I used to think that one of the jobs of us psychotherapists is to help people get rid of their anxiety. Anxiety was always a measure of how healthy or unhealthy a person was: too much anxiety could be paralyzing, and lead to all kinds of mental illness, including depression, which usually has a large component of anxiety connected with it. Gouchy people, stressed-out people, and worry worts all have too much of this commodity. Anxiety disorders, such as phobias, obsessive-compulsive disorder, and post traumatic stress disorder (PTSD) all show that people are suffering with this illness.
Recent studies, however, have shown that anxiety is not all bad. Neurological researchers are finding exactly what anxiety does in the brain, and blood studies show the chemistry of anxious reactions in the body. As a new article in Time Magazine (September 5, 2011) states “That’s not to say all anxiety should be battled. Sometimes it should be embraced – even celebrated. In just the right amounts, the hormones that drive anxiety can be powerful stimulants, arousing the senses to function at their sharpest.”
Since everyone has a little anxiety, I always used to feel that anxiety and excitement are two sides to the same coin. Both produce stimulation and anticipation. Both make our palms sweat and our hearts race. But sometimes, we are not worried or upset, we are just excited. Sometimes it may be hard to distinguish one from the other, but it might be good to test the state of mind to see if we are scared and worried, or just excited!
Filed under: Psychotherapy on December 7th, 2011 | No Comments »
The term “mindfulness” is used a lot in psychotherapy today. It is borrowed from the Buddhist religion and Buddhist psychology and it means to have a heightened sense of awareness in all that we do. Buddhism and psychotherapy have very similar interests and goals. There is a concern in both for personal happiness and the highest possibilities of human development. Awareness or mindfulness is one of the signature qualities that separates the human species from the rest of the animal kingdom. And it is the one quality that can help us take the fullest advantage of life on this earth.
The two disciplines are also similar in that they seek the nobility and beauty to be found in all human beings. It seems to be hard for many people to find and appreciate the positive qualities they possess. Robert Johnson, the noted Jungian analyst has said “Curiously, people resist the noble aspects of their lives more strenuously than they hide the dark sides..” Most of us who do psychotherapy find that people often give themselves more fits by being critical of themselves. This is often what causes the pain in their lives. Mindfulness and psychotherapy ask people to look at all aspects of the inner life and decide what to keep and what to modify. The word “nobility” derives from the Greek word, gno (as in gnosis) which means “wisom” or “inner illumination”.
What a wonderful world this would be if we could search for the nobility in each one of us!
Filed under: Psychotherapy on November 30th, 2011 | No Comments »
Self-Confidence is one of those human components that starts early and stays late. If we are lucky enough to have supportive parents and a rich nuruturing environment, we are very fortunate indeed. Then with that great start if we have many experiences along the way that support our confident opinion of ourselves, it just locks in the original assumption and gives it staying power even through slings and arrow of difficulty along the way.
However, this is not the beneficent treatment most of us are acquainted with. Most of us have all sorts of bad treatment, or just plain neglect, to form our own patchwork of confidence. Many people don’t have bad parenting, but they may have what psychologists like to call not “good enough parenting”. For instance, parents may talk a good game and tell the child what a little star he is, even if he is clearly not doing well at all. This just convinces the child that either his parents don’t know what they are talking about, or they are just biased in his favor. There have been many studies that show that many parents today over-praise their children to their detriment. Either the child will get an undeserved swelled head or they will not develop a critical facility to monitor their own behavior and accomplishments.
Another pitfall in the “confidence game” is parental modeling. I have seen many grownups who did not have any verbal guidance at all from their parents, but the parents were such overachievers and stellar role models, that the bar was set very high. Sometimes I think it might be better for children to grow up with fairly inadequate parents so they don’t develop inferiority complexes early.
Because a lot of self-confidence is connected to the way we are parented, people then get the idea that it is something that cannont be improved or changed. Nothing could be further from the truth. With insight into the origins of our lack of confidence, and enough resolve to change it, we can definitely make improvements. Another method for gaining confidence is through meditation and looking inward. This is where real self-confidence is born. Soothing ourselves, and praising ourselves is usually much more effective than looking outside of ourselves for praise.
Filed under: Child Psychotherapy, Psychotherapy on October 25th, 2011 | No Comments »
Some people walk around in an unconscious daze a lot of the time, but most of us do not realize the extent to which we walk through life in a slight hypnotic trance. As soon as we wake up, especially on work days, we begin a routine that has been set and honed over many years of repitition. This produces a kind of hypnotic state; we don’t have to think about it – almost like sleep-walking. The same thing happens in relationships between people. After we know someone for a while we get into a pattern with them that gets set in our neurosystem. When we see the office jokster coming, we set our neurons to deal with it. If we don’t like his jokes, we try to ward him off or ignore him. If we do like it, we fall in and see what we can do with it, adding to the fun.
I work a lot with couples. And after a while most couples notice that they get into hynotic spells with each other. Patterns of communication that have been developed over years get hardened into habit and produce a kind of hynotic effect. If she is waiting at the door with her coat and ready to go, and he is still checking an email on his iPhone, she may feel a familiar feeling of frustration and anger: “Hurry up, we are going to be late!” He rejoins, “I’m right here; what’s the problem?” Then she comes back “You always make us late for appointments!” And so it goes on from there in a dialogue that probably varies little from time to time over a pattern that hardly ever changes. Whatever else may be going on, these two are locked in a dance for two that has many hynotic aspects to it.
In therapy with couples, I like to find these patterns and tell the couple to interrupt them. Change any part of the dance, the the whole choreography changes. If, instead of waiting at the door, she justs walks out, it breaks the spell. If he shares an interesting email with her, or includes her in some way with his last minute activity, that also breaks the spell. If she tells him the appointment is 7:00 instead of the actual 7:30, this also breaks the spell and has the effect of making her more patient. I encourage each person to try different things. The main purpose is to interrupt the hypnotic spell so the dance has a little more variety and grace.
Filed under: Couples Counseling on October 20th, 2011 | No Comments »
I know “anger management” has become a hot topic today, but really since the dawn of human activity we have all struggled with the management of our anger. I usually sense that anger begins in frustration. We get angry when things are not going our way or someone tries to stop us. Someone cuts us off on the highway and we get angry and there is not much we can do about it. So if anger and frustration are closely linked, it makes sense that today has seen an uptick on the awareness of a need to control anger. These are frustrating times!
In the early days of psychotherapy professionals used to think that if we had anger bottled up inside, the trick would be to “get it out” or burn it off. We used plastic bats to beat a chair or punch a bag. But then as this approach came under scutiny it was found that all the technique really accomplished was an increase in the intensity of anger. Expressing anger and rage in this way just produced more and more anger and rage!
With my clients I try to convert the angry energy into effective action. This greatly lowers the level of frustration. I had a client once who had a bad encounter with a New York City transit worker. He told me that as he walked away, he kicked a garbage can he was so enraged. I told him there was a lot of power there, and I went back over the incident and got him to think about what else he could have done to express his frustration. He came up with all sorts of solutions: he could have gone back and expressed his displeasure to the person directly, he could have written a letter to the transit authority, he could have related the story to his friends to get some sympathy. Not all of these attempts at management would have been successful in terms of outcomes; but the very act of trying effective things gives all of us the sense that something can be done. We also can feel better about ourselves that we were able to take a frustrating situation and turn it into something more effective than just kicking the can!
Filed under: Couples Counseling, Psychotherapy on October 20th, 2011 | No Comments »
When couples come in for couples counseling they often report that they are having a lot of fights. Upon further analysis it seems they may be having the same fight over and over again. It might be about rasing the children, or dealing with the relatives, or about money or sex, but people usually have a list of problem areas that cause friction.
The issue for counseling at this point is to sort out the themes that cause trouble and work with them to have the conversations they need to have. Even if couples don’t fight that much, they may be avoiding discussing a list of things that typically cause tension in the marriage.
On of the first things the counselor might do is to get the discussion on a rational basis, and even stop the couple from raising their voices. It has been shown with many studies that if the heart rate of either of the two people goes over 92 beats per minute, nothing good will happen. Keeping the discussion between two rational adults and helping them get somewhere with it, gives them hope that if they put their minds to it they can resolve many of their difficult issues.
Filed under: Couples Counseling on October 10th, 2011 | No Comments »
Most therapists spend a great deal of time thinking about what makes their work effective. When people come to us, what actually helps them in ways that really work?
In the past, in the earlier years of psychotherapy, therapists in training wanted to make sure they had a good theory to go with their practice. Did they believe deeply that people are psychodynamic creatures ? Or did they think people are a composite of behaviors that needed to be changed? Or did they think people are a product of their thoughts and belief systems? Depending on what you believed, you worked with people in particular ways. Psychodynamic therapists explored insights that would give people a sense of their unconscious and how it was operating in their lives. Behaviorists identified dysfunctional behaviors and tried to get people to change them. And cognitive therapists uncovered faulty logic and belief systems that stand in the way of successful living.
Generally, as long as therapists had a grounding in their particular theory and practiced it with the conviction of belief, they were felt to be doing good work. Most studies showed that if the therapist strongly believed in their theoretical orientation, their clients would be helped no matter the belief system of the therapist; one theory was not thought to be better than the other.
This is probably as true today as it was then, but one more factor has been added. Because insurance companies have become more active in determining treatment, there is a push for psychometrics. In other words, we are being pushed to help the client quickly and efficiently. There is a bias toward using techniques (or “technologies”, as they are called) that get the biggest bang for the buck. Goals are set early in treatment and then progress is measured toward those goals.
There is nothing wrong with this in one way: people don’t have a lot of time today to just explore their lives and look for possibilities. They come for specific problems, and they want to get them fixed as quickly as possible. On the other hand much is lost in not having the luxury of time to explore avenues and make way for fulfillment on a richer scale. With linear, goal-directed therapy, we may have lost a lot of depth and satisfaction, which is a different kind of effectiveness.
Filed under: Psychotherapy on October 6th, 2011 | No Comments »
A lot of marriage and couples’ counselors today tend to focus on the process of communication. Many couples come into therapy arguing and screaming and yelling at each other, thereby doing a lot of damage to the fabric of their relationship. And since people do not stay in therapy too long, many couples’ therapists feel they need to do something FAST. They figure if the couple could only work out their differences in a more rational and controlled manner, they could feel much closer to each other.
There is some truth to this assessment. If couples could have the rational conversations they need to have about their important issues, they would certainly be better off. They might even feel that the relationship was “good enough”, if not perfect. Certainly, the peace and quiet would be a relief! And they might even start to like one another again if they felt their discussions were getting somewhere.
Into this fond hope for improved communications comes another school of couples’ counseling, primarily propounded by Dr. Susan Johnson from Canada. A well-known and successful therapist, teacher, and author, Dr. Johnson says that what couples need beyond better communications skills is to reconnect in an emotional way. She bases a lot of her work on the “attachment” studies of John Bowlby, who says the greatest human need in this world is to feel safely and happily attached to our closest friends and family. Our spouse or significant other is the primary source of this security and happiness. Johnson investigates the emotional bond of the couples who come to her on the theory that the bond has been broken or lost. It is this desperate emotional conundrum that causes couples to fight, and the only way to get relief is to work with a therapist trained in helping the couple reconnect to one another emotionally.
Filed under: Couples Counseling on October 6th, 2011 | No Comments »
Believe it or not people usually tend toward a bias of optimism. Most of us actually expect things to turn out well most of the time. In fact, studies have shown that most people are no good at predicting the future in terms of positive outcomes. Most of the time, what actually happens is worse than we expected.
I am sure you know people who seem to have the opposite problem. They are sure that nothing will ever work out and that they of all people will get the worst deal on anything. Life is a lot of impossible challenges and then we die.
We would expect this negativity bias to be a part of the outlook of depressed people. But it turns out in studies done by behavioral economists show that people who are depressed actually have a more realistic view of potentials and outcomes. They often predict with great accuracy what will actually happen, not what they wish for.
I guess we could see this as an advantage of depression, since it seems like a dangerous point of view to be either too positive or too negative. On the other hand, it is unlikely that many new or better outcomes would be accomplished if we all were totally realistic all the time. Positive people often try new things, even if they fail, and they usually stretch themselves, even though they might not yet be up to the task.
Filed under: Psychotherapy on October 6th, 2011 | No Comments »