THERAPY

Some of the goals of therapy

To find ways to love and accept love

How to stop getting stuck in feeling bad about yourself

To create a fuller and happier life

To find ways out of helplessness and the feelings of being overwhelmed

To find a way out of the unnecessary pains, sadness, and losses in our lives

Tuesday, August 30, 2011

THE UNWANTED CHILD AND DEPRESSED FEELING STATES

The feeling of being unwanted is such a terrible feeling.   Back in 1929 a psychoanalyst named Sandor Ferenczi  noticed a phenomena in his adult patients.   He found that the frequency in conscious experience of depressed and morbid thoughts and feelings and images was significantly connected to their experience of being unwanted in childhood.   Sometimes the essence of feeling unwanted is in the child's cry  "I should never have been born".    The real pain of loneliness often centers upon the history and depth of feeling unwanted.


For an interesting discussion of the some aspects of the issue see:
http://books.google.com/books?id=2UIA3Uv6Fg0C&pg=PA77&lpg=PA77&dq=cherishment&source=bl&ots=yW2UnauCTD&sig=QowNaM95m_frScL7RrgHm_DwaXw&hl=en&ei=-H1dTueBKYiFsgKF-4wq&sa=X&oi=book_result&ct=result&resnum=2&ved=0CBwQ6AEwATgK#v=onepage&q&f=falsel

Sunday, August 28, 2011

MEN AND BABIES

     The arrival of a baby is a very significant time for a family.  The baby is completely dependent upon the caregiver, let's assume that it is the baby's mom.  The mother in essence becomes an "attention giving" figure on a 24/7 basis.  It is important to realize that the process of getting attention is a profound human need.  The husband in this scenario experiences a significant status change.  He goes from being the woman's main attention, the number one priority for the receiving of loving attention,  to someone in a third or lower position.  He can have a helping role in the family system, but in the dyadic system of husband and wife,  a kind of a "time out" process sets in.  Most often, this time out process is expressed in a diminished amount of attention the woman can give to the husband and also in the sexual life of the couple.    In addition, the mom's need for the getting of attention (attention from the husband) is still extent, and if anything, the need is somewhat amplified since she is giving out so much.
       How a couple handles this shifting of attention, this shift in prioritizing, is central to the quality of their relationship and of the family life.  How to tolerate this time out period and how to transition out of the time out era are crucial issues to work out.

The need for attention is so fundamental that discussions regarding this need most often go towards discussions about when it is problematic.
see for example: http://psychology.about.com/od/personalitydisorders/a/narcissisticpd.htm

a simple pointing towards the need: http://counsellingresource.com/features/2011/02/09/look-with-me-attention-need/

Wednesday, August 24, 2011

DEPRESSION AND DEMENTIA

Depression is such an important subject to discuss.   I want to talk about it in detail in future postings.  There are more studies emerging showing links between depression and the deterioration of the mind.
See for example: http://www.medscape.com/viewarticle/724876

STORIES III

      Let's look at another story.   A person remembers quite vividly a time when his mother is crying.  He/she remembers feeling helpless and upset that she seems so distraught.   He/she tries to console her.  Say the apparent precipitating event connected with her tears is some willful action on the persons part (as child).  The causes of the mothers pain may be multiple and this particular interaction may actually be a small part of her distress but this event is sort of the thing that breaks the camel's back.
     What kind of stories get internalized.  First off, there are many possible variations and so these ideas point to only one of the possible stories.   One story would involve the  child connecting the dots between his/her willfulness and the mother's hurt.  An internalized story might be "getting my way hurts the person I need, love".    So, what happens to the internalization of this story.   Our sense of self partly resides in our experience of will and agency.    So, as the person moves about in the world, trying to build a life, he/she may have some difficulties around "agency" (making things happen) especially when the his/her intentionality may conflict with someone he/she cares about.  An example of one of these difficulties would be a hyper alertness to the feeling state of the other - am I hurting the other.   Of course,  hurting the other is not the aim but with this internalized story, hurting the other takes precedent over all other factors.  Factors, such as, maybe the others "hurt" is that person's reaction to not getting his/her way.  In a way, this internalized story trumps reality, the person is more responsive to "hurt" in the other than the actual consequences of the various choices and intentions in play.







Tuesday, August 23, 2011

STORIES II

      Elsewhere in this Blog I talked about how each of us has a bunch of stories in the back of our mind (that is, the stories are not present in day to day consciousness).  These stories shape how we interpret and behave in our present relationships.   One goal of therapy is to help the person see and experience the living out of these stories and their effects.   If we look closely at one of the stories, the first thing to notice is that they usually involve the person and one or two other individuals.  Second, a story involves a background theory about how things "work" between persons.  Infant Research has shown that the mind is equistely designed to detect connections, to connect the dots.  This connecting, this linking is how the person creates a story.   So, one obvious implication is that the first stories involve the self (I and me) and the moms and dads.  In fact, each of us has "learned" the most from how these persons behave with us, with our siblings, with our neighbors, and with each other.
     So, a problem brought up in therapy may include how the person feels about his/her body.   There are many issues/causes surrounding these feelings.  One important story involves how the infant/child experiences the behavior and mental state of the parent's early handling.  Does the parent like changing the baby or are they disgusted with cleaning up the poop; does the parent like giving them a bath and playing with them or is the parent predominantly elsewhere and in a "hurry".   What are the reactions of the parents as the child "discovers" their genitals.     Out of these many experiences the child creates, often an unarticulated set of stories about his/her body which carry into adulthood.

For a somewhat complex discussion try: http://www.changeprocess.org/articles/Foundationalaccepted.pdf
    

Friday, August 19, 2011

ALIVENESS

Aliveness rather than walking through life.  A great idea but how do you reach this state of being?  Often the world seems to demand our attention to the exclusion of our dreams, our visions fueled by our yearnings.  One way to think about depression is that we no longer dream, no longer have hope about our visions.   Therapy tries to bring the person back to their dreams and negotiate and find a place between the dreams and the demands of reality.   To rediscover our dreams and their potential expression in the present time and place is very much helped by a good listener and thoughtful participant.   Good therapy will find a way for this to have a chance at happening.  

Wednesday, August 17, 2011

BLAME II

 Some  persons seeking help through therapy often will say something such as "I don't want to dredge up the past just to end up blaming my parents".    This concern has many ingredients.  Often a major ingredient is that he/she is burdened with frustration, and anger and senses linkages with how they grew up.   The purpose of understanding the past which is alive in the present, is to get a grip on the conditions where we learned ways of living that don't work.  How these methods of coping and behaving are anchored in the stories of our early relationships.  And how the theories of living that emerged out of these relationships and stories are inadequate for are present lives.

POEM IV

WHAT WORK IS


We stand in the rain in a long line
waiting at Ford Highland Park. For work.
You know what work is--if you're
old enough to read this you know what
work is, although you may not do it.


Forget you. This is about waiting,
shifting from one foot to another.
Feeling the light rain falling like mist
into your hair, blurring your vision
until you think you see your own brother
ahead of you, maybe ten places.
You rub your glasses with your fingers,
and of course it's someone else's brother,
narrower across the shoulders than
yours but with the same sad slouch, the grin
that does not hide the stubbornness,
the sad refusal to give in to
rain, to the hours wasted waiting,
to the knowledge that somewhere ahead
a man is waiting who will say, "No,
we're not hiring today," for any
reason he wants. You love your brother,
now suddenly you can hardly stand
the love flooding you for your brother,
who's not beside you or behind or
ahead because he's home trying to
sleep off a miserable night shift
at Cadillac so he can get up
before noon to study his German.
Works eight hours a night so he can sing
Wagner, the opera you hate most,
the worst music ever invented.
How long has it been since you told him
you loved him, held his wide shoulders,
opened your eyes wide and said those words,
and maybe kissed his cheek? You've never
done something so simple, so obvious,
not because you're too young or too dumb,
not because you're jealous or even mean
or incapable of crying in
the presence of another man, no,
just because you don't know what work is.

by Philip Levine, US Poet Laureate


Everyone knows that he/she has to create an economic life.  As the attack 
in our nation upon community and caring grows even more successful and 
vehement, we hear the words of  Philip Levine.   Words about waiting and 
brotherly love.   About the squandering of our heart beats and
about  alienation and the misuse of power.  He slices through the mist 
and fog with the vision of the possibility of comradeship and
brotherly love, if only we can get up the nerve to reach out and speak 
and embrace the other.
You can listen to Levine speak this poem by going to:
http://www.ibiblio.org/ipa/poems/levine/what_work_is.php

Sunday, August 14, 2011

TALKING WITH TEENS

"Many mothers believe that unless they're having heart-to-hearts (like those Supermoms on TV) they're doing something wrong. True a conversation in the midst of ... driving to pick up pizza doesn't have the same official stamp of "intimacy" as snuggling ... or having a quiet talk at bedtime. But this is when kids naturally open up. The best you can do is accept that the most important information you'll get will be in the form of a two-minute sound bite dropped in your lap when you least expect it."
Ron Taffel from his book Why Parents Disagree
http://www.rontaffel.com/


In the late sixties Ron and I led therapy groups at a school for troubled teens.  My clinical experience and parental experience fits the picture he paints here.  Parents need to adjust their expectations as the teen joins another "tribe/family".  They still need us, yet in less obvious ways.  They want to learn about life more through direct experience rather than our parental vision.



Friday, August 12, 2011

BLAME

~ Children usually do not blame themselves for getting lost - Anna Freud


Every parent is familiar with the child attributing to some other as the cause of his/her behavior.  One of the tasks of development is to accept authorship for your choices and the life you are creating.  This is  a life long project.  Yet, understanding the stuff that goes into the denial of our authorship is not easy and finding the places where you can begin to choose differently is even more difficult.   Everyone needs caring help to succeed at this.
In psychology this kind of blaming is an instance of a more general way of defending the self called "projection".  see for example: http://www.outofthefog.net/CommonBehaviors/Projection.html

Thursday, August 11, 2011

POEM III

At Last the Secret is Out

At last the secret is out,
as it always must come in the end,
the delicius story is ripe to tell
to tell to the intimate friend;
over the tea-cups and into the square
the tongues has its desire;
still waters run deep, my dear,
there's never smoke without fire.


Behind the corpse in the reservoir,
behind the ghost on the links,
behind the lady who dances
and the man who madly drinks,
under the look of fatigue
the attack of migraine and the sigh
there is always another story,
there is more than meets the eye.


For the clear voice suddently singing,
high up in the convent wall,
the scent of the elder bushes,
the sporting prints in the hall,
the croquet matches in summer,
the handshake, the cough, the kiss,
there is always a wicked secret,
a private reason for this.
WH Auden

POEM II


Those Winter Sundays
by Robert Hayden

Sundays too my father got up early 
and put his clothes on in the blueblack cold, 
then with cracked hands that ached 
from labor in the weekday weather made 
banked fires blaze. No one ever thanked him. 

I'd wake and hear the cold splintering, breaking. 
When the rooms were warm, he'd call, 
and slowly I would rise and dress, 
fearing the chronic angers of that house, 

Speaking indifferently to him, 
who had driven out the cold 
and polished my good shoes as well. 
What did I know, what did I know 
of love's austere and lonely offices? 
THE STORIES OF FATHERS ARE MANY, HAYDEN CAPTURES 
THE REALITY OF ONE THAT MAY LAY IN THE CORE OF 
OUR BEING.  A FATHER USED BY THE HARDSHIPS OF 
LIFE.  A FATHER UNABLE TO ARTICULATE HIS LOVE .
A FATHER WHOSE LOVE SPEAKS THROUGH SOME ACTIONS.
YET, FOR SOME OF US SUCH A FATHER WOULD BE
PRECIOUS COMPARED TO THE PAIN OF ABSENCE.
IT IS SO VERY HARD TO MAKE UP FOR ABSENCE.  
AUTHENTIC THERAPY HAS A CHANCE TO DO SO.

you can listen to Hayden at http://www.youtube.com/watch?v=pjosL9VpXjY

Tuesday, August 9, 2011

POEM

Account by Czeslaw Milosz
The history of my stupidity would fill many volumes.

Some would be devoted to acting against consciousness,
Like the flight of a moth which, had it known,
Would have tended nevertheless toward the candle's flame.

Others would deal with ways to silence anxiety,
The little whisper which, thought it is a warning, is ignored.

I would deal separately with satisfaction and pride,
The time when I was among their adherents
Who strut victoriously, unsuspecting.

But all of them would have one subject, desire,
If only my own -- but no, not at all; alas,
I was driven because I wanted to be like others.
I was afraid of what was wild and indecent in me.

The history of my stupidity will not be written.
For one thing, it's late. And the truth is laborious.


Berkeley, 1980.
Czeslaw Milosz was a poet, novelist, essayist and translator.  He won the nobel prize for literature in 1980.  He roamed the rooms of his interior and had the courage to bring it to us. 
to see some of his other poems go to: http://famouspoetsandpoems.com/poets/czeslaw_milosz

Monday, August 8, 2011

THE MOMENT


But in the meantime,
Before you cross the street,
Take my hand,
Life is just what happens to you,
While your busy making other plans, 
John Lennon

     John brings together two important stories.  A story about the fleeting moments of childhood and parenthood.   Each of us who have had the good fortune of having a child knows of the exquisite moment of your child reaching up to hold your hand at some crossroad.  And the moment of sadness as we look back and realize our child has grown and no longer creates this moment with us.   Hopefully we have enough of these special moments and the regrets that comes from the end of that era are not too many.
     The second kind of story is all too true with our endless "to do lists" and our "pie in the sky" schemes.  Our society has linked Madison Avenue consumption with appearance and success and entertainment.  We often are so busy in these pursuits that the moments of our lives are just blurs on the screen of consciousness.
The lyrics come from "Beautiful Boy"
http://www.youtube.com/watch?v=2vmSG8EyI88&feature=related

Thursday, August 4, 2011

RECONCILIATION

        Sometimes something bad happens between members of a family and/or very close friends, and the reaction to this bad thing is basically withdrawal and subsequent avoidance.  This not talking or not engaging the other leaves both parties injured and also with a frozen connection, a frozen image, and a frozen story.  This frozen presence may recede into the background but it will haunt both parties.  The two parties need help to find a way out of this.   Reconciliation involves a slow process of helping each party to see the injury - to bring it forward and put it out on the table and accept its presence without defense.  Why would someone agree to do this?   Because  both parties are haunted by the injury, whether consciously or unconsciously (unconsciously by means of "forgetting" but this forgetting means losing part of your history which is a kind of tear or hole in the fabric of your identity).
      A therapist can help the two parties navigate these kind of meetings by helping to contain and work with the feelings and defensiveness such an attempt requires.  I think this quote speaks to part of the reconciliation process.

"Forgiveness is the only way to break the cycle of blame--and pain--in a relationship...It does not settle all questions of blame and justice and fairness...But it does allow relationships to start over. In that way, said Solzhenitsyn, we differ from all animals. It is not our capacity to think that makes us different, but our capacity to repent, and to forgive."

Wednesday, August 3, 2011

PTSD - POST TRAUMATIC STRESS DISORDER

PTSD is such an important issue for both our military and folks in general.  In essence, something so terrible happens to the individual that their capacity to "deal", handle it is overwhelmed.  Results of a study done by VA has looked at the "usual" treatment for PTSD; the use of anti psychotic drugs.  This  study helps us see that drugs were minimally helpful and that human connection through therapy is to be preferred.  Especially, because this particular class of drugs has very significant side effects.  You can view a review of the study at: http://www.msnbc.msn.com/id/43994382/ns/health-health_care/
also see and perhaps listen at: http://kuow.org/program.php?id=24142

CARING ABOUT THE SELF

      Caring about the self involves making efforts to do the things which enhance and value the self both in the present and where the effects of these efforts extend into the future.   Efforts in the here and now are more easily taken up then efforts organized around a future self.  There are many ways to not care about the self, especially the self extended into the future.  In most of these non caring instances the person does not even think about the self extended into the future.   He/she does not have an image, a story of "I", "me" and what these choices will help create and/or wreck for some future me.
       Why does this lack of caring happen.  I think there are many forces at play, one of them involves "a lack", and "absence" in the persons growing up years; for example,  think about whether the child was required to take care of his/her teeth growing up, and what kind of effort was put into it.    Another factor involves the aging process, wherein opportunities for the creation of possible parts of a self have waned.  Part of the task of therapy is to help the person see this lack of caring about the self and find ways to challenge the person to take up the effort.   Belief in the patient's potential is very important here.

Tuesday, August 2, 2011

SONGS AND MOVIES

     Art is both personal and social.  Art is a bridge between the artist and folks.  Yet, it also permits a bridge between folks.  A scene in a movie can be a shared starting point,  for example in the movie "On the Waterfront", Marlon Brando in a cab with Rod Steiger, talks about identity (I could have been somebody...), about love (I did it for you), about humiliation (lets face it I am a Bum), about betrayal (you was my brother, you should have looked out for me).  So much emergent meaning carried in a 5 minute clip.    Elements of scenes like this can serve as templates for therapist and patient to find a common starting point to understand the stories, both conscious and unconscious, which shape his/her lives.
    So too, songs allow us to share with each other through the music and lyrics, a common ground, a common story.  They can carry us into feelings and moods and even contemplations.  The listener, for example, may find him/her self wondering about the arc of their life when David Byrnes in his song,  "Once in a Lifetime", sings "you may ask yourself, well, how did I get here?

Monday, August 1, 2011

STORIES

One way to think about how our minds work involves accepting we have a bunch of stories in the back of our mind.  These stories involve you and your mom, you and your dad, you and your brothers, you and your sisters, and you and other important persons in your life.  In these stories things happen between you and the other person - things such as you hurting your mom, your mom not paying attention, maybe your dad or mom getting drunk, etc.  There are many such stories alive in the back of your mind.  These stories have "weight" and effect how the self ( I and me) understand what happens between our self and whomever we are interacting with now.
Our memories often touch upon some part of a particular story so our memory can be a sign post directing us to relevant stories that shape are expectations and interpretations of what is happening in present time and place.
Film sometimes uses flashbacks to convey this process, for example in Federico Fellini's movie "8 1/2" or more recently "Saving Private Ryan".

COMPROMISE

Compromise is a word splashed over the news these last few days.  In real life compromise  is about finding solutions between folks.  Compromise is about recognizing limits about "getting my way", and about finding a way to talk things out so that each person can make a choice that has the feeling of "acceptance" in it rather than the feeling of "submission".   Sometimes it is good to hear in your mind the opening refrain by Mick Jagger - "You can't always get what you want".....