A Great Recent Read: “How to Do the Work” Book Review
Every few years, I read a personal development book that fits like a key into a lock inside my brain. These books open up entirely new avenues of self reflection and growth, and it happened recently while reading Dr. Nicole LePera’s debut book, “How to Do the Work: Recognize Your Patterns, Heal From Your Past, and Create Your Self.” My reading of the book happened to coincide with a new stint of cognitive behavioral therapy (CBT) for chronic sleep issues and ongoing couples therapy with my partner of four years. Between these three channels of self-reflection, it feels like a breakthrough is brewing.
A little bit about “How to Do the Work”
Before we get into personal reflections, let’s start with some basics on the book.
About the author
According to her bio, author Dr. Nicole LePera was trained in clinical psychology at Cornell University and the New School for Social Research. She also studied at the Philadelphia School of Psychoanalysis and counseled in her own private practice prior to leaving the field. Her frustration with the limitations of traditional psychotherapy lead her to seek out and draw inspiration from:
Established scientific fields, like neuroscience and cognitive behavioral therapy
Emerging scientific fields, like epigenetics and psychoneuroimmunology (gut-immune-brain connection - I’m listening!)
More debated fields, like mindfulness, spirituality, and psychoanalysis
Between her traditional education and more exploratory studies, LaPera now practices what she calls a blend of these various fields, dubbing it “holistic psychology.” She gained her popular following via her Instagram @the.holistic.psychologist, which I’ve followed & vibed with for years prior to discovering her book in the window of Powell’s Books in Portland.
About the book
I was attracted to this book for the same reason I write a blog on positive psychology. My whole life, I’ve had the niggling thought that I wasn’t as happy as I could and/or should be. That I inexplicably suffered from more unexplained sadness and anxiety than those around me. Positive psychology has helped me move the needle on my everyday sense of contentment, but it’s only designed to take people from zero to ten, from languishing to flourishing. It’s not the field to turn to if you need to work through real psychological shit.
The phrase “recognize your patterns” is what ultimately got my attention. I, like many, have dealt with patterns of low self-esteem, high need for validation, and generalized sadness. I saw myself immediately in LePera’s personal recollections and experiences of her most frequent clients: perfectionism, hyper achievement, constant traveling, insomnia, anxiety, shame-based narratives, physical dysregulation. Finding a book with a unifying theory about all of these persistent maladies had me like a fish on a sharp line. I was hooked.
Predictably, the book spends a lot of time discussing the influence of our childhood on who we become as adults, how their treatment and example affect our worldview and subconscious so dramatically. While not a novel concept, I found it well worth further engaging with the neurodevelopmental patterns of children to understand how even a relatively lovely childhood (like the one I experienced) can produce a lot of “work” in an adult. Here’s what I understood the crux of her point to be:
The main thesis of the book
Little kids, especially from infancy to seven years old, just want to be safe, seen and loved. We rely deeply on our parent figures for these three things. The problem is, our tiny underdeveloped brains don’t have the finesse to categorize the things that happen to us outside of these three categories. Like a black and white film, they interpret the world and all that happens to them in binaries, as “safe or unsafe,” “seen or unseen,” and “loved or not loved.” When core needs are not met (or there is a perception by the child that a core need is not met), kids can develop a feeling that they’re not worthy of having those needs met.
Let’s use an example: When a parent forgets to pick their child up from daycare, the 5-year old brain can’t comprehend that the adult is busy, tired, and capable of making simple mistakes. They may simply interpret the event as “not loved.” If this happens once or twice, it might not have a huge effect on the child. But similar to the idea of epigenetics, millions of micro moments like these throughout a childhood can flip the “loved” and “seen” switches on or off. Every “not loved” moment gets tallied subconsciously, and if there are enough, it may lead to a persistent feeling of unlovable-ness in the child.
The emphasis of this book is not on blaming parents for the harm inflicted on their children. Even the best parents will make their child feel unsafe, unseen, unloved at times, explains LePera, because 1) they’re dealing with their own stuff and 2) meeting all of someone's varied & unique needs 100% of the time is near impossible. It’s both sad and comforting when LaPera assures her readers:
“The majority of us feel unseen, unheard, and unloved, and we carry this pain with us throughout our lives.”
There’s a lot of talk about trauma these days, and if you dabble in the mental health community, you might use the “big T” trauma and the “little t” trauma vocabulary. I think what LaPera is trying to tell us is that, even those without big T trauma (abuse, neglect, etc.) in their life still walk away with a lot of little t’s that we will unconsciously act on throughout our life. Or, we can choose to work on them.
My experience reading “How to Do the Work”
I found so much in this book to be highly relatable. It was to the point that I’d put the book down and think, “Wow, I had no idea anyone else but me thought this way.” LaPera writes about her childhood anxieties of home break-ins and her parents dying. In my own childhood, at maybe age 8, I would lay awake at night worrying myself sick over “bad men” breaking into our home to steal my mom and I away. I’d also have recurrent nightmares of my mom dying. On the flip side, LaPera writes about what she believes to be a young addiction to cortisol, rooted in the unconscious belief that life is supposed to be filled with wild rushes of emotion, whether positive or negative. I relate to this. For both of us, it showed up in a constant feeling of boredom as a child, as well as a gravitational pull toward risky behaviors as a teen.
She writes about high-functioning anxiety and perfectionism and insomnia, which are three themes that have been emerging for me lately in both my relationship to sleep and with my partner. I found “How to do the Work” helpful in that it allowed me to further reflect on the moments in my childhood that may have made me feel unsafe (leading to hypervigilance) and unloved (leading to perfectionism as the main avenue for receiving it). It’s helped me realize that, even when I’m not in an acute state of anxiety, where my heart is pounding, vision narrowing & stomach in knots, I carry with me a persistent, low-level state of stress in which I’m seeking to bring perfection to every aspect of my life. And I’m not the type who’s picked just a few things I’d like to be good at. However consciously, I hold myself to the standard of perfection at work, in my relationship, with my health, within my friendships, and as it relates to my personal development, hobbies, and passion projects. It’s been said by many that you can’t “have it all,” and I think I’ve been striving to for my entire life, because there’s a part of my inner child that believes once I have “it all” and “it’s perfect,” then I will be happy. Then, I will feel safe and seen and loved. Oy.
The last thing I want to do is blame my parents for any of the work I need to do today. They were going through so much together when my brothers and I were young, and I have nothing but love and empathy for them today. We remain deeply close. And yet, I’m finding it helpful and therapeutic to identify certain patterns in my childhood that left me with a lifetime of challenge. Not because it’s someone to blame, but rather, it’s a way to pull up and out from blaming myself. Every therapist I’ve ever worked with will tell you that I’m really hard on myself, that I’m in a constant battle with myself over whether I’m a “good” or “bad” person. If I’m reading this book correctly, it signifies a deeply held feeling of unworthiness. And those feelings are typically rooted in the parent-child relationship. This book has helped me reflect on my childhood relationships and experiences with curiosity and empathy, opening up new avenues of healing.
My takeaways from “How to Do the Work”
Sometimes it’s fun to hear about individual reflections, and other times, you just want to know what I learned so that you can apply it to your own life. Thankfully, LaPera’s book left me with a few salient takeaways that I’m excited to pass on.
Get out of autopilot. To get out of a situation, you must first become aware of the position you find yourself in. LaPera advises that we break “the spell of unawareness” by coming into the present moment and fully recognizing our patterns. Meditation, journaling, and therapy can be particularly helpful tools in identifying your own negative patterns.
Build trust with yourself through consistent self care. So much of healing centers on the concept of self-love, and many of us have not intentionally invested in a relationship with ourselves. This type of self-care often starts with nailing the basics for wellbeing: movement, journaling, spending time in nature, connecting with others, and good sleep. LaPera says you can rebuild lost trust by making small promises to yourself and following through. I often do this with 20 minute workouts or forgoing gluten (which tastes great but hurts my tummy). This is a form of loving self-discipline that’s required for really taking care of ourselves in the modern world.
Learn your intuitive voice. Many of us have spent so much time listening to our parents, our friends, and the media that it makes it hard to understand what our own hearts, minds and bodies are telling us. LaPera urges us to learn what our own voice sounds like and learn to trust it over everything. Importantly, she says “the only person who can validate your reality is you. Your reality is valid because you’ve experienced it, not because someone or something external has said so.” Your intuitive voice is also an important signal in your healing journey; learn to ask “what can I do for myself in this moment?” when you recognize a pull toward old, unwanted patterns.
Cultivate emotional maturity. The three parts to focus on here are: ability to 1) regulate your emotions, 2) tolerate others, and 3) communicate your emotional boundaries. Emotional regulation is how you notice your emotions as they arise & mindfully engage with them, letting them flow through rather than peaking and cratering with every passing feeling. Being able to tolerate your own emotions is the first step in being able to tolerate the actions and emotions of those around you, which gives you more power over your emotional state than those tied to the people around them. And establishing your boundaries without fear or shame allows you to maintain emotional regulation of yourself and others all the more easily and consistently.
Accept that you will disappoint others. Speaking of boundaries, it’s critical to learn to be at peace with being misunderstood. As a recovering perfectionist & people-pleaser, this is perhaps my favorite takeaway of all. Part of being true to your intuitive voice and loving self-discipline practices will mean you disappoint others. Per LaPera, “When you are authentically you, you will encounter judgment & criticism. . . .These are just facts of life - a part of being a dynamic, individualized human. It does not mean that you are inherently wrong or right.”
Find wonder & play. Many of us live with the implicit belief that life is hard and requires serious, applied attention to survive and thrive. While some of that is true, humans evolved to transcend and they evolved to play. There is something so healing in reflecting on our own smallness, our insignificance, as well as our connectedness. Similarly, the act of imagination and creation, especially when paired with laughter, is required nourishment for the human soul. A life without these two things will leave anyone struggling to do the work.
What I didn’t love about “How to Do the Work”
It wouldn't be a proper book review without some authentic reflection on what I didn’t love. Here’s a few things that left something to be desired:
Some of the science is questionable. There was a weird moment in the book talking about the “nocebo effect,” in which LaPera cites two small studies to make a point about the body’s self-healing powers…it seems to get pretty meta-physical and outside the realm of science. Plus, with only two very small studies and anecdotal evidence, it felt like a distraction at best and a question toward her credibility at worst. Fortunately, there weren’t too many examples of this.
There’s a lot of repetition. Especially towards the ends of the chapters, she seems to be filling space by restating the themes of the chapter and some relatively unhelpful prompts for self-reflection. I’d prefer they were omitted & the book slimmed down.
There’s not a lot of “new news.” Especially for the existing psych lover like myself. While I didn’t learn new concepts, the book did help me connect some dots I hadn't been able to before, and that was helpful.
It addresses a lot of topics at surface level. LaPera tries to connect a lot of disparate topics in the book, but does so in a way that often feels like a “drive-by.” A concept is introduced, maybe explained in a sentence, and then moved on from. If you are looking for more of a deep dive on any psychological concept, you’re unlikely to find that here.
That said, I’ve recommended this book to at least 10 people in the last few months. And I’ll continue to do so for anyone struggling with some of the patterns the book focuses on, like anxiety and perfectionism. It was a powerful read and extra useful when paired with therapeutic support.
Have you read “How to Do the Work?” Let me know your thoughts on it in the comments!
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