Sunday, 1 November 2015

Part I: Boundaries In Relationships: Is That Your Suitcase?

Recently, I was standing at Pearson Airport in Toronto waiting for my luggage to come off the conveyor belt when I realized that I had made a big mistake buying my London Fog suitcase in
black.  There was a sea of black suitcases pouring down onto the revolving platform all of which looked almost identical.  I had to look at tags to check whether or not a couple of familiar looking pieces were mine and hoped to god that every one else was having the good sense to do the same.  I was visiting my sister and all I needed was to end up without any clothes for the next five days!  This vivid memory came to mind one week later when I was in session with a gentleman in his early 60's whom I had worked with for a while.  He was talking about his adult son's problems with gambling and the strain that it was having on his marriage when all of a sudden, he stopped dead mid-sentence, looked me in the eye and said:  "I know, I know what you are going to say...it's not my suitcase." What he said stuck with me like glue because it brought back the memory of being at that airport and I realized that the suitcase analogy he had come up with was a fabulous way of making a distinction between what stuff belongs to one person and what stuff belongs to somebody else.  He had worked with me long enough to realize that not only was his preoccupation with his son's suitcase ineffective in solving his son's problems, it was also conveniently distracting him from dealing with his own anxieties about retirement which happened to be part of his luggage at the time!

As a clinical psychologist who has done hands on psychotherapy for over 35 years, I have witnessed people struggle again and again with the dilemma of trying to sort out what they are responsible for and not in the complex world of human relationships.  How do you figure out what belongs to you and what belongs to somebody else?  Figuring out whose suitcase is whose can be an especially difficult task when it involves a close family member.  I remember working with one couple where the husband had been diagnosed with Type II Diabetes.  His wife, who was a lovely person, very loyal and extremely competent, once the diagnosis was made, immediately set about researching cookbooks and recipes for how she could change their eating lifestyle in order to combat the disease. She clearly cared a great deal about her husband and he about her.  So why did they end up in my office?   Well, major conflict erupted when to her shock and surprise, she found out that he was sneaking off to the greasy spoon down the street for hamburgers and fries when he was supposed to be eating the paper bag lunch that she had carefully prepared for him to take to work.  I understood why she had taken so much responsibility and poured herself into trying to help him.  She was terrified that he could end up blind or losing a limb or worse still, six feet under far before his time. But how effective can any of us be in helping somebody else to solve their problem if they do not want to help themselves?  And if you take somebody else's suitcase, not only do you get weighed down but you might even decrease the chances that the other person will rally and take responsibility for their life choices!

Now the truth is, some people don't want to take responsibility for their suitcase.  I had one client whose mother would call her every day complaining about this new ailment and that new ailment. If it was not one physical complaint, it was another.  The mother would take up all the air time during these phone calls, seldom coming out of her self absorption long enough to ask the daughter any questions about how she and the grandchildren were doing.  This adult daughter, described time and time again in session feeling pained by her mother's suffering and trying hard to offer suggestions that might alleviate her mother's distress.  My client became frustrated to no end, however, because her mother NEVER followed any of her suggestions.  Therapy can be invaluable in these situations because when you are smack in the middle of a relationship dilemma with someone you love, it is most definitely hard if not impossible to see things clearly.  As we deconstructed the interaction between her and her mother, it finally became evident to my client that contrary to her belief, her mother was not looking for advice and that, in fact, her mother was clearly not unhappy enough to want to make any changes. Her mother's behavior suggested that she enjoyed the attention she got from talking about her problems and was not going to give up this behavior any time soon.  So sometimes, we can get lured into trying to take care of somebody else's suitcase, when in fact they don't want us fiddling with it at all.

There are people who were trained up from an early age to feel responsible for others.  They jump into action to be of service to others without even thinking as if on automatic pilot.  These are the over-responsible people in the world.  Often, situations early in life shaped them to be that way. Perhaps they grew up with a chronically ill sibling that they needed to take care of.  Maybe they wanted to be liked so badly that they were willing to do anything for anybody in order to win approval. Another possible early scenario might be that they grew up with a self centered parent who taught them that to take care of their own suitcase was selfish and that if they wanted to be loved, they had better look after other people's suitcases.   These are the collectors.  They often without realizing it take on other people's stuff. While often others come to see them as the "strong ones" and the ones who will take responsibility and get the job done, these people oftentimes in the end get so overloaded and end up carrying so many suitcases that they become exhausted and may even become totally burnt out.

We are living in an age where too many parents are feeling overly responsible for their children. Some of us have agonized over our children's pain, trying to save them from the disappointment of failure, the trials brought on by a tough economy and the hurts of rejection even though a voice deep inside is telling us we should know better.  In carrying their children's suitcases, some parents have even sacrificed their life savings or delayed retirement.  More scary still are statistics regarding illness and mortality rates that are showing that these parents are compromising their health and longevity by taking responsibility for their children's welfare.  While our behavior may be well-intentioned, the truth of the matter is that when we carry our children's suitcases for them, they do not build the muscle necessary to shoulder life's burdens.  Rather than empowering them, we send them the message that they need us to help otherwise they would not be able to manage on their own. If we want our children to be strong, we need to let our children carry their own suitcases and figure out what's in there.  Parents need to question what is motivating them to take responsibility for their children in cases where their children are able.   As a parent, if you have not dealt with the painful stuff in your own suitcase, it is hard to stand by and hold the fort while your child suffers through whatever hurts, pain and rejection they need to endure in order to learn their own life's lessons.

For every collector of suitcases, there are those who don't want to have to carry or even look at the stuff in their suitcase.  These are the "blamers".  These are the people who do not want to face up to things.  Some are so sophisticated and shifty that they can convince you that you are to blame even when they themselves so clearly have been the culprit.  They will hand you their suitcase over and over and try to convince you that it is your fault things did not turn out well and your job to take care of things.  Anger can be used as a club to instill fear and intimidation.  When somebody is mean, angry or condemning, how easy it is to start to question yourself and ask: "What did I do wrong? How did I make them mad?" If you have lived with someone like this for long enough, more than likely, you have ended up with little self-esteem and a distorted version of who you are.  You get so bamboozled that it becomes impossible to figure out  which suitcase is your suitcase.  Situations of abuse in couple relationships are often this way.  The boundaries get so blurry that in extreme cases the law has to intervene with a restraining order saying: "Don't you dare touch that other person's suitcase!"

And yet, there are many situations that are not so black and white.  Sometimes the person is unable to carry their own suitcase and without assistance, they will end up flailing. I was talking with a friend the other day whose husband was diagnosed with Alzheimer's.  There are many things she has tried to do to help him yet not so atypically, her husband has refused.  What is her responsibility?  Should she persist?  Can she even make a difference as regards how quickly her husband's illness progresses? People differ on this point.  How much will he and other determinants dictate his fate as opposed to anything she may do or say?   How much should she sacrifice her life in order to care for him? Sometimes it is no easy job to determine:  How much responsibility do I take?  What is my suitcase? While some would like to get up on a high horse of righteousness and claim that they have the right answer, what is right may differ for each individual depending on their health, responsibilities, sense of duty and value system. The job of a therapist is not to dictate to people what they should do but rather to help them see more clearly what is right for them so that they can be at peace with themselves.

Sunday, 18 October 2015

Mindfulness: What is it and why do it?

More and more therapists are learning about mindfulness and teaching it to their clients.   Yet, it was not long ago that those of us teaching psychology at mainstream universities, were studying about near eastern practices on the hush, hush behind closed doors out of fear of being labelled flaky. However, scientific research since the late 70's has increasingly proven that mindfulness has multiple positive benefits. Practicing mindfulness can decrease your blood pressure, calm your mind, make you less emotionally reactive, increase your patience, help you to be more accepting and less judgmental, increase your mental clarity, give you greater self control and much more.

What is mindfulness?  Quite simply, it refers to intentionally becoming aware of your present experience. Whether you are driving your car, talking to someone, walking to work or eating a meal, mindfulness means being "fully present" to whatever it is you are doing with all of your senses. In this fast paced world of instant communication through technology, multi-tasking and quick take-out McDonald's service, most of us are either so busy making plans for the future or mulling over the past that we are anywhere but here!  In fact, we are so used to being somewhere else that to learn to be more present requires a rewiring of the brain.  We are learning, though, that the brain is malleable and indeed one can build new pathways if one so chooses. It takes some practice but one can learn to become more present and it need not be onerous or time consuming.  I suggest to clients that they choose some routine activity that they do on a regular basis such as brushing their teeth, taking a shower, cleaning up the kitchen, tucking their children into bed or making coffee in the morning in order to practice becoming fully present for just 2 to 3 minutes every day.  My personal favorite way of practicing mindfulness is this:  Instead of becoming thoroughly frustrated when I hit a red light while driving, I now use those few minutes to drop my shoulders, lean back into my seat and just allow myself to notice the color of the sky, the shapes of the trees, the feeling of the air against my skin, what I am thinking and how I am feeling at that very moment.  "Buddhify" is a fabulous iPhone app that asks:  What are you doing?  It then provides over 80 different guided narratives to assist you in becoming mindful of whatever it is you are doing whether it is waking up, taking a work break, walking in the city, trying to fall asleep, dealing with difficult emotions or waiting around in the grocery store. What is lovely about mindfulness practice is that it allows you to experience the richness of the present.  In doing so, one discovers the extraordinary in ordinary things and life becomes an experience of wonder.

There are a variety of different mindfulness practices that you can learn in order to become more present to yourself just the way you are.  Different practices involve the body, the breath and/or your thoughts.  Whatever the focus may be, the idea is to be able to pay attention to your direct experience with complete acceptance and without judgement.  For instance, you can learn to do a body scan where you tune in to all the different sensations and feelings that are happening in your body noticing wherever there is tension or relaxation.  You can do this with a yoga posture as well or you can walk a labyrinth being mindful of every sensation as you put one foot in front of the other. Alternatively, you can learn to pay attention to your breath as it gently flows in and out at the tip of your nostril. Or you can become an astute observer of your thoughts whether positive or negative, simply observing them and letting them go without investment or analysis. Unfortunately, too many people have been turned off sitting meditation where one tries to observe whatever thoughts are occurring without judgment. This is often because at first it can be very unpleasant to realize how many negative thoughts automatically appear.  This very common experience has sometimes been referred to as "the trance of unworthiness."

In the West, we have discovered that people tend to be quite self critical in their thinking.  In cases where the negative self talk is very intrusive, it can be very helpful to start out by doing more directed mindfulness training.  There are more focused mindfulness practices where one can deliberately focus one's attention on any number of themes including loving kindness, compassion, acceptance, or forgiveness for both self and others.  In addition, any visual image or sound or movement can be used to assist in calling forth particular feelings such as a sense of safety, contentment, relaxation, non-judgement or belonging and then just sitting with these.  Thinking of someone from whom you have felt unconditional acceptance, remembering a sunset, listening to music or focusing on something from your childhood that brought you joy, can all be very powerful catalysts to bringing forth particular thoughts, sensations and emotions.  You do not have to sit still nor do you have to practice for hours in order to reap the benefits of mindfulness practice.   Actually, we are learning that much shorter periods of mindfulness practice can be quite effective and that 8 minutes of meditation, 3 times a week is sufficient to make very significant gains. I always encourage my clients to set small goals at first that are achievable.  If expectations are too high and unreasonable, often one just ends up giving up and feeling inadequate.  All it takes is a few minutes a day and as one client put it: "Even a brief period of mindfulness can feel like a month long holiday for the brain!"

Know that it is commonplace when one starts exploring sitting in silence to feel uncomfortable and to become aware of feelings of agitation and discomfort.  It helps to approach mindfulness meditation with a sense of lightness, warmth, friendliness and curiosity. Mindfulness meditation is a far less arduous process when one can learn to bring not just attention but a caring attention to the process. As a mother lovingly cradles her child, so can one learn to create a compassionate and nurturing holding environment. When one sits to observe one's inner world, a good question to ask is: "How can I be with myself as if I was with a dear friend?"  In order to be effective, mindfulness needs to have heart. Sometimes the feelings that arise may be negative and at other times, positive. The key is to accept whatever the feelings may be just as they are without judgment or over-identification.  The understanding is that only through being present to all of our feelings can we truly experience joy and the richness of life. In Buddhist psychology, there is no separate word for heart and mind.  And so it is...there is as much "heartfulness" as mindfulness in mindfulness practice.

Sunday, 4 October 2015

Are you living with false hope?

They had been friends for years.  Good friends.  There was a a lot they had in common and they understood one another very well.  When Cheryl got upset, though, she would do an inner dive and Pat might not hear from her for weeks.  This pained Cheryl greatly and she still hoped that the day would come when Pat would call her up and reach out for support.

When they had been married, he had invariably put his needs first, giving short shrift to her wants and desires.  He was the major breadwinner and though she worked too, he behaved as if the money was his and expected her to ask before spending while he purchased all kinds of expensive toys without a second thought.  Since their separation, she had hoped that he would be fair and collaborative in dividing up the assets.  She was terribly distressed when she found out that he had no intention of trying to work collaboratively and showed no willingness to make the division equitable.

Her adult son had always been rather self centered and often forgot important birthdays and holidays. Nevertheless, the mother always put a great deal of effort into choosing gifts for him and hoped that the day would come when her son might surprise her by showing up with a card or present without having to be prompted or reminded.

She knew that her Dad wasn't much good at giving warm fuzzies and that he had very high expectations and seldom gave compliments.  Nevertheless, she worked tirelessly to gain his approval, often getting the highest grades in the class in addition to performing incredibly well at sports. Despite her desperate attempts to win him over, more often than not his response was to find the one flaw in her performance or to ask: "And where did you lose the other 2 per cent?"  Knowing this, she still felt disappointed each and every time he failed to acknowledge her successes.

They had gone out on several dates by this point.  Most of the time, she had talked about herself and seemed oblivious to the fact that she had shown little if any interest in him.  He was very attracted to her and listened attentively to all she had to say.  Though he felt empty and rather invisible by the end of each encounter, he told himself that next time she would be different and that she probably was just nervous.  After all, a girl like her had to have a caring, sensitive side.  

There is good hope and bad hope.  It is good to be positive and  to think the best about people. However, when despite all evidence to the contrary, we still cling to the idea that things will be different, we have become enamored with "false hope" and are headed for trouble.  In relationships, it is so easy to get caught in the trap of hoping that someone you care about will be different and change. Unfortunately, this is a wicked kind of denial and results in incredible disappointment in the end.  If anything, people are who they are and more often than not, people are consistent. Hoping that someone you love will be different next time, is not only unfair to them, it just sets you up for a nasty fall.

Sunday, 20 September 2015

How to say hello/goodbye to your therapist?

Now and again, a client has come for an initial interview and the dialogue has been so profound that the memory of it has remained imprinted on my brain.  The following was one such occasion: A very bright and enthusiastic young woman began our conversation by sharing with me what she had been doing to prepare for our first session together.  Among other things, she commented that she had read a book that had proven to be very helpful.  With genuine curiosity, I asked, "What was the title of the book?" Her reply was: "How To Say Goodbye To Your Therapist".  I looked at her quizzically and remarked, "But we have just met!" She then proceeded to explain to me that according to the author/therapist of this book, how one says hello, has all and everything to do with the kind of goodbye the person anticipates.  While memories of former goodbyes may remain unconscious, nevertheless, they have impact.  For example, if former relationship endings with people of significance have been painful or difficult, chances are that the person will enter into new relationships with considerable caution or they may not even enter at all!  Traumatic endings, such as early experiences of rejection or abandonment, can wreak havoc with one's relationship life. New beginnings may be avoided or it may take a great deal of time before the person opens up.  After all, if you don't get in too deep, it's not likely to hurt so bad when the relationship ends.  

I was sharing this information the other day with a client of mine whom I have seen for some time. Her relationship with her mother was harshly ruptured in her late teens when her mother left the family abruptly and soon after moved to another city.  To this day, feelings towards her mother remain unresolved and this painful early life experience has proven to have enormous influence on her capacity for closeness with others.  Relationships with others generally have remained pretty distant and superficial.  Her own feelings are often blunted and she does not let people in too deep. In new social groups, she is slow to enter into conversation and it can take several encounters before she connects with people.  She never felt like she was enough for her mother and consequently remains terrified that if anyone really got to know her that they would head for the hills!  Some internal voice is relentless in trying to convince her that nobody would be interested in her and that if they were, she would not have much meaningful to say anyway.  In romantic relationships, she has chosen men who do not like to talk about feelings and they seldom ask questions about her which suits her just fine. Her choices allow her to keep her own feelings at bay and to feel secure in the walls that she has erected to ensure that people do not get in too close and personal.  Goodbyes can refer to so many things...the end of a trip, graduating from school, losing a pet, relocating cities, completing a team project, launching a child, etc.  Endings are inevitable in life and whether you are aware of it or not,  the ending you anticipate often colors the way you will enter these experiences.

One of the gifts that therapy has to offer is a chance to do things differently when earlier life experiences have been difficult.  When this happens, tremendous healing can take place.  A good therapist is reliable, attentive, and non judgmental.  A climate of safety is created so that an entirely different kind of joining and ending can be experienced.  Ending therapy is a whole new opportunity to address struggles in former goodbyes.  It can allow a client to have an experience of saying goodbye that is mutually agreed upon, conscious and feels right.  Such an experience can heal old wounds and make for more intimate and meaningful beginnings.

Sunday, 6 September 2015

What is CBT?

Nowadays, chances are that if you have been diagnosed with depression or anxiety by your G.P. and she encourages you to seek counselling that she will suggest you go to someone who does "CBT". What is CBT and why do many people see it as the treatment of choice for these kind of psychological problems?

CBT is an acronym for "Cognitive Behavior Therapy".  It refers to an orientation used by therapists from a variety of backgrounds that involves helping people to change how they feel by assisting them in changing their thought patterns.  The assumption of this way of working is that the way you feel is very much a product of the way you think so if people can be taught to change their thinking then this is one very powerful and effective way to feel better. Psychological research with tens of thousands of subjects has taught us that people who are depressed or anxious tend to think in ways that are distorted and that there are forms of "twisted thinking" that are identifiable and common to those who suffer from problems with mood. For instance, people who are anxious tend to catastrophize and magnify the negative in situations.  They also tend to make negative predictions by fast forwarding into the future and imagining worst case scenarios .  On the other hand, people who are depressed are good at discounting the positive and focusing in on the negative feedback that they receive; they also tend to be harshly self critical and personalize blame.  Outcome studies have provided scientific support for evidence that CBT is an effective treatment for anxiety and depression. The premise of the approach is that by teaching people what we have learned about the types of distorted thinking patterns that negatively affect mood, they can more easily notice when these are occurring and learn to modify the things they say to themselves so as to feel better. To achieve this, however, people first need to learn how to become good observers of their own thoughts.

There are many who do not realize that there is constant mind chatter going on in their heads. The only time they might become aware of these internal voices is on long distance car rides or right before falling asleep when it is so silent that these internal thoughts become starkly apparent.  Those who grew up in cultures where meditation has been a part of daily life know that the mind is always filled with chatter and that what these internal voices say should not necessarily be accepted as truth. These ideas, however, have only recently been introduced into the mainstream of Western thinking through the contemporary surge of interest in Buddhism, yoga and meditation.  Up until recently, Westerners have been so identified with their minds that most people do not question what they think and in fact have believed that if the mind thinks it, it must be true.  Only recently have we come to realize that the mind has all kinds of masterful ways of distorting reality and that as one young blogger so bluntly put it, when you are depressed, the mind lies to you!  I worked with one older man in his 70's who had suffered social anxiety all of his life.  This is a condition where the person often fears that others are watching them and scrutinizing them with a critical eye.  At the end of therapy he said to me, "I cannot believe that in all these years up until coming to see you, nobody ever explained to me that just because I have a thought, does not mean it is true!"

You do not have to be depressed or have an anxiety disorder to benefit from learning to correct negative thinking and to shift to a more balanced, rational, positive view.  We all have internal voices that can take over and make our lives miserable.  Some examples of these negative voices are: "the critic", "the worrier", "the victim" and "the perfectionist".  Imagine these parts as characters sitting at a boardroom table in your psyche.  When the critic takes over, all you hear about is how you screwed up and what you should be doing differently.  If the critic was able to give constructive advice then it could be useful. Unfortunately, these parts that lead to distress are uni-dimensional and have a single focus.  The critic only knows one thing and that is how to criticize.  If the critic has you in its clutches, there can only be one result and that is, you feel terrible.  Thank goodness for all of us, the psyche is also balanced with positive parts such as"the supporter", "the nurturer", "the cheerleader" and "the optimist".  Even "the objective observer" is a welcomed voice when "the critic" has been ruling the roost!

It would be impossible for anyone to be constantly tracking their thoughts.  Fortunately, there is an internal guidance system or signal that lets us know when negative thought patterns have taken over. It's simple really.  All you have to do is be tuned in to your feelings.  When you feel bad, this is your cue to begin to examine your thinking.  A good question to ask anytime you find yourself feeling negative emotions such as depression, anger, anxiety or hopelessness is: "What am I saying to myself?"  This is what people who do CBT teach their clients.  Psychologists teach people how to stop and try to identify what's going on in their thought system whenever they are feeling bad and to modify these internal thoughts with more balanced, rational thinking.  CBT is not learned over night. When you think about it, there are hundreds of thousands of hours of tape time in your head filled with negative ways of thinking.  These thoughts now happen automatically and have created well- traveled deep ruts in your brain.  To turn around thinking takes conscientious work.  Often clients are taught to use thought records when they are feeling bad which are written recordings of the thoughts that have triggered them into distress.   They are then asked to formulate and write down alternative thoughts that are more realistic and balanced.  It seems that the most significant change takes place when people do these written exercises and write their thoughts down.  It keeps the thoughts from remaining hidden and under the radar. Writing makes the thoughts conscious so that they are easier to spot, separate from and modify. While doing thought records takes work and commitment, the rewards can be far reaching. It is amazing to witness how within 4 to 6 months of diligent effort, people can change the way they have been thinking for 20, 30, 40 and sometimes 50 years.  It is well worth the effort and never too late to change the way you think and ultimately the way you feel!  

Sunday, 9 August 2015

How to heal from betrayal?

If you have been hurt badly, you may find that you have a hard time trusting others.  Betrayal can hurt deeply and it can take a long time to heal after you have discovered that someone you cared about deeply has betrayed you.  Following this kind of trauma, it is easy to think that perhaps you had it all wrong; that maybe there are not as many people out there capable of being trustworthy, reliable, true to their word, faithful and loyal.  As a result of such injury, the lens through which you see the world may have shifted radically.  Having been a person who tended to see the good in others and the world, you may now be a skeptic, wary, more reclusive and full of caution.  While visiting this place for awhile may in fact be an inevitable part of the journey of dealing with and healing from betrayal, it is not a fun or healthy place to hang out for the long-term.  Yet, how does one get unstuck and find a way out of such a quagmire?

The Taoists had it right.  The reality of the world is that there is good and there is bad; there are those who can be trusted and those who cannot.  The world is not black or white.  It is grey and none of us are immune from having negative encounters no matter how smart or insightful we are.  I have spent thirty seven years of my life studying relationships and I have to say that despite this, I am not always accurate in my assessment of people.  It takes time to get to know someone and it becomes even harder if they do not know themselves.

One of the ways people get stuck in healing from betrayal is by adopting the view that people are untrustworthy and that the world is a dangerous place.  In the long-term, this attitude is a formula for resentment, bitterness and loneliness. Another way people get snagged is by blaming themselves for what has happened. While it is important to do some sort of review when things go wrong and to learn from life's experiences, it is also vital and humbling to recognize that bad situations cannot always be foreseen. We want to believe that the world is just and that bad things do not happen to good people. However, this is a child's way of thinking and simply not true.  Life is not conflict free and in the end we all inevitably face challenges and betrayal of one sort or another. One way of holding on to the myth that negative life experiences can be avoided is by ruthlessly blaming oneself. You might wonder: Why would anyone want to add salt to injury by blaming themselves?  Is the pain of betrayal not enough? Well, believe it or not, while painful, such thinking also has an upside. If you are to blame for bad things that happen, then you have the power to prevent them from ever happening again.  The wish for a secure and happy future can be so strong that we are willing to suffer self recrimination to sustain such a dream.  Not unlike the rape victim who maintains the belief that if she had only dressed differently, the event would never have happened, we find some flaw in ourselves to explain painful life events in an effort to feel less vulnerable and to have some sense of control over our future.

Unfortunately, life is difficult and painful events are inevitable.  Just as people in the world are neither all good nor all bad, so it is that life experience brings both the positive and the negative.   Re-calibrating from a painful encounter means being able to see reality for what it is and recognize that you are not immune to ending up in negative encounters. Sometimes, people's actions are predictable but at other times, their behavior just comes out of left field with no warning.  Learn what you can from the experience but do not take on the blame for something that is not yours.  This can only inevitably end in self harm and low self esteem.

There is a well kept secret here that I want to share. When you have been betrayed, while it may seem that the issue you face is whether or not to trust others, such is not the case.  There will always be those who are trustworthy and those who are not.  The trust you need and the trust that matters most in order to heal from betrayal is the ability to trust yourself again.  Life will always challenge you with difficult and unpredictable situations. The only true security and healing lies in having renewed faith in yourself that whatever life brings you, you will deal with it.  Take a look.  Whether you realize it or not, you always have dealt with it!

Sunday, 12 July 2015

What does a panic attack feel like?

You can look up all kinds of definitions but they won't tell you what it feels like inside to have a panic attack.  To gain the slightest sense of it, you need to be willing to listen (and I mean really listen) to someone who has gone through it.  So many of my clients who have suffered panic tell me that what makes it hard is that significant others and loved ones do not understand what they are going through. As a result, despite the best of intentions, friends and family end up saying things that make things worse, not better.  Telling somebody who is prone to panic not to worry is about as effective as saying "Don't think of a pink elephant!".  It only adds salt to a wound because people who panic know in a tiny part of their brain that what they are thinking is irrational.  The problem is that in the midst of panic, it is the fight or flight part of the brain that has become activated, and once that happens, life and death thinking takes over.

Having a panic attack is a terrifying experience.  It is awful to feel like you have been rendered helpless and totally out of control in the face of what your mind and body are doing.  Everybody is different but some body symptoms include palpitations, sweating, shaking, shortness of breath, chest pain, disorientation, lightheadedness, feelings of unreality and out of body type sensations.  It is not uncommon for people having a panic attack to feel like they are going crazy or that they are going to die.  The feelings of dread can be so powerful that some people literally throw up. Perhaps the worst part is that attacks are most often unpredictable; they come out of left field, with no trigger or warning.  No wonder fear often fuels fear and people can begin to panic because they anticipate that a panic attack is just around the corner.

The aftermath of a panic attack is no fun either. Physically and emotionally, panic attacks are exhausting.  The body has gone on emergency thus draining itself of all resources. It can take days for the person to recover and feel like herself again.  The best way to describe it is to imagine what it would feel like if you literally had been in a life and death situation.  For example, what would the aftermath feel like if you were caught in a house that had suddenly gone up in flames? Imagine how exhausted you would feel if this happened to you everyday, let alone several times a day!

Over the last twenty years, psychologists have learned a lot about how to help people prevent panic attacks from occurring.  As much as people might like it to be so, it is seldom an overnight cure. Most people who suffer anxiety attacks have knowingly or unknowingly experienced a pile up of stress over a long period of time.  It is not surprising then to learn that to undo this takes work, time and commitment.  So the next time somebody close to you tells you that she suffers from panic, don't make the mistake of thinking that you have to try to fix it.  Just listen carefully and try not to dismiss or minimize what she is going through.  The last message that she needs to hear is that she is being a baby, irrational or simply not trying hard enough.  Ask her what she needs for support. Everybody is different and they are the best judge of what can be helpful. Some people just want to be left alone. Others feel reassured when someone else is there and can be calm. Sometimes, all the person needs is to know that you care while she rides through it doing the best she can.


Sunday, 21 June 2015

When can persistence be negative?

When you hear the word "persistence", it is hard to think of anything but something positive.  "She was persistent and so she got the job"; "He knows how to persist when times get difficult".  Yet as is the case with all traits, a characteristic is neither positive or negative in and of itself.  Whether a trait is positive or negative depends on degree and context.

Recently, therapists have coined an interesting term, "negative persistence".  Needless to say, it refers to situations where a person keeps plugging away at something despite the fact that doing so has become hurtful.  For some of us, being tough minded has been such a strong survival trait that we may not be aware when pushing ahead is backfiring.  Perhaps the most salient example of this for me as a therapist was when a client of mine so badly wanted to be close to her brothers that she was willing to do anything to win them over.   Their dad had died recently and the will had created a rift which had made it even more important to her to be able to reconcile these relationships.  Yet her brothers who had never really given her the time of day, would disregard her calls and texts and when she was finally able to talk with them, they would put her down in the worst possible ways, discounting any positives that she shared from her life. Accepting that people in our lives whom we love are simply not interested in connecting is terribly painful.  This is an easy situation in which to keep trying despite hitting up against a wall of concrete.

We have all had the experience of persisting in situations without realizing that it was not the best action to take.  Common examples are:  trying to get a teenage son to keep his room clean; working overtime trying to please your boss, your mother or your father when they simply are not able or willing to give you what you are looking for; trying to warn a friend that the guy she is seeing is bad news; refusing to give up on an argument because you know you are right; or trying to persuade your daughter that her friendship circle needs changing.  In all these cases, pushing too hard can come back to bite you. Persisting just creates a tug of war between you and the other person and damages the relationship. The First Nations people call this: "creating bad medicine".

What makes us keep pushing when it would be far wiser to simply let go?  If you take a look at times you hammered away refusing to stop, you might just find out that the culprit was fear.  Fear can get us to do all kinds of foolish things without thinking. The wise mind takes a vacation and you are on automatic pilot.  To cease engaging in negative persistence, one has to have the courage to stop and face the fear that fuels it.  This can be uncomfortable for sure, however, the price to be paid for not visiting your discomfort is often not only disconnection from yourself but a disconnect from someone you love.  

Sunday, 7 June 2015

What is depression in normal language?

Why would I write an article on depression?  After all, doesn't everyone know what it is and if you don't, can you not just google it?  I decided to write an article about depression because so many of my clients have told me how frustrated they are that close friends and relatives do not seem to understand what they are going through.  Somehow, the clinical descriptions do not do it justice so I figured I would give it a shot using language everyone can relate to.

Too often, people make the mistake of thinking that depression is about feeling sad.  As one of my clients so succinctly put it: "People did not seem to understand.  I was not sad.  When I got depressed, it was more like someone turned a switch, the lights went out and I simply could not function.  I had no energy, no motivation and nothing seemed to matter anymore".   Another client described it this way:  "Being depressed is a lot less about sadness and a lot more about feeling oppressed, trapped, and cornered without any hope of getting out". The word depression is so often used colloquially to mean just feeling down.  As a result, many people who come to my office depressed do not realize what's happening or don't identify themselves as being depressed. Part of it is that clinical depression is much more than just feeling blue but also the nature of the beast of depression is that when you are in it, you may feel so numbed or in the pit, that you don't realize what is happening to you.  As they say, sometimes you do not know you are in darkness until the sun starts shining again!

When I have diagnosed people as depressed, some clients have said: "The notion that I was depressed, never occurred to me.  It was not as if I couldn't get up in the morning". These people have often had a parent or relative who were so compromised with depression that they could not function at all and this then became their idea of what depression looked like.   However, you do not have to be completely unable to mobilize in order to be diagnosed with clinical depression. You may still be able to function at your job or take care of your kids though not at optimal capacity.  Aspects of day-to-day functioning do become impaired.  Basics such as sleep, energy or appetite are often out of balance in some way.  While depression can show itself differently in different people, one of the surest signs of depression is a lack of energy and loss of interest in things that ordinarily have been stimulating and satisfying in the past.  Energy is so low that getting through a day may feel like walking through mud from the waist down. People who are depressed invariably withdraw from those around them because they are too preoccupied; they don't have the energy to give to others; or simply feel so negative that they know they would not be good company.

There are big individual differences in how people experience depression.  Some people become highly anxious when depressed even to the point of having panic attacks (often referred to as "agitated depression") while others may not experience much anxiety at all.  Some people experience strong bodily symptoms such as headaches, stomach upset and aches and pains. Men often show depression differently than women. Socialization plays a role in how depression manifests itself. There is more permission in our society for women to cry so they are more likely to become teary while men are more likely to become irritable and angry.  Both genders usually find themselves far more emotionally reactive and less in control of their emotions than they would like. What some people do not realize is that clinical depression not only effects the body, behavior and mood but also thinking. When depressed, you may have problems concentrating; you may forget things easily and become easily preoccupied and distracted.  Even processing information and fully registering what someone is saying may be difficult. Attention is turned inward and thinking often becomes obsessive; thoughts can spiral into repetitive endless loop tapes.  Needless to say, when you are depressed, it is hard to be present.

Depression can be brought on by a negative life event (sometimes referred to as "situational depression").  More insidious and hard to identify is when it is brought on by an accumulation of stress over time.  People with a biochemical tendency to depression may not be able to pinpoint any external stimulus at all that brought it on.  Becoming unstuck is not an overnight affair and often takes considerably longer than people realize.  It can take a year before you feel like yourself again. One of the things that we know for sure is that if your symptoms are serious enough to warrant medication, then for long term success, it is very important to do therapy as well.  This makes sense as the medication may be able to re-calibrate your biochemistry but it will not help you to find out why you feel in such despair nor will it help you to learn better coping skills.


Sunday, 24 May 2015

How can I stop being so judgmental?

Is there anybody out there who can honestly say that they have never been harshly judgmental?  I thought not.   Welcome to being human!  Being judgmental is an easy way to protect yourself when you are feeling raw and vulnerable.  It does a great job of pushing others away when you feel threatened.  Good defenses are nothing to be ashamed of.  You are not in control of these automatic pilot reactions anyway.  They kick in unconsciously, protecting you from perceived danger whether you request them to or not.  However, once you become conscious of what you are doing, you can get into the driver's seat.  Awareness of when you are being judgmental can allow you to modulate it and to detour quickly when you find yourself going there. This is good to know.  Why?  Precisely because while being critical may momentarily feel good as it allows you to puff yourself up and feel superior to another, it can have devastating long-term consequences.  When you are judgmental too often, too much of the time, this can fuel negativity, isolation, resentment and bitterness. Furthermore, it is not a long-term cure for insecurity.  So how does one head off criticism at the pass before it makes you into a curmudgeon?  Getting in charge requires first understanding how criticism works.

The first thing to understand is that harsh criticism is a form of self protection and that you use it, not necessarily because someone else is lacking (though they may be) but because you feel threatened in some way. If you feel confident in yourself, there is no reason to be brutally critical of another. Many people make the mistake of thinking that if someone has criticized them, it must mean that there is something wrong with them.  They get all bent out of shape when someone finds fault with them and they wonder what they did to deserve such disapproval.  The psychological truth, however, is that being on the receiving end of criticism does not necessarily mean you did anything wrong.  In fact, negative judgments reveal much more about the giver than they do about the recipient.  If when walking down the street, I think to myself, "That woman could lose a few pounds", actually you know little about her but a lot about me.  She may be overweight and then again she may not.  What you know for sure though, is that I am a person who has issues about weight.  If you are out shopping with a friend and start thinking to yourself, "She sure does spend money frivolously", believe it or not, what we know is that money is an emotionally charged issue for you.  If you see a guy at the gym and you think "He sure could work out more", we can deduce that in your world, being fit is a priority.

It is important for people to look at their own judgmental behavior and see it for what it is.  Criticism operates as a potent protective device because it makes the criticizer feel powerful and pushes the other person away, keeping them at a safe distance.   Being able to modulate criticism of others means acknowledging that you feel threatened, figuring out the source and finding some other way to cope with the vulnerability that has been triggered.  The causes of harsh criticism can be varied and are often unconscious. For instance, you might become critical of another person because you feel envious of them.  They may have achieved some success that you wish you had or they may have positive qualities that you feel deficient in.  Then again, unwarranted criticism can be caused by perfectionism which leads to unrealistically high standards of others and the assumption that they are somehow lacking.  Negative stereotyping is another underlying cause of judgmental behavior. Ignorance and prejudice can lead to extreme criticism and sometimes even hatred.  Lastly, you might discover that you have become judgmental of another because they mirror back to you some quality that you dislike in yourself.  In some spiritual circles, a tool for coping when you find yourself harshly criticizing another is called: "using the other as a mirror".  It means taking back what you have attributed to someone else and trying to understand what button has been pressed in you.  Examining how your criticism of another may be due to seeing in them some quality or issue that you find disturbing in yourself, can be a very powerful tool for self growth.  To do this, however, takes much more courage than bad mouthing someone else!

I was in a therapy group once of about twenty-five people.  Few of us knew one another and we were thrown together for 21 days for the purpose of learning about how we related to others.  In such a setting where no one knows one another, it is normal to be attracted to some personalities and turned off by others.  At the start of our experience, we were told by our group leader to pay particular attention to whoever in the group irritated us the most.  While many of us had difficulty believing it at the start, we were told that this person could probably teach us more than any other participant. Why?  As the group unfolded, many of us discovered that the person we clashed with the most, was also the person who reminded us of the qualities we least liked in ourselves.  So pay attention to the people in your life who irritate or repel you and you could learn more than you bargained for!  Also, when that inner critic goes on and on preying on some real or imagined flaw in somebody else, consider finding out what button has been pressed in you rather than getting caught in the quagmire of negativity.  In the end, judging others really is about our own insecurities and feelings of inadequacy and we can all benefit from understanding that and working to root out judgmental behavior whenever it rears its ugly head.



Sunday, 10 May 2015

Do you believe in a just world?

Some people end up in a therapist's office because an unexpected negative event happened in their lives that they were thoroughly unprepared for and it led them to feel like the rug had been pulled out from under them.  Maybe they got laid off from a job without warning; maybe someone complained about them professionally or worse still, charged them with a crime they did not commit; maybe a partner dumped them without warning; maybe an unexpected law suit landed at their door; maybe they became seriously ill; or maybe they just got so overextended at work that they ended up totally burnt out. The comment that I often hear from people faced with such situations is: " I really thought that if I was a good person; that if I worked hard, followed the rules and was honest, that things would work out for me. What happened?  Why me?"

Many of us don't realize it until some unfair misfortune happens to us but we are inclined to believe that the world is an orderly, predictable and just place where people get what they deserve.  That is, we tend to believe that noble actions are eventually rewarded and evil actions eventually punished. This commonly held (often unconscious) belief has been referred to by social psychologists as the "just-world hypothesis".  It makes sense that we would want to believe in a just world as it gives us a sense of control and security to think that we can influence what happens to us in predictable ways. We want to believe that if we do good that good will come to us.  Moreover, to justify this belief that life is morally fair and that consequences are fitting, we also tend to go so far as to tell ourselves that when misfortune happens, the person must have deserved it. Such thinking can easily result in blaming the victim.  Perhaps the most striking example of desperately clinging to the belief in cosmic justice at any cost is the rationalization that the rape victim must have been asking for it.  Otherwise, how scary is it to have to face that your wife, your daughter, your mother are all at risk of the same traumatic event happening to them no matter what precautions they may take?

It is often just a matter of time and life experience before life teaches us that such cause and effect does not match reality.  Just because someone has been accused of immoral or unethical behavior does not mean that they necessarily did anything wrong.  Similarly, just because you work hard and play fair does not mean that everybody is going to play fair with you.  As Rabbi Harold Kushner tells us in his book called "When Bad Things Happen to Good People", we only co-create our universe. Yes, by all means we influence how our lives unfold.  However, random acts of misfortune also happen.  In his own case, his three-year-old son was diagnosed with a degenerative disease causing him to age prematurely and die in his early teens.  What Kushner tells us is that rather than seeing events that happen to us as necessarily a result of our goodness or badness, we need to realize that lightening can strike anywhere and that the true measure of our worth actually shows itself not in what happens to us but in how we cope when bad things happen to us.  This is where therapy can be invaluable.  As a facilitator of people's growth, I thoroughly believe that breakdown can be break through.  I have seen again and again how people who have been the victim of misfortune with guidance and support can turn that negative into a positive by learning to cope in a way that makes them stronger for it.  I am not trying to sugar coat things here.  There is no question about it. Shit happens.  When it does, though, the nicest thing you can do is turn it into fertilizer!  I had a mentor once who called this phenomenon of turning misfortune into opportunity, "white magic".  Needless to say, she taught me a whole lot.

Sunday, 26 April 2015

How do I know whether I am helping or enabling?

I can't tell you how many clients have asked me this question!  Clients who in all sincerity wanted to help a son, daughter, husband, mother or friend, only to discover that they were fueling the very problem they were hoping to eliminate.

The word "enabling" initially emerged from the literature on alcoholism.  It was used to describe situations where the spouse of an alcoholic in a desperate attempt to get their partner sober, would try everything from lecturing to searching the house for bottles to pouring the alcohol down the drain.  It was discovered that rather than decreasing the drinking behavior, more often than not, it exacerbated their partner's drinking.  The addict simply became better at lying, sneaking around, hiding bottles and covering their tracks.  Why?  Well, think about it.  I have yet to meet someone who liked being controlled.  So, when someone tries to control us, the instinct often is to fight back.  In fact, the addict can become so focused on being angry at their spouse for "nagging" and trying to control them that it becomes a great distraction from them having to examine for themselves how self destructive their behavior is.  The war with their partner consumes them and as a result, they don't have to come up against their own internal struggle. Similarly, a mother who hounds her 16-year-old son to study, may find that he is so caught up in being angry with her for getting on his case, that he hasn't really considered whether it is important to him if he graduates high school or not!

Nowadays, the word enabling can be used to describe any interpersonal situation where attempts to "help" only make the problem worse in the long-term because they allow the other person to refrain from taking full responsibility for their behavior.  Enabling can take many forms.  It can involve bailing someone out, making excuses for their behavior, lying for them, trying to fix the problem for them or colluding in denial and pretending that the problem does not even exist!  One of the most vivid examples of enabling that I can recall from my practice was working with a middle aged couple where the husband had recently been diagnosed with Type II Diabetes.  The husband had taken the news quite casually, whereas, the wife was beside herself with concern about the very real potential medical complications (e.g., blindness, loss of limbs, coma) of not controlling the illness.   In reaction to her husband's failure to take steps to address his condition, she researched the illness, bought cook books, diligently prepared meals for him and started him on a rigorous discipline of healthy eating.  A crisis erupted in their marriage, however, when she found out quite by accident that her husband had been frequenting the greasy spoon down the street for their fabulous burgers and fries!  The wife though very intelligent, was unable to accept that until her husband was motivated to address his illness, proper management of his condition was unlikely to happen.  Overcome by her fear of losing him, she could not resist continuing to try to control his diet though she knew intellectually that doing so was a lost cause.

How do you know whether you are helping or enabling?  Well the best yardstick to use prior to offering "help" is to ask the question: Is the other person able?  Simply put, helping is doing something for someone that they are not capable of doing for themselves.  Enabling is doing for someone things that they could or should be doing for themselves.  If the person cannot help themselves, it makes sense to intervene and offer assistance.  If, on the other hand, the person is perfectly able to act on their own behalf, then they have their own reasons for refraining and pushing the river is more likely to lead to rebellion than to compliance.  Ask yourself, "Does this person need help or do I think she needs help?  Sometimes, what you want for someone you care about is simply different from what they want for themselves.  It can be hard to get out of self righteousness and accept that there is no right or wrong, just opinion.  It is much more difficult, though, when the other person's behavior is clearly self destructive as is the case with addicts of any kind.  It can be very hard to stand on the sidelines and watch while someone you love self destructs. It takes enormous strength to keep on loving them and yet not try to control their behavior.  Feelings of helplessness and fear can drive us to engage in some pretty crazy behaviors.  When someone you love challenges you to have to stand by while they do things to harm themselves, know that there is no shame in seeking out help from a qualified psychologist.  This is one of the most heart breaking and difficult life situations to manage. There is no need to have to do it alone.

Sunday, 12 April 2015

Are you a parental child?

When you were growing up, did you often feel like you had to be the "responsible one", the "good child", "the reliable one", the one that could be counted on to take care of others and to do "the right thing"?  Did you have to look after younger siblings in fundamental ways such as getting them dressed in the morning? making them meals? getting them to school and ensuring they went to bed on time?  Did you find yourself worrying about adult-like things like whether or not there would be enough money to pay the bills or whether or not your parents would make it home safely at night? Were you at home tending to household chores or working a part-time job while other kids were outside playing without a care in the world?  Were you the teenager that always volunteered to be the "designated driver"?  Did you feel responsible to make sure that other kids made it home safe and sound?  Did you seldom feel that there was anyone that you could turn to for guidance or support?  If some of these things are true for you, then you very well may have been a parental child.

Family systems theorists have observed that when parents for whatever reason (e.g. alcoholism, domestic violence, mental health problems, physical disability or recent immigration) are unable to fulfill their duties as parents, oftentimes, one of the children (often but not always the eldest) will step into the parental role in order to fill the void.  It is instinct, unconscious and a matter of survival.  If I can take care of my parent(s), then maybe, they will be able to take care of me.

Parental children bring into their adult lives some wonderful strengths.  They often take on strong leadership roles.  People rely on them because they get the task done and are reliable.  Often they are excellent organizers and good at taking care of others.  Working as a therapist, though, I am also aware that parental children face losses and challenges and need support to contend with these. For example, they do not easily ask for help because it simply is not in their repertoire.  Their experience is that people count on them, not vice versa.  However, once in the door and able to accept guidance, parental children work hard in therapy as they often have in life.  Furthermore, one would think that being "super responsible" (a term used to describe feeling overly responsible for others) means that parental children know how to take care of themselves.  However, this is often not the case.  In fact, the focus on others' needs often leaves the parental child ignorant of her own wants and needs.  An important piece of her therapeutic work may well be learning how to identify and address her own feelings and building a more solid sense of self.  Parental children often have to face real sadness about what they missed growing up.  Many do not know how to play because they never experienced much of that as kids.  Often being able to be carefree and spontaneous was and still is beyond their realm of experience.  They are serious adults who do not know much about how to be light-hearted. They often worry far too much.  

Many of the parental children that I have worked with in therapy have had to learn basics that come naturally to others like: how to receive from others, how to be gentle with themselves, how to tune in to their own needs and how to relax and have fun.  As adults, we tend to do what is familiar, not necessarily what is healthy.   We tend to lean into the familiar and go with what we know.  It requires awareness and mindfulness to stop operating on automatic pilot and fill the holes of what has been missing in order to attain balance in our lives.  While working with parental children has often meant helping them to navigate through rough waters of anger and loss, it ultimately freed them to create a life that was truly theirs, rather than one based almost exclusively on service to others at the expense of self.

Sunday, 29 March 2015

Have you become a human doing?

I had a client once who when asked what had prompted her to call me said: "I am here because I recently realized that I have become a human doing and I want to be a human being."  As her story unfolded, she talked about how she had become sick with a chronic pain condition which gradually took over her body and her life. She described how as she increasingly lost function, the warrior in her had presented itself each and every step of the way.  She had begun as a successful singer. When she could no longer sing, she played music; when she could no longer play music, she taught; and when she could no longer teach, she began to help those less fortunate than her.  While listening, I was awed by her courage and resilience but, then her story took quite a turn.  She said that she only began to see the flaw in the tapestry of her life when her capacity to function became so compromised that there were few options for achievement left.  She related it was at this point that she finally had an earth shattering realization: she had lived her life functioning more like a machine than a human believing that without the ability to do and achieve, she was of little worth.  

While most people do not reach this point of crisis, many of us are on the treadmill of life, thinking that we have to be productive, otherwise, we are of little value.  Busyness and performance have become a way of life.  As one client who works as a civil engineer put it:  "I live my life at such speed that there is no margin for error.  I have no room for a flat tire in my day."  We are living life as fast as we can and in the process missing out on huge chunks of it!  Without any time to sit still, think and reflect, we have effectively eradicated any feelings of discomfort.  However, in the process, we have also blocked out any sense of joy.  Being productive and achieving can bring great joy and self-esteem.  If it defines you, however, it can be deadly.  Make sure you have time to just be.

Sunday, 15 March 2015

What is willful blindness?

I remember when I first moved to Winnipeg, Manitoba, standing in minus 43 degree weather at the bus stop with tears streaming down my face wondering how it was that I could have moved to this god forsaken city!  Every year it was the same old story. Winter would come...I would get furious and yet I would still put on my flimsy Toronto parka, boots with no lining and a tattered, cotton crocheted scarf.  For years, I lived in the fantasy that Winnipeg was merely a short stop on my way to some other destination and that it was just a matter of time before I would find work in another city. It took 6 to 7 years of living here before I finally went out and bought myself a top of the line North Face parka and Sorel boots.  Boy was I shocked to discover that in fact with such clothing, Manitoba winters were more than tolerable!  As I worked as a therapist with people over the years, I learned that I was not alone in my masterful ability to go blind to what I did not want to see.  Unlike denial which sneaks up on you out of your unconscious, willful blindness is a very deliberate knowing and then choosing not to know.  As one of my clients so beautifully put it: " I looked out the window, saw something I did not want to see and then closed the curtains."

Cynthia put on nearly 60 pounds in about a 14 month period.  Though most of her wardrobe no longer fit, she wore the few items that she could, refused to buy any new clothing and was so divorced from her body that she hardly was aware of the extra weight that she carried.  Every now and again, she would catch a glimpse of herself in a mirror and she would be shocked at her own reflection but it was not long before she simply blocked the image from her mind and proceeded to pretend that everything was just the way it had always been.

Norman knew that his wife was likely having an affair.  She would call to say that she had to stay late at the office once again.  He would look after giving the kids dinner and putting them to bed and would talk with friends about how committed his wife was to her career.  It was just too painful for him to face the fact that his marriage had ended years ago.  He simply could not let go of the dream of the intact family that he had always wanted.  His own upbringing had been riddled with domestic violence and substance abuse and all he ever wanted was to have a real family of his own where life was safe and normal.   

Sam had applied for dentistry four times already.  He was preparing to do so for a fifth time when he came to see me.  This was the case, even though he knew that he did not have a high enough GPA to be accepted into the program.  He simply could not imagine what it would mean if he did not become a dentist.  His father and his father's father had been successful dentists. Everybody in the family expected the same of him and without that as a possibility, the future was a blank slate, impossible to face.  

Wouldn't it be wonderful if choosing not to see meant that our problems would disappear. Unfortunately, this is rarely if ever the case and this is why any good psychologist will try to help you face reality before the sky falls on your head.  One woman I worked with told me at the end of our work together that there was a German expression for what she had experienced in therapy which probably could best be translated into English as the following:  "The skin has been peeled from my eyes." This expression remained so vivid for me that I never forgot it!




Sunday, 1 March 2015

How do I explain to family and friends why I am seeing a psychologist?

There is no one right thing to say to family and friends about why you are going to see a psychologist.  The best advice I can give is this: make it simple and be honest.  As I tell many of my clients, there is no form of therapy that I do with others (individual, couple or family) that I have not experienced as a client myself.  When I think about what led me to pick up the phone and finally make that call, it was first, being in a great deal of pain and second, being willing to admit that I needed help, usually after much distress!  We do not hesitate to call upon a specialist when there is a physical problem. Why should it be any different when the problems are mental and emotional?

Unfortunately, we live in a society that still stigmatizes people for seeking help to deal with psychological problems.  This is so despite the increasing numbers of people from all walks of life who have sought out therapists.  It is as if the reality of what's happening out there remains a secret until somebody has the guts to talk about it.  Then, once out in the open, it is rare to find somebody who has remained unaffected by mental health issues either in themselves or some close friend or family member. Social attitudes and messages relayed early in life, however, die hard.  What are some of these covert messages?  "Don't air your dirty laundry in public", "You made your bed, lie in it",   "Strong people solve their own problems", and "Only people who are weak-willed go for counselling".  None of us totally escape this conditioning which is why there is usually some ambivalence at the start for everybody who walks into a therapist's office.

What many do not realize is that people's judgments about therapy say much more about them (their values and outlook) than they do about you and what's right for you.  So it is very risky to take too much to heart another's point of view whether it be positive or harshly judgmental.  If you find yourself being significantly affected by someone's critical comments, it would be wise to look inside at what is likely your own mixed feelings about seeking help.  After all, isn't it far more important what you think than what others think? When a client says to me: "My husband thinks it is a waste of time and money", my response typically is to ask: "And what do you think"?  Granted, it is difficult when the people close to you, family or close friends, are unable to provide emotional support for your decision.  If someone close to you cannot support it, though, don't make the mistake of getting hooked on trying to change his or her mind.  Seek support from those who can give it.  They are out there!


Sunday, 15 February 2015

I come from a pretty messed up background. Shouldn't my parents take some of the blame?

I used to have a bunch of magnets with funny sayings on them on the side of the metal filing cabinet in my office.  One of the magnets said: “Blame my parents.  Don’t blame me!"  Whenever a client passed by and caught a glimpse of that particular one, they would inevitably respond with a big grin.  

Wouldn't it be nice if we could put all the blame on parents and not have to take any responsibility for our woes!  Interestingly, the word responsibility means just what it says: “the ability to respond”.  While parents play a very significant role in shaping who we become, even more important is the way we have responded to their influences.  Our response is a product of many variables not the least of which are: biology, temperament, birth order, personality, learned coping skills, and how we have chosen to interpret our life experience.  At some level we all know this.  We know that children grow up in the same family under similar circumstances and yet they each cope and turn out differently. We know that there are people who endured great hardship in their childhood yet they manged to flourish later on in life. There’s got to be more than the facts of what happened to explain where we are today. 

While it may feel comforting at first to think of oneself as the victim of a difficult upbringing, in the end, the cost is too high.  After all, if parents are entirely to blame for the way you are today, there is not much that can be done, is there?  In the end do you really want to feel that degree of powerlessness?  I am not saying that neglect and abuse don't occur and do damage.  I am saying that how you choose to interpret what happened to you, is the more critical determinant of how you feel today. Most of the time, trauma leaves us frozen in time, interpreting past life events through the eyes of a child.  Usually, the greatest damage occurs because children can't help but blame themselves when things go wrong.  As a result, they end up feeling defective, damaged and not good enough and carry these feelings into their adult years.  Getting help to get unstuck from those old feelings and obtaining an objective view so that old, mistaken interpretations get updated, can make a huge difference.  Psychologists understand that they can't change what happened to you but they can help you to change how you feel, think and respond to what happened. This is where your power lies. Some call it "empowerment".  Thank goodness, the true determinant of your well being is not what happened to you in your life but rather how you choose to see it and what you do about it! 

Sunday, 25 January 2015

Why is acceptance so important?

What is the saying?  It takes much more energy to resist than it does to persist?  Whenever we try to swim against the current, we have to exert far more energy than going with the flow and it becomes very tiring.  For many of us, learning how to be mindful of this would make life a whole lot easier. This does not mean giving up, losing hope or compromising.  It simply means being willing to see things as they are rather than fight and rail against reality.

A friend of mine used to say: "It is what it is."  At first, I thought it was some cute cliche.  Then, the more she said it to apply to elements of her life and to mine, the more I began to realize that there were many things in my world that I would rather block, minimize, obsess about or try to undo...all symptoms of this nasty need to control the uncontrollable.  This difficulty in accepting what is can apply to anything...having to accept that you are depressed, coming to terms with the fact that your son has ADD, needing to take medication, having a mother who cannot love you the way you want to be loved, facing an addiction or dealing with some harsh life event that you were not prepared for and did not ask for. As one client in such a bind said, "When you accept it, you get a foothold and can climb out.  You really know what the problem is that you are facing and you can address it".  How true, for if you are unwilling to name and identify the problem, how can you begin to find solutions? For some people, accepting their situation finally brings them to therapy.  They realize that "it is what it is" and are now ready to find ways to cope with that reality and move forward with their lives.  For others, acceptance is found once they begin the therapeutic process, and becomes the first therapeutic objective because without it, no significant progress can be made.

Jeff  Foster, a teacher, poet, spiritualist, self examined depressive talks perhaps more eloquently than anybody about what this process of acceptance is about.  He has a Facebook page and has written the most beautiful book entitled "Falling In Love With Where You Are".  He speaks in seminars about how after years of exploring many psychological avenues and various spiritual paths to try to deal with his depression, his final conclusion was that acceptance is the ultimate cure.  Take a look at his work.  At the young age of 31, he is old beyond his chronological years and quite the wise one!

Sunday, 11 January 2015

How do I stop feeling sorry for myself?

Everybody feels sorry for themselves sometimes.  It's normal to go there now and again.  Problems arise though (as they do with all negative emotions) when you get stuck and those internal voices keep playing over and over like a broken record.  Then it is time to stop, tell yourself, "This isn't working for me!" and make a change.

The best advice I ever got from a mentor of mine about self pity was this: "It's O.K. to feel sorry for yourself.  Everybody does.  If you are going to have a pity party, though, for God's sake, put a time limit on it!"

That was one of the best pieces of advice I ever got.  Of course, it makes sense.  Fighting emotions...feeling guilty...telling yourself to snap out of it...none of that works.  Besides, problems only emerge when you end up stewing in your own juices.  So, if you are feeling sorry for yourself, let yourself cry, kick, scream, mope, stay in your sweats, hide out at home, refuse to answer the phone, watch Netflix, eat chocolate, etc., whatever is your comfort!  However, once you have indulged for a period of time, promise yourself that by such and such a time, you are going to stop the drama, pick yourself up, dust yourself off and get moving... whether that's going out for a walk, meeting a friend, cleaning out that closet or getting to the gym.

It never works to try to ignore or push away negative emotions.  You can do them up big.  Just put a time limit on them!