Click here to contact Holly and/or see her GoodTherapy.org Profile

There are several styles of hypnotherapy that are commonly adopted by practitioners and not all styles work well for all clients. One way to access what style might work best for you is to respond to this question: How do you normally respond to people telling you what to do? If you are the type of person who feels secure when you have instructions and direct requests, the directive approach will most likely work for you. If you find you are rebellious when people tell you what to do, a more permissive approach will suit you better. When you interview a prospective hypnotherapist you might want to question her about her training and style to discover if you will feel comfortable and be responsive to her approach. The following is a basic overview of the different styles of hypnotherapy to help you understand your options.

Directive Approach

In the directive approach, the hypnotherapist guides the client into a state of hypnosis and the hypnotherapist gives the client suggestions. People are most familiar with this approach to hypnotherapy because it is the technique that is most similar to what we witness with stage hypnosis and see in the movies. And, clients expect that if they go for a hypnotherapy session that the hypnotherapist will give direct suggestions.

All styles of hypnotherapy will adopt aspects of this style. Simply, telling the client to sit comfortably and to take a deep breath is a direct suggestion. If the client is suggestible, open and receptive to the process, and if the client is without inner conflicts about the focus of the session, direct suggestion can work. These “ifs” are the big issues with the direct suggestion approach. New clients may not yet trust the hyypnotherapist or trust their own abilities to respond to hypnosis. Clients may also have misunderstandings about what hypnosis is and how it works that contributes to anxiety about being hypnotized.

Misperceptions about what to expect from hypnosis can make it difficult for the client to relax and flow with the process. For instance, many people falsely believe that the hypnotherapist can control them or make them do things they would not normally allow themselves to do.

But, most importantly, clients often cannot respond to direct suggestions because they come in for hypnotherapy living with many inner conflicts about the issues they want to work on. The subconscious’ limiting beliefs, negative attitudes, misperceptions, and encoded traumatic past experiences will usually override any positive suggestions.

Most experiments in directive hypnosis are controlled with the use of one specific induction or script using direct suggestions. The results in these studies typically show that not everyone responds to direct suggestion. And, if a person responds to direct suggestion, it is probable that the suggestions will wear off over time when a client has subconscious beliefs or perceptions that are contrary to the suggestions. If the directive approach doesn’t work for everyone and the effect of the suggestions can wear off, what are some alternative approaches to hypnosis?

Non-directive, Open-ended Style

The open-ended and more permissive style of hypnosis came into vogue in the 1970’s and 1980’s, with the work of a famous hypnotherapist and physician named Milton Erickson. In the field of hypnotherapy, Erickson is renown for both teaching medical students hypnosis and working individually with patients. He taught hypnosis by hypnotizing his students through story telling, using teaching metaphors and by using hypnotic language patterns that speak directly to the unconscious. His hypnotic techniques are effective because they are a back door approach to the unconscious. Instead of telling a client to close her eyes (a direct suggestion), a hypnotherapist using a permissive style of hypnosis might use an embedded or permissive suggestion like, “You notice that your eyes are open and you may find you will be more comfortable when you close your eyes.” In this embedded suggestion the language mirrors what the client is already experiencing and that she has freedom to respond to the suggestion, or not. The client’s unconscious, however “hears” the suggestion, “ Close your eyes”. A permissive approach builds into the session that the client has choice. The hypnotherapist’s utilizing what is already true and happening in the process of hypnotizing the client takes the stress out of whether the client can be hypnotized and relieves the client’s conscious mind of the task of wondering or scrutinizing if she is “doing it right”. Commonly, with an open-ended style, the hypnotherapist will use the language of metaphor to teach the client new inner responses to situations or to expand the client’s perceptions and resources about an issue or problem. The client of this non-directive style typically experiences hypnosis as being more organic, fluid and effortless than the directive approach which requires the client’s willingness and receptivity to respond to direct suggestions. The client simply listens and goes with her natural responses to the process. She may close her eyes or experience the hypnotic state with her eyes open. This style is excellent for the client who fears being controlled, is unable to stop the mind chatter, or has self-consciousness that can create resistance to experiencing hypnosis.

Transpersonal Approach

Somewhat new to the field of hypnotherapy, but as old as the traditions of most indigenous cultures, is the transpersonal approach to hypnotherapy. In traditional hypnotherapy and psychology, there is an understanding that we have both a conscious and an unconscious aspect of mind. In the transpersonal paradigm, there is also a superconscious aspect of mind that goes beyond the personal self. This superconscious aspect is called by many names, such as: Higher Power, Atman, Christ within, higher Self, or intuition, In the transpersonal approach, this greater mind or higher Self is an active co-therapist in the hypnotherapy process. Of all the styles of hypnotherapy the transpersonal approach is the most client-focused and non-directive. The client and hypnotherapist co-create the session through a verbal and energetic interplay as the session unfolds. The transpersonal approach is more about “being”, rather than “doing.” Often the hypnotherapist will directly invoke the client’s inner wisdom and ask it for support in guiding the session. The client accesses this wisdom and works directly with it in trance through voice dialogue, symbolic communication and inner knowing that has direct access to healing, wisdom, insight and creativity. This style supports the cultivation of the client’s ongoing relationship with this inner wisdom. A transpersonal approach may likely include directive and non-directive languaging as needed, depending on the inner guidance of the client’s higher Self.

Which style is right for you?

Knowing about these different hypnotherapeutic approaches will help you interview a hypnotherapist so you can learn about his or her training and hypnotic style. If you are a new client to hypnotherapy, you may not yet know what style works best for you. So perhaps, it will be wise to work with someone who has training in all the styles who can be flexible in his or her approach as you learn about your own responsiveness. A transpersonal hypnotherapist can be directive if necessary, but a traditional, directive hypnotherapist may not know about the more contemporary non-directive or transpersonal approach.

Whatever approach you choose, accessing the state of hypnotic consciousness will give you access to your inner resources and the power to transform yourself.

©Copyright 2009 by Holly Holmes-Meredith, D. Min., MFT, Board Certified Clinical Hypnotherapist. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Holly and/or see her GoodTherapy.org Profile

Click here to contact Jeanette and/or see her GoodTherapy.org Profile

I do what you want, but you never let me do what I want!
Duncan had his heart set on the new BMW sports car, but Estelle wondered whether it was the best way of spending money at this point. There were other more important priorities like her business start up, the kids school fees and house repairs to consider.

Duncan blew up. “You never let me have what I want! When you wanted to go to Peru I agreed because I knew what that meant to you. I let you choose the living room furniture even though I hated it. Yet when something is important to me you pour cold water all over it, and make me feel selfish.”

You just want to stack up points to use against me!
“I’m sick of your whining. You have the money. You can buy whatever you want. I don’t know why you bother asking for my approval. You’re going to do what you want anyway. If I don’t agree I’m a spoiler, and boy do you punish me for it afterwards! You make me pay for all the times you did things my way. You just do it to stack up points that you can beat me with when I don’t agree with you.” Estelle retaliated with fury to being manipulated.

Duncan wanted his wife’s permission, so he didn’t feel guilty.
Duncan was independently wealthy. The BMW wouldn’t hurt his financial portfolio, and he could take it as a business expense. But buying the car just because it was possible wasn’t satisfying to him. He was hungry for something much more valuable- permission to want things just for himself, and just for the fun of it. That was the real prize. He was mad as a hungry bear that he couldn’t get a loved one to okay his wishes. He wanted to rid himself of the guilt that washed over him whenever he wanted something just for fun. He was fed up with always having to justify it as worthwhile.

Duncan was torn between feeling selfish and being a burden.
Duncan had been angry a long time. As far back as he could remember his mentally challenged younger brother Trevor got all the free passes at home. His father gave into Trevor’s tantrums to keep him quiet and manageable. His mother was torn between trying to anticipate Trevor’s moods and erratic behavior and keeping her marriage together. Duncan was expected to be the good son who never needed nor wanted anything other than the basics. If he ever wanted a new game, a special restaurant for a treat, or a trip to Disneyland he felt like he was adding to his parent’s burden.

There was little room for him to have his childhood wishes without shame, guilt and a belief that his needs were illegitimate. That’s when the anger started. Why were his needs less important than Trevor’s.? Why was it wrong for him to want his mother’s approval and his father’s attention for being a normal healthy son? Why couldn’t he be spoiled just once?

Duncan became furious when his carefully thought out plan failed.
The injustice of his childhood kept the anger smoldering on a bed of hot coals that was constantly stoked up. Each time Estelle didn’t gush with enthusiasm and give him the green light to get what he wanted he relived the torment of his childhood. He got more and more furious that even when he didn’t have to compete with a needy brother, he still didn’t get his wishes accepted and nurtured. Duncan made a deal with himself. If he let his wife have what she wanted even if he didn’t like it himself, then he would be entitled to expect the same from her. He bit his tongue when he agreed with her suggestions, waiting for his turn to get his wishes approved.

Duncan’s plan didn’t work. Estelle didn’t buy into his scheme. Duncan’s rage grew fiercer and the relationship became a battle ground. Duncan refused to give himself permission to enjoy things he could get for himself, and Estelle refused to be put in the role of the bad guy who spoiled his life.

How can Duncan and his wife stop getting mad at each other?
How can Duncan and Estelle stop the cycle of anger that interferes with their intimacy?

• Duncan needs to get clear on what his anger is really about. His anger is not about the car. It is about not knowing where he stands with Estelle and trying to figure it out. He used the car as a way of testing his wife. Would there be enough room for him on her priority list, or would he get shoved to the bottom just as he did when he was a kid?

• Duncan should share with Estelle his feelings of guilt, unworthiness and rage at never feeling secure enough to be able to legitimize his own wants and needs.

• Estelle should try and hear it as part of Duncan’s issue rather than take it personally and strike back. She can then share her hurt when he puts her in the role of judge and jury.

• Estelle should encourage Duncan to do what he wants from time to time so that he can develop a sense of pleasure and legitimacy about his wishes. He will become more comfortable with his decisions and less dependent on Estelle. It will also help her avoid being put into a no-win situation.

• When Duncan and Estelle feel and hear each other’s hurt, anger and frustration, they have begun to take a new journey together towards satisfying the hunger they both have to be seen as good, worthy and loveable people.

©Copyright 2009 by Jeanette Raymond, Ph.D. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Jeanette and/or see her GoodTherapy.org Profile

Click here to contact Beth and/or see her GoodTherapy.org Profile

The intense and painful experiences of grief are generally considered “normal.” However, when those experiences are extremely distressing, unduly interfere with day-to-day functioning or do not subside to a manageable level over time, the bereaved may be experiencing complicated or traumatic grief. Complicated grief has been proposed as a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and suggested components of the diagnosis include (1) that sufferers experience bereavement by death; (2) that their reactions include intrusive and distressing symptoms, including yearning, longing and searching for the deceased; and (3) that the bereaved exhibit at least four marked and persistent trauma reactions, which may include: “avoidance of reminders of the deceased, purposelessness, feelings of futility, difficulty imagining a life without the deceased, numbness, detachment, feeling stunned, dazed or shocked, feeling that life is empty or meaningless, feeling a part of oneself has died, disbelief, excessive anger or bitterness related to the death, and identification symptoms or harmful behaviors resembling those suffered by the deceased” (Mitchell et al, 2004, p. 13).

Even in cases that do not fit the criteria for complicated grief as described above, the events surrounding the death may be sufficiently traumatic to interfere with daily functioning or result in unrelenting distress. As a psychotherapist specializing in grief and loss, I have found EMDR (Eye Movement Desensitization and Reprocessing) to be an effective tool for alleviating trauma in grief. As in grief, trauma affects the whole person — body, mind and spirit, and on a hierarchy of needs, trauma must be dealt with in order for the healing process of grief to proceed in a healthy, and healing, fashion.

What is EMDR?

In brief, EMDR was developed by psychologist Francine Shapiro after making a chance discovery that the lateral movement of her eyes reduced the intensity of disturbing material she was dealing with in her life (Shapiro, 1995, p. 2). Dr. Shapiro spent several years scientifically studying this phenomenon, and found that bilateral stimulation, i.e., stimulation on both sides of the body — whether in the form of eye movements, tapping, sound or other forms — released traumatic material from the brain in a way that made the material workable. Trauma that is locked in the brain leads to the “fight, flight or freeze” response, and EMDR helps transform traumatic images into memories that no longer have a deleterious hold on the individual.

In addition to this physiological response to trauma, the traumatized individual often develops negative beliefs about him or herself (such as “I do not deserve love, “I was at fault” etc). The beauty of EMDR is that it works on a cognitive level as well as the physiological level, not only facilitating the transformation of traumatic images in the brain, but also allowing the individual to replace negative cognitions about him or herself with positive ones (such as “I deserve love”, “I did the best I could”, etc.). EMDR also works on a somatic level, with the therapist guiding the client to feel the traumatic images and negative beliefs in the body, thus further facilitating the transformation of the images into non-intrusive memories, and also transforming the negative beliefs into positive, useful ones. Therapists need to be trained to practice EMDR, and follow a standardized protocol in EMDR work with clients.

Case Studies

Two cases in my practice are illustrative of the effectiveness of EMDR in resolving traumatic grief. “Carol”, the mother of two small children, came to see me complaining of ongoing distress after the death of her husband nine months before. “Bill” was in a motorcycle accident, sustaining a broken leg. After being admitted to the hospital, Bill suffered a stroke and brain swelling, and died after being taken off life support two days later. Carol was concerned about her irritability, particularly toward her children, and her anger toward Bill for dying and leaving her with two small children to raise alone. She also expressed guilt regarding her anger toward Bill, which I spent time validating and normalizing, since anger is often exhibited as a normal grief response. Carol spent much time telling her story — a useful healing tool for making meaning of a seemingly senseless situation (White, 1995). She did not exhibit signs of trauma for the first few months that we worked together. However, as the anniversary of Bill’s death approached, Carol found it difficult to sleep, being awakened by intrusive images of Bill lying in the hospital bed and her shock when she learned of his condition. We explored Carol’s negative cognitions around these images and Bill’s sudden death. The negative belief that that most impacted Carol was her belief that Bill’s death was her fault because she had a premonition that he would be in an accident, and she did nothing to prevent it. In describing the images of Bill lying in the ICU and her belief that it was her fault, Carol felt tightness in her chest and had difficulty breathing. After two 90-minute EMDR sessions, Carol was able to replace her negative belief “I was at fault” with the positive belief “I did the best I could.” She reported that she still, of course, experienced memories of Bill’s death, and reported she was very pleased that that she could feel sadness without guilt. Carol was thus finally able to process her grief and loss in a healthy way.

My work with “Mary” was deeply profound and moving. Mary’s husband “Don” suffered with Lou Gehrig’s disease (ALS) for three years, and Mary witnessed the horrible, inexorable ravaging of Don’s body while his mind stayed strong. Mary’s expressed purpose for coming to see me was that she was unable to feel Don’s presence in her life. Mary described Don as her soul mate, and I assured her that because of the strength of their bond, she would find a place for Don in her heart and feel his presence as a support in order to move forward. However, it was clear that she would first have to deal with the traumatic images that prevented her from fulfilling this step in her grief process. The most disturbing image, and target for our EMDR work, was finding Don lying in a pool of blood on the bathroom floor after falling out of his wheelchair. I taught Mary the “butterfly” technique, in which the client crosses his or her arms across the chest in a hug and taps alternately below each shoulder, simulating the bilateral stimulation used in formal EMDR sessions. I instructed Mary to use this technique at home as a resource when traumatic images arose. After two sessions, with Mary working at home with the butterfly hug when disturbing images and emotions arose, Mary reported that those images had receded as mere memories that were no longer unduly disturbing.

Mary came into our next session glowing, and reported that she had felt a tug at the back of her shirt while sitting quietly one day and “knew it was Don, back in my life.” She reported that she subsequently felt Don’s presence coming to her every night before she fell asleep. Our trauma work was done, and Mary was well on the way to healing her grief.

Conclusion

Dr. Roger Solomon has observed that: EMDR often results in the emergence of positive memories of the deceased with associated affect….It is the emergence of memories of the deceased that let us know and acknowledge the meaning of the relationship, the person’s role in our lives and identity, and enable us to carry the basic security of having loved and been loved into the future.

My work with both Carol and Mary, as well as many others, has enhanced my confidence in my therapeutic skills in identifying and working with traumatic grief, and has increased my trust and faith in the effectiveness of EMDR as a healing tool in grief.

References

A. Mitchell, Y. Kim, H.G. Prigerson, M.K. Mortimer-Stephens. (2004). Complicated Grief in Survivors of Suicide. Crisis 25(1), 12-18.

F. Shapiro. (1995). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures. New York: Guilford Press.

R.M. Solomon, EMDR and Grief. www.emdr.org.il/dls/solomon.doc. Retrieved October 25, 2009.

M. White. (1995). Re-authoring lives. Adelaide: Dulwich Center Publications.

©Copyright 2009 by Beth S. Patterson, MA. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Beth and/or see her GoodTherapy.org Profile

Click here to contact Pam and/or see her GoodTherapy.org Profile

Somehow you have ended up on the wrong side of the “whose fault was it” argument with your spouse. You know it was your fault but you have lots of really good reasons why you acted like you did. Plus, you were well intentioned and actually only said those things because your partner needed to hear them. Nonetheless, you can see that there is a breach in the relationship and if you don’t do a repair, you are not going to like the icy silence or hot reproachful words that come back. So, it is time for an apology—to eat crow, “fess up,” or bow low to ask for a pardon.

Actually, I find myself in this position more than I like to admit. In all honesty, I don’t like to apologize. Sometimes, I have trouble getting my attitude right so my words don’t sound very sincere. At other times, I simply do not think I’m the one in the wrong. I will begin to list the ways I am right, with sound reasons, wonderful logic, and a clear sense of righteousness on my side. As you might guess, that doesn’t work either.

As a marriage counselor, I have learned the art of apology from my clients and from my training. None of this came natural for me. I have learned to take several deep breaths and tell myself to listen to what my husband’s concerns are before I respond. Over the years, I have learned to stop providing all the really good reasons why, in fact, I am not wrong because sometimes I am wrong.

Then I remind myself of the ABC’s of an apology:

Always Be Calm: Take several deep breaths and remember what’s at stake. Calming your nervous system and reducing your heart rate will help keep you from blurting out something you’ll regret later. Hearing your partner and thinking about the validity of their statements is so much easier if you are calm.

Avoid Being Critical: While it is natural to think of all those times your partner has been wrong, this is not the time to bring them up. Heaping criticism onto your partner will only confuse the issue and cause tension to increase.

Accept Blame Civilly: Be gracious and humble. Use those polite words your mom always wanted you to use. Here are some examples:

1. I really blew that one. Let me try it again.
2. Oops! How can I make things better?
3. Let me start over again. I think I went too far.
4. I really don’t want to be bossy with you. I can see how I came across that way. Sorry.
5. Look, your feelings are important to me. I shouldn’t have said what I said. I hope we are OK now.

And lastly, be kind to yourself. It’s OK to be wrong sometimes. John Wooden, basketball’s coaching legend and Hall of Famer, led the Bruins at UCLA to 88 consecutive winning games. But he knew that one of the secrets of success is to be accepting of failure as well. He famously said: “If you’re not making mistakes, then you’re not doing anything.”

©Copyright 2009 by Pamela Lipe, MS, LP. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Pam and/or see her GoodTherapy.org Profile

Around the world, bullying in schools presents problems that can range from the slight to the serious, with many children suffering from chronic, violent behaviors that can detract from academic performance as well as happiness. Finding ways to combat this issue is largely dependent on the attitudes of children, suggests the work produced by a Spanish study on bullying. Unfortunately, the study’s findings suggest that children accept that bullying has been and always will be part of life, thereby justifying it to themselves and creating a psychological block against its addressing and prevention. The study may, however, help the mental health professional community understand how to help children overcome bullying issues.

Click here to contact Mitchell and/or see his GoodTherapy.org Profile

If I’ve witnessed it once I’ve witnessed it a few hundred times during my years counseling couples. One partner reacts as if his self worth has been decimated by words or actions originating from his partner. The curious and perplexing aspect of observing this process unfold, relates to specific instances when from my perspective evidence of anything that smacks of criticism or judgment is as detectable as an evaporated water spot on a shirt.

This brief article discusses the imperceptible shifts that can take place between partners that explain how one partner ceases to use and value his autonomous self to relate to and process his partner’s communications and then, blames the partner for feeling useless and worthless when an emotional crisis is precipitated. Such a crisis is borne of disappointed expectations shaped by lessons learned at the knee of caregivers that have curiously stood the test of time despite being invalid and unreliable. To illustrate this theme I offer a clinical illustration. The spouses are composites of patients I have worked with over the years.

Sheila had reached a crisis in our couples work with her husband Jim. She was in the estimation of both her husband and myself despite her denials to the contrary, re-living apprehensions that Jim would abandon her as did her father when he joined Alcoholics Anonymous, divorced Sheila’s mother and for all intents and purposes discarded his hats as husband and father in one fell swoop. Why were these apprehensions coming to the fore when they did, and why couldn’t Sheila see them for what they were? They shaped her ultimate vulnerabilities to feeling at the mercy of an alleged phantom attack at the hands of her husband.

Sheila’s father had, prior to his AA recovery activities, submitted to his wife’s wishes to dominate him in the same manner that Jim had permitted his wife to dominate him before and during a period of time in which he was unemployed and depressed. Now Jim was employed and growing in self respect for himself as a direct consequence of individual psychotherapy sessions with me. His burgeoning comfort with standing up to Sheila’s efforts to control his self expression had quickly stimulated unconscious associations to her father’s path out the door of her life. Sheila was in denial that her mind was trying to fit a round peg of the current circumstances into a round hole of her past recollections. She was most uncomfortable with not knowing what the future held for them, as trusting herself to adapt accordingly was more responsibility than she bargained for.

The most glaring symptom of devaluing her self was that Sheila had ceased to ask questions and actively clarify with Jim what he was saying and doing and what he intended by his words and actions. Anything incongruent with what she believed to be true based on her own internally generated perceptions were dismissed and discarded as inaccurate and/or disingenuous. Sheila had her husband all figured out and yet, it seemed pretty obvious to Jim and myself that whomever Sheila was relating to was not the Jim he understood himself to be, or I understood him to be. Sheila had lapsed into mind reading; however, the only mind she was reading and relating to were parts of her own inner world of internalized relationships now projected onto her husband and confused with the husband in the room.

Sheila’s unconscious mind increasingly took a stranglehold on how she perceived reality and constructed meaning. Jim grew in self assurance and increasingly presented himself as the master of his own ship and not to be controlled. Sheila became passive as if not to rock the boat and drive her husband out, as she feared her mother had done to her father once he was sober, had a support system, and no longer needed her mother to enable his alcoholism. It was as if Sheila progressively became passive as if to say “please don’t leave me with mom.” During Sheila’s childhood she and her father found in each other solace and comfort as both shared the experience of having been bullied by Sheila’s mother. Sheila had learned early in life that weakness and vulnerability invited exploitation, so the more she identified with the little girl who feared abandonment the more she denied her weaknesses and vulnerabilities that inhibited her self assertiveness. These recollections were not accessible for discussion as Sheila’s capacities to make space, observe herself, think about her feelings and reflect on them, had temporarily disappeared. During childhood her mother had not tolerated Sheila’s strivings toward autonomy. These strivings were considered to be disrespectful and an attack on her mother’s self worth. In Sheila’s confusion between the past and the present, she denied her anxieties around expectations that she might be manipulated by myself and her husband as she had been by her mother, and to a lesser degree by her father, who recruited Sheila to join him and covertly defy and oppose her mother through acts of omission.

Sheila’s defenses against anxiety became less mature as she regressed to defend against the specter of her husband leaving her. Adults behaving like children are less likely to be left by disgruntled spouses than adults behaving like adults. Such is the power of guilt. Sheila, with little if any awareness of her evolving emotional crisis, began to idealize what she had learned to expect as a little girl. To escape her terrifying weaknesses and vulnerabilities Sheila identified with the recollected mother of her inner world. This way Sheila could feel close to her mother, experience her support, forgive her transgressions, and invest herself with the authority she felt was slipping from her grasp, as the passivity reminiscent of a childhood organized around pleasing her parents took hold of her. This unconscious metamorphosis meant creating and exploiting an experience of being wronged to justify making demands of her husband. Cast in her mother’s perfect self image Sheila was to be the architect of her own victimization, deny responsibility for the consequences of her actions, blame the actors cast in her historical enactment, hold a grudge, and then, demand that justice be served. All that was needed was a pretext for this morality play to be repeated.

Sheila victimized herself at the hands of Jim’s brother, Tom, who was not to be trusted or relied upon to be respectful and considerate of himself or anyone else for that matter. Unfortunately, in this case neither Sheila nor Jim actively processed what might happen and how they might feel in doing business with Tom. However, Jim was able to accept responsibility for his decision and separate himself from his brother’s unjustified, disrespectful and inconsiderate actions. Sheila could and would not.

When Jim’s brother Tom tried to help them buy a kitchen appliance through his company but could not deliver the model Sheila desired, she bought it elsewhere with Jim’s blessings. Tom was at first accepting of this disappointment after doing what he could to help his sister-in-law and close a deal for himself. Later however, he disparaged his sister-in-law to the rest of his family as having selfishly used him. This was Tom being Tom. Sheila told Jim that until Tom apologized (which was unlikely to happen as Tom milked the role of victim as readily as Sheila did), she would not attend any of his family’s functions under any circumstances. Sheila’s self worth at this point was completely invested in the idealized wish that her husband would come to her rescue and choose her over his family unlike how her father had chosen his AA fellowship over his mother and herself. It was Sheila’s turn to turn the tables and step into the shoes of her mother whose sense of entitlement was entirely linked to real and/or imagined experiences of being treated unfairly and unjustly. The need to rely on such leverage was evidence of how undeserving Sheila felt in her own right to begin with. Sheila’s mother was not one to forgive and move on. Now Sheila, the self styled victim who under ordinary circumstances still felt like a hostage of her mother’s demands to be pleased at Sheila’s expense now felt empowered to collect her emotional debts with interest. Many of the unpaid debts I’m referring to were the unpaid debts for sacrificing herself at the hands of both parents that she never forgave, which had nothing to do with what Jim owed her under any circumstances.

Getting what Sheila demanded was unreasonable, unrealistic, disrespectful and inconsiderate of Jim and yet she pursued her agenda with a desperate vengeance. Jim was compassionate and empathetic towards his wife and validated her perception that his brother had done her wrong. However, she was putting him in the middle between herself and his entire family by asking him to choose. Sheila would not listen to reason and would not consider Jim’s desire to attend his brother Harvey’s birthday party at which Tom would be in attendance. She would not listen and process any proposals that respected and considered both of them including Jim putting his family on notice that if anything was said during the event that might potentially embarrass Sheila, they would leave immediately.

A life’s worth of accumulated rage, hatred, vengeance and anger was bubbling to the surface for Sheila and she was not inclined to look at, think about and try to understand what piece of history was being enacted here. Jim told Sheila that her position was not acceptable to him and Sheila looked as if Jim had just taken an ice pick to the heart of her worth as a human being. When I asked Sheila to take some deep breaths, step back and reflect on what she just heard that was so wounding to her, Sheila accused me of abandoning her and left in a huff. Jim wound up staying with me in individual psychotherapy and Sheila was supported to find another therapist for herself.

This vignette illustrates how unsubstantiated yet idealized expectations can precipitate an identity crisis, that when disappointed, can leave the author of such expectations with the experience of his self worth having collapsed like a house of cards. Nothing is left. When Sheila could not replay history with her wished-for “happy ending,” in a moment of gratifying vindication she gifted her husband and myself her feelings of worthlessness and uselessness and attempted to disconnect from both of us by walking out like her father had on her mother and herself. She temporarily rid herself of needing either of us. By not getting what she demanded, Sheila had nothing to show for her complete and utter sacrifice and devaluation of her self except to exact revenge.

Sheila desperately tried to get the outside world to conform to her internal expectations based on history. Necessity being the mother of invention, Sheila regressed to a stage of magical thinking, desperate to be all knowing and all powerful in the face of apprehensions that should her husband not dance to her tune, she would be left feeling as useless and worthless as the day her father left her. Her idealized expectations were all she had left to protect herself from what she imagined would be a fatal wound to her self worth. This bright and competent adult had become fearful of annihilation as if her valued identity was inextricably tied to enacting history with a different outcome. From the perspective of Sheila’s inner child, what she got or didn’t get is what she deserved and what she deserved put the final nail in the coffin condemning her to be punished as a bad little girl. Her badness was nothing more than the fear and dread of what her unconscious hostilities toward her parents had done and might continue to do to kill off love and concern for her as a separate person. She had never learned to own and use these feelings constructively, as her recollections were rich with lessons that her mother would attack her if she asserted herself and her father would behave as if he had been killed off.

This article discusses the mechanisms by which one spouse may experience another spouse as having the power and authority to attack and rob him of his self worth. The alleged victim is in truth, a victim of his own complete identification with idealized, unprocessed, archaic and illogical expectations which when they are not validated are experienced as an annihilation. These are cases of complete absence of malice on the part of the accused. Implicit in the disappearance of autonomous thought processes is the temporary disappearance of capacities to regulate self esteem. Thus the alleged victim who is emptied of self worth in obligatory self sacrifice to the falsely idealized partner, and whose value depends on controlling how the partner responds to himself, feels like nothing when his expectations are frustrated and disappointed. A false dichotomy is set up between being all knowing and all powerful, and being powerless, useless and worthless.

©Copyright 2009 by Mitchell Milch, LCSW. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Mitchell and/or see his GoodTherapy.org Profile

Click here to contact Jeanette and/or see her GoodTherapy.org Profile

Achieving her goals was a bit too easy for Nadine.
Thirty-five year old writer and director Nadine got three clients as soon as she put the word out about her new venture as an acting coach. Her script for a TV show was accepted and she was hired to direct the production. She was amazed at how quickly and effortlessly everything was falling into place.

Nadine’s dreams were about to come true. Her talents were prized and she felt giddy with excitement. Expressing her creativity felt authentic but scary. She dared to imagine being famous. She dared to imagine herself happily married with a family. She dared to imagine having it all.

Acid Reflux and puffy eyes ruin Nadine’s new found success.
The only fly in the ointment was the continuous acid reflux, swollen ankles and puffy eyes. She was eating a healthy diet, had good energy and felt accomplished. Why would her body be reacting in this manner?

As soon as Nadine pictured success and happiness she felt the acid reflux in her mouth. The images weren’t all good. She saw her father leaving the family when she was three years old. She saw her mother leaving her alone for hours at a time to fend for herself. She heard her parents voices fighting about whose turn it was to take her, and never once considering her feelings. She recalled having to be the grown up and comfort her mother who was always in a state of panic. She smelled and tasted the fear of being banished from the love of family if she dared speak up about her feelings and wishes.

When things went well in her external world, Nadine’s body went into action big time. Her ankles became heavy with fluid making her feel lethargic. The puffy eyes made her feel ugly. How could she coach, direct and be in the public eye feeling so lousy and looking so freaky? Her excitement and energy turned into a sense of futility and failure. Feeling ugly and sick was a good reason for not hiring a cast and finishing the script changes. Putting off her coaching was necessary because she couldn’t stand for long with the swollen ankles.

Should Nadine go with her success or fail and get sweet revenge?
Success would mean letting her parents get away with treating her badly. It would mean taking them off the hook. Worst of all it would suggest that what they did wasn’t that bad because her life turned out good. Climbing the achievement ladder would mean her parents wouldn’t have to pay for the damage they did to her as a kid. Making a name for herself would mean she would have to give up her vengeful thoughts and her wish to punish them. She wanted them to suffer and own their part in her childhood suffering. Success would rob her of her entitlement to demand an acknowledgement of their wrong doings, punish them and expect restitution.

Swollen ankles put a stop to continued success.
Thank goodness her body put the brakes on her fast track to success! If fame and fortune could be this quick and easy, she would have to take her parents off the ‘blame hook’ for good. Nadine wasn’t ready to do that. She needed more time as a failure to rub their faces in it. She wanted to prove them bad people even if it meant her demise. Her body came to the rescue and gave her ample reason to halt her progress. Her physical symptoms acted as a protector of her strong and powerful desire to make her parents pay for what they did. It was worth the price.

How should Nadine deal with her conflicting wishes?
While Nadine’s body may protect her vengefulness and boost her sense of power, it acts as a saboteur for her future fulfillment. The war being fought between Nadine’s healthy wish to grow and her need to fail is being won by the saboteur. The saboteur comes disguised in the form of puffy eyes, swollen ankles and acid reflux, to make her roll back her development.

Nadine has a good chance of making a truce with her two battling factions. She can ask herself some important questions that can help her choose and stay on the path to success:

How long am I prepared to wait for a sign of atonement from my parents?
What sign will I accept?
Will any sign be enough?
Am I prepared to destroy my talents for the remote possibility that my parents may own up to their failures?
How will I feel in 10 or 15 years when I am still alone and envying my friends watching their children grow up?
What if it’s too late to make a life for myself if and when my parents admit their mistakes?

Calling a truce and choosing fulfillment will make Natalie’s body behave itself.
Let’s assume that Nadine doesn’t want to sacrifice her future in the faint hope that her parents will atone. Once she opts for success and fulfillment her body will be released from acting as the proxy for that vengeful part of her psyche. Giving herself permission to flourish and thrive will create an emotional calm and that in turn will create a physical balance. At that time Nadine can begin working on telling her parents about the hurt and anger she has stored up for so long and begin the process of living a full life without having to pardon or forget.

©Copyright 2009 by Jeanette Raymond, Ph.D. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Jeanette and/or see her GoodTherapy.org Profile

When the issue of problem gambling –an addiction that can have dire consequences for individuals and families– comes to mind, many people think of those in the middle or later years of their lives, but as with all mental health issues, problem gambling doesn’t limit its potentially debilitating effects to a single age group. Young people, even adolescents, can find themselves grappling with the complications of problem gambling, and young boys especially may be at particular risk. Recently, a study was conducted which links occurrences of problem gambling with other signs of conduct issues, giving parents, general practice doctors, and mental health professionals a more distinct ability to screen for a variety of difficulties often experienced by modern boys.

The study found that boys were significantly more prone to developing conduct issues, such as vandalism, impulsive behaviors, lying, shoplifting, aggression, and substance abuse, than were girls, though as a collected group, the surveyed youth revealed that those with conduct difficulties had a twenty three percent chance of also experiencing difficulties with risky gambling and addiction. The researchers noted that for each additional symptom of conduct issues that was reported, participating youth had another eighty percent jump in likelihood to have an issue with problem gambling as well, a strong correlation that provides ample persuasion for cross-screening young clients.

Describing problem gambling and other issues covered by the study, researchers proposed that this “cluster” of behaviors may be observed early on in adolescence and should be addressed at the onset to help encourage a better quality of life into maturity and adulthood. Sponsored by the University of Buffalo’s Research Institute on Addictions, the study is one of many modern attempts to prevent addiction issues in young people rather than focus all efforts on treating fully developed cases in adults.

In the gym, the notion that one has to suffer a bit to succeed in building muscle or losing weight is a common one, yet this idea is rarely applied to life in general. Seeking to discover the roots of happiness as they relate to stress or discomfort, a study sponsored by San Francisco State University has found that this same principle is relevant in the mastering of skills which in turn promotes happiness. Asking participants to report both during skill-aquiring and honing activities, and at a later point, the researchers found that momentary stress and discomfort were present initially, but that a positive memory emerged at a later point, in which the participants described the activities as adding happiness to their day. The work has recently been published in the Journal of Happiness Studies.

Click here to contact Dana and/or see her GoodTherapy.org Profile

Where do you begin when you’ve just found out your spouse has had an affair? Or, what if you are the one who’s had the affair and your partner has just found out?

If you’ve just found out your partner has had an affair, be prepared for the roller coaster of emotions. It is not a time to make any permanent life-changing decisions. Here are some important things to consider:

• You do not have to know right now if you are going to stay or go. You are in crisis and may feel like the rug has been pulled out from under you. Give yourself time to make important decisions. Emotions are very raw right now so it’s okay to not know which direction to go yet.

• Some people make the mistake of telling friends and family and then regret it later. So be choosy about who you share this with, the best route is to seek out a counselor who can help you sort through all the challenges that are in front of you.

• You are going to experience a lot of different emotions from anger to sadness, betrayal and fear, confusion and frustration. All this is normal. Research has shown that individuals who have been betrayed show symptoms of post traumatic stress. You may have flashbacks of the affair and images that you never even experienced. You will have triggers like when the phone rings or your partner gets a text message, where the fear and anger comes alive. You may want to cry one minute and scream the next.

• In this kind of situation, the fight or flight response kicks in, but neither are conducive to moving forward. If you want to save your marriage, you can neither fight nor flight. A normal human reaction is to act out the rage and blame, yell at, accuse, distrust or “check up” on your partner. While these are normal reactions, they do continued damage to the relationship and to your own self esteem. Sometimes what might make you temporarily feel better in the moment, makes matters worse in the long run.

• Self care is critical during the time of healing. Self care includes things such as exercise, going for walks, getting enough sleep, spending time with those who are supportive, getting counseling, making sure you eat well and enough. These small things might seem trivial or difficult to do, but it is important to take care of yourself.

• You may want to ask questions or know details about the affair. It is okay to ask these questions, just be sure that you really want to know the answers. For some people the not knowing causes suffering and they would rather know, for others they would rather not know. There is no right or wrong, only you can know what is going to be helpful.

If you are the person who has had the affair, some important things to consider:

• There is no “right” time frame for “getting over” an affair. So do not push your partner. Your patience and support is critical. Do not avoid talking about, do not give excuses or blame. Right now your partner needs to know that you understand the impact this has had. This is not going to be easy for you either, but it is important that you remain supportive during this challenging period.

• This may seem obvious but it bears pointing out: be honest. Be where you say you will be, do what you say you will do, don’t leave anything out no matter how insignificant it seems. Rebuilding trust is going to take time, but it starts now.

• Listen to your partner. If they ask questions and want to know the answers, it is important that you answer them with total honesty. Do not decide for them what they should and should not need to know. It is important to allow your partner to make the determination what he/she needs to or wants to know.

• Be an open book for your partner. And remember, this is temporary. But this is an important time to be in close physical proximity to your partner to maintain a sense of safety. Allow your partner to see your phone, text messages, emails, to regain a sense of safety. You can have your privacy back at some point, but for right now your partner may need this to begin the process of rebuilding trust and feeling safe.

• You are going to go through difficult emotions as well. Guilt, shame, regret are all normal feelings to experience. It is important not to let them get in the way of being there and listening to your partner. It is also a good idea for you to seek counseling as well to deal with these emotions and to understand why you made this choice.

If you want to save the marriage (or even if you are unsure) it is important to seek couples counseling as soon as possible. It may take some time to find a counselor that you feel comfortable with. Remember, affairs happen in good marriages and to good people. There are many reasons why an affair occurs and it can take one to two years to recover whether you stay in the marriage or not. Take your time, seek help and work together to begin the healing process.

©Copyright 2009 by Dana Vince, LMHC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Dana and/or see her GoodTherapy.org Profile

Click here to contact Arthur and/or see his GoodTherapy.org Profile

Dyadic Developmental Psychotherapy, which is an evidence-based, effective, and empirically validated treatment is composed of a variety of elements and based on a number of principles that have strong empirical support. Dyadic Developmental Psychotherapy is, in some respects, an amalgam of effective principles of treatment. This article will describe the elements of Dyadic Developmental Psychotherapy and a few of its underlying principles.

It is helpful to remember that everything begins with building an alliance. “Without an alliance there can be no secure base. Without a secure base there can be no exploration. Without exploration there can be no integration. Without integration there can be no healing.”

Safety is the first principle of treatment. Without safety (physical, psychological, relational, and emotional) nothing else can happen. So creating and ensuring safety comes first. Safety is provided for a child by a caregiver who is…

1. Available
2. Sensitive
3. Responsive to the child’s needs
4. Able to provide Interactive Repair
5. Insightful
6. Reflective

Intersubjectivity is a central concept in Dyadic Developmental Psychotherapy. Once safety is provided and maintained, and the safe base created, the child can begin to explore, learning primarily from the child’s parents’ experience of the child and of the world. Intersubjectivity is a reciprocal process. It can be concordant or discordant. Intersubjectivity is composed of the following three elements:

1. Shared emotion (attunement)
2. Shared attention and joint awareness
3. Share intention; cooperation and collaboration

Shared Emotion: Children who have difficulty regulating their emotions cannot do this on their own. They need a sensitive and responsive parent who can do this for them and then with them so that the child can internalize this capacity. This co-regulation of affect is necessary if the child is to be able to explore past traumas that may generate anxiety or shame.

Shared Attention: This is a reciprocal taking turns. There is an interest in the other’s experiences and a common attention to what is occurring now.

Shared Intentions: This refers to the enjoyment of shared experiences and being together. It involves getting to know each other and the other’s experience, feelings, and perceptions.

Another central element of Dyadic Developmental Psychotherapy is the affective-reflective dialogue. This refers to a “conversation” that includes emotions and reflection on the self, other, and the relationship. Self-aware reflection is a cornerstone of healing.

The practice of Dyadic Developmental Psychotherapy involves and recognizes the importance of the co-creation of meaning. Often what makes trauma traumatic is not the objective facts, but the meaning we ascribe to those events. What experiences mean create the emotions we experience and then lead to the behaviors we exhibit. In treatment we join our experience of an event with the child’s experience of that event and reflect on the similarities and differences of our experiences. This reflection of the implications of other ways to experience events, past and present, can lead to new affect and new modes of behavior.

Self-aware reflection, the reflective function, is another key element of Dyadic Developmental Psychotherapy. It involves “the thinking mind” with regard to the inner world of self and other. This leads to greater understanding and greater flexibility in responses available. When parents have a well developed reflective function, this leads to the child experiencing that they exist in a positive way in the heart and mind of the parent. New meanings lead to new options for action that leads to healthier functioning.

Interactive repair happens in treatment and at home. It is the reestablishment of the relationship and the reestablishment of concordant intersubjectivity following some conflict, separation, mistake, or other breach in the relationship. This highlights the importance of the relationship and that mistakes can be repaired. It is primarily the adult’s responsibility to make this happen.

In a future article I will describe the stages of treatment and other aspects of Dyadic Developmental Psychotherapy that make this an effective treatment.

©Copyright 2009 by Arthur Becker-Weidman, Ph.D. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Arthur and/or see his GoodTherapy.org Profile

Click here to contact Cedar and/or see her GoodTherapy.org Profile

I had a long talk the other day with someone who wanted to understand more about this odd word: “power differential.” Since he associated power with, in his words, “power OVER and force and nasty hierarchies.” It is very important to him to think of us all as equal. Of course, I agreed with him about the fact that we are all equal in our humanity and in our right to be treated with respect and kindness. So, I wondered how I could break down the power differential idea into something that would be more agreeable and understandable to him. Power Differential actually covers a lot of territory. So, in our conversation, we began to break it down into smaller differential chunks. There are role differentials, age differentials, maturity differentials, education and training differentials, income differentials. We could go on. Naming and understanding these differentials, and be this I mean differences, the question becomes not one of over or under, but rather whenever you are on the “more or greater” side of the differential, what are your responsibilities and opportunities?

For and overly simple example, when I am caring for a child, I am on the older side of the age differential. The child is equal to me in humanity and right to be treated with respect and kindness, but it is my responsibility to set good boundaries, keep the child safe, healthy and fed, and my opportunity to provide love and set a good example. Doing this requires me to use the wisdom that has come from my greater number of years and experiences. If I become a child myself or expect the child to respond the way those of my peers respond, I can inadvertently cause the child a lot of harm. Since the definition of power is “the ability to have an affect,” this age difference is also an example of a power differential.

In our conversation we talked about the other differentials listed above. The role differential is the most complex and the one referred to as an ethics issue. Called the power differential because of the actual and potential impact of the role on the client. For example, the one in the power-up role position bears performance assessment responsibilities of all sorts as well as responsibility for making numerous decisions about work and work load. The way in which these responsibilities are carried out can cause harm. The nature of the relationship is also affected by this position power differential. For example, the client or employee may feel too much at job risk to offer the power-up person feedback that might be difficult to hear.

My friend felt much more at ease after this conversation when he understood the power differential to be less about power over and more about owning and being sensitive to the responsibilities and opportunities, and even freedoms, that accompany differentials of all sorts, and especially professional ones.

There’s an old saying: “The fish are the last to discover water.” Often those in positions of authority are the last to discover the power differential.
_____________

A number of people responded to my last posting about change. I’d like to share a few.

Tony says: Easier said than done. When your family thinks you are a controlling person, any change is met with criticism and that to me is one of the biggest hurdles to becoming a new you. Sometimes people in our lives don’t expect us to change for the better. That can be pretty tough to deal with. Cedar replies: You’re right. I’m sorry it’s been so tough for you. I trust that even though others are criticizing, you feel better about yourself. You are changing for yourself, not just for others. People tend to get used to the way they have experienced you. Even if they don’t like it, it’s familiar. You put a new ingredient into the soup and the whole soup changes.

Interestingly, Derrick now speaks for the other possibility. Sometimes people in the family are very supportive of changes that you are making. Sounds like you made it very clear to them that you were putting the effort into changing: I have been married 30 years now and only 5 years back I hauled myself to therapy to change my controlling nature. I am a grandfather and I thought people wouldn’t be bothered. My family has seen me through this. It definitely makes a lot of difference when people know you don’t want to be a stubborn old mule and intend to turn a new leaf.

Brent adds: It is so hard to change the only way you have ever known, but I am trying and applaud others who are out there doing the exact same things. It IS hard to teach an old dog new tricks, but once you make the committment to yourself and your family, the payoff is well worth the effort! Cedar replies: “Bravo, Brent.’

Amy says: Most times people who wield power can’t be told they are overpowering. It’s very difficult when you have to bell the cat. It’s easier if they realise they need help. Cedar replies: You bet, Amy. Please refer to the last paragraph of this article. Remember the cat can be belled. It takes strategy, skill, sensitivity, and collaboration with others. You can wield your own kind of power.

And in closing, here is a wise and inspiring piece from Nina. Thank you so much for this, Nina: We are all so fragile, and this is a good place to begin, as it is an essential Truth that we all share. Once we are able to appreciate the intelligence of our sensitivity, we can come to a condition of practiced compassion and gentle kindness for our Selves and others.
Our sensitivity is what educates us to the Truth of what is going on outside of us and inside of us. Our feelings tell us what is up on our insides and on our outsides. That being said we are all in this together….

Below are a few suggestions that have worked for clients in power struggles:

#1. Everyone is doing the best they can! A controlling person is that way for a reason. He/she learned to be controlling as a way to get through life. If one is in a practice of compassion and sensitivity, one can attempt to change the discomfort of controlling dynamics by naming how the relationship is uncomfortable by using “I” statements. (Remember blame creates resistance).

#2. In healthy relationships, we always get to practice basic ‘rights’ of expression in order to be safe, healthy and happy.
If your “I” statement doesn’t work for the controller…that’s not your problem… Take some distance from the relationship in order to feel safe.

#3. You are in charge of you, first. Truth creates a clear field that supports change.

And lastly, for those of you who feel that your family environment doesn’t allow for much change… know that even the smallest change has a ripple effect. Be patient and do the right thing…. for yourself and for the greater good. There are few sources of happiness greater than the path of non-harm. We all get to be happy… that’s why the feeling exists!
I wish you all Peace.

©Copyright 2009 Cedar Barstow, M.Ed., C.H.T. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Cedar and/or see her GoodTherapy.org Profile

“A Social Problem Does Not Exist For A Society Until It Is Recognized By That Society To Exist” – H. Blumer

The following is the first of a three-part series of articles:

It was in a high school literature class that I was first introduced to the Oedipus Complex, defined as “a boy’s unresolved desire for sexual gratification through the parent of the opposite sex, especially the desire of a son for his mother”. It was in a college film class that I was shown a famous French film entitled “Murmur of the Heart” which took the Oedipal theme and played it out in a contemporary middle class setting. In this film, the sensitive youngest son of a beautiful, tempestuous Italian woman is ushered into manhood by her as he recovers from a heart murmur at a countryside sanitarium. The film would have you believe that although mother and son both realized that they had crossed a forbidden line, neither was scarred by the experience, and that in fact the son was now able to go on and become a man. At the time, I never questioned the implications of this theme.

Mothers have been idealized for thousands of years. So the notion that the most trusted figure in our lives – the Madonna - could betray and abuse us sexually is particularly hard to fathom. And I would contend that that is the primary reason that this particular form of abuse has not been properly identified and addressed in our culture. Statistics, however, begin to set the record straight: A July 2000 Justice Department report found that “woman account for 4 percent of those who sexually abuse children under 18 years of age, and about 12 percent of those who molest children younger than six years of age.” Mind you, these types of studies look at a prescribed definition of abuse – one that more readily fits the notion of the male as aggressor - and does not address other questionable (and damaging) behaviors such as parents (mothers) sleeping with children; bathing, fondling and massaging them; dressing and undressing in front of them; engaging in sexualized talk and making them touch them in inappropriate ways. And it is believed that abuse by mothers is so grossly under-identified and under-reported that these statistics only reveal a fraction of the problem.

Why is abuse by mothers so much more under-reported than abuse by fathers?

Because of the very nature of the relationship. Professionals consider mothers more trusted figures than fathers. And even if there is suspicion of abuse, there is likely not to be any physical evidence. Additionally, a mother’s actions can be more confusing because of her traditional role as the primary physical caretaker and nurturer. In many cases, the child’s family includes only the mother. What child would risk losing his/her only family? She may be the only one available for love and support?

In many instances of mother/son incest the abuse occurs because the son becomes a substitute for the non-existent father. His sense of protecting and taking care of her and being the “man” she needs becomes enmeshed in the abuse. And the type of abuse that takes place between a mother and son doesn’t always fit into social stereotypes. Society views sexual abuse as something violent or coercive and aggressive – and something that usually involves intercourse. But whether coercion is used or not, “if a child is introduced to a sexually stimulating behavior- which is inappropriate to his (or her) psychosexual and psychosocial developmental maturity – by a parent, it is incest and it is abusive” (C.A. Courtois, 1988).

For male victims the situation becomes even more complicated. Boys are less likely to feel victimized and/or to report sexual abuse, especially mother-son incest, because they either see the abuse as something positive (mother love) or they believe that it is either consensual or they are to blame. Especially, if they became stimulated and ejaculated, they believe that they wanted it. Furthermore, boys are more likely to internalize and not tell - in fact disclosure during childhood was the only sexual abuse variable that differentiated the genders in a study by Roesler & McKenzie (1994) – 31% vs. 61%. But the most significant finding in this study was that the long-term symptomological response to childhood abuse among adult male and adult female victims was similar – in other words – abuse has profound negative long-term effects for both sexes. This shatters another myth - that boys can handle incest or childhood sex and may even welcome it as a right of passage.

The psychological consequences of mother/son incest are significant. Because boys don’t tell, they can experience a greater degree of shame, stigma and self-blame than girls. Especially in our current environment, where girls are encouraged to speak up, boys are left to hide something that cuts to the very core of their male hood. In his study on the Psychological Impact of Male Sexual Abuse, David Lisak says one of the most crucial aspects of the experience of male sexual abuse is “a fundamental loss of control: over one’s physical being, one’s sense of self, one’s sense of agency and self-efficacy, and one’s fate”. And yet, as one boy put it, “the thought of losing her was more frightening than her abuse of me.” Lisak refers to the helplessness, isolation and alienation boys experience as they grow up hiding their secret and “seeding the potential for a lifelong struggle with alienation from other people.”

In order to compensate for the feelings of victimization and helplessness that permeated their childhood, adult males abused as boys deal with their masculinity in one of two ways, they either become hyper-masculine and exhibit a lot of anger, especially in relationships with women, or they become passive caretaker types putting everyone else’s needs before their own and exhibiting little or no male ego. Either way they are fighting deeply ingrained feelings of masculine inadequacy. But possibly the most destructive long-term consequence of the abuse is the victim’s inability to trust and therefore to connect with other people. If you have been betrayed by the first and most important figure in your life, how can you ever trust anyone else?

©Copyright 2009 by Roni Weisberg-Ross L.M.F.T. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Roni and/or see her GoodTherapy.org Profile

There are many negative aspects of thoughts and feelings of depression that can interfere with an individual’s daily life, and the emergence of physical symptoms associated with the issue may play a major role in overall outlook and mood. A study conducted at the University of Iowa found that those with depression issues also report stronger common discomfort symptoms such as various aches and gastrointestinal problems when asked to reflect on how they had previously felt and recorded. The research asked a group of women to record their levels of discomfort daily, and to report them again at a later date; those with signs of depression exaggerated their symptoms on follow-up reports, suggesting that the mental health concern may have an impact on self-perception as to personal health.

The prevalence of anti-depressants and other psychiatric medications has experienced a great increase recently, and many concerns are rising in response to the growing dependency on such substances. While there are some medications that have proven to be helpful in improving the quality of life for pregnant mothers and young children, some in the mental health professions remain skeptical over the ultimate utility and safety of such medicines. Adding support to this camp, a study at Georgetown University Medical Center has recently suggested that medicines indicated for mood issues, pain, and epilepsy, when administered to pregnant women or to infants and young children, may cause mental health concerns at a later age.

The study focused on animal models, specifically working with rats in a laboratory setting, but suggests that the issue is likely a prominent one for humans, as well. After administering various modern treatments for mood issues, as well as those indicated for pain and for epilepsy, researchers monitored laboratory rats, finding that those animals which had been treated with the medication were more likely to exhibit signs of mental health complications as adolescents and adults.

The researchers suggest that identifying different drugs for the treatment of young children and pregnant women is vital, and the idea that psychotherapy and other non-invasive approaches may be highly preferable to treatments involving medications is certainly supported by the study. Through focusing on collaborative and therapy-based treatment models, pregnant women and young children may receive the help they want and need without risking harmful situations in the future. The study is one of several that have recently been launched exposing serious problems with the psychiatric medication model.

Through most people would characterize the experience of raising children as a positive one overall, having kids –especially in high numbers– has been reported as detracting from life satisfaction levels in some studies. Challenging this notion, a recent study from the University of Glasgow has shown that satisfaction actually goes up in married couples, and increases with the addition of more children. The study suggests that those who “gear up” for child rearing and have the social, psychological, and real-world resources typically offered by marriage are more likely to find parenthood rewarding than those who are single or separated.

Recent debates about the acceptability of torture in certain situations has led to renewed academic interest in the subject, and a study at Harvard University has examined the effects of complicity on perceptions of guilt among people submitted to pain or stress. The study split participants into those who met and did not meet a woman who was later heard being “tortured” over an intercom by having her hand placed in ice water, based on the accusation that she had cheated to secure money. Those participants who met the woman and responded to the feigned torture reported higher levels of suspected guilt the more the woman appeared to suffer, whereas those who did not meet the woman–-thus not taking part in the witnessing of ongoing torture–were more likely to suspect less guilt as apparent pain level and distress rose. The study may have important implications for understanding the psychology of torture administration and prevention.

In an effort to control and improve behaviors among the general public, whether focusing on theft prevention in stores or the establishment of good habits among children, various methods are employed, all with varying degrees of efficacy. From talking to passive suggestions and even threats and violence, people may resort to all manner of measures to seek positive behavior in others. But a new study based at Brigham Young University presents evidence suggesting that something as simple as a clean scent may achieve this goal quickly and efficiently.

Though the idea that a mere scent may be able to sway the course of behavior might seem too simplistic or incredible to some, the study tested exactly this hypothesis, with a positive outcome. Dividing participants between two rooms, one with a “normal” scent, and one freshly spritzed with orange-scented Windex, the researchers asked participants in both rooms to engage in a number of identical activities aimed at gauging such moral behavior elements as generosity and fairness. From a model in which participants were trusted by unseen partners to fairly divide twelve dollars to one in which participants were asked to score their interest in donating to charity, and many other modules, those in the “clean” smelling room consistently and significantly exhibited more positive behaviors.

The researchers note that keeping work areas –as well as rooms within the home– clean and pleasantly scented may go a long way towards producing desirable behavior from workers, customers, and family members, all at a minimum of cost and without the need for potential emotional fallout. The study may hint at long-understood benefits of aromatherapy, and may have great implications for the future of mental health improvement without medications.

The search for effective tools to help people quit smoking has been underway for many decades, with scores of mental health professionals devoting some or all of their careers to assisting clients curb the habit. A study aiming at addressing smoking with the help of virtual reality has recently concluded, with positive findings that may make the technological technique popular for cessation programs. Participants who crushed virtual cigarettes as part of a smoking cessation program showed significantly greater rates of abstinence and lowered nicotine addiction at the end of the treatment and at a six-month follow up than participants who squeezed a virtual ball. As virtual reality technology advances, so too may addiction treatment programs.

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The song from which I borrowed my title continues: “The one you shouldn’t hurt at all.” Yet it does indeed seem to be nearly universal that we hurt, and are hurt by, those with whom we believe we are “in love.”

When we are on the receiving end of the hurt we usually try to understand it in one of four ways: (1) My partner doesn’t understand enough about my sensitive spots, and if I can just get him or her to understand where I am vulnerable then he or she will be more careful not to poke me in those spots. (2) My partner is unconsciously angry at me for some reason, perhaps my gender, and is acting out that anger in a hostile way. (3) My partner has some conscious anger at me for some way he or she feels I have been the cause of his or her pain and I need to either (a) explain that he or she took my words the wrong way and therefore should not feel hurt, or (b) acknowledge the way I have caused him or her pain and promise to refrain from doing it again. (4) I am just being completely paranoid and misinterpreting my partner’s loving behavior as something hurtful.

While all of the above theories may account for some of the pain we experience in intimate relationships, there is a larger perspective that encompasses all of them and can help us stop hurting each other. This perspective is the spiritual one. Much of it is outlined in Deepak Chopra’s book “The Path to Love: Renewing the Power of Spirit in Your Life.”

From the spiritual point of view each attempt at intimate connection with another human contains a projected spiritual component. We try, usually unconsciously, to experience intimate union with The Divine through our intimate human relationships. This happens fairly naturally and easily when we “fall in love.” The other is experienced as perfect in every way—i.e. Divine. Over time this projected image of the Divine collides with human reality—“the honeymoon is over”—and the real work of sacred union through a human relationship can begin. The trick is to realize that the glimpse of The Divine seen when falling in love occurs is something that can be sustained, but that it requires the real interpersonal work of the cultivation of intimacy. The deepest hurt comes from feeling abandoned by The Divine when the honeymoon is over. Without the conscious awareness that one was seeking to connect with The Divine one ends up blaming one’s partner for this terribly painful feeling of abandonment.

©Copyright 2009 by John Rhead, Ph.D. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact John and/or see his GoodTherapy.org Profile