While on my walk today, and realizing that people are dying, that others become greedy or aggressive in our stores, or others who are unable or unwilling to realize that their lack of social distancing could unwittingly affect so many others beyond themselves--even lethally, I encountered passers-by walking their dogs, walking by themselves, or bicycling, each greeted me with a friendly wave that seemed more than those times when life is moving along swimmingly and we often rush on to the next activity. It seems our circumstances can slow us down and aid us towards seeing our need for the essential. Human connection, basic survival, and so on.
And if we pay attention, others are doing what they can to make this crisis better. One of my neighbors is making cloth masks that are washable and therefore re-usable. Another woman in the neighborhood, my wife reports, whose health is compromised and cannot go out, is offering to connect with others through Skype, others are making meals for shut-ins, still, others running errands for those who can't. For the religious, whether struggling to make it or faced with death, many are brought closer to the Infinite. I think that perhaps that we have the potential to be better people when in crises, rather than when we "get everything we want."
Sometimes we learn from the relationships, but other times we feel so bad that we need to escape it. The bitter sadness and/or loneliness can something we need to go through. Some of us deny it and never go through the feelings, which can result in what Carl Jung said (I paraphrase), "Whatever remains unconscious is lived out in fate." Others begin to conclude that this is their life. Like Edith's character in "Downton Abbey," at one point her assumption seems to be that she will never have a good relationship, will always be alone, and that this will be her fate. And this can certainly be how this feels. However, sometimes something changes. And it isn't just good fortune. Someone does pursue her. The turning point is not her being pursued. It is her ability to let go of the painful disappointed feelings and let in the good feelings that can come with the experience of someone pursuing them. This change inside does not guarantee one will have a successful relationship, but it opens up that possibility. If we cling too tightly to the the pain, perhaps protectively because to do so offers the protection from it never happening again, we may feel safe but cannot notice or let that good come in when it does and we might unwittingly perpetuate the sadness and loneliness. Sometimes we need someone to go through those hard times with us to move beyond it to be able to find room to let the good in.
The topic of despair comes to mind this holiday season as many kinds of feelings emerge at this family time of year. While a joyous time, a time of celebration, giving, and inspiration, unresolved family issues, unsuccessful relationships, and other disappointments can surface for some as well. These bad feelings can be magnified at this time of year. Unfulfilled longings, loss, breakups, and loneliness to name a few, can create some harsh and desperate feelings. Sometimes the desperation can be ended by connecting with someone, or by finding something else to be fulfilling. Others might try to stay busy, drink, or numb out with other methods to try not and feel it. All too often, these solutions often prolong the bad feelings (e.g., they are still there the next day). Sometimes it can feel like there is not a way out. The bad feelings can progress into despair and it can be hard to get out of despairing black holes. At its worst, when despair does not end, and a person cannot see a way out, and if progresses even further, unending despair can create feelings of suicide as the only escape. Obviously, this undesirable state is serious and one we want to avoid. This raises the question of how do we prevent the downward spiraling feelings of desperation from slipping into serious levels of despair. One potential problem is noticing that we do some things out of desperation that are only short-cuts. These often only lead to no change at all, or at its worst, can make us feel even worse in the long run. Although I cannot be exhaustive on ways to manage these feelings here, I will say that it is very important to try to connect, to feel and receive compassion and understanding from someone. It is hard to estimate the importance of what this means. This can be the hard part--getting past the bad feelings and fears that revealing such feelings at all, let alone during a season of what seems to be such a joyous time for so many, to tell someone what you are going through. Most people know what is like to suffer, and unless you have evidence that someone is unable to be receptive to such feelings, it can be very helpful to not hold it all inside, have someone understand, and stop feeling so alone. When efforts to break out of this kind of desperation break down, or if despair is becoming and enduring experience, especially if you or someone you know is unable to take positive experiences like this in, more help could be needed. The desperation and despair are important signals of something ailing that is usually crying out for help. Remember that addressing the negative can be a positive, like pulling the weeds out to reveal the beauty of the garden.
Many people wrestle with what to do with the past in therapy. Common fears include falling into self-pity, having one's partner hold what can feel like an endless grudge against them, falling into despair, never moving on with one's life, etc. The problem with the past is not the past. The past is done. However, the past needs to be reconsidered when we discover how much we keep bringing the past into the future. When we begin to see patterns in our lives like being afraid of commitment, sabotaging ourselves, becoming over-reactive with friends or partners (either emotionally or becoming way too overly rational; in other words, way too defensive with others), and so on, we are likely confronted with how we are dragging our past into our future. Unfortunately, many people who refuse to think about their past stay mired in their past more than they realize. Carl Jung once said (I paraphrase) that whatever remains unconscious is lived out in fate.
While it is probably not fruitful to conduct an "archaeological dig" of one's past, learning how patterns that we live that stem from the past is just plain smart. We all need to learn from our mistakes. That is just common sense--unless we refuse to learn from our mistakes. One gentleman that I worked with was so bent on avoiding the experience of pain or disappointment, that he would continually talk himself out of even the most pleasurable experiences. By exploring this, we were to come to see how he had failed to grieve and experience past pains so that he was essentially pushing his pain from those experiences, and the fear of experiencing them, off into the future. You might say he was projecting his past into the present and the future. So this exploration of his symptoms led to explore the the past, but with the goal of finishing it and learn how to experience himself in the present. You see, he could not let go of his past because by avoiding those feelings, he had been dragging them into the future. Sometimes the past cannot be simply swept under the rug. One goal of therapy should be to learn to live in the present, facing the challenges that experiences bring, but also free to get the most out of our lives!
So you have decided to enter into therapy. Its time to find the "right fit," someone you can have enough confidence to work with. Now, as if the decision to go to therapy was not enough, you need to find someone who can really help you make the changes you want to make. This can be somewhat of a daunting task. If it feels like a "piece of cake," you may not be taking this decision seriously enough and/or you may not get much out of your experience, unless you are very lucky! Here are what I hope will be some helpful guidelines for going through this experience:
1. Ask someone for a referral from someone that has been in therapy (or can point you to someone who has) and has seen someone who was helpful to them. Try to get up the courage to ask them if they know of a good therapist. Ask them how they were helpful and see if that resonates somewhat with what you are looking for.
2. Do not be afraid to shop around. Therapy is a big investment of your time, money and effort. It can be discouraging to not get anywhere with someone or get nowhere and have to start over, or perhaps worse, give up on seeking help/change altogether. If you make this decision too quickly, you might ask yourself if this is a part of a pattern for you that sets you back: not thinking through your decisions before making big life decisions, etc. Visit two or three (or more) therapists to compare your experience. Many therapists are willing to provide a free initial consultation to help you along with the process, although some might ask you to pay later only if you decide to continue with them.
3. Good therapy, convenient location, whether they are on your insurance plan, etc., DO NOT always go hand-in-hand. If you are able to not restrict yourself in these ways, the more limits you place upon the possibilities for help, you run the risk of compromising your experience. However, this does not mean that you will not have a good experience if you need to use your insurance, can only drive a limited distance, etc. Just try to not start out with too many limitations, or assume all therapists are the same. This is not a statement so much as therapists being better than other, but more aimed at finding the better or best therapist for you--the best "fit." Place as much value on yourself and your life that you can. If you do not have to cut too many corners, this gives you more chances and potential to find the best fit for you.
4. Beware of therapists who: a) Seem to claim to be an expert in everything; b) specialize in a particular diagnosis or types of diagnoses. Diagnoses say very little about the person. There is no "one size fits all" approach; c) therapists who have not been to therapy/are still not in there own therapy. While some people can think that a therapist should have mastery over their lives in order to help people, growth is an ongoing process as life's challenges bring to each of us. Has your therapist been to their own therapy? Are they currently in therapy? It has been said that a therapist who has not/is not in therapy can be like a religious minister who is not sure (s)he believes in God; d) Also watch out for therapists who make guarantees or promises. While this may seem desirable, the ability to hope, to feel that resolution of life's challenges are possible is probably more realistic than promises.
5. Qualifications. Are they trained and have a degree from a graduate program in psychology, counseling, social work or related behavioral science. Are they licensed in their field of specialty? Next, consider how they might qualify for you. Would you prefer to see a man or a woman? What age seems like they might relate more to your situation?
6. Meeting with a prospective therapist. How does it feel to sit with them and talk? Do they feel realistic to you? Are they able to flexible and learn about your situation or do they seem to steer you towards their perspective (seem to have already formulated what is needed)? Do you feel heard by them? Do you feel, as much as is possible for a first meeting, that the two of you could develop a mutual and working understanding of your issue/problem and how it will be worked on? How flexible are they...if they mistake what you are saying, can they flexibly adapt to what you are saying (e.g., get back on track with you)? In other words, can they accept feedback and admit mistakes if they make one? Do you feel taken seriously, that your life situation and concerns matter to the therapist? Has this prospective therapist worked with the kind of issues you are hoping to address? What is your therapist's belief about therapy and how it works. What is their "theoretical orientation?" For more on what a theoretical orientation, you can start with this article: Demystifying Therapy: What's a Theoretical Orientation? It is important to begin to explore what approach to therapy feels like it might be right to you, or at least begin to explore this.
This list, while not complete or comprehensive, should give you a fair start in the process of finding the right therapist for you.
This blog just went out in my newsletter and I decided to put it in my blog so others could read.
Although we think of relationships as sitting down and talking through (and ultimately we need to do this), I would like to address the problem of when those conversations keep going nowhere or result in repeated counter-productive results. Sadly, this is not too far from one of our modern definitions of insanity! "Insanity is doing the same thing over and over again and expecting different results." So how do we get out of this problem?
While the notion of individual therapy often connotes blame or needing to go to therapy because we have deciphered the real "problem" of the relationship in one individual, we know or hopefully come to know that relationships are mutually constructed. So, regardless of who attends individual therapy, the client/patient who attends psychotherapy gains the privilege of having more perspective and ways to be present in the relationship.
We come to therapy to change. This is most commonly seen as getting relief from symptoms or problems. However, changing a symptom may not change the pattern. When our mind operates a certain way, we might get rid of the imminent problem, but as our characteristic manner (patterns) of coping persists, a new problem will arrive again. Therefore, individual therapy, in my mind, must do more than remove symptoms, it must also help us see how our mind works so we can avert producing the same results again.
Let me illustrate this by sharing not a case, but an amalgamation of cases that illustrates similar problems: A woman who appeared to fall in love with a gentleman years after a failed marriage, wanted to be with this man, but could not tolerate being with him in the form of living together or getting married. She did not want to be alone, but struggled with what she was to learn about herself, that she unconsciously assumed that she would not get what she wanted to have in the relationship. Thus, commitment would mean losing herself. He was a nice man, but she could not get past the feeling that she must almost exclusively accommodate her partner to be in the relationship.
What had happened? At some point in life, she had come to give up on what she wanted and had unwittingly compromised herself. Relationships meant partnership, but a quiet deprivation. After becoming more aware of this, when she and her partner negotiated living together, she was surprised to learn that her partner wanted to and actually invited her to have what she wanted. Strangely, before therapy, because her mind would instantly diminish such possibility, she would not have been open to this kind of conversation, until she came to realize that her mind was doing this. It was her silent assumptions that others do not care, that she was destined to deprivation, and therefore, she must control and distance herself from others to feel some kind of safety and gratification. This also greatly constricted her interactions with her male partner.
Helping her resolve one conflict or another would only lead to another conflict unless this intelligent but reticent woman would be able see that her mind constructed this reality. Until she could do this, and see how her mind works, she would be unable to participate in the more rewarding experiences of a relationship. More challenges ahead? Of course. But now she is armed with the awareness of a whole part of her mind that constructs reality this way and that this is not the only reality. Further, she can test out her perspective or other possibilities, in her current experiences what is real in her relationships.
Therefore, psychotherapy can be useful if it both provides relief, but also teaches us how our mind works so we can see ourselves and our relationships more completely.
"I came for couples therapy because our relationship is severely threatened!" Many worry that focus on the individual within the couple might mean many troubling things. Does our couples' therapist think I am the problem? Also, if our relationship is in crisis, don't we need to spend every available moment to save the relationship? Won't focusing upon me be more of a selfish than a relational focus? Is our couple's therapist trying to make more money for themselves or for some other colleague, from us?
These are all valid questions that should be answered. There are many other concerns/anxieties that such a referral can bring.
While I cannot speak for other marital therapists, I will try answer these questions somewhat indirectly. When couples are in crisis, they tend to be so because they keep getting stuck in the same places together. Often, regardless of what they fight about, they end up approaching their conflicts in the same way, all but guaranteeing they will continue to fight and get nowhere. It is if they think privately that the therapist will referee and determine who is at fault and, and help my partner see the ways they "just don't get me," and so on.
Who is to blame is not likely going to help. I can help couples see the ways they communicate and what this will result in, but more importantly, most couples struggle to be curious about why they are disagreeing, and because their defenses get triggered by what their partner says, they struggle to do much more than withdraw, counter-attack, stonewall, accuse, act like a martyr, become sarcastic or some other counterproductive maneuver. Couples need to be able to sit and talk things through, as emotionally loaded as things can become, without shutting each other down within moments or seconds. This is where individual therapy can come to the rescue.
Many participants in marital or relational therapy often do not benefit because of several reasons: 1. they are not able to be clear about their needs and emotions when in conflict with their partner; 2. they become emotionally triggered--individual therapy helps try to build more perspective, security, tolerance for and ability to emotionally regulate themselves more while in conflict; 3. while fully aware of what their partner is doing that they do not like, they also need to learn about what their contribution to the conflict might be (e. g., learn about the dynamics of their involvement in the relationship, not assessing the blame for those difficulties).
So these are some thoughts about the asset individual therapy can be to saving a relationship. Many relationship therapists find that they cannot do relationship therapy with couples because couples cannot do some of these things I have listed here. It is as if this is a prerequisite to relationship therapy. Without it, I often find I can only referee epic battles that only end in futility. When couples cannot and sit together in couples therapy, bring on individual therapy to save the relationship!
In a previous blog I wrote about ways anxiety can be a helpful guide. While this is still true, there are variations on this theme. So often we make mistakes because we just did not anticipate something. Although we cannot always have all of the information to make the best decision, there are other times where we simply make mistakes because we want to relieve the tension or anxiety that is associated with waiting. While moving ahead now may provide some relief, there are times that our unwillingness to feel the tension robs us of some of life's most important experiences. We give up on moving on with a relationship or moving to the next step in life (job, relationships, etc.) because we are afraid to feel, think, and/or talk about it. Or we miss out on an important opportunity because some part of our mind has already decided on the outcome.
It is only later that we find out, "If I had only known," I would have decided differently. While fears are about real threats, anxieties are our body's warning system, usually influenced by our instincts and past experiences. While the experiences are real, sometimes we evade our anxiety in order to get away from that feeling from the past. When we do this, the past actually has had its way with us when we thought we were the one in control. For instance, so many individuals assume that a dating relationship is not going well and they end it because they want to head off the rejection (an anxiety about being rejected in the past) before it occurs. I cannot tell you how many times people have found out things such as their partner was anxious about the same thing, or that their partner thought they were losing interest (they were acting cool and distant because of their anxiety about it being over!). This is not to say that we can have guarantees if we choose differently. However, part of the work of therapy is to help us tolerate the investigation of finding out what our anxieties about. Sometimes this is what freeing ourselves from our past is all about--being able to face what is going on in the moment, rather that unwittingly projecting our past into the present!
Depression, often called the common cold of emotional disorders, can be a perplexing and sometimes debilitating experience. More than just transitional blues, when I looked up quotes on depression, most of them focus on avoiding it, snapping out of it, not dwelling on it, and not letting it get to you. This can be good advice, especially when it comes to avoiding chronic depressions and perpetual self-pity that keeps one from going anywhere, becoming an Eeyore, the chronically depressed and down on himself donkey of Winnie the Pooh.
But to return to the common cold metaphor, when we have a fever, many are inclined to try to "get rid of it" by taking aspirin, etc. However, except in fevers of 104 degrees Fahrenheit or more, fevers have actually been found to mobilize the body's immunological abilities. In other words, when allowed to play its part, it can be part of the cure. So is there an example of this with depression?
While most do not want to enhance their depression, what can depression be telling us? Depression often signals that something is no longer working. We cannot move through life freely. Our energy can fill zapped. Something ails us that needs our attention. For some, an ungrieved part of themselves intrudes into the present by holding us back from opportunities, a relationship, or some other pleasurable activities.
The author Thomas Moore sees depression as having "gifts," or a perspective on one's self that cannot be seen until depression brings its darker moods that can be of help. In my experience, depression brings many clues that can tell us about what ails and what needs mending to get us back onto the road to recovery. These clues cannot be found by merely avoiding, thinking positive, or the proverbial, "going shopping." Learning from depression does not have to be morbid dwelling on depression, but the road to recovery and finding out how to live a more fulfilling life.
Many people are enthusiastic about the prospects of therapy, others not so much. On one hand, they may hear of the benefits from a friend or acquaintance. They may observe genuine change in someone. On the other hand, some come more at someone else's bidding. Regardless of the reasons or motivations, the realities of what is involved become daunting, can become a reason for pause, and for some, retreat. Symptoms such as anxiety or depression, or problems in relationships can invite us to seek help, but the symptoms' "nudge" may sometimes result in finding out that it is only the tip of the iceberg that leads to things that we would rather avoid. A rock-solid person who has anxiety attacks may want to stop having the attacks, but their symptoms may reveal a crack in their armor. We have defenses to protect ourselves. Let us be honest. Therapy can be threatening because it usually involves a certain kind surrender of certain defenses. However, we need our defenses. Good therapy helps us find more flexible and adaptive defenses so we can be more open and resilient, balanced by our concerns and needs for safety. Finding out why the mind and body is communicating something to restore order and balance can be emotionally uncomfortable to our normal sensibilities and need for "control." I put quotation marks around control because while we all need some control, at some level ultimate control can be so illusory. For some, these become motivations for not entering into, or continuing with therapy. Others may feel that they have no choice. All of these concerns are realistic and a part of the caring relationship that any deeper and meaningful therapy experience must address openly...
steve harris, phd
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"What Is Right With Me?"