Fed Up with the Set Up Equates to Readiness

Monday, June 20th, 2011

I’m sure you have heard the phrase, “ready, set go” Webster Dictionary defines the word Ready as “prepared mentally or physically for some experience or action.” One of the factors I assess when I see clients for therapy is whether they are ready for soul searching, insight and working through the issue at hand. What do I mean by that? Many clients travel various different routes in life before they decide to come for treatment. They have many experiences, disappointments, events that are difficult to explain and some that do not make much sense. There are situations that are unfair and painful. Most times, the pain and the fear of the unknown is what keep clients from coming in for treatment. The fear of the unknown can be as simple as what will change in me or my life once I start the journey of working through the pain and fear. Sometimes clients present for treatment, but are not ready to handle the inner work that comes with the insight that is explored and revealed. This can slow down or even discontinue the treatment process.

When a client is ready to deal with the presenting issue or issues, several events have already taken place:

1. The issue at hand has impacted the client’s social life.
2. The issue at hand has impacted the client’s most intimate relationships.
3. There could be a physical impact of the presenting issues, i.e., not sleeping, eating less or more, feelings of fatigue.
4. There is a psychological impact of sad feelings, anger, constant racing of thoughts, feeling overwhelmed.
5. The loss of something very dear to the person has changed their view of life or their life in general.
6. Financial trouble or concerns.
7. Feeling as if one is not in control of their life anymore.

Most of all, clients have reported that they are just tired of things being the way they are, and are ready for an experience or action. There that word goes again – Ready. Are you ready??

Posted in Therapy | | Leave a comment

Problems with Boundaries

Tuesday, May 31st, 2011

This blog post is going out to all fellow therapists!  The advice I gave earlier it appears I need to listen to as well.  Especially when one’s ability to provide life changing care is involved.  Unfortunately, when a therapist works with young people (these young people can be as old as 40!), they must work and communicate with the family as well.

The family MUST be involved in some kind of treatment themselves or else the dynamics that created the dysfunction in the young person in the beginning will most likely continue in some form.  The most frustrating aspect of this kind of work is when the parents will refuse to cooperate with the treatment, or even communicate with the clinician.  In these cases, one can conceive of the work in two ways:

1.  The work will always be sabotaged by the family, and therefore it’s best for the therapist get out of the case entirely.

2.  If this is the family the young person has, then perhaps one has to ally with the young person all the more.

In this way, one has to tolerate and accommodate for the “slings and arrows” that the family can muster as they will be determined to diminish and devalue the work both of you are doing!  Nonetheless, IF one can withstand situations like this, then one might be genuinely be engaged in a truly important work.

One is providing the young person with an alternative to the script that the family of origin might want the young person to internalize.  In this case, the therapist might have a moral imperative to stick with an individual, no matter how difficult it might be to tolerate the devaluation that occurs at the hands of those that made the young person sick.  It is times like these that one needs to listen to Stephen Sondheim’s “No one is Alone” on continuous loop!

I am confident that I’m not the only clinician to find himself (or herself) in such dilemmas.  But such is the price we pay for the privilege of beholding the miracle of healing that brave people bestow upon us like a gift of which we are unworthy.  Thus, if one is in this situation, perhaps it has a deeper meaning even for the clinician.  And thus, it becomes all the more important for us to listen to our own spirits to maintain the wisdom and energy necessary for this work.

Posted in Blog, Therapy | | Leave a comment

What keeps people stuck

Monday, May 9th, 2011

A problem that many individuals in therapy and therapists often have to confront is the issue of why do people stay stuck in their symptoms. These symptoms can range from the mildly annoying to the truly life threatening and despite this, some patients stay wedded to their symptoms as if they were wedded by the Pope! What gives? Why do people stay attached to their symptoms? It is my belief that people (for the most part) do not want pain and suffering in their lives. Yet somehow their symptoms can plague them for months, sometimes for years. So what’s the underlying reason for all this?

It has been my experience as an analytic therapist that what keeps people attached to their symptoms is some kind of payoff – a gain that they get for having them. But what they are unaware of is a “secondary gain”; it’s hidden in the unconscious mind. People are often taken entirely by surprise when in therapy they realize why they have had to live with symptoms for as long as they had.

This is really important for the following reason: NO ONE is to be blamed for the secondary gain that other people can sometimes pick up on in the behavior of their loved ones. Even if this secondary gain is obvious to other people, it can remain a mystery to the person with the problem. And yes, it is a problem. Even if people seem to be enjoying some aspects of their symptoms, in reality their symptoms are keeping them from enjoying life and becoming their true selves. Thus, symptoms and even the secondary gain that sometimes attend to them are in reality not an expression of anyone’s genuine identity.

From this understanding, we can identify two important lessons:

  1. It does no one any good to nag someone about their symptoms – even if they seem to be enjoying life. Nagging, no matter how long or intensely practiced, has never gotten anyone to give up their symptoms. Not once.
  2. If you know someone afflicted by any kind of psychological or emotional symptoms, what they most truly need is the insight into why they have their symptoms and secondary gain. Thus, if they are in therapy, they need to persevere no matter how painful it might be.

For those who are trying to support those in therapy, try to hang on to the fact that their loved ones are making progress. Even if the process takes some time, remember that letting go of things that even had the appearance of working takes work and courage. In this way, therapy is truly a community action, and never occurs just with or by a single individual.

Posted in Blog, Therapy | | Leave a comment

When in Limbo…

Tuesday, May 3rd, 2011

Many of my patients at SPARK are twenty-somethings who, for whatever reason, need therapy. Sometimes the most difficult aspect of treating someone of this age and generation is getting the pitch-perfect level of support and structure from their parents. The mistakes often get made in trying to provide too much of either.

A generational gap may lead to a state of limbo

Parents sometimes don’t understand that what they could do when they were 18 or 25 is NOT what their son or daughter can do. As a result, parents sometimes end up doing too much for their children, not letting them have the “stretching” experiences of having to work at something.

Sometimes, parents may throw up their hands in understandable frustration and say, “He’s on his own!” But their young adult child might not have the skills to be able to figure out the world on their own. This leaves parents in as much a state of limbo as their children, everyone floundering around trying to figure out what his/her appropriate role should be.

Being supportive means being there

The most difficult and most appropriate thing for the parents to do is to be in the limbo with them. What for one child could be very necessary help, might for another be enabling and infantilizing. So unfortunately there are no hard and fast rules for this limbo in which so many of this generation are living.

The smart parenting question is: “Can my child do this (whatever this is) by themselves?” This might be a difficult question to answer. But a realistic assessment of what young people can and cannot do is essential to giving them the structure and support they need in order to get to the next step. Oftentimes, young people will act out, avoid, or complain about tasks that they simply do not understand or are beyond their skill sets. They engage in these behaviors because they find this internal experience of humiliation (which is what it is) intolerable and have to vent this uncomfortable affect somehow. One hopes that these acting out behaviors are not inherently self destructive.

If parents think that their children (of any age) are engaging in behaviors that are inherently self destructive, getting a professional consultation is advised. And might save a life. Remember, problems – if left alone long enough – don’t get better or go away. They only get worse. The problem is not finding oneself in limbo with one’s child; it’s not knowing how to navigate out of there!

Posted in Blog, Therapy | | Leave a comment

What Passover Can Mean

Monday, April 18th, 2011

It is again that time of year when Jews all over the world gather around dinner tables of many sizes to recount the story of the Exodus:  the story of the Israelites’ journey from Egypt into the desert where they wondered for over 40 years to get to the Promised Land.  To many people, especially my teenage patients, this ritual is merely an endurance test.  Can we survive the stories we’ve heard a million times to get to eat…..and we don’t even get bread?  What is it with this matzoh?  For too many young people, the seder can be a grueling test of survival, the meaning of which is:  when do we get to eat?

I would like to offer a differing view point.  I believe that the story of the Israelites can be everyone’s story.

How so, you ask?

In this way: it is the story of the human movement from slavery to freedom. And that is everyone’s story in some way.

“Isn’t this what everyone does?”

The Hebrew word for Egypt means literally “the narrow place.”  Thus, the place of bondage – the place of no freedom to move – is a place of slavery.  I suspect we all have these places in our lives:  whether we are slaves to work, chemicals, harmful relationships or a “cool” dedication to a meaningless life with little-to-no value.

It is my belief that life lived in this way IS slavery.  We might not be forced to make bricks, but we certainly are not our own masters and directors of our fates. But many people are convinced that since the surface looks good, the emptiness they feel just comes along with the territory. So they compromise and put on a happy face; after all, isn’t this what everyone does?

A new kind of freedom

To that question, I would answer, “NO!”  The Exodus story and the mystery of being truly alive calls us to freedom. That freedom is from all the things I have already mentioned or perhaps some other kind of tyranny which we are afraid to admit even to ourselves.  Thus, the call to freedom, as the Deuternomic writer would say, is issued to us TODAY.  Today we are called to a new kind of freedom.

Is freedom free?  Of course not.  Ask any soldier and they will tell you that freedom always has a price.  For us this Passover, perhaps the price of freedom is a new level of honesty–with ourselves or others.  Perhaps it is the courage to confront old habits that do not work and trying new things.  Perhaps it might mean a very real and profound change of lifestyle:  giving up the comforts of a great salary for work that for us has more meaning.

Confront your reality, find your freedom

Whatever the price might be, the Exodus story calls us to confront the reality of our own slavery and ask ourselves, “What am I getting for these chains?”  If we approach Passover with this mindset this year, perhaps we are positioned actually to hear the story.  Perhaps for the first time, this Exodus can be OUR Exodus.  In this way, the movement from slavery to freedom will be brand new for us, and indeed as new as it was for the Israelites of old.

Some cynics might argue that such freedom cannot exist.  But we don’t know till we try.

Posted in Blog, Spirituality | | Leave a comment

Parenting the “Other”

Saturday, April 9th, 2011

Perhaps one of the greatest challenges that parents face is the parenting of a child (of whatever age) who is radically different than you.  This difference could be as basic as something as gender, or it could be deeper.  Maybe, it’s values: they place worth in places that you might not or, worse, that you disdain.  And maybe the difference is psychological, making the rift an emotional one as well.

Change! Be like me.

The reason why this becomes a problem is that in your efforts to parent, the subtext of your interactions could be something like, “Change, be like me, don’t be yourself.”  Sometimes this is called for (i.e. a drug abuse that could be life threatening).  But all too often, the attempts to parent are experienced by the child as a form of devaluation; the parent comes off as not caring about or, worse, diminishing the child’s opinion or views.

Sometimes, this can become so intense for a young person that the introject of “Don’t be yourself” becomes translated into self-destructive behaviors:  chemical abuse, addictions, self-injury, even suicide attempts and completion.

Choose to love, and try not to be frustrated

The answer to this cycle is insultingly simple:  Love your child.  By this I don’t mean just provide things like food, which is rather expected.  (If you’re not doing that, just call DCFS now.)  But loving things that are different than us or that we don’t always understand, even if we are talking about one of your own children, is not easy.  Indeed, it is perhaps one of the the most difficult things you will ever do.

But despair not!  There are concrete steps that one can take to improve one’s relationship with one’s child:

1.  Identify the way in which your child is different than you that is disturbing

2.  Examine your own heart and mind as to why this trait is so disturbing/difficult to make some kind of connection

3.  Learn where you learned your distaste for this trait and what’s at stake for you; perhaps it could be some sense of your own identity

4.  Examine the trait that is so difficult and force yourself to see what possible purpose it serves your child

5.  Attempt to see the benefit it provides your child and see if from this perspective you might be able to value it in some slightly different way.  Often times, it is through our children that we learn how to be more open to the world.

It takes time and patience

Now this process is NOT easy.  I can safely say it will be one of the most difficult things you do in your lifetime.   It might require the help of someone trained in psychotherapy and analysis.  It might even prompt a new, challenging journey for yourself.  But the price you pay for not taking this journey is to continue to engage your child in unproductive ways.  That gets NO ONE what they want.

Perhaps your child is your own walking, breathing invitation to your own journey to human growth.  And if your child ultimately invites you to a life that is more full and abundant, what better gift could he/she give you?  It might not be comfortable at first, but perhaps the life of real attachments is not supposed to be.

Posted in Blog, Therapy | | Leave a comment

The serenity prayer and family therapy

Monday, April 4th, 2011

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and wisdom to know the difference.

This is known as the Serenity Prayer, but this could very well be called the family prayer.  Most people live to change the people they love.  It is only when that desired change is met with resistance will that person realize that the change process is really about them and not the other person.  Most times it takes a while before we realize that we cannot change our family members, but we can change how we relate to them.  This epiphany is a way of accepting things we cannot change.

Acceptance is tricky in a family where there is maladaptive behavior.  However, acceptance is the best treatment plan for boundaries.  It is almost paradoxical.  For instance, one can’t change the behavior of another, but they can remove themselves from the pattern in which the behavior is carried out.  Hence, the struggle of trying to get a person to stop or change the behavior ceases and the acceptance of creating healthy boundaries for oneself so that they will no longer be a part of the maladaptive behavior begins and wisdom is birthed.

In family therapy, the problem is approached with the intent of creating desirable change in the maladaptive patterns of behavior that a family has established.  When equating this concept to a family, it helps us to understand the pattern of behavior that is behind how a family relates and communicates.

When a family comes for help, one of the first things that a clinician is told is the presenting symptoms, i.e., a family member gets drunk every weekend, my spouse is having an affair, our daughter is disrespectful, our son is failing school, my spouse is never at home, etc.  These can all be viewed as symptoms, but they are also the way a family relates, which can be signs that something is wrong.  For the clinician, the pattern of relating is used to analysis the movement of the family.  To unpack this concept further, within families there are roles, rules and then what I like to call the “state” of the family or homeostasis.  In other words, how the family usually relates to each other.  The family can experience this state as being pleasant, dramatic, troubling, hurtful or even unbearable.  What is certain is that no matter what event happens in the family, the family manages to get back to their “state” or way of relating to each other after the event has ended.  It is this redundant pattern of behavior in families that resist change.  Within these patterns is what family therapists call circular causality.  The behavior of one person causes the behavior of another; however, this is not to suggest that the behavior of one party is to blame.  The behaviors of both parties have to be present to create the pattern or circular causality.

Often these patterns are carried out between two people in the family (a dyad), and at times there can also be a triangular relationship to help maintain the “state” of the family.  Within this dyad and/or triangular relationship, there is a circular and causality pattern that has developed.  For instance, one person becomes distant and the other person becomes the pursuer.  This can take shape in one person nagging and the other person not coming home.  Another example is favoritism is shown to the older brother and then the younger sister becomes disrespectful to the parents.  Some families recognize the pattern, but others are deeply entrenched in the patterns of behavior, and they only know that the family is suffering from the maladaptive behavioral pattern.  Sometimes this is all that is needed to get a family on the right path – the wisdom to know the difference between maladaptive and adaptive behavior, and the courage to bring that behavior to the light.  What maladaptive behavioral patterns have been established in your family?  Are you ready to set healthy boundaries?

Posted in Blog, Spirituality | | Leave a comment

Parents: What’s wrong with my kid???

Sunday, April 3rd, 2011

It’s happened more than once that a young person will be brought to my office, sometimes unwillingly, by parents who are confused and very frequently very scared by the behavior of their son/daughter.  This behavior usually falls into one of two categories:  familiar inappropriate behavior and unfamiliar inappropriate behavior.  With all this behavior living on a spectrum, it can get dicey trying to figure out what exactly is offending the family subculture.  In some families, marijuana use is just part of what people do–I know of parents that will get high with their kids.  In other families, a single joint is cause for a trip to rehab.  In all these cases, what is very important is the parental perception of their children.  Often times it is the young person not meeting the traditional marks of adulthood that becomes the root of family concern.  Things like:  not graduating from high school on time, trouble with college, not graduating from college on time, difficulty finding a job, not being able to live on one’s own, not being to obtain healthcare, or lacking a sense of direction in life can become cause for a trip to the therapist’s office.

For parents and children perhaps some comfort, albeit cold, can be found in the fact that none of you are alone.  Studies are showing across the board that much more than many believe, young people are taking longer to hit the developmental milestones than their parents did.  In short, 30 is the new 21.  The decade of the twenties becomes a searching period; when young people are taking the time at hand to explore their world or themselves.  That is in many way a best case scenario.  Better to ask the hard questions now, rather than asking them at mid-life when one has more obligations and less freedom to make changes.  If on the other hand, this time is spent getting high all day and playing x-box live, then a trip to the therapist’s couch might be in order.  But even this young person is not beyond hope!  I for one would say that even if a young person appears “stuck”, they might be searching for something:  some kind of attachment or work that might give their lives the meaning they are trying to achieve on their “quests.”  In this sense, there is hope for all of us!

Posted in Blog, Therapy | | Leave a comment

His decision, your outcome: dealing with father alienation

Thursday, March 31st, 2011

Today, I would like to talk about women who have never had a relationship with their fathers or any father figure while growing up.  In the field of psychology, we call this ‘father alienation.’  Even adult women who were raised with their fathers can still experience father alienation if their father was not available to them emotionally.  Whether the reason is that a father was not around or available to his little girl, for some adult women it has left a social and relational deficit when dealing with the opposite sex.

The adult woman from a family where she experienced father alienation can go without answers to some of the most difficult questions such as:  why did my father leave, and why did he not try to make any contact with me; why was he emotionally distant; and  how am I like my father?

She might also struggle with questions that can change the landscape of her relationships.  Those questions might be:  who will walk me down the aisle;  how do I relate to a man if I have never had a man in my life; and, where does he fit in my life?  For many women the answers to these questions have set them on a journey of unhealthy relationships, self-doubt, low self-worth and body image challenges.  The internalized pain of being abandoned and never being affirmed by the first man in a female’s life can take on the appearance of  biological and psychological disorders.

In addition, the unconditional positive regard that a little girl did not get from her father sets in motion a social, relational and psychological development trajectory that can result in that daughter growing up to be a woman who lives a co-dependant, unhealthy lifestyle.  Most women would like to believe that the impact (or lack of impact) of a father has nothing to do with the type of woman they have become, but most researchers and psychologists believe otherwise.  As a father shows unconditional positive regard to their daughter, that daughter observes her father on a deeper level with expectations of the future.  These futuristic expectations are grounded in four fundamental principals.

  • Positive Self-concept
  • Feeling confident in male-female relationships
  • Comfortable with showing affection
  • Healthy interpersonal skills

Each one of these principals are essential for raising healthy daughters who then turn out to be healthy women.

Have you experienced father alienation?  Let’s talk about it.  You might be surprised to find that you are not alone in living with the residue that father alienation has left like fears and self-doubt in your current heterosexual relationship.

Posted in Blog, Therapy | | Leave a comment

What is Personality Reconstruction?

Saturday, March 26th, 2011

A term I use frequently in the work of therapy is “personality reconstruction”.  This term can cause a lot of misunderstanding.  I am not saying that I do not like people the way they are; I’ve always found something to admire in every patient I’ve ever counseled.

When I say personality reconstruction, I mean repairing the damage a person sustains through life. That damage is different for each person: trauma, loss, or some other set of events. This damage has prevented the person from actualizing their full potential self. For example, maybe a past trauma has stunted their progress towards his or her native talents and gifts; now, they are in an unbearable state because they aren’t living the life they were meant to.

The term personality reconstruction refers to the process of accompanying a person through whatever process they need to become the best person he or she can be.  Now the crafty among you are saying, “You’re mean I’m not being myself!”  To that complaint, I respond with a resounding YES!  Too many people walk through life not being the self they truly are; they are bagged by symptoms and know deep in their hearts that they are living some kind of false self.

In short, they are living a lie of some sort.

To borrow a term from Martin Heidegger, they are living an inauthentic existence, giving way to desires that are not truly their own.  They are living as if they are  part of the “herd”,  borrowing their ideas, affections, and even sense of self from everyone else but themselves.  What analytic psychotherapy does is afford a person the chance to become the person he/she most truly and deeply might be.   This process and even way of life is not easy;  it can put one at odds with former friends and lovers.  But as the French writer put it well, “Better to be hated for who one is than loved for who one is not.”

Posted in Blog, Therapy | | Leave a comment

« Older Entries
Newer Entries »