuality, and my sense of worth. My life looked like a series of one-night stands and affairs throughout my relationships and marriages. I would overshare with women in an attempt to create false security, sensitivity, and empathy. It was inauthentic pseudo-vulnerability because it was self-serving, intended to gain immediate favor, sympathy, and positive regard. My oversharing and “transparency” was a form of seduction, weaponizing vulnerability for my own personal gain.

There were nuances to my oversharing and vulnerability, though. It was not all ill-intended and misguided. Deep inside me there was a small boy crying out for attention and acceptance. I wanted to show all of my cards and expose myself because I wanted to be accepted and loved. The problem was, I was using people to validate myself. The work that I needed to do was to learn to love and accept myself completely. I found my time, space, and clarity to do this after I voluntarily checked myself into rehab; finding resources and people willing to guide me. This self-discovery is requisite before deeping other relationships. Otherwise, you are leaning on others to validate you, to “complete” you. In this sense, people and relationships are mirrors. You can only authentically show up for others as deeply as you show up for yourself. If you have to abandon yourself to meet another, the gesture or act is disingenuous and tenuous at best.

Finding the right balance between vulnerability and discretion requires attunement and discernment. Discretion is important to knowing when to share private information and discernment requires us to be judicious in our perceptions and judgment of situations and/or people. This is the “chicken or the egg” dilemma. An early full disclosure, i.e. “showing all your cards,” often bypasses discretion and discernment. It’s a full frontal assault - sometimes it works, in the case when someone is ready to receive you, and sometimes it doesn’t, in the case when someone runs for the hills or judges you. Think about your longest, deepest relationships. Those relationships are slowly built and fortified by hundreds or thousands of little acts of kindness. Those are the moments. Your raw and honest exposure to those friends is justified as they have shown that they will care and tend to your vulnerabilities with loving kindness, too.

In new relationships it is imperative to be discreet and discerning in who we share our personal information with until we develop our love map with them. A love map is all of the ways that we are connected to and relate with our partner. It is the deepening of our understanding of the explicit and implicit elements of our partner’s or love interests' life. When we share conditionally in an effort to receive acknowledgment or love it will come across as inauthentic and overwhelming, leaving you open and exposed to judgement and wounding. It may seem contrary, but when we are oversharing and forcing “vulnerability,” it actually distances ourselves from the people we are trying to connect from. In your case, it seems that may be an unintended consequence of sharing yourself. In my case, it was intended as I didn’t want to be close to the people I was pursuing. I need the space and separation to distance myself from the horrible acts I was perpetuating.

There are fundamental prerequisites to allow authentic and vulnerable exploration: safety and trust. But, how do you develop trust and safety with someone that you don’t fully know, yet? How do we get to know someone if we don’t know if they are safe and trustworthy? This is another “chicken or the egg” situation. In order to share openly and honestly, you need to trust your partner and know you are safe. In order to know you are safe and trust your partner, you need to share openly and honestly over time to reinforce the bond. At some point there will be a moment when faith is all you have. Faith is essentially “blind” trust. It's not completely blind because there are typically signs, conscious and unconscious, tangible and intangible that help direct us towards safety. Your faith will be strengthened by your discernment and experience with people, but there will always be an unknown. Your intuition is soul-guidance; trust it and trust yourself.

To be continued...check back next week for Part 2 of this exploration.

With love and light,

John Moos, MD

Why must I still wear a mask? Part 2

 Dear John,

Now that I am vaccinated, why is the government insisting that I still wear a mask? (Part 2)

Since writing part 1 in this series, there have been new developments with respect to vaccination protocols and data supporting their efficacy. Children aged 12-15 are now eligible to receive the Pfizer vaccine under an Emergency Use Authorization (EUA). This still confuses me as this age group is the lowest risk age group and not likely a major contributor to hospital beds, deaths, or contagion. Two of my children in this age group elected to get vaccinated for their peace of mind. I can only presume efforts were made to include this demographic to boost vaccination statistics and reduce any further limitations to getting our kids back into school full-time. Our kids being out of school has had devastating psychosocial consequences manifesting in the huge uptick in mental health disorders, screen time, disconnection, and social languishing in school-aged children. Getting our kids back into school needs to be a priority.

The other information that has come out to quell fears and reduce hesitancy about the vaccination are: 1) evidence supporting that fully vaccinated individuals are “unlikely” to spread the virus, 2) nearly all side effects or complications in vaccine development are discovered within the first 2 months of clinical trials, and 3) the vaccine is just as likely to protect you from serious complications and hospitalization with the original strain (alpha) of Covid as it is the delta variant. From both social and safety concerns, this checks all boxes. Yes, you can still get Covid if vaccinated, but the preponderance of evidence suggests that approximately 80% will be asymptomatic and over 90% will not require hospitalization. If you are fully vaccinated and you get Covid, the data shows that the viral load is “unlikely” to be great enough to infect another individual. They may be exposed, but exposure doesn’t equal clinical disease if the viral load is too small. This is not the case with the delta variant. Initial studies are showing that the delta variant rapidly reproduces once in the host, achieving viral loads great enough to spread. Also, because it reproduces rapidly, symptoms often present in 4 days instead of 5.5 days with the alpha variant. We have seen contradictory statements made by governmental, scientific, and medical agencies only to be later revised or retracted. This is not from a position of ignorance or stupidity, but in an attempt to circulate the best and most current information early and often to the masses.

I personally was very hesitant to get the vaccine when it was released for a few reasons, which I will share: 1) I am a low-risk individual in a low-risk age group. I have no comorbidities or risk factors, live an active and healthy lifestyle, don’t drink or smoke, am not overweight, and have deep and meaningful relationships in my life. 2) I wanted to see more long-term data on the vaccine before I decided to get a vaccine that was rushed through the clinical trial process and eventually given emergency use authorization (EUA). 3) I wasn’t sure that the vaccine prevented the spread of the virus. 4) From a safety perspective, I was concerned about the rush to push the vaccination into development and distribution under an EUA.

Fortunately, my concerns have not proven to be valid. Vaccination efficacy, specifically Pfizer, at preventing clinically significant disease is 93% vs 88% for alpha variant and delta variant, respectively. It’s essentially the same. And, while vaccinated individuals may still spread delta variant, at least it won’t be sending them to the hospitals or causing hundreds of thousands of deaths per day. Scientists are methodical and meticulous in their work. Knowing that most, if not all, complications of vaccinations are discovered and remediated within the first 2 months is important to know. The vaccine was released for EUA in December 2020. We now have 6 months of data from the public, which does not account for the Phase 1-3 clinical trials. Given the impact on our hospital systems and the astronomical number of new cases and deaths, it was a no-brainer to release the vaccine and stop the hemorrhage. The more recent outbreaks and uptick in Covid cases is predominately a result of unvaccinated populations.

The choice to vaccinate or not is a personal one. However, there are some important facts to know when making that decision so that you can make an informed one. There was a moment during the late Spring, early Summer where it looked like we were “out of the woods.” Around that same time, the delta variant ravaged India and its unvaccinated populations, spread through Europe and the world, eventually landing in the United States. Now, we are dealing with the delta variant, forced to mask back up, and reinstitute safety guidelines and preventative measures. We are losing the social liberties we gained after the deadly Winter. For those who choose to remain unvaccinated, you are a host for the virus. If the virus has a host, it can infect, replicate, and spread. The more often it can do that, the more often it will mutate. If the virus continues to infect available hosts and mutate, we could be dealing with variants that eventually reinfect those that are vaccinated. The alpha variant or original strain of Covid was unable to spread once it infected a vaccinated individual. Now, the delta variant is here and able to remain contagious once in a vaccinated host. Fortunately, it is not likely to cause significant clinical disease in vaccinated individuals, but that is no guarantee if people continue choosing to remain unvaccinated and ignore safety recommendations. The coronavirus will continue to mutate at a rapid pace if we don’t stop it from spreading, which could lead to devastating social and global consequences. We will keep playing catch up if people don’t do their part by following precautionary guidelines, managing risk if they choose to remain unvaccinated or getting vaccinated to reduce the hosts available for spread.

As you can see, new information is coming out all the time, which reminds me to stay open and discerning. I need to do what is best for myself, my family, but also make sure I do my part for society at large. We all have a part to play in helping the world heal from this pandemic. We have more evidence now to support removing our masks when vaccinated, but it is still important to follow local business rules and governmental regulations. If you have concerns, questions, or curiosities, please reach out. Be safe, be healthy, and be well!

With love and light,

John Moos, MD

Why must I still wear a mask?

Dear John,

Now that I am vaccinated, why is the government insisting that I still wear a mask? (Part 1)

Disclaimer: I received this question in March and answered part 1 in early May. Shortly after May, there was new evidence to support the removal of masks for vaccinated individuals. Complicating things even further, since the CDC guidelines permit vaccinated individuals to remove their masks indoors, the delta variant of Covid has spread throughout the US prompting scientists and officials to again re-evaluate the mask and protective provisions. This further highlights just how complicated it is to anticipate and make safe recommendations based on science and safety. New information and data is constantly coming out. I have added an updated addendum to account for this new information, which will come out next week in part 2.

Dear Covid Curious,

It’s been over a year and I’m sure you, like most of us, are worn down after the toilet paper shortages, mask wearing, sheltering in place, disruptions in our routines, and loss of freedoms. We all initially donned masks to protect ourselves and to protect each other when fear and uncertainty were both high. These were major disturbances to our daily lives and the stress of that has been wearing on us all. Covid fatigue is real, and the masks are a reminder of what we have endured.

One, just because you are vaccinated does not mean you cannot get SARS-CoV-2, commonly referred to as Covid-19 or more simply, Covid. A mask can help prevent exposure to the virus. A study from Denmark, commonly referred to as “The Danish Mask study,” is erroneously cited as finding that masks make no difference in protecting us from Covid. The British Medical Journal subsequently published a rebuttal, clarifying that the study was “inconclusive” and not “negative,” two very different conclusions. From these studies, it was highly suggestive there are strong benefits to wearing the mask, not to mention the potential benefits of reducing both the spread of droplets and diminishing the concentration of aerosolized viral particles. This is important as several studies have shown that the severity of infection correlated to 1) duration of contact and 2) concentration of exposure. In layman's terms, the longer you are exposed and the more virus you are exposed to, the greater the chance of inoculation and severity of infection.

Two, it is still unclear whether or not you can spread Covid if you are vaccinated. My thought on this is to assume you still can spread the virus rather than believing the opposite. If you are wrong, you have only inconvenienced yourself by wearing a mask. If you believe the opposite, you are potentially increasing your chances to not only get coronavirus (CV), but also spread it indiscriminately. This brings up a common discussion point, what is the individual's responsibility versus social responsibility? I will touch on this shortly.

Third, it is becoming clear that Covid is both highly contagious and mutates rapidly. This means that variants will always be emerging as the virus replicates in the human host. With the number of variants that are showing up across the globe, there is no telling when you will encounter a variant that could potentially bypass your immune system, even if you have been previously infected or vaccinated. The prevention, however, does not change, such as washing your hands, social distancing, wearing a mask, and limiting time in or avoiding large crowds and indoor spaces.

Fourth, we don’t know what we don’t know. We have experienced 3 major waves of CV since it was first reported in December 2019. We have been under quarantine recommendations or restrictions for over a year as we sought to understand this novel virus and limit its impact on the world. Globally, as of August 10th, 2021, there are over 204M cumulative cases of CV, 4.3M deaths, and a daily average of over half a million new cases with 10,000 deaths per day. We are now in our fourth wave of surging cases. By no means do we have things under control, and we are continually learning about this virus at breakneck speed. It is very clear that risk management strategies do work though, e.g. hand washing, wearing masks, social distancing, vaccinations, avoiding large crowds and prolonged time indoors, etc. Even as we look to vaccinations as our savior out of this pandemic, it is not exempt from it’s share of obstacles, such as delivery, production, storage, and distribution. Because of the degree of uncertainty and the constantly evolving nature of the virus, it makes sense to continue to wear a mask until we have truly impacted the natural history of the disease.

And finally, circling back on the point touched on earlier, what is everyone’s responsibility from an individual and social standpoint? I don’t think these two are mutually exclusive. There are many examples of individuals or groups prioritizing their individual autonomy over the greater good of society. But, the actions of a few impact many. It is important to remember the people to the left and right of us are our neighbors, our community, our friends and family. They are someone’s loved one and a person worthy of our care and consideration. When we adorn a mask, you are taking personal responsibility for your actions as well as sharing with others that you care about their well-being. We don’t know who has an underlying or possibly undiagnosed medical condition, who is vaccinated and who is not, who has a loved one at risk at home, or any of the other variables in a stranger's life. When we gather with close friends and family, we can choose and agree on the risk we are willing to take; mask or no mask, vaccinated or not, indoor or outdoor - those are the terms we get to mutually agree on. This is the very nature of informed consent, honoring everyone’s ability to manage their risk, choose for themselves, and preserve their free will and autonomy.

To bring it back full circle, why is the government insisting that you still wear a mask? Probably because it is the safest recommendation to make for yourself and the greater good of our country. Do you have to wear a mask? No, you don’t. Hopefully through education and empathy you can see why it might be best to do so for the foreseeable future.

With Love and Light,

John Moos, MD

Who is Dear John MD?

I have been involved in the helping and healing of individuals for the last 20 years. I dedicated my life to the practice of medicine. My pre-medical work included working as an emergency medical technician and finally a procurement transplant coordinator helping families decide whether or not to make the ultimate decision to gift their loved ones organs to let others live. During this time, I was a staunch atheist and spiritually disconnected. I treated my personal traumas and psychic pains with numbing, escapism, and addictive behaviors. My substance of choice was alcohol and my behavior of choice was sex. Despite my inner turmoil, I graduated with honors from my undergraduate education, secured honors in my surgical rotations during medical school, and ultimately attended my top choice of residency programs in general surgery, Keck School of Medicine of USC. Throughout residency, I was part of thousands of cases to help restore form, function, and save life. After residency, I remained dedicated to helping those afflicted by trauma. I worked at USC in academia under two surgical divisions. It was during this time I experienced my spiritual initiation on September 29, 2015. It took me falling to my knees, my life utterly shattered, before reckoning with the brutal reality that my actions did not reflect my values. A lifetime of self-destructive behaviors and coping mechanisms expressed through alcoholism and infidelities finally caught up to me. This dark-night of the soul was the beginning of my sacred dismantling. And, it was a gift.

During this time, I dove head first into self-transformation. I attended rehab for alcohol and sex addiction, joined the 12-step community of Alcoholics Anonymous and Sex Addicts Anonymous, attended spiritual services, and fundamentally changed my life. I was involved in extensive therapy, sat in sacred ceremonies, and graduated from The Hoffman Process. I changed my diet to reflect mindful intent, no longer consuming for indulgence, but for nourishment and sustenance. I reconnected with my body, which had felt stagnant and static for years, 30 lbs overweight, and started running again. I created a community through support groups, podcasts, and books to fill the void from the friendships and family I lost. I consumed hundreds of books ranging from spiritual psychology, human development and behavior, addiction and mental health disorders, memoir, shamanism, mystical experiences and sacred psychedelic therapies.

It was throughout this self-development and reintegration that I eventually left my surgical academic appointment at USC to cut my teeth in central California as a trauma surgeon in a busy level II trauma center. Throughout my process of self-actualization, I felt I was able to connect and heal patients prior to touching them. In the subsequent 4 years, I treated thousands of patients all touched by the hands of trauma. But, this left me feeling empty, knowing there was more I could do; a deeper calling unanswered and awaiting.

Over my career in medicine, I’ve had the distinct privilege of helping and healing those in need for nearly two decades. I’ve been a conduit in the saving of human life, and witness to the compassionate ending of it as well. Felt the spilling of blood of people touched by the hands of hate and trauma. Throughout this time, I’ve experienced and endured the greatest challenges of my life. All of this while silently suffering; leading a duplicitous life with no exit in sight. Until that day; when it all fell apart. Confronted and exposed, I was forced to choose between living a lie or reclaiming my life. Stripped of my coping strategies, I struggled to answer two perennial questions: Who am I? What is my purpose? This was a gift, an opportunity to face and heal my own trauma. A chance to reclaim myself and my life. It was my hero's journey.

During this initiation, after dedicating my life to the art of medicine, I was called to put the scalpel down and find a new way to heal. Accepting and surrendering to my reality, I got to work transmuting my suffering to wisdom to serve humankind. Throughout my journey, I was able to reclaim my life and integrate myself through The Conditions: integrity, nurturance, play, stillness, and community. These were the conditions that allowed my love and light to shine. In healing my soul, I claimed my inner abundance and honored my perfectly imperfect self. This was, and still is, my wholehearted journey of self-healing.

Once integrated and whole, I met a woman in divine synchronicity who further and forever changed my life. We consciously chose to adventure into love and relationship. In co-creating our love, we made each other better people; realizing we were healing each other in ways we hadn’t anticipated. The signs were apparent, literal, and loud. She changed lives through homes; I felt like I never belonged. I was a healer of trauma; she experienced many throughout her life. Relationship became the path towards a higher consciousness. Our conscious co-creation opened new doors to joy, healing, and love. A love far beyond our wildest dreams.

It is with these realizations and life experiences, guided by knowledge and wisdom gleaned from science and mysticism, that I reach out to heal with you. I’ve been fortunate enough to live a full range of life, through childhood trauma, marriage and divorce, academic failure to success, financial despair to freedom, addiction to recovery, and codependency to co-creating. I’ve experienced infidelity from all sides, both the victim and the adulterer. I’m a child of a divorce and created children of divorce. I’ve defined my life with lies and compartments and felt the restoration of my integrity through the disclosure of my truth. I’ve learned to love myself and love others more deeply. I’ve experienced the lowest lows and the highest highs. This has been my path of self-actualization, and finally, self-transcendence. It is time to birth a new paradigm of healing and love; to reclaim the self so we can co-create together.

We are all confronted with obstacles and difficulties that give rise to life’s perplexing questions. I want my messy life to be an invitation to you, to bring your messy life and complicated questions forward so you can be seen and heard. There is no judgment or criticism here, only shared humanity. Your privacy and anonymity are sacred to me and will not be shared to the public. Together, we can transform constricting patterns or beliefs into expansive opportunities. I want you to create the conditions for your best life to manifest through you.

With love and light,

John Moos, MD

Moos | MD