Thoughts from a Therapist

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  • Selfishness is also Selfless

    Quick summary: If you allow yourself selfishness you can increase the effectiveness of your selfless intentions. 
    There are many different types of people and people are impacted by the drives of selflessness and selfishness in differing ways and by differing degrees. The message here is most suited for the people who act with intended selflessness with greater frequency than selfishness.
    In this post I am not engaging in an argument as to whether true selflessness exist (I have tried to create a case against egocentrism’s apparent universality, but that subject can be for another time)… so let me quickly suggest that selflessness is doing for others with greater effort than you do for yourself. Selfishness is doing for yourself with greater effort than you do for others. (In this post lets assume that selfishness does not inherently have a negative effect on others… it is simply focusing the positives on the self).
    When I say that selfishness can be selfless I am pointing out an apparent truth of the human reality… the innate limitations of the human body and mind make a degree of selfishness necessary to properly operate (which is why egocentrism is so difficult to disprove). In short, we must do enough for ourselves in order to operate at a level which would lead our selfless intentions to effective actions.
    At times the more selfless people give more than they can truly afford to give… the result is deterioration of both the brain and the body’s ability to function optimally (and in some cases to function at all). 
    the truth is that often many selfless individuals work in positions in which they are asked to do more than is reasonable (or rational) and those in positions of authority unknowingly reduce the effectiveness of their employees by ignoring the limitations of being a human.  It is very likely the vast majority of all healthcare, social workers, educators, military personnel, and police officers (to name a few) are being asked to work with greater time and effort than is ideal… yes, I am saying that by decreasing there time spent at work you would likely increase their effectiveness (though this seems counter intuitive it has been researched to be true). 
    When we neglect the self we can unintentionally put our body into survival mode… often the willpower (or ego) of a selfless individual is so strong that they stay the selfless course… they are able to resist the body and mind’s plea for rest and recovery.
    In doing so they maintain an ability on the surface to continue to engage in selfless actions… but the body and mind are self-protective, and they will shut down. 
    Though the individual might engage in the same selfless actions, they will likely be doing so with less cognitive, dialectic, physical and empathetic etc ability. The result is a dramatic decrease in the efficiency and effectiveness of the helpful act. The helpfulness of the help given is reduced. So by this I suggest that selfishness is also selfless in such an instance.
    If you allow yourself the time and space to recover… to find balance… to reduce reactivity… to increase supports for yourself… to increase hope… to increase the happiness of your own existence, then you will be better able to offer such benefits to others. Therefore selfishness can increase the effectiveness or your selfless intentions. 
    My supervisor put this point very succinctly the other day when he stated… “It is unethical for you to not take care of your self.” I had just received some personal news and I was contemplating whether my ethical responsibility was to cancel an appointment or to keep an appointment. 
    In the field of psychotherapy there are many very well trained people with an advanced knowledge in helping people to find solutions… in order for a therapist to actually help they must be empathetic… it is empathy which is the driving force behind effect therapy (though on the surface one might conclude that strategy is most important).
    Without a high degree of selfishness a therapist will lose there ability to engage with their full empathetic potential… therefore I agree with my supervisor… from a business and from a personal view of ethics… it is unethical to not indulge in a bit of selfishness.

  • Motivation v.s. Dedication … Can dedication be created?

    Quick summary: My coach at Easton Brazilian Jiu Jitsu in Boulder Colorado chose to talk about the difference between motivation and dedication to illustrate an important point that he arrived at while contemplating the journey in becoming a black belt. I believe he had two intentions – one was to inspire and the other was to assist the students by offering them a glimpse of reality (the reality being that in a process which takes years and is exceptionally difficult, many if not most people will fail to reach their initial goal). The basic concept is that nothing good comes without effort, and motivation does not ensure the same longevity of that effort as dedication can provide. Motivation is fleeting and is often related to the positive impulses of a finite time period… because of the inherent finite nature of motivation, motivation alone will not produce the effort needed to achieve a long-term goal. Dedication is an internal contract which attempts to guarantee that effort or work will continue with regularity even when motivation is lacking or when apathy or hopelessness are present (this is the definition in my own mind… the actual original definition of dedication suggests that it is an external process – almost every definition I could find had to do with faith or religion – I believe that both I and my couch are talking more of an unrelenting commitment to an internal goal or intention.) This point is very accessible when related to exercise – it is unreasonable to assume that you will have motivation to train or workout every day that is needed for you to meet your individual goals – sometimes you’ll be tired, lazy, apathetic… it could be too cold, too hot, too rainy etc. Those who succeed will need to be dedicated to follow through even when they have zero motivation. Is dedication a choice that all people have equal access to? If dedication was a learned behavior that could be grown in apparently un-dedicated people what effect would this have on our culture?
    I was very surprised in my brief investigation about the lack of information concerning the process of dedication.
    The dedication that was so commonly referred to seemed to be inherently flawed and therefore somewhat unhelpful in my search for answers as to how to increase dedication.
    dedication I found was most commonly found in religious writings… the problem that I found was that often the writings were not talking about dedication at all … instead they were talking about being recurrently motivated by the fear of punishment (such as hell) or the by the acquisition of positive (heaven).
    -I am not intending to pass judgment on such a process (the process being the use of punishment and rewards to encourage a behavior), instead I am investigating how dedication came into existence… is there dedication which is unaffected by rewards and punishments? I believe the answer is yes… I believe that there are people who are dedicated to their religions, relationships, goals etc that are not doing so out of promise of reward or fear of punishment…
    But what is the source? How can one become dedicated? Is it simply a choice?
    One way of creating dedication is through anxiety – both intentionally and unconsciously. If you attach the meaning of your life to a certain variable then you are perhaps more likely to stay dedicated to that variable. This can be done with an “I am” statement – such a statement suggests a permanence that actually does not exist. If you rigidly define yourself with an “I am” statement then you will likely experience significant existential anxiety (anxiety surrounding apparent meaninglessness) if you lose your dedication to a variable which defined “who you are”.
    By this reason the quick path to apparent dedication is to strengthen your ego (an ego is the apparently stable identity that you created to explain your own existence – your ego attaches itself rather rigidly to beliefs and characteristics in an effort to define an objective existence and to promote the misguided notion of predictability – all this in an ironic effort to reduce existential anxiety – the irony being that there is no existential anxiety without the ego).
    As a psychotherapist I believe that the topic of dedication needs quite a bit more attention from my field…
    A therapist can do many things to help an individual or group of individuals to find awareness and hope surrounding changes that would harvest positive benefits… we can encourage and motivate people to engage in those changes, but the therapist cannot ensure that a client will stay dedicated to their desires and goals.
    As it is we can increase awareness, we can increase skills, we can increase attachment, and we can increase motivation etc… not only can we do so but we also have a rather stable understanding or how we are doing so.
    We do not seem to have a stable understanding of how to create dedication though sometimes dedication is the result of a psychotherapy intervention.
    Dedication is the key to maintaining the benefits of a change over a long period of time. The most obvious is substance abuse… it is very common for people to make changes regarding substance abuse… but many of those people will not be able to maintain the effort needed over time… especially when key supports are removed.
    I hold dedication… and yet I have no idea or philosophical explanation as to how that dedication came to be…
    As I contemplate this issue my mind seems to hover around words and thoughts such as intention, consciousness, the absence of judgment, collective, authenticity, destiny, breath work, and the moment.
    A part of me seems to believe that dedication is an authentic intention which arrives at our conscious awareness through finding the destiny or purpose of the non-judging self as is related to the collective intention of all…

    By this reasoning dedication would be inherent… dedication would be an unyielding drive towards authenticity… and authenticity which is not created by the mind or encouraged by the environment… perhaps then you can not be dedicated to something which is not authentic or to something which does not reflect your most fundamental purpose.
    The purpose of one is related to the intention of the collective… we are all part of the homeostasis… we are all part of the balance… we are all part of the whole while being the whole itself.
    To find balance perhaps you must find yourself… you must find your purpose related to the collective… I believe this is more difficult than it sounds as most of us have spent a large amount of time ‘creating’ a self which is a different process then finding oneself…

    For dedication to exist there must be a part of all of us which is a constant… from that point arises dedication… dedication is the belief that constant exists… dedication is the intention of the constant.
    I find myself once again going to the breath… to find dedication you might follow your breath… follow that breath past judgment… past belief… past identification… to acceptance… acceptance becomes the constant that we find ourselves dedicated to without need of intention… authenticity is arrived at… the gestalt is found… dedication is to your placement in and as the gestalt… dedication then is one with our authentic intention.

    I shall receive a black belt if that is my authentic purpose… if that is what is the purpose of the collective… this is true so long as I am able to find my authentic purpose.

  • Love is something we experience with our emotions

    Quick summary: This sounds very obvious – what is less understood is that many people impact their ability to love by using logic and other defenses to guard themselves from the suffering that love can bring. As a couples therapist I can suggest that when you guard yourself from being emotionally impacted from your partner, you often unintentionally make your partner less important to you… it seems that it is virtually impossible to love someone if you have successfully protected yourself from being emotionally responsive to your partner… in making your emotions concerning an your partner ‘unimportant’ you in turn make your partner ‘unimportant’. There are many different ways to interact with our environment… in different time periods and in different cultures we find that one interaction or organizational tool is used with greater frequency and value than another tool (hearing, vision, logic, being mindful, and using emotion etc are examples of ‘interaction or organizational tools’). Currently logic seems to be in favor though I am both excited and hopeful that other tools seem to be gaining popularity. The point of all this is simple – with the tendency for our culture to favor the use of logic many people are finding themselves falling out of love with their partners. Often this is do to an individual’s conscious or unconscious intention to protect themselves from the vulnerabilities which are inherent in being emotionally available… though such a method is useful in certain professional functions and though it is indeed a safeguard against certain types of suffering, the method creates a problem itself… using logic to trump emotions seems to disable some of your ability to love… an inability to love often creates a suffering which can neither be fully understood nor resolved by logic… perhaps the explanation for this is simple… you don’t hear with your eyes, you don’t see with your mouth, and you don’t experience love with your logic…so again… Love is something we experience with our emotions.
    To be clear, one way in which love is inherently painful is the existential truth that anything that exist can cease to exist… love exists within the dialectic of being infinitely alive and infinitely dead at the same time.
    “We all fear love for we all fear losing the love.”
    Much of this dilemma is tied to dialectics (again there are many definitions for this term – I have blended many of the definitions for my personal philosophical investigations. I tend to look at dialectics as being the ironic opposite of dichotomies. Dichotomies suggest ‘either or’… black and white thinking… you are either bad or you are good… it is with dichotomous thinking that we created what we refer to as opposites. Dialectics suggest ‘both and’… everything is infinitely everything thinking… you are bad and good and in order for bad to exist there must be good… the very nature of everything is the coexistence of what we call opposites at the same time. A simplified example of a dialectic would be stealing… stealing is good for the one who obtained the needed goods for free and bad for the individual who lost for no gain.)
    Using dialectics I can suggest this – If love is happiness love is also suffering… there is no happiness without suffering and there is no suffering without happiness – on a deeper level, which is way beyond my current intellect, it would seem that apparent opposites are fundamentally the very same thing.
    “The sharpness of pain is the cornerstone of passion”
    To live with the full potential of love you must open yourself up to both the pain and the joy which is inherent in love.
    When you cut off your reception to feeling painful emotions you cut away at your ability to experience love.
    As we try and experience love while guarding our self from the pain that being emotionally available creates…  we find that that thing we call ‘love’ is no longer particularly important to us… we become altogether un-reactive to this ‘love.’
    If you are emotionally un-reactive to your partner then what interactional tool are you using to experience the ‘love’ in your relationship?
    Love is much like life – it is a roller coaster of inexplicable experiences – I hold gratitude that my current conscious existence has feelings to experience the greater collective existence… I hold gratitude for my suffering and my happiness… it is within such experiences that I gain a certain understanding and enjoyment of love and life itself.
    My grandmother’s motto was to never be bored… this is truly helpful advice… and to do so I would suggest opening your self up to love – love is many things at the same time, but it is rarely boring when left uninhibited.
     
    We often grow from nurturing and suffering… we rarely grow from avoidance.
     
    Many suggest that life is love… if we block ourselves from experiencing the ups and downs of love do we also block ourselves from experiencing life itself?

  • Labels, identification, and judgments from an existential view

    Quick summary: Sometimes the masses seem to all engage in a consistent behavior … and when such an occurrence happens it is easier perhaps to take the phenomenon for granted so as to not put all too much thought into what motivates such a seemingly universal behavior. Most humans pass judgment, assign rigid labels, and identify with certain beliefs or attributes etc… but why do we do this? Of course there is the basic reason which is fairly consistent amongst all animals – if you label your environment you can act accordingly to increase your likelihood of survival (learning cause and effect demands this ability)… but what about when assigning labels, passing judgment on others, or creating a rigid identity has no measurable outcome on basic survival or is arguably detrimental in some way?… what then is the purpose of this common behavior? From an existential perspective I would suggest that we do such in our endless effort to create meaning from meaningless and to provide evidence that we exist in the first place (perhaps the idea that we don’t truly exist is even more frightening than the inevitability of death). The point is that by better understanding this tendency we are able to move towards a greater acceptance of ambiguity which can set the stage for being more accepting of the transitory nature of all things… this could reduce the anxiety you hold pertaining to the subject of judgment, identification, and labels… and perhaps reduce your need to pass judgments and to hold labels which might not be in your best interest or in the best interests of others. Increasing your tolerance for ambiguity fosters an improved ability to change.
    Who am I and who are you if there is not consistency?
    If I cannot label you how can I understand what you are?
    If I don’t judge you how do I contrast observations to comprise an image of who I am?
    In other words if there is no label or judgment that I can identify with than I will have no way of proving my own existence… I know this sounds way out there so let me bring it down a notch.
    Who are you?
    The answer to this question holds the point of this conversation…
    What words do you verbalize to yourself and to others when asked who you are?
    “I am a psychotherapist, in a loving relationship, who loves to play music, who lives for tele-sking, charismatic, philosophically investigatory, grad student, mislabeled introvert, funny but often too deep guy, compassionate, wild, nature lover…”
    this is where is gets tricky… if your labels stopped being ‘true’ would you still be you?
    In my experience many people want to say that they would still be themselves without the labels, but in truth they hold uncertainty and a high level of existential anxiety about the idea of living without the ability to identify themselves in objective terms.
    existential anxiety is an anxiety that surrounds our underlying understanding that there might not be any meaning in life, that we will all die, and that we have no certainty that we are not or will not at some point be completely alone.
    How do we calm our existential anxiety?
    The answer is simple…
    – We make our own meaning.
    – We create an identity to identify with.
    – We create stories to explain death.
    – And we place judgments on our relations to other objects.
    “I think therefore I am.” – I would agree that you think therefore you think you know something… but personally my mind is not very adequate at conceptualizing existence… in other words my mind is mostly unable to comprehend the objective meaning of the phrase “I am”… perhaps this is do partly to the fact that my mind believes more in objectivity than reality seems to.
    At this point I must point out that there is no definitive answer to any of the questions that I have provided… can you accept that?
    I would suggest that your ability to come to a place of acceptance surrounding the ambiguous nature of some of the most fundamental questions to the human race is a useful journey.
    As you embark on this journey you may find that change comes with less reactivity and defensiveness and with more curiosity and gratitude.
    No need to quantify existence all the time… enjoy the idea that a lack of predictability and objectivity is scary and exciting at the same time.
    “We are more likely to change in a way which is advantageous to the collective if we are willing to place less importance on both our tendency to pass judgement and on those judgments themselves.”
     
    “I’m not right and I don’t know anything for certain and within this belief system (itself as transient as the next) I find an almost ironic comfort… something about the acceptance of ambiguity holds a secret about our fear of death… for me not knowing, and accepting such, is far more comforting than anything my rather limited mind can propose concerning the subjects of life and death.”
    By this a proposed meaning of life is…– “the meaning of life is to live within the transient constructs of the relative moment’s interaction with the collective.”
    yep

  • Forgiveness is the Heart of Justice

    Quick Summary: Forgiveness is the heart of justice… by this I mean to say that the ‘justice’ we seek can often be deconstructed into meaning simply vengeance. There is no justice is vengeance as the suffering which we seek justice for actually tends to grow with acts of vengeance (these acts which perpetuate suffering are often validated by suggesting that they are healing mechanisms inherent in the concept of justice). Forgiveness is the balance to suffering… in forgiveness you interact with the suffering as opposed to the host of the suffering (the offender). In forgiveness you see the intention of suffering and you recognize that to balance the suffering in this world you cannot simply take measurable action against other biological entities… suffering is an abstraction… it is with compassion and empathy and love that we might balance the suffering in this existence. Forgiveness is not to condone or to forget… it is to love everything unconditionally.
    Ultimately we are all interconnected – you can look at this ecologically, from a social dependence stand point, from a biological attachment stance (we need secure attachments to others to function optimally) or from any other vantage point such as the spiritual… whichever way you choose to look at the issue I am suggesting that vengeance ends up hurting the very people who were tempted by its dramatic pull.
    The perpetrators of vengeance unintentionally expand and perpetuate the very suffering which was done unto them.
     
    – let me clarify here that to some degree we are all the perpetuators of suffering to some degree at some point in time… I do not claim to be above this influence.
     “If I shall be wronged I shall feel my offender’s pain so as to not pass on suffering again…”
    In our existential pursuits to make meaning from meaninglessness we created good and evil and chose to view the subject dichotomously.
    I have felt the pain of unimaginable suffering transmitted into the safety of my therapeutic space and I have something to report… there are no evil people.
    Instead there are people who’s suffering is of such a magnitude that that suffering unconsciously and/or consciously encourages the host (the person who suffers) to perpetuate that suffering.
    Our innate ability to offer compassion in the face of suffering appears to be relative to the individual – by this I mean that for some unexplainable reason there are people who have suffered comparably less and engage in colossal acts of vengeance and there are people who have suffered unimaginably who are not persuaded by the temptations of vengeance.
    I would also suggest that to some degree we have the ability to feel the suffering of the world in its’ entirety… so then we can feel a compassion for the world in its entirety.
    Forgiveness is love, compassion, empathy, acceptance and an appreciation for the interconnection of all things. Forgiveness is not to condone but rather to transcend suffering… to see suffering as a natural part of life… and to then choose to let your intuition guide you towards being compassionate towards all, which is the way to truly be compassionate to yourself.
    Forgiveness is something effectively offered to suffering itself… a suffering which has been around infinitely longer than the offender who newly presented to you an old abstraction.
    I personally do not claim to truly know forgiveness… perhaps such an ability requires transcendence.
    Though I perhaps engage in relatively less acts of vengeance externally I will often perpetuate suffering with endless ruminations… these ruminations affect my emotions… which then effect the collective.
    Yet I hold hope… a hope which is growing… that I will find forgiveness… That we all will hold forgiveness.
    Perhaps this is what Jesus was saying… (I hold gratitude for the teachings of all religions)… perhaps the greatest suffering known to life is the death of that life. In forgiving those who would take your very life perhaps you move the collective towards compassion universal… peace… balance. In the moments of his suffering he called for forgiveness though he had followers enough to suggest vengeance – or some other act of suffering.
    Holding the energy obtained from empathizing with suffering is extraordinarily heavy and perhaps doing so leads many people in the helping professions to ironically develop dissociation, rationalization and avoidance tendencies…
    I maintain that I will hold the suffering with hope and let the compassionate path of my breath take me closer to forgiveness.
    In order to forgive the suffering sometimes you need to find that suffering first… In my experience the breath can take you there…
    If you can love one thing you can love all things…
    peace

  • Fear

    Quick summary: So I was contemplating feelings of discomfort that I was holding some time ago and I started to think about this article that I had just read concerning a scientific discussion about our universe and the possibility of other universes existing that were governed by differing laws of physics. Fear is the feeling that I was holding… I was uncertain about some huge life choices that I had recently made and I was fearful about the lack of predictability in my life. Then I started thinking about the other universes and I tried to conceptualize what a universe, which was governed by different laws of physics, would look and act like. I imagined another universe crashing into our universe… I started laughing at how ridiculous my thoughts were… then I started to laugh at how ridiculous fear was in general. Fearing the future became quite the same thing as fearing another universe crashing into our universe… I decided that it did not do me all too much good to fear such things… or anything.
    Perhaps this is one part of the therapeutic process that is helpful and somewhat difficult to articulate…  therapists can allow you to express your fear and to attach a different emotion (or no consistent emotion) on that subject which was expressed… sometimes fear goes away when you allow your self the space to interact with the fear.
    Fear is a huge component of couples counseling in my opinion… I can think of many occurrences where couples “fixed” their “problems” simply by allowing themselves the space to verbalize, in a useful way, the fears that they were holding (this is why the therapist is helpful – without assistance it can be difficult to articulate fear, and to understand and listen to your partner’s fear, in a constructive way.)
    Once fear is recognized it can be accepted… once fear is accepted there is generally little reason to fear… if you accepted that one day you will experience death, would you fear it?
    We all tend to propose the “what if?” question with regularity… what if you stopped asking such a question to yourself? What would happen to your fear? How would the cessation of that question affect you ability to enjoy the present moment as opposed to holding fear about a most unpredictable future… what if an alternate universe crashed into our universe.
    Most of us fear:
    Meaninglessness – we fear that our life will be without meaning or purpose.
    Losing important relationships and being alone – we fear that there is a part of who we are that could lead us to lose those who are important to us. “If I tell you what I think, what I feel, or who I believe I am… I fear that I will lose you.”
    Death – we fear that we will not survive and we hold fear about the unknown experience of death.
    It seems somewhere along the way the human condition created somewhat of a dysfunctional relationship with fear as it is hard to define why fear would be in anyway beneficial to the above variables
    Fearing death has no effect on death…
    Fearing meaninglessness will not help you find meaning…
    And fearing the loss of a relationship often causes the loss of a relationship (jealousy, criticism, pessimism etc are often the products of fear).
    I was asked by a man the other day if there was any type of fear that was useful…
    I don’t know if fear is useful at all, but in my current state of development, I answered as follows:
    “Fear is only helpful in the moment as it prepares your body to react to a threat that is actually in existence… fearing something that already did happen or fearing something that could happen is not a particularly useful process.”
     
    Some would say that “fear is what encourages people to do the right thing… without fear a community could not function in an ethical way.”

    • Do you believe this?… think about it… it is ok if you do most people think that this is true.

     

    • Does the forest act ethically because of fear? Are all ecological principles based on nature’s adherence to fear?

     

    • How is it that the earth seems to survive in balance without the human race’s fear based governance?

     

    • I would propose the opposite… all earth entities have an innate drive to maintain the balance of the whole (the earth)… It is fear that is the creator of future thinking and unethical behavior (behavior that would throw of the balance and hurt the whole). Good = Balance…

     

    • My Bias – I believe that all things are intrinsically good… good is relative to conduct with other parts of the whole… we are all the parts and the whole – the balance is what is good by my definition.

     

    • My other bias – I believe that “the ends justify the means” is irrational and motivated by fear and the misguided notion that life is predictable – as life is not predictable the ends do not truly exist – the only subject to judge is the means – all that can be good is the means.

     
    Many would argue that fear is adaptive as it prepares us for survival – the idea would be that if you were constantly afraid of something such as a venomous snake… then you would be more vigilant and therefore less likely to be bitten by the snake…

    • Perhaps (though I’m not convinced) you would be less likely to be bitten by a snake if you were in a constant state of fear about snakes, but if you were so preoccupied with such a specific fear would you not be less likely to appropriately engage other stimuli in your environment? How would this distraction affect your relationships?           

     

    • In short if you are holding a fear for the future aren’t you distracting yourself from the present… don’t you then negatively impact your chances of survival if your attention is not on the present moment (a snake can only bite you in the present… a snake can not kill you now from in the future).

     
    The final point is stress and anxiety – the killers of health, relationships, presence, and productivity.
    If you had no fear would you have stress or anxiety? If the point of fear was for survival, and stress limits your chances of survival, then perhaps fear has become a mostly useless part of the human condition.
     
    Fear is a cognition which elicits an emotion … you have more control over your cognitions that you might believe… you are already “emancipated from your mental slavery” – you simply need to accept that this is true.
     
    “Fear is a choice… it tempts you to follow… what will you choose to do… to believe…to feel?”

  • Forgiveness

    Quick summary: Forgiveness is one of the most difficult tasks that is asked of us in life. It requires us to be humble, honest, compassionate, selfless, accepting, authentic, open-minded, loving, positive, hopeful, empathetic and emotionally mature.
    I will define forgiveness as – reaching point of complete acceptance surrounding a pain and suffering so that you and your environment are liberated from the suffering which is perpetuated by the negative emotions that were created by the act or thing to be forgiven. Forgiveness is freedom from automatically reacting to your suffering with actions that could be in conflict with your morality or ethics (people that do not believe in killing others would not suggest that killing others was reasonable retribution if they honestly felt forgiveness.) Forgiveness is feeling empathy and compassion for your offender… with forgiveness you do not condone behaviors which cause suffering, and you do hold compassion for those whose actions are dictated by their own suffering.
                True forgiveness is incredibly rare in my opinion… in many situations if you break down the act of forgiveness you find that it was truly either:
          An act of truce (“I agree to not react with vengeance or to seek retribution but I still hold negative emotions regarding the instance (which may affect actions in conscious and unconscious ways”).
          A change in the forgiver’s subjective perception of the event (I no longer think that the action that the person did to me is wrong… I therefore am no longer upset at them).
          A move towards indifference (“that person doesn’t live around me or effect my life anyway… thinking about that person is not worth my time.”). (this is very rational – our emotions are not dictated by ration)
          A move to initiate the recovery that follows true forgiveness (some people forgive as they believe that the action of forced forgiveness will make themselves more likely to eventually honestly reach forgiveness).
          A well intentioned effort to do the ‘right thing’ or to make the situation better (forgiveness is done because that is what is ‘supposed’ to be done and the person offers forgiveness in an effort to be someone extraordinary… the act is intended to serve ‘the greater good’ though the forgiveness might not actually be felt.)
    So how do we reach forgiveness? Most of us have probably reached a point of forgiveness surrounding acts that did not create a large degree of suffering (“I forgive my brother for stealing my pack of gum when he was ten… I can understand the temptation and the act had no intention of hurting me.”)
    What is more difficult to forgive are the acts that cause continual and life changing suffering such as murder, rape, intentional oppression, violence, destruction of something that was significant to us, acts of war, and actions that harm important relationships.
    Why should we seek to forgive? If it takes so much effort why should the process of forgiveness be engaged?
    I personally have never met a “bad” person… I have worked as a therapist in situations where my clients had engaged in “bad behaviors”… they all had endured their own suffering… some endured unimaginable suffering and found themselves suffering long after the cruel actions were no longer an occurrence in their lives.
    If there are not bad or evil people then why are there bad and seemingly evil actions?
    I have found that suffering is something that we all carry and it is something that grows despite a person’s intention… the suffering we carry seeks to spread itself to new people, things and environments.
    When someone puts there own suffering onto another person in the form of a cruel or bad behavior, that suffering does not dissipate in strength… instead it seems to grow stronger.
    Often the intention was not to spread the suffering… people try to make meaning of their own pain and suffering and in the process they at times will reenact and transmit the suffering they feel onto another entity. This creates guilt and more suffering for the person that continued the spread of suffering… and now forgiveness must be attained for the actions received and for the actions engaged.
    The cycle of suffering in strong at this point…
    The willingness to cause suffering to others in a futile attempt to relieve your own suffering is increased…
    We become willing to sacrifice our own morals in an effort to relieve our pain…
    We lose a degree of our free will and find ourselves acting automatically to the impulses of the suffering that we hold… and then we perhaps arrive at the truth that forgiveness is freedom… forgiveness is for your self.
    This is why we seek forgiveness… to stop the spread of suffering… and to regain our own freedom.
     
    The research has also found that forgiving people are statistically more physically and mentally healthy… so the scientific reason to forgive is that it is good for your health.
     
    The process to reach forgiveness seems to require an enlightened individual… a wise person who is humble and patient in extraordinary ways… how can we become this type of person?
     
    Ho do we become this forgiving person who can not only maintain but can increase their own health while ensuring that any suffering put onto them is eradicated with forgiveness instead of spread with vengeance?
    How is it that just about every religion speaks of forgiveness while the human race continues to choose vengeance… to choose vengeance even in the name of the very religion which was trying to teach them the wisdom of forgiveness?
     
    Perhaps we believe that we are less free than we are… perhaps the answer to the forgiveness quandary is to start with something seemingly simple – A CHOICE…
     
    Yes I am saying that the 1st step toward forgiveness is to choose to try and become a genuinely forgiving person… If you value the path you will put your energy towards it.

    •       You will seek to empathize with the offenders of the world so as to recognize that when we offer forgiveness and empathy we offer the opportunity for resiliency to spread through the collective.

     

    •       Perhaps you will see that we are all victims of suffering and we are all hero’s when we triumph over suffering with forgiveness.

     

    •       There are no enemies in objective terms… an enemy who’s suffering can be healed with your empathy is your friend… they never were the enemy… and it is understandable why it would seem that calling someone an enemy would make your suffering better… but it will not.

     

    •    Life is not fair… it seems as though vengeance is an act of justice… this makes sense if you believe in bad people… but people are not bad only their action are… and I have yet to see a human help another human without using compassion, empathy, and acceptance.

     

    •       Though forgiveness seems to be an external process it is an action mostly for the good of your self… the injustice that was done onto you may have been from a source of suffering born hundreds of years ago… you can keep that suffering and pass it along to others with acts of vengeance… or you can heal yourself and in doing so you can heal countless others that would have suffered if not for your strength and resiliency.

     

    •       With the freedom of perception that is born of forgiveness who will have the presence and the sensibility to act for the advancement of justice and equality without being misled by the temptations of suffering unrecognized… without being led to perpetuate suffering with ideas of vengeance.

     

    •       You have the freedom to define the hero as the one who forgives as opposed to the one who seeks vengeance at all costs. (the typical movie hero)

     
    I will not pretend that I have reached a point at which I could immediately forgive actions done directly towards the ones that I love… and I know that I am moving in the right direction. 
    Forgiveness is a process… I can forgive enough to help people that have engaged in actions that have harmed others… I can offer empathy… and I can help them to heal… in this way I am growing with forgiveness and I cherish the opportunity to do so. 
    “As I forgive I become free… I learn to accept… I gain purpose as forgiveness opens the door for me to help a wider range of people… and I gain love… unconditionally.”

  • Chaos, structure, rigidity, compassion and acceptance

    Quick summary: The path to “enlightenment” is indeed a bit confusing and as I was contemplating my own journey I came to an interesting point of discovery. I have not reached enlightenment and therefore do not know exactly what it is … perhaps until you reach the state, the experience of enlightenment in mostly inconceivable; I will offer some interesting notes that pertain to my current journey. I was thinking about how a path of chaos or a path of structure might lead a person to acceptance and compassion (generally thought of as the more important ingredients in an enlightened entity).
    I will define acceptance as – freedom from automatic reaction, freedom from automatic categorizing, living in the moment, instantaneous forgiveness, unconditional love and compassion for all, and a drive for harmony and balance with a genuine empathy for that which disrupts the balance.
    Most people have heard the ideas about not judging your environment so as to reach a point of universal compassion and acceptance… what choices affect this end goal? I could choose to align with chaos to reach acceptance… in this way I will hold no consistent beliefs or morals and will therefore be better able to accept most anything (any occurrence, philosophy, perspective etc) without the stress and anxiety that arrives when existence proposes something contrary to the constructs I might have otherwise held in order to explain my existence.
    The chaos model promotes a general indifference which is not necessarily in line with the concept of compassion, which is generally associated with enlightenment. If nothing is good or bad then I would have no basis for concluding whether or not an action was compassionate.
    The opposite (according to some constructs) of chaos is structure. With structure I could neatly arrange my existence to create somewhat of a linear path toward enlightenment. I would use theories such as deductive reasoning, probability, and other cause and affect based beliefs to create a path that was mathematically most likely to arrive at the variables associated with enlightenment. The Jedi (Star Wars movies) generally used this modality – Yoda even made comments about love – something like, “love leads to fear… fear leads to anger… anger leads to hate.” on such a path one might avoid certain types of love as doing so could make attaining acceptance more difficult (it is easier to have acceptance for the murder of a person you are not so connected to… if someone murdered your child or you spouse it would be very difficult to come to a place of acceptance). Structure can carry a degree of rigidity that distracts a person’s attention from what is… this can creates a resistance of the present moment.
    Both paths seem to carry a strong theme of avoidance for me… and on my current journey I have found myself confused. Avoiding structure can make acceptance easier while avoiding certain experiences or beliefs can also make acceptance a bit easier. So which is the path?
    I have been trying to use dialectics to aid in this philosophical inquisition. When using dialectics the path to enlightenment becomes both chaos and structure (as opposed to structure or chaos) – this means that perhaps the constructs which suggests that opposites can’t simultaneously exist (this is called dichotomous thinking) is what makes the subject so difficult for my growing mind to comprehend.
    Perhaps the variables which could clear some of this up are the ideas of destiny, intuition, and living in the present moment without resistance. Trying to find a “path” is ultimately a choice to engage in future thinking… the future is uncertain and does not exist (except in your mind). If I focus my attention on the future and believe that I can create predictability then I will be distracting myself from the present moment (which is all that truly exists).
    I would suggest that universal compassion, acceptance, authenticity and empathy are perhaps more difficult to achieve when you decide to live outside of existence … or outside of the present moment.   (This usually means that you are living within the constructs of your brain – you are using your brain to create an existence that is separate, to a degree, from the shared existence.)
    In this philosophical inquiry I am reaching a point of understanding based ironically on simplification – chaos and structure are both mostly irrelevant and/or unproductive if they are used as mechanisms to resist the present moment – to resist existence.
    All that one needs to reach enlightenment is in the current moment… acceptance is allowing one’s self to experience the flow of the river as opposed to finding ways of making that flow predictable. As you accept the flow of the river you will intuitively know what is required from you in the moment to maintain the balance of the whole – the while is the parts and the parts are the whole. The river is chaos and structure.
    When in the present moment you can accept and hold compassion for all as you free yourself to see that you are the all… and so empathy and selflessness is understood.
    Some people will flow towards hours of medication in areas removed from the complexities of a diverse array of relationships… some people will flow towards a diverse array of relationships.
     It is not the type of flow which is perhaps most important… instead it is the acceptance and the dropping of resistance towards the flow, which will guide you in the present moment… enlightenment is for everyone… it already exists… our resistance makes it elusive… sometimes our resistance is born of our method of dropping our resistance.
     
    “Chaos is the resistance of structure while structure is the resistance of chaos.”
     
    “I entered chaos to find the structures of my acceptance and the structures of my resistance”
     
    “In structure I found the acceptance of chaos.”
     
    “Follow the breath… water the sole.”
     
    “Existence is chaos and structure”
     
    “If you are striving for enlightenment than you are trying to live in the future (which does not exist)… enlightenment is an occurrence of existence… enlightenment is in the now.”

  • Journaling for health, for context, for hope, for expression and for awareness

    “This is Not to Judge or to find Strive to fit within the Confines of Definitions” – old journal entry. I just read an entire old journal of mine and was spirited to share the value of such a practice. My body vibrates with the emotions and body sensations described in my old writings – I have had an interesting journey and am currently living within the hopes of old poems. I have held sadness and I have held stress… in holding such my body has suffered along with the realities that my mind focused its’ attention on… and now I have found a health not yet experienced and I am grateful for my journals as they have put my current state in to a place of context… my journals paint clear pictures of the mountains and valleys of life… exquisite detail… and in my current moment I look at the old words – the deep valleys from which I traveled and am overcome with appreciation. My journals allowed a healing through expression… my journals allowed my spirit to rise above the oppressive or defeatist thoughts of my mind… my journals hold my poetic and lyrical most fundamental self… my journals show me where I have been and offer hints to where I am going… my journals show love to be infinite… my journals show my self to be consistent and continuous… my journals show the gifts of resolution and wellness that were given to me that I may pass on to those around me.
    Just write…
    Put down what is helpful for you…
    There is no wrong way to journal…
    If detail is not important to you don’t use it…
    If your sentences only make sense to you this is fine…
    If your thoughts don’t even make sense to you wait a bit and read them later…
    Draw if you are moved to do so…
    Add morals sometimes and sometimes end with confusion…
    Be honest and authentic…
    Observe yourself in relation to you words…
    Is there a difference between the thinker and the observer…?
    Does your writing say things that you were not yet aware of…?
    i can help you… find me at www.whbtherapy.com
    I have written songs driven by the sadness felt by my friends only to find years later that the songs are now for me… in my own times of healing.
    The world has so many constructs and ‘should do’ and ‘should be’ manipulators…
    Let your writing medium flow free and you will find who you are separate from oppressive suggestion.
    Forever the hurt, injured, and oppressed have embraced a lasting truth… you are always free to hold your poems, morals, songs etc… you may always journey to a level of existence which cannot be oppressed by the physical world… if they take your books, dictate your pen, or censor your mouth… meditate to a place where your words are always yours…
    “No they can’t, no they can’t, no they can’t…. take away our music” – the band  – War

  • Gestalt Psychotherapy – an overview

    Quick Summary: For this post I will give an overview of Gestalt psychotherapy, which is popular for both its’ experiential nature and its large amount of techniques.
     
    Key Concepts
    View of Human Nature

    • Fritz Perls viewed clients as manipulative and apt to avoid responsibility.

     

    • Contemporary Gestalt therapists view the desired relationship between client and their environment as one of interdependence.

     

    • Human beings are capable of knowledge via the immediate experience of the perceiver.

     

    • Views individuals as striving toward actualization and growth

     

    • Believes that people have the ability to self regulate

     

    • People change when they become more aware of who they are.

     

    Four Basic Underlying Principles

     
    Holism: The whole is different from the sum of its parts
    Field Theory: A client must be understood within their context, which is always changing.
    Figure – formation Process: How the client organizes his or her environment from moment to moment.
    Organismic Self-regulation: When our equilibrium is disturbed by the emergence of a need, we do our best to restore the equilibrium.

    The Now

     

    • The present time is the most significant tense in Gestalt Therapy.

     

    • One of the main contributions of Gestalt Therapy is its emphasis on learning to appreciate and fully experience the present moment.

     

    • When the past comes up in therapy, the Gestalt therapist tries to bring it into the present as much as possible.

     

    Unfinished Business

     

    • When figures (or issues) emerge from the background (field) but are not completed or resolved, what is left is unfinished business.

     

    • Can manifest as unexpressed feelings, grief, guilt, resentment, etc.

     

    • Are carried into present life and interfere with effective contact with others and ourselves.

     

    • Persist until they are faced and dealt with

     

    Personality as Peeling an Onion

     

    • 5 layers of neurosis:

     

    1. The phony/cliché
    2. The phobic/phony
    3. The impasse
    4. The implosive
    5. The explosive

    Contact and Resistance to Contact

     

    • In Gestalt therapy, contact with the environment is necessary for change and growth to occur

     

    • Effective contact means interacting with self and others without losing sense of individuality

     

    • Prerequisites for good contact are:

     

    •  
      1. Clear awareness
      2. Full energy
      3. Ability to express oneself

     

    • According to Gestalt Theory there are 5 major ways people try to resist contact:

     

    •  
      1. Introjection
      2. Projection
      3. Retroflection
      4. Deflection
      5. Confluence

     

    Energy and Blocks to Energy

     

    • Gestalt therapists pay attention to energy – where it is located in the body, how it is used and how it is blocked.

     

    • Blocked energy is another form of resistance

     

    • The therapist actively seeks to bring these blockages into the client’s awareness by helping them experience what they are blocking.

     
    The Therapeutic Process
     

    Goals of Therapy

     
    The basic goal of therapy is attaining awareness and thus greater choice. Involves:

    • Knowing the environment and what is happening around us

     

    • Knowing ourselves and accepting all aspects of ourselves

     

    • Being able to make contact with the internal and external world

     

    Other Possible Outcomes

     

    • Gradual ownership of one’s experience

     

    • Development of skills and values that allow one to satisfy his/her own needs without violating rights of others

     

    • Increased awareness of one’s senses

     

    • Acceptance of responsibility

     

    • Movement from external to internal support

     

    • Ability to ask for and give help

     
     

    Therapist’s Role

     

    • By engaging with clients the therapist assists them in developing their own awareness and experiencing how and who they are in the present moment

     

    • Creates safe space for client to explore him or herself and try out new behaviors.

     

    • Encourage clients to attend to their sensory awareness in the present moment.

     

    • Pay attention to client’s body language as a provider of rich information regarding his or her feelings and potential avenues to increase awareness.

     

    • Pay attention to client’s language patterns as avenues to increase awareness and experience in the present moment

     

    Client’s Role/Experience

     

    ·        Active participant in the process

    • Treated as an equal
    • Client decides what changes to make
    • Willingness to explore oneself
    • Tolerate spontaneity within sessions
    • Capable of insight
    • Willingness to try out new behaviors with therapist and others outside of session
    • Willingness to try often “bizarre” techniques

     

    Relationship Between Client and Therapist

     

    ·        Trust very important

    • Involves person-to-person relationship where therapist is affected by client and client is affected by therapist
    • The relationship with each other is experienced in the here and now
    • One of complete acceptance
    • Therapist is genuine – fully themselves
    • Therapist self discloses in appropriate way
    • Therapist is a therapeutic instrument
    • Therapist is willing to explore client’s fears, expectations, blockages, resistances, and feelings

     
    Application of the Theory: Techniques and Procedures 
     
    The techniques and experiments that a Gestalt therapist uses usually evolve out of the process – what is happening in the here and now.

    Techniques versus Experiments

     

    Techniques

     

    • A ready-made technique used to evoke emotions and awareness

     

    • Used to make something happen within the session or reach a goal

     

    Experiments

     

    • Grow out of interaction between client and therapist

     

    • Aimed at helping client learn by experience

     

    • What is learned is usually a surprise

     

    • Are spontaneous and usually one of a kind

     

    • Designed to bring out internal conflict by making the struggle an actual process in the room

     

    • Help the client gain fuller awareness, experience internal conflicts, resolve inconsistencies, and work through an impasse

     
    IMPORTANT: When using an experiment in session it is important that the client be well prepared for it!

    The Role of Confrontation

     
    Confrontation can be viewed as a way of inviting clients to examine their behaviors, attitudes and thoughts in a gentle and respectful manner.

    Techniques

     

    The Internal Dialogue or “Empty Chair”

     
    Bringing a conflict between two opposing poles in the personality (or personal struggle) into the room to increase awareness. Can also be used to help client dialogue with another person.

    The Rehearsal Exercise

     
    Rehearsing with therapist in session before doing it outside of session.

    The Exaggeration Exercise

     
    Asking the client to exaggerate a movement or gesture repeatedly usually results in an intensified feeling attached to the behavior making the inner meaning clearer.

    Dreams

     
    Dreams in Gestalt therapy are brought to life and relived as though they are happening now. The dream is acted out in the present.
    Evaluation
     
    Contributions
     

    ·        Very experiential in nature

     

    • Dynamic way of helping clients deal with the past in the here and now

     

    • Very unique approach to dreams

     

    • Very holistic approach

     

    • Very creative approach that encourages creativity, spontaneity and present-centeredness in both client and therapist

     

    • Sessions can be very fun

     

    Limitations and Criticisms

     

    • Therapist can get too technique oriented because of the plethora of techniques available to the therapist

     

    • Not much room for psychoeducation because client comes up with things and the therapist is the facilitator

     

    • Requires therapist to have high level of personal development and self-awareness.

     

    Multicultural Strengths

     

    • Techniques and experiments are tailored to the individual

     

    • Approaches clients opening without preconceived notions

     

    • Paying attention to nonverbal cues may be helpful with clients from cultures here indirect speech is the norm

     

    • Because of the holistic approach, the Gestalt therapist attempts to understand fully the client’s culture and context.

     

    Multicultural Limitations

     

    ·        Focus on affect may be putting off to some individuals

     

    • Need to be careful not to intimidate client through confrontation

  • Spend your energy on that which you can truly influence

    Quick summary: How much time and energy do you spend on things that appear to be urgent and important that are not particularly urgent or important to you, your family, or your community directly? My sister sent me an article about how little of an effect politics and government agendas actually have on the more important variables concerning a population such as longevity and overall quality of life. The author provided some very compelling research that very much substantiated his point… he displayed how dramatic government policy shifts ended up having very little effect on variables we tend to think of as most important. I then was reading a condensed version of ‘The seven habits of highly effective people’ and found that the author said somewhat of the same thing… spend most of your energy on that which you can significantly influence. Other sayings started popping in my head such as “think globally act locally”… I came to the realization that I completely agree… my intention would be to do so… but I too get caught up in over thinking about issues that I really don’t have much control over. The process is detrimental on a range from wasted energy all the way to being destructive and isolating as the energy spent often does not produce while it does create more conflict.
    In becoming a therapist I did a good share of my own “work”, which involved some extremely helpful supervision and individual therapy. 
    The best supervisors where the ones that had the courage to help me to explore how my history, my family, and my identity influenced the therapy I conducted; the most memorable help that a supervisor ever gave me was when he asked what my emotional reaction to a specific therapy case had to do with my own history… transformative.

    • On a quick side note I was just asked an interesting question the other day being … “If someone goes through a difficult or challenging experience won’t they be better able to help or empathize with someone currently going through the same thing?” – The answer is very often no… if you have not done your work to come to a place of understanding, meaning, and acceptance around a difficulty you survived you may actually be less able to help a person presently going through a similar difficulty… this is related to over identification, projection, and transference (future blog).

    Anyway, while doing my own work I found that the way I interacted with politics was destructive and a waste of energy… the shock value news stories we are constantly exposed to tend to elicit strong opinions and the ego (your view of who you are… beliefs, character traits etc) gets very emotional as it defends a topic that it decided to over-attach to.
                The ego is why political conversations can get so heated… you identify with the topic and then you actually unconsciously start defending yourself (as you believe that the topic is a symbol of yourself or your history etc) when on the outside it appears that you are still talking about politics (often you are not… you are defending a part of your identity… that is what I was doing).
    The point is this – my political conversations (which I often initiated) made people feel isolated and defensive… the conversations took greatly from my energy and wellbeing… and they had pretty much no measurable positive effect on any outcome…
          I spent energy and I did not influence in the way I intended to.
    In short, arguing about politics is entirely ineffective and the process is often actually destructive.
     
    Solution – What if I did exactly the opposite?
    What if instead of arguing over politics I decided to be open-minded, empathetic, and supportive of a person’s right to a differing political opinion?
          What influence would that have on important variables?
    This is the great irony… in arguing about politics we are trying to have a positive influence on things that are important to us such as family and community; by avoiding political confrontation we would live within those very variables we were trying to create.
          By being empathetic, open-minded, and supportive of differing opinions you are actually doing effective work at influencing your family and friend’s wellbeing… these qualities will have a measurable effect in the moment.
          You can argue with your brother about the US policy with Iran till your vocal chords dry up… will you effect anything in a measurable way? (obviously this would not apply to people such as the president of the United States – are you the president?… leave a comment)
    Spend your energy on being empathetic, understanding, compassionate, open-minded, and supportive instead and this will have the following influence:

    •       reduces stress and anxiety
    •       reduce conflict  – encourage harmony, ease, and peace
    •       increase trust and emotional intimacy
    •       encourage reciprocation of empathy and the other above variables
    •       encourage more effective communication
    •       foster a solution focused mindset
    •       create greater acceptance and less attachment to the ego

    What influence would we have on the community if our families and circles of friends were able to access these benefits… what impact would it have on the entire planet if other families and circles of friends started modeling such behaviors…? How would this effect politics? Want to save the world?… Try acceptance… especialy in your family.
    This is my own personal example – What do you spend your energy on that does not have the influence that you intend?
    How could you use your energy to influence more effectively?
    I may no longer read the news everyday… and yet I still help this democratic nation by picking up trash when I’m out in nature, by supporting families and individuals with therapy, by recycling, by modeling a passionate commitment to my relationship, by smiling and honestly wishing kindness to people…
     

  • the 7 things you need to create meaningful change – precursors of change

    Quick summary: Dr. Fred Hanna did some excellent work on identifying the variables which must be in place in order for a person to experience change. He not only studied these 7 variables he also came up with specific techniques to encourage those variables into existence. According to him, the seven precursors of change are:  a sense of necessity  –  a willingness or readiness to experience anxiety  –   awareness  –   confronting the problem  –   effort of will towards change  –   hope for change  –   and social support for change.
    Dr. Hanna Currently works at the University of Northern Colorado you can find out more about him and his publications at http://www.unco.edu/cebs/counsed/faculty/hanna.html
    He wrote an excellent book which I believe is a must read for anyone working in the mental health profession –

  • Hanna, F. J. (2002). Therapy with difficult clients: Using the precursors model to awaken change. Washington, DC: American Psychological Association. 

    • I learned about Fred’s model as I was lucky enough to have him as a professor and I have read his book and most of his research – his philosophically themed investigations are awesome… He exposed me to some super facinating literatureon subjects like phenomenology.
    The 7 Precursors of Change
    The seven precursors of change are those qualities that must be at least partially present in a client for a client to change.
    Clients must have:
    A sense of necessity  –  a willingness or readiness to experience anxiety  –   awareness  –   confronting the problem  –   effort of will towards change  –   hope for change  –   social support for change
    The Precursors
    (These are not linear and they are all interconnected)
    I will provide a definition, one example (using a person with alcoholism to be consistent), one technique to develop the precursor, and one common belief held by people lacking the precursor.  Note: Dr. Hanna has over ten techniques for every precursor. Many techniques can be used with more than one precursor. (if you life this basic summary – you will love his book)
    A sense of necessity:  the client must feel that a change in circumstances must take place. The client essentially needs to have a reason to change. The goal is to create anxiety in the client so that they feel a sense of necessity. 

    • Example: If a man doesn’t quite drinking his wife (whom he enjoys) will divorce him. 
    • Subpersonality technique:the therapist asks the client if there is a small percentage of him/her that wishes things were different. The therapist asks what percentage of the client holds that belief. The therapist then asks permission to talk with that part of the person’s personality. The goal is to increase the subpersonality’s influences so that the majority of the client feels a need to change. 
    • Belief without the Precursor: “I am just fine the way I am.” 

    A willingness or readiness to experience anxiety or difficulty: The client must be willing to deal with the inevitable discomfort which arises naturally with the onset of change. Often the maladaptive thought or behavior etc is in place to reduce anxiety.

    • Example: The alcoholic man must be willing to face the hardships of temptation and the anxiety surrounding the process of finding new ways to cope without alcohol. This often means that one must accept that new environments and new habits must be found.
    • Educational metaphors technique: metaphors are used to teach the client that things will get better once they face the anxiety.  The intention is to use a metaphor that the client can relate with to display that very little is accomplished without effort. The workout metaphor, ‘no pain no gain’, is used to display the idea that if you do not let your muscles feel tension they will not in fact grow.
    •  Belief without the Precursor: “if I have no feelings I have no pain.”

    Awareness: This is simply knowing that a problem exists and then being able to isolate what thoughts behaviors and feelings are connected to the problem. This is closely related to accurately perceiving your environment.

    • Example: an alcoholic must be aware that he drinks too much and he must be aware of what thoughts feeling and behaviors occur within him and around him when he drinks too much. 
    • Role plays of others technique: the client is asked to role play someone whom he/she trusts very much. This is essentially an empathy building exercise where the client is asked to perceive him/her self from the vantage point of a trusted companion.
    • Belief without the Precursor: “If I am not aware of something it can’t hurt me.”

    Confronting the problem: This is when the client is willing to focus his/her attention on the problem so that they can fully understand all of its’ attributes. Essentially this is knowing and accepting all the effects of the problem and admitting the truth to yourself.

    • Example: the alcoholic man might know that he drinks too much but he has not focused on the problem enough to find that his drinking is inhibiting him from spending quality time with his family 
    • Representational or concretized confronting technique: this technique is used to make a tangle object (such as a pen or a paper weight) symbolize the problem. As the clients acknowledges the problem, but then quickly changes the subject the therapist can hand them the concrete object and tell her/him that it represent the elusive problem. This forces the client to stay with the problem so they can investigate its’ nature 
    • Belief without the Precursor: “if I ignore a problem it will go away. I can deny the negative repercussions of my problem.”

    Effort or will towards change: this is when a client takes action to solve the presenting problem. This is the actual effort.

    • Example: the alcoholic man will actually make effort to stop his drinking. This would likely manifest itself in actually attending AA and/or actually stop ingesting alcoholic substances.
    • Assigning graduated tasks technique: First it is important that any goal is both reasonable and is something that the client wants to do. This is a behavioral technique which focuses on getting the client to start small so they are reinforced by success. If a person wanted to start eating better for example you would have them eat a healthy meal just one time a week to start. Gradually the goal would be to eat healthy meals 80% of the time etc.
    • Belief without the Precursor: “I know that if I try I will fail.”

    Hope for change: this is having the belief that change will occur. This is a realistic expectation based on ration. Hope in this sense is not synonymous with wish. Hope involves seeing how things will change and believing you can accomplish and overcome all you need to. 

    • Example: hope for the alcoholic man would be that he actually believes that he will succeed in controlling his drinking and that his life will in fact improve as the result of his efforts.
    • Reframing negative behaviors as skills technique: a great way to instill hope is to reframe negative behaviors to shed light on the usable and positive aspects of such a behavior. For example the same skills that are needed to manipulate someone can be used to help someone in that manipulation necessitates a firm awareness of the person in front of you. If you are great at manipulating situations for yourself, it would not be a huge stretch to manipulate situations for the better of everyone.
    • Belief without the Precursor: “no matter what I do, things will never really get better.”

    Social support for change: this is having people in the client’s life that are supportive of the relevant change to be made by the client. The relationships help the development of the other precursors. This obviously does not encompass those people who inhibit the development of the other precursors. 

    • Example: for the alcoholic man this would be having relationships with people who believe that his life will be better when he controls his alcohol. Those people might also being willing to help.
    • Concentric circles technique: the therapist draws five circles each representing a level of intimacy. The counselor tells the client that the outer most circle is for people who simply know surface level stuff, and the inner most circle is for people who know or have known the client’s most intimate and personal secrets. The two then discuss which people are instrumental towards the desired change and which people are hindrances. This could bring up past relations that were dissolved do to the problem.
    • Belief without the Precursor: “people really only care about themselves.”

  • Attachment – why we say and emote one way when we truly feel and think a different way

    Quick summary: I was just re-reading some articles on Emotionally Focused Therapy and on Attachment Theory and I thought I might offer a noteworthy piece of information. Often we say what we don’t mean and we offer an emotional response which is different from how we truly feel in order to protect ourselves from attending to our attachment concerns or fears… ok, so what does that mean? Quite simply it is easier to attack, avoid, defend or distract than it is to allow yourself to be vulnerable and to express your vulnerability concerning an important relationship… it is easier to be mad than it is to be sad… very often anger and emotional withdrawal are very effective means of distracting yourself from your sadness or your fear. Vulnerability arrives when we acknowledge that we hold fear about losing relationships which are important to us… Relational bliss lies within the honesty of allowing yourself to acknowledge your vulnerability in a supportive and empathetic relationship.
    Examples:
    –         It is seems easier to get mad at your teenager for being late for curfew… were you also afraid for your child’s safety… what is typically expressed with greater effort, the anger or the fear?
    –         It seems easier to get mad at your partner for his or her choice of seductive clothing…were you afraid that your partner would leave you for another mate? Was this ever expressed? How was this expressed?
    –         It seems easier to focus your attention on a fair way of dividing the estate of a deceased family member – most families experience angry and hostile interactions during these times… was the family prepared to talk openly about the sadness they felt for a lost relationship? Where do we learn to express our vulnerabilities?
    Please do not interpret this as blaming – in truth we are very well trained in distraction, avoidance, defensiveness, and attack strategies – we tend to be less prepared to express vulnerability.

    • There are many negative associations with the word ‘vulnerable’ – what does it mean to you? What do you believe that it means to your partner?
    • Is allowing yourself to be vulnerable considered a strength or a weakness in your relationships?

     
    Society can tend to label vulnerability as a weakness and defensiveness, attack strategy, avoidance and distraction as strengths (defensive – rational/intelligent, attack – powerful/leader, avoidance – clever/independent, distraction – witty and humorous).
    –         If everyone feels vulnerable at times than is it truly weak to acknowledge your true feelings? Does it not take strength to be authentic and honest?
    The Answer – we say things different from what we honestly think and we display emotions different from what we actually feel because somewhere along the way we learned that it was easier to do that than to express vulnerability.
    Solution – (note: this is tricky stuff and it is very helpful to seek a Couples and Family therapist) – much of what therapists are trained to do is to bring behaviors, thoughts, and emotions into your conscious awareness – self-awareness can be difficult to achieve unassisted.
                – sometimes our vulnerabilities need the support of a professional helper – in becoming a therapist most therapists seek therapy in order to sit more comfortably with their own vulnerabilities.
    Identify your patterns – what do you usually do when your are feeling vulnerable (attack, withdraw, defend, distract etc)
    Identify what you feel vulnerable about – (breaking trust, abandonment, losing love, unequal degree of love in the relationship, not truly loved, being used, being replaceable etc)
    Externalize – separate yourself and you partner from the behavior patterns in your relationship – they are not a permanent part of you or your relationship, they are separate – once you see this… once your allow the pattern to be separate… you can use your freedom to choose a new pattern.
    Identify where these vulnerabilities might have grown from – (divorced parents, adoption, infidelity in a past or current relationship, troubled relationship with a parent, lack of safety or neglect in childhood etc)
    Identify what gets in the way of your ability to be empathetic, genuine, authentic, and to be a good listener. – If you are going to seek support from your partner you should be prepared to learn how to be supportive back (again a therapist is very helpful here).
    –         There is not one way of being supportive – you must identify how your partner feels supported – a willingness to accept constructive feedback can be important.
    –         Note: many people do not know how they like to be supported.
    When support, safety, and empathy are present you get to express your vulnerabilities… the listener is responsible for compassion and empathy – they are not enlisted to ‘fix’ anything – (empathy and the resulting increase in intimacy is the ‘fix’)
               
    When this happens most people feel a significant decrease in relational conflict and they feel more attached or bonded to their partner.
     
    Pragmatic solutions – once you have acknowledged your vulnerabilities it is significantly easier to handle more surface level conflicts as you have learned to be more self aware, more aware of your partners needs, a better listener, and more honest.
    This is one of the more confusing goals of couples and family therapy – often the goal is to help the structure, dynamics, and interaction patterns of the clients so that they can be better able to solve all the problems that inevitably surface in life.
    As I have stated in an earlier blog post this is all scientifically substantiated – studies have even been shown to display positive changes to the brain itself. Dr. Sue Johnson has done an excellent job of applying the science to the subject of emotions as they relate to relationships.
     
    Attachment theory is mind-blowing – if you want to have that ah ha moment surrounding the mysteries of psychotherapy I suggest you read about attachment theory (Emotionally Focused Therapy and most of the successful childhood trauma recovery strategies are largely based on attachment theory).
    “The more that you show your partner the more he or she will have to love” – me

  • The Talking Cure for Trauma – holding freedom – you are the lotus

    Quick overview: There are many aspects to the trauma recovery process such as support, empowerment, finding new meaning, and engaging in techniques which help to ‘rewire’ the brain. In this blog I will talk about the benefits of talking to a trusted, supportive and safe person such as a therapist (or to your loved ones or to a group of survivors with the assistance of a therapist). Talking about a traumatic incidence in a safe and supportive setting can free a person to experience repressed emotions (emotions affect us whether we are conscious of their existence or not), to make new meaning of the occurrence, and to become empowered by his/her ability to take control over the subject.
     
    * You dictate your own reality through the stories that you tell yourself and others about how you perceive your world.
     
    * Traumatic experiences have many effects on a person’s well being… one noteworthy effect is related to oppression and a coinciding feelings of a loss of freedom.
     
    * Your freedom to perceive yourself as in control of your destiny, and your emotional and physical reactions can be taken from you after experiences of trauma.
     
    * Talking to someone in a supportive setting is a way of taking back your freedom.
     
    * Talking about trauma allows you to control the story line … the very same story line which had historically oppressed you.

    • You then take back your right to dictate the meaning of the traumatic occurrence.
    • You can begin to choose how the experience will shape you by controlling the moral or subjective meaning you reach concerning your traumatic story line.
      • You may move from victim to survivor.
      • You may move from oppressed to heroic or courageous.
      • There is power in finding that you have the ability to create your own story… the occurrences that you experienced were perhaps out of your control… but you control the impact that story will have on you and on others.
        • Your story can in fact take power back from the very thing that traumatically exerted its’ oppression on you.

     
    Other people hearing your story – this makes your story more true to yourself as it becomes a truth to other people.
     
    Truth is not a permanent entity– it is based upon a chosen collective perception – truth is what we have collectively chosen to agree upon.

    • By sharing your story with others you take control and power over your own truth.

    The importance of groups – as you are able to share your story with other people who have survived similar traumatic experiences your powers come together to create a network of support.

    • Emotional support coming from empathy and compassion.
    • Existential support coming from listening to the meaning that others have created.
    • Support for the empowerment of your chosen identity.
      • The group will help to allow you the freedom to create your own identity – an identity that is no longer dictated by the trauma.

     
    Humans are relational beings – we heal within the compassion, trust and empathy of supportive people.

    • Though techniques differ from one supportive group to the next the truth is that supportive groups themselves are inherently healing… How they are run (what techniques and theories are used) is not a particularly important variable in relation to outcome (assuming that the leader maintains an atmosphere of safety and support).

     
    One aspect of therapy which is difficult to understand is why simply talking could have such a profound effect on a person’s perceived well being – as well as a visible effect on the individual’s brain.

    • Talking allows a re-experience of the trauma in a dramatically different context. The brain can then store the experience differently.

     
    As a person speaks of their trauma is a safe and supportive environment that individual takes back a degree of control concerning how the traumatic experience is encoded in their brain.

    • The story can be encoded with different physiological responses, with different views of power and control, with different meaning, and can utilize more diverse selections of the brain.
      • This is the basic idea of why bi- lateral stimulation (EMDR is the most well known) is an effective intervention for trauma – by stimulating both sides of the body (sound, sight, touch etc) at different times (around 4 second intervals) you can encourage both sides of the brain to interact with the story line.
        • This creates different association between the traumatic story line and the person’s emotional and physiological responses.
          • Example: where the story line would have created just fear responses and a sense of no control – you might now receive less or different automatic physiological responses and feelings of resiliency.

     
    The lotus flower metaphor – a beautiful flower which grows from the dead muck and compost of a pond.
    Some of the most beautiful aspect of this world come from or grow from the suffering, death, the difficult, the oppressed, and the less pleasant.
    Many religions (if not all) believe that resiliency and acceptance in the face of suffering and adversity is the surest way to enlightenment.
     
    You too have the potential to be the lotus flower – you can grow from the muck into something beautiful enough to be considered enlightened.
     
     

  • ‘Empirically based practice’ has been proven irrelevant to therapy outcomes – empirically

    Quick summary: check out www.scottmiller.com  -With all the political talk about healthcare reform sometimes we can miss the idea of reforming the healthcare which is already in place. The current trend in psychotherapy is and has been (for about a decade) to find a ‘one size fits all’ ‘empirically based or evidence based intervention’ which can be standardized and implemented consistently by all mental health practitioners… sounds somewhat reasonable in theory especially if psychotherapy is to be looked at as a purely medical intervention. So what is the problem? Ironically scientific investigation has proven that the evidence-based trend is unhelpful (the trend will not improve therapeutic outcomes – note: outcomes were already very good before the trend)… and having worked within a mental health center I would suggest that the trend is horribly hurtful as it wastes an unthinkable amount of money, time, and emotional and physical energy. Whoever came up with this trend seemed to overlook all the science related to therapeutic outcomes, which show (and had shown even prior to the evidence based movement) that the technique and the theory used by the therapist is almost irrelevant to successful psychotherapy outcomes (some studies find no relevance others suggest theory and technique accounts for about 8% of outcome).Therapy will not advance if it is continued to be managed as such… fortunately there is exciting research about what does impact outcomes – feedback and adaptability. Would you prefer a therapist who used one way of helping everyone or a therapist who specifically catered their therapy to serve the specific and unique needs of each individual client? Is there one universal answer to the question, “how can I help you,” as it is related to therapy?
    If you are a therapist – read Scott Miller’s writings (www.scottmiller.com) it is very good (he has a particularly good article in the ‘newyorker’).
    Why is this important to the general public? – A huge percentage of therapists will not work for managed care companies, will not take insurance, and will not be a part of any bureaucratic network because of the tendency for such organizations to blindly follow misguided trends that do not help the client and do hurt the therapist.

    • This makes it more expensive in many cases for people to access the benefits of therapy.
    • This makes it more difficult to find specific therapists with specific specialties.
    • Therapist cannot afford the emotional and economic detriments of spending 50% (while making 70% less income) of their time doing paperwork and attending mandated trainings that have thus far proven to be irrelevant to therapeutic outcomes.
    • The mandated procedures and policies are often developed and implemented by people with no therapeutic experience.
    • There are limmited options available to people who would benefit from therapy, but do not have a diagnosable condition.

     
    Irony – people commonly seek therapy for troubles related to stress, depression, helplessness and anxiety. Trying to work within the current mental health system often produces those very symptoms within the therapist – which obviously does impact therapeutic outcomes.
    This trend requires so much oversight that well over 50% of all money spent on mental health is going somewhere other than to the people that are actually offering the mental health interventions.

    • Many if not most of the people offering the oversight of all the paperwork, authorizations, and ‘empirically based trainings’ that are irrelevant to outcomes actually have the credentials to offer mental health services.
      • So by throwing away this useless trend we could theoretically increase the amount of people offering mental health services by 100% without any increase to the budget.

     
    The other most significant problem with mental health services that are funded by insurance companies or by managed care companies is that they can currently only offer reactive interventions (imagine if the fire department was not allowed to respond to a fire until at least 4 houses in the neighborhood were already burning)… or interventions based on the medical model (you have an illness to be fixed or removed) as opposed to the wellness model (we can use your strengths to build new strengths while enhancing your relationships, your sense of purpose, your perception of your self, your sense of purpose and your general abilities etc.)
    Psychotherapy is infinitely more effective if it is used pro-actively.
                *example: it is more effective to offer marriage counseling than counseling for a child with depression resulting from a divorce.
    –         Unfortunately the only way to receive services from a managed care company or from an insurance company (there are a few exceptions) is for the therapist to give at least one person an individual diagnosis (clinical depression, schizophrenia, Bi-polar disorder and not – child–parent conflict or marital discord) which will effect their ability to access other benefits.
    So what do we do?
    Use what we know – therapeutic outcomes are already very good so the service is not in horrible need of some revolutionary trend.
    Therapist function very well independently and there is already an immense amount of oversight involved in the process of becoming a therapist – perhaps people who spend 50 grand to earn less then 30 grand a year need less oversight then what is in place (I’ve never met a therapist who is in the trade to steal money from the government or from the insurance companies – a huge percentage of the paperwork is ironically to prove that a therapist is not wasting money, but that paperwork is inherently wasteful).
    Get baselines and promote a culture of feedback – have the client qualitatively rate their progress and the effectiveness of the therapy – the therapist should adapt to meet the needs of the client.
    Eliminate waste and harmful stress – private practice therapists have around 400% less paperwork and are able to offer the same outcomes.
     
    Private practice therapist have supervisors for case consultation and have the same outcomes as people in mental health organizations who can have up to 6 or 7 tiers of upper management (why?).

    • Again if we fixed this we could make therapy available to more people with the same budget. – Most of the managers are not offering direct services though they have the credentials to do so.

     
    A therapists’  Hope, Empathy, ability to listen, ability to monitor his/her own internal reactions, ability to create hope, ability to interact without being judgmental, authenticity, ability to empower etc all effect therapeutic outcomes – If there is one ‘one size fit all’ idea that could be offered I would suggest this – healthy therapists are better at promoting healthy clients.
                * if what is being asked of therapists is not helping client outcomes and is hurting a therapists ability to function optimally – then why are we not reforming this trend?
     
     

  • Stating your internal feelings – acknowledge for acceptance – resistance is suffering

    Quick summary – are you crazy if you intentionally talk to yourself? What about all the unintentional talking (thoughts that your have automatically) in your head that happens all day? I do not remember where I learned the habit of acknowledging my emotions to myself, but I just started the practice up again… and it works great – journaling or writing a dairy has the same positive affects. For this blog post I will skip the science and simply give you some exercises to try. The idea is to say aloud what ever you are experiencing. ex. “I am feeling guilty that the waitress was offended by the way I ordered.” You can also acknowledge these feelings to another person who is available to listen.
    This is the exercise –
    – Simply state the emotions that you have decided to hold (guilt sadness anger etc).
    – Then offer a kind reason as to why you are not going to hold that emotion (that person has anger that they were trying to have me carry… I have the freedom to respectfully decline… I will not carry that emotion it is not mine to carry).
    The alternative is that your let the emotion control you which usually means that you are going to automatically react against the person who automatically reacted towards you.
    Yesterday I went out to dinner with my wife and some friends. The table next to us was experiencing moments of uncomfortable silences.
    I picked up on the use of the most common conversational mechanism found in times of social discomfort – criticism and critiquing.
    I noticed a feeling in my body which desired to assist (as communication assistance is a strength I hold).
    I then noticed a bit of self-judgment as I am personally working on reducing the amount that I pick up on other peoples’ emotions outside of conducting therapy (my empathic ability requires boundaries for the benefit of myself and my personal relationships).
    Our table was having a very cheerful conversation that was flowing without much of any effort and without a need for consistent direction.
    The dynamic creating a strong emotion in one of the people at the table next to us, and he very loudly critiqued the way that I conversed and the topics that we chose…

    • This critique created a temporary relief to the social awkwardness at the table (as they were able to talk about something), but it was at the expense of the critiqued – myself.

     
    Quite honestly my feelings were hurt – even though I was well aware of the conversation strategy before the personal attack occurred. (Rationalization is a defense mechanism – this is what I used first – it didn’t help much)
    I noticed guilt (for being charismatic), sadness (for being judged with negative intention), anger (for unresolved or unnoticed feeling being projected onto me), and awkwardness (for having to sit next to such volatile emotional energy).
    I held all of those emotions in and it was really uncomfortable.
    I then released the emotions aloud to my wife as we left the restaurant…She did not choose to carry the emotions… All I did is state the feeling that I found myself holding (they were not for wither of us to carry). I was almost 100% better… why?
    I released them back as the emotions were never mine to carry… I chose to pick up the negative energy… and I then chose to verbally release it.
    You now when someone gets mad at you for something you did that you really were not horribly at fault for… those instances in which there was good reason for you not to know better?
    examples –
    Being in the ‘wrong line’ at a place you have never been before.
    Putting your DOB as month day year when they asked for day month year.
    Asking for pickles at a restaurant that does not serve pickles.
    Ordering breakfast at a dinner that doesn’t serve breakfast…. etc.
    Complimenting someone’s hat only to find that it’s not called a hat.
    The emotional reaction that you get in these instances is not for you… they are obviously holding onto some unresolved issue and they are trying to offload that emotion onto you.
    The best way of getting rid of the emotions that you unintentionally picked up is to acknowledge it and then follow it with a helpful suggestion such as… (say these to yourself)

    • that is theirs to hold
    • I can be responsible for my actions but I can’t be responsible for their emotions.
    • I respect myself enough not to carry that emotion.
    • I choose to let that emotion stay behind.
    • I feel for that person’s pain and I will not carry that pain… that helps no one.
    • I have the freedom to carry what I want and leave what I do not want.
    • I offer that person the dignity to carry their own suffering.

     
     

  • Past blame or “whose fault it is” and on to solutions

    Quick summary: whose fault is it? This question is a big one from governmental to family politics. How does assigning fault help in the solution? The most common argument is that “if people know that they were wrong than they will not make the same choice again in the future.” the problem with this logic arrives when the ‘fault’ was either an accident or the fault was do to probability not landing in a person’s favor. To be more specific, accidents happen and life is not predictable – random things occur. Though it is important to find fault in select incidences (ex. who was the criminal in this case), the act of assigning fault simply delays the acquisition of a solution in many cases. What is the point? – perhaps solutions are more important than assigning blame, and even in those instances were fault needs to be assigned to support justice we should not loose site of creating solutions.
    The purpose of this blog post is do one simple thing… offer an alternative perspective on the widely held notion that assigning fault is an integral part of the solution process.
    Family Scenario –
    Someone left the garden hose on 5 hours ago and as you stepped out the front door to go to you meeting and your foot finds itself in mud past your ankle… you have twenty minutes till you meeting which is 15 minutes away. You have three kids all over 12 and a partner… what do you do?
    Answer 1 – you spend time figuring out who left the hose on… you then assign fault along with some form of punishment (either a verbal reprimand or a loss of privilege) … you are now flustered as you have 10 minutes to drive a distance which will take you 15 minutes… the added anxiety makes it difficult for you to remember were your other shoes are… you find your clean shoes and put them on and leave for your meeting.
    Answer 2 – you change your shoes in 2 minutes and leave for your meeting with time to spare.
    Political Scenario – the literacy rates in the county drop and teenage unwanted pregnancies, drug use, and violence increase… what do you do?
    Answer one – you look for ‘miss use’ of the budget to assign fault for the shortages in education budgets… you blame the opposing parties liberal or conservative views for the increase in unwanted behaviors… you bring attention back to former bills or positions that were not put into place and suggest that the problem would not have happened if this liberal or conservative bill had been passed… you attack the opposing party with personal attacks while suggesting that the fault is that the politician is too liberal or too conservative… you then start working on solutions with both sides offended and polarized.
    Answer 2 – you start looking at what is going well in the school system… you look at solutions that are working… you begin creating solution that both parties are in agreement with… you implement the solution of not choosing to work with the politicians, whether liberal or conservative, that are going to waste your time with the blame game.
    Learn from your mistakes – It is important that we do not repeat a mistake assuming that we have a choice in the matter. When someone is given constructive feedback he or she can choose to behave differently in the future.

    • Accidents don’t tend to be influenced much by education of constructive feedback… “Next time don’t trip, stub your toes and break my vase.”
    • Chance or probability means that sometimes things happen that were unlikely to happen. Again fault along with constructive feedback aren’t going to help much… “you should remember not to put you boat in the water because we know now that it could get hit by a tsunami.”

     
    Behavioral modification – the punishment or the reward has to be delivered relatively quickly following the behavior in order to affect that future use of that behavior. This means that if you spank a child an hour after he peed on the carpet the child is unlikely to associate the spanking with the peeing… behavior change is unlikely.

    • Assigning fault for a behavior that happened in the past is perhaps functional for educational and justice reason, but it is relatively ineffective at shaping behavior.

     
    You are mostly delaying – Ultimately a solution is going to make you feel better… assigning fault is mostly just delaying the acquisition of a solution… it is often a waste of physical, cognitive and emotional energy.
     
    If some one pushes you into the tiger exhibit at the zoo you could spend time figuring out who’s fault it is… but ultimately you need to do the work to get out of the that tiger cage.
     
    It might not be your fault… but it would be wise of you to help in creating the solution.

     

  • Externalization – you are with the problem… you are separate from the problem

    Quick summary – externalization is a technique from Narrative therapy which uses language to separate a person from their problem so that the person is better able to manage that problem. The basic idea is that it is easier to fix a concern if the concern is not rigidly attached to the person’s identity or personality (you are not stubborn… you use stubborn behavior). In this way the therapist would help a person to see that they are not a depressed person… but rather they are a person living with depression. This process offers perceptual freedom to a person… If they no longer view themselves as innately depressed then they can choose what to do with the depression which is with them (as it never was truly part of them). Narrative theory tends to view diagnosis as counter productive as a diagnosis encourages a person to over identify with the label… this takes away the person’s freedom and hope.
    Let me start with some quick examples: the first quote will use over-identification language and the second quote will use externalization. Which wording seems more solvable?
    I am a cancer patient – I am living with cancer
    I am an anxious person – I am person who carries anxiety
    I’m fat – I hold extra weight
    I’m a bad parent – I am a person with underdeveloped parenting techniques
    Are these just euphemisms? (Nicer ways of saying the same thing)
    Yes and No
    –         The secondary benefits of this technique are based on positive psychology principles.

    • Narrative therapists believe that you create your own reality through the stories that you tell yourself… and with the stories that we agree upon collectively.
    • Yes – if you tell yourself more positive stories then you will live within the reality of those more positive storylines. This is one of the more controversial aspects of positive psychology, narrative therapy and other constructionist and postmodern views.

     
    –         No… not just

    • The main benefit of this technique is that it allows a person to see himself or herself as separate from the problem which then makes it easier for that person to look at the problem from a different perspective.
    • The technique also encourages people to stop using unhelpful generalization so that they can see when the problem has less or no impact on their life.
      • Example: if you are a depressed person then you have made the generalization that you are always depressed. If you are a person with depression than it is easier to perceive the times when depression was not ‘with’ you.

     
    Externalization is also perhaps a more helpful and compassionate way to communicate with a person concerning a problem that they hold.
                * For example – would your rather be told that you are a messy person or that you are a person with some messy habits? Would you want someone to say that you are a mean person or would you rather he or she said that you are a person that uses less sensitive language?
    Over-identification causes suffering – certain Buddhist beliefs suggest that our over attachment to labels, material items, identities etc are the root of our suffering.
     
    Hope – hope is a statistically significant variable in relation to therapeutic and medical outcomes – hope has a positive correlation with recovery. The more you believe that you will heal = the more likely you are to heal.

    • It is easier to foster hope in a person when that person believes that they are separate from their problem… If a person believes that they are the problem then they believe they have to change themselves – that process is far more difficult than changing an externalized problem.

     
    Externalization trick – Something that you can practice in your life.
     
     * Try adding a verb and/or a preposition before your descriptors.
     
    I am depressed – I am living with depression
    I am learning disabled – I am a person who has a learning disability
    I am unhappy – I am a person who notices unhappiness in my life
    My cousin in developmentally disabled – my cousin has a developmental disability
    “Word choice effects your perception and your perception affects your emotions.”

    “I am with the snow balls … the snow balls are separate from me.” – Lucy the dog

  • Motivation to Exercise – why it is hard and how to make it easier

    Quick summary – Psychotherapists are not allowed to prescribe exercise for liability reasons though many of us have an understanding of neurology and the connection between physical and mental health… the research is both abundant and specific (as with most fields we are required to tell you to consult with a doctor to ensure that you are healthy enough to exercise). Much of what pharmacology (taking medication – such as anti –anxiety pills) does is to reproduce the release of neurotransmitters (think of them like chemical signals in the brain which affect or ‘turn on or off’ your thoughts, emotions, your hormone levels and ultimately your behaviors). Neurotransmitters associated with reducing depression, anxiety and stress are often released naturally during experiences such as exercise. Exercise has been studied to reduce stress, sleep problems, anxiety and depression while increasing euphoria, hope, sexual drive and neurogenesis (basically the creation, maintenance, and enhancement of neurons which are the functioning ‘parts’ of you brain.) The association between exercise and the resulting benefits does not happen naturally for reasons that I will explain – you must create the associations yourself. 
    With all these benefits (many of which can come from nowhere else)… why is it so hard to exercise? 

    • Delayed gratification and pain – Unfortunately you need to overcome a bit of difficulty (around 30 minutes of exercise) before you get the benefits.
      • Conditioning (behavioral psychology) – we tend to pair stimuli together to create learned associations. ‘That feels good – I like that…’
        • With exercise it has been suggested that the delay in time between the initiation of exercise and the positive benefits of exercise inhibits our ability to connect exercise with the resulting benefits… and we probably pair exercise with the initial feelings – pain, inconvenience, etc

      

    • Fatigue, lethargy, apathy, and other symptoms of depression– a lack of exercise can be associated with certain depressive symptoms, which can make you less motivated to initiate the exercise you need to reduce those symptoms. (note: symptoms of depression means that you have one or more symptoms of depression without necessarily have a diagnosable case of depression – most of us have depressive symptoms relatively regularly)
      • There is no substitute for exercise if you have stress levels that are too high – stress has a physical effect on the brain. Exercise is the leading component in repairing a stress cycle (an over-active state used to respond to danger in which you almost always feel as though you are in the ‘fight or flight’ mode).
      • Hopelessness is a symptom of depression which would make any motivation to heal through exercise seem futile or useless.
      • Apathy is another symptom in which you believe that you don’t care – so why would you even bother trying to be more healthy – “what difference does it make.”
      • Lethargy – doing nothing physically exertive can have sedative effects – which makes you temporarily feel better if you are suffering from stress or anxiety… as with alcohol and other sedatives the effects are temporary and often cause other concerns. 

    Alcohol and Comfort foods – both alcohol and comfort food can temporarily appear to assist with depression, anxiety and stress – unfortunately they might harm in the long run more than they help. 

    • Both make you less motivated to do exercise.
      • If you are full, hungover or drunk you are probably less likely to want to exercise.
    • It is more difficult and can take more energy to exercise a body which is impacted by over consumption of these substances.
      • This likely increases you association between pain and exercise.
      • To sedate the pain of depression, stress and anxiety without exercise you would need to indulge in comfort food and alcohol to a degree that could create a body that was more difficult to exercise.

    Sexuality – other mammals in the animal kingdom are encouraged to maintain physical health for reproductive reasons. 

    • Hormones and neurotransmitters (those signal chemicals in the brain) are connected, which means that the neurological benefits of exercise also affect your hormones – which affect you sex drive.
    • Exercise and been shown to effect you libido (your sexual drive).
      • Perhaps some humans experience a reduced enough amount of exercise to impact the natural drives of mammalian sexuality.
    • It appears that sexuality can be a huge motivator for people to exercise as some people connect exercise with meeting sexual desires.
      • This form of motivation seems to be especially evident in reality TV show actors. 

    Survival – other mammals in the animal kingdom associate physical health with survival. 

    • If an animal does not have health they could be chased down and eaten – many humans don’t tend to face such a concern
    • If a human does not maintain health they risk suffering from disease or body failure. 
      • Again the time line between not exercising and the onset of disease is too long for us to make a meaningful connection automatically.

      
    Solution for the Day… 
    You as a human have a developed enough mind to create your own associations, connections, and beliefs… which influence your behavior. 

    • Why do you associate ‘murder’ with ‘bad’ or ‘charity’ with ‘good’? – You and society made those connections…. people have beliefs even though they have had no relationship with the subjects.
    • Why would anyone have a retirement fund? There are no immediate benefits – you have to condition yourself to believe that it is beneficial.
    • Why would you have a tornado shelter? What is the immediate benefit – how can you know that it even is beneficial? You told yourself it was.
    • Why would you ever try in school if you didn’t like school and you would have rather been off playing in the woods? You created an association between doing your schoolwork and meeting your dreams – you can do the same with exercise.
      • There is a huge social component here – it is easier to make association when society at large is all in agreement (we are a social species).

    You can make your own association between exercise and the resulting benefits– increased libido, feelings of euphoria, reduced mental and physical health risks etc. 

    • I have created an association between hopelessness and apathy (the depressive symptoms I experience more often than others) and exercise.
      • If I start to have thoughts such as “there is nothing that I would be happy doing right now… I just don’t seem to care.” I will go exercise – for myself there is a 100% connection – those thoughts go away 100% of the time following exercise.
        • I remind myself of this truth to create a motivating belief system.
    • I associate exercise with my passion for the mountains – every time I am out in nature I thank myself for the exercising that I did which allowed me to access nature with such ease – this creates a connection.
    • I exercise a lot with my dog – she is immediately happy – so I create an association between exercise and creating joy in my good little friend.
    • The mental, relational and physical benefits of sexuality are remarkable (perhaps a future blog will cover this.)
      • You can create or recreate an association in this context. 

    The truth is this – We are a social species and much of our reality is created by collective agreement – or perception of reality is neither correct or incorrect – we simply all agreed that our beliefs, customs, rituals etc. were either correct or incorrect…  

    • When we collectively agreed that the world was flat we all behaved as though the world was flat.
    • When we all collectively believed that cigarettes were not bad for you – we behaved as though they were not bad for you.

    You are a social being – join with groups of people who associate exercise with positive benefits and you will increase your ability to make such beneficial associations. 

    • There is no one on the planet that I am closer to than my wife – our agreed upon belief concerning the benefits of exercise makes it infinitely easier for me to engage in and to motivate to exercise.
    • Groups work.
      • Groups work for everything from trauma recovery to substance abuse treatment to weight loss to spirituality etc. 

    Make life easier on yourself – get with a group of people that have positive and motivating beliefs associated with exercise and let the collective help train your mind to engage in the healthy activity known as exercise. 
     
      
     

  • Harmful Interaction Patterns – which do you do and what can help?

    Quick summary – Dr. John Gottman has done extensive research on the variables which affect a stable marriage (or committed relationship). He is able to predict with just over 90% accuracy if a couple will eventually divorce after as little as 5 minutes of observation. He isolated four interaction patterns (he calls them the 4 horsemen) which are potentially devastating to a relationship. The interaction patterns to work on are contempt, criticism, defensiveness and stonewalling.  Please note that we all engage in these interaction patterns… the harm is related to frequency, degree and the absence of reparation strategies and a firm relational foundation. You might not be aware that you are using any of these patterns… couples therapy can help increase your awareness of what interaction you tend to utilize (and why) and what you can do to improve the interactions in your relationship.
    For more about Dr. Gottman you can visit – http://www.gottman.com/
    Contempt – This is when a person displays distain, hatred, or disgust etc towards their partner. When someone is using contempt in an interaction he or she is attempting to belittle the person or to cause him or her psychological/emotional pain.
    –         Behaviors include:

    • Personal insults (generally containing a generalization – “you are bad person” – “sure I’ll do that for you fatty.”
    • Sarcasm or hostile humor – “sure that will work because you are sooo good with money.” – “maybe we should call the restaurant and see if they will take a reservation for a dumbasses.”
    • mockery, commonly with body language – rolling of the eyes, laughing at a person for there mistake etc.

     
    Stonewalling – this is intentionally ignoring a person or leaving the person without attempting a resolution (or offering a better time to work things out). The person often believes that they are helping by avoiding the conflict… the behavior leaves the other partner feeling alone, isolated, and helpless.
    –         Behaviors include:

    • Leaving a conversation without informing the person – if and when you will come back – or why you are leaving the interaction (it is ok to say I need a minute to cool down I’ll be back in an hour).
    • Changing the subject – instead of listening to your partner you distract him/her with irrelevant subjects… the partner feels unheard and unimportant.
    • One word or emotionless answers – ex. “honey I am really concerned about our son… it hurts me that he’s acting up so much.” – response – “Fine” or “don’t worry about it.”

     
    Criticism – This is the act of constantly judging and looking for fault in your partner. Criticism is an attack on the partner’s personality. This is the most confusing interaction as there is a thin line between informing your partner about your needs or opinions and criticizing your partner. Criticism involves judging a person while getting a need met involves judging a behavior. Ex. “You are a dirty person who never cleans up anything.” is a criticism.” “I would like it if you would please put your dishes away after you have used them.” is a way of getting a need met by directing the attention on a behavior.
    –         Behaviors include:

    • Generalizations – “you always….”
    • Statements concerning a person and not a behavior – “you are a messy person.” instead of “you engage in this messy behavior.”
    • Looking for the bad instead of the good – the person will notice more bad things than good things. This is also extremely ineffective for changing behaviors. Always focusing your attention on faults or on the negative.
      • 5 – 1 rule (or 7 -1) – in order to change a behavior you should have five positive statements (reinforce what was done ‘correctly’ or in the right direction of the goal) to every one negative or corrective statement. Example: If someone is messy you should compliment 5 acts that were steps to improve messy behavior (thanks for cleaning your fork) for every one suggestion about how they behave messy (will you try to clean your fork after you use it).

     
    Defensive – defensive is an act in which you essentially stop listening to your partner and start defending your subjective experience. When a person is being defensive they are not allowing themselves to be open to their partner’s individual opinion, thoughts or emotions. The interaction pattern serves to prove the other person is ‘wrong’ and their behavior serves as an attempt to avoid or defend from a perceived attack. The point is that most arguments are based on opinions – no one is right or wrong… therefore sometimes the only goal is to hear and to be heard by an open-minded and accepting partner.
    –         Behaviors include:

    • Whining – “it is not fair.”
    • ‘No but’ or ‘yes but’ – “no but I had to because of the rain.”
    • Excuses – “I wouldn’t have done that if I had taken the class I wanted to take.”
    • Repeating yourself instead of listening.
    • Addressing a critique of a behavior with a critique of your own – “I might not do the dishes but you are the one wasting all our money on gasoline.”

     
    Steps to interact well:

    • Appreciate that your partner has a right to his or her own beliefs and emotions.

     

    • Accept what your partner is saying … though you are not required to understand or to agree… “I accept that you see it that way though I still see it differently.”

     

    • Listen and try to care for your partner despite the fact that you have a difficult time with the subject.

     

    • Separate the subject from the person…he/she feels, behaves or thinks this way but the whole is greater (and more complicated) than the parts and I love him/her.

     

    • Remember that there is no resolution to around 70 -90% of all arguments as most arguments are based on individual perception or opinion.

     

    • Remind yourself that you love the person and it is perfectly fine to disagree.

     

    • Sometimes you need to agree to simply stop arguing… neither of you is right most of the time… as ‘right’ rarely exists.

     

    • Focus on behaviors and not on personalities – It is easier to behave differently than to ‘be’ differently.

     

    • Admit when you know that you are wrong… apologies beget apologies.

     

    • Reinforce repair attempts. Ex. if one of you says – “we’re just arguing for the sake of arguing I’m sorry.” thank them for healing the interaction.

     

    • Practice open-mindedness – “you may be right” “I want to understand you better”, ”I would like to see how you see it”

     

    • Self-awareness – know your role in the conflict … know what interaction pattern you tend to use… begin to explore how your interaction pattern is influencing your partners interaction pattern (stonewalling begets criticism as criticism begets stonewalling).