Posts from the Unconscious

THE MIRACLE OF ADAPTATION AND MR. WHITE EGRET

noreply@blogger.com (May Benatar) — Tue, 18 Oct 2011 23:53:00 +0000

I was on a walk the other day. The sun was out after many days of rain. The creek along which I walk so often had become almost a river. For the very first time, I noticed a white egret standing motionless by a man-made waterfall on the creek. The elegant bird looked as if she were trying to figure out how to navigate the cascade. The creek had been but a trickle all summer. But this fall had been unusually wet and stormy. And the water was high and fast.

Strangely the bird was still there in the same spot, standing like a statue, unchanged, 30 minutes later when I passed on my return trip. I raced home for my camera, sure he/she would be there when I returned. In the meantime I had an elaborate fantasy (the kind of fantasy only a psychotherapist would have!) about that poor bird. It went something like this: The bird, probably young, had adapted to the stream at its lowest ebb during the summer. Growing up beside a trickle, it was well adapted to those conditions. When the stream swelled, her/his adaptation style no longer sufficed and he/she could not figure out what to do.

Of course, this reminded me of the essential human dilemma. We adapt as children, with brains, nimble and flexible, to the conditions of our environment: the family we are born into, the emotional surround be it one of privation or abundance. We are veritable geniuses of adaptation. Problems arise latter when our brilliant adaptation styles no long suffice. When the floods of later life come, we are often at a loss. The tools of the earlier years are more than likely useless.

The child Holocaust survivor who starved and had to scrounge for whatever food was available in order to live, may well have trouble at the dinner table as a middle aged adult now seated at the groaning board of American abundance: obesity and diabetes II ensue. The woman who has witnessed the suffering of older siblings who resisted a controlling parent only to be vilified, and rejected by that parent, learns submissiveness at home and fails to develop the assertiveness she needs to succeed in adult life.

I returned with my camera, maybe 15 minutes later. Mr. White Egret was gone. There goes my theory. Somehow he had navigated the falls. Maybe he was just a patient fisherman all along.

Days passed, no egret. No egret, but another lesson came my way.

A week or two later, I had the good fortune to reconnect with a client I had known over many decades. She was in her mid twenties (I in my mid thirties) when we met. We worked together for many years and then just on and off thereafter. She was in tough shape in those early years, nearly mute in our sessions for probably two years. I did the talking, guessing at her pain, her shame, her fear. She cancelled more often than not. But often I could talk her into coming. She had adapted well to an early environment in which it was dangerous to speak up, it was dangerous to be noticed at all. From a very large family, dominated by alcohol, violence, including sexual violence, she was denigrated, humiliated, unprotected. She felt insignificant, unsafe, and unworthy.

Most significantly she was separated from herself—to survive her childhood her essential self had gone into hiding. What was left was a child hovering in fear, whatever strength there was seemingly defeated. She was the only one among 17 children who had managed to finish high school, but there was very little evidence of pride, and certainly no accolade from the family. Any sign of independence, strength, intelligence was seen as a negative not a positive by her family.

Fast forward 20 years. In the interim this woman went to college, gave birth and raised a child single handedly and successfully without a father. She bought a home, rose in her profession to a role of leadership, survived a life threatening illness through sheer grit. On and off she used therapy to help her navigate these crises, at times I was the second parent to her daughter, but for long stretches of time she did not call or come in to see me.

The one longing unfulfilled, was the inability to sustain an intimate relationship with a man.

Now in her 50’s we are again back in touch and this time because she is in an intimate connection with a man, someone who sounds mature, loving, and accepting and who wants to marry her. She knows she needs a little extra support until she decides what to do.

The white egret has adapted to the falls. A sustaining relationship with me over the years was certainly part of that critical adaptation. But the real wonder here, the awesome reality, is that she had the capacity to use that relationship and all other positives in her life, the terrific child she gave birth to, her teachers in school, friends, neighbors, a few members of the extended family that did not put her down—whatever came her way she used to grow and change and reconnected with all that was positive in her.

She herself has described it as the child within, the one I saw cowering in the early days mute and frightened, has grown up.

This is not the only story I have of the awe-inspiring nature of our ongoing, life-long capacity for change. It’s just the latest.

taking off for a good new year.

noreply@blogger.com (May Benatar) — Fri, 07 Oct 2011 18:48:00 +0000

Mourning into Dancing

noreply@blogger.com (May Benatar) — Tue, 20 Sep 2011 15:32:00 +0000

The other day a Debbie Friedman song popped up on my ipod shuffle. I had no idea it was even on my ipod or how it got there. Debbie Friedman was a singer and composer of songs, many in Hebrew, often reworking prayers from the Jewish prayerbook.

“Mourning into dancing” is Debbie Friedman’s riff on Psalm 30, a song of gratitude.

It was a day or two after I had some terribly sad, shocking news and I took it as a sign. Somehow I needed to transform my mourning into something like dancing, a creative expression of gratitude. I did not get the chance to do this before she died. She failed to give me notice.

The woman who died, suddenly, unexpectedly was my compass for over 25 years. Eda Goldstein was alternately my supervisor, or rather I was her apprentice, she was my teacher, my mentor, a model of professional accomplishment, my guru. She helped me negotiate a good bit of my professional and personal life. I was not in continuous contact with her over those 30 years, but she was always there when I got into trouble and I needed help in sorting things out. She was without peer in both her loyalty and in her wise guidance.

I think I need to say “thank you”

When I first started to go into New York City to get supervision from her, in the early 80’s, a friend and colleague noted that I was awfully quiet about what was happening there. Well I was quiet because it was a humbling experience.

I remember my brief case was new (now scruffy, battered, ripped and repaired). The children had reached an age when I felt comfortable working more and my priorities were getting re-shuffled. I was determined to learn from a master. So I cheerfully schlepped into NYC to sit at her feet. And it was overwhelming.

She was a tough task master, she never sugar coated her counsel on cases and frequently I would smart from her observations. Later, much later, she observed that most supervisees just want to be admired, not taught. I’m sure I was one of those, but I stuck it out, nonetheless and ultimately her toughness gave me confidence.

I discovered Eda at a lecture in New Jersey. She was a annoyed with her sponsors. Nonetheless she was a brilliant presenter at that meeting. My friend E. agreed that she was special. I decided right there that she was to be my mentor

That friend and colleague loved her too. The supervision group of which we both were a part, shared her in a way, even if they never schlepped into New York to see her, they shared her with me, her wisdom, her depth, her clear-eyed respect and compassion for clients. Among her more notable qualities was that clarity. There was a kind of laser-like quality to her thinking (and her writing). She effortlessly peeled back, down right ignored, what was extraneous, not central to the issue at hand.

Social workers all have inferiority complexes. No matter how advanced their training, no matter the length of their experience, no matter their academic credentials they feel and often are regarded as “less” than their clinical colleagues, psychologists and psychiatrists. They are paid less and related to as less, despite the fact that their training may be equivalent or even surpass other mental health professionals.

Being associated with a star like Eda Goldstein did a lot for my own professional self esteem. She is described by the Dean of New York University, School of Social Work where she taught and led faculty and students in many roles for decades: “ Eda was, and remains to the day of her death, the foremost social work scholar of contemporary psychoanalytic theory and practice. Her loss is a great loss for our community and for the field.” This scholar and brilliant clinician thought I was okay, maybe even bright. That helped a lot.

For decades I was comforted by the certainty that any idea I had, plan of action, or major move I contemplated could be run past her. I could and actually still do comfort myself with that, even though I can only do it in my imagination now. Mostly I know what she would say. But when my imagination runs aground, I am bereft.

I wish I could just send this to her. I would love her feedback. And more importantly, I would want her to know how much I loved and will miss her.

noreply@blogger.com (May Benatar) — Sat, 03 Sep 2011 15:40:00 +0000

There is really an interesting "chat" on huffington post (link below) on a piece on "inner wisdom" that I wrote for this blog some time ago. If any are interested, see the comments section. Others have chimed in with helpful suggestions for deepening the inner conversation.

http://www.huffingtonpost.com/may-benatar-phd-lcsw/consult-inner-wisdom_b_931374.html

KAFKA AND THE DOLL: THE PERVASIVENESS OF LOSS

noreply@blogger.com (May Benatar) — Fri, 19 Aug 2011 16:01:00 +0000

Franz Kafka, the story goes, encountered a little girl in the park where he went walking daily. She was crying. She had lost her doll and was desolate.

Kafka offered to help her look for the doll and arranged to meet her the next day at the same spot. Unable to find the doll he composed a letter from the doll and read it to her when they met.

“Please do not mourn me, I have gone on a trip to see the world. I will write you of my adventures.” This was the beginning of many letters. When he and the little girl met he read her from these carefully composed letters the imagined adventures of the beloved doll. The little girl was comforted.

When the meetings came to an end Kafka presented her with a doll. She obviously looked different from the original doll. An attached letter explained: “my travels have changed me…”

Many years later, the now grown girl found a letter stuffed into an unnoticed crevice in the cherished replacement doll. In summary it said: “ every thing that you love, you will eventually lose, but in the end, love will return in a different form.”

There are many versions of the story of Kafka and the doll. I heard this one from Tara Brach, psychologist and Buddhist meditation teacher in Washington DC.

Only after many tellings am I able to relay this story without crying. And I have found that when I tell it to others young or old, my listener is invariably moved, occasionally bursting into tears.

When I went online to find confirmation for the story, I found one source that referred to it as a “healing story.” That seems right. For whether this actually ever happened the story is real and true and provides a template for healing.

For me there are two wise lessons in this story: Grief and loss are ubiquitous even for a young child. And the way toward healing is to look for how love comes back in another form.

I think there are advantages to viewing grief as omnipresent, an inescapable part of being a human being. Grief encompasses far more than the loss of a loved one, although that is perhaps its most profound manifestation. The loss of the doll in the story is devastating to the little girl. This is what moves Kafka to create the wonderful stories of travel and adventure. He perceived the depth of her pain. It is reported that he put as much time and care into creating these letters for the little girl as he did in other writings.

Holding the perspective of the universality of loss, helps us with shame and loneliness. If a profound grief reaction to divorce or children leaving home or the loss of a pregnancy, or unemployment, or retirement, or having to confront the limitations of our children, or aging, or the loss of health is something I share with my fellow beings, I am less alone. And I don’t have to be ashamed that I feel the way I do, for shame is part of the legacy of isolation.

And love coming back, in a different form? I believe it was Kafka’s letters that were the real gift of love, and what was ultimately healing for the little girl was the relationship that that was the balm. Someone cared enough for her pain to write her lovely stories of the lost doll’s adventures. A great writer at that.

How healing it is to hold this conviction, that love will return. It is our job to recognize it in its new form.

CONSULTING YOUR INNER WISDOM: PART 2

noreply@blogger.com (May Benatar) — Tue, 09 Aug 2011 15:33:00 +0000

Last October I wrote a post on listening to your inner wisdom (Oct. 1, 2010

http://postsfromtheunconscious.blogspot.com/2010/10/consult-your-inner-wisdom-it-has-all.html)

The post was based on experiences from my practice with a visualization technique that seemed helpful to people and furthered the ends of the psychotherapy treatment. It often helped us cut through confusion, obfuscation, denial, and conditioned thinking and got us quickly to the heart of whatever matter we were wrestling with.

This work was especially helpful with and for individuals who relied heavily on “dissociation” a coping mechanism we all resort to at times, but is particularly important for individuals who have experienced childhood trauma. I have experimented with the inner wisdom technique with others whose “traumas” were less obvious or less extreme or even non-existent and found it useful in a lot of situations. Inner wisdom is wise and I think universal.

I’m revisiting this issue, after reading an article by Martha Beck in this month’s Oprah Magazine, (yes, Oprah) on a very similar topic which reminded me of some other issues related to implementing this practice which might be useful to comment on.

The existence of “inner wisdom” is based on the assumption that there is something in all of us that, unimpeded, will right us when we wobble. Maybe “inner gyroscope” is more accurate. A gyroscope will always get us back in balance if we just let it.

I think of inner wisdom as right-brained, body-based, nor necessarily verbal. It’s that still small “voice” within which may not be a “voice” at all, but arrive in the form of images, kinesthetic sensation, or even sound.

I sat with a client once on the same morning I had received some awful news about a dear friend. I tried to set this aside and set to work with this client. I thought I had. Very quickly, I got drawn into a confusing, chaotic, tumultuous session. It wasn’t until she reported “hearing” a loud bang that we began to get some clarity. The bang, it turned out, was the dreadful memory of the sound of a car hitting and killing her best friend, an event that she had witnessed decades past. Her “inner wisdom” was telling her something very similar was happening to me. And it was.

We live in an extremely left-brained culture. By this I mean we value words, logic, socially conditioned values. We more often make choices based on “shoulds,” “oughts,” the evaluations of others, negative judgments. We don’t let the gyroscope do its work.

We also live in a culture brimful of distraction.

To “hear” your inner voice you have to get quiet, you have to learn to cultivate and tolerate silence. The blackberry, iphone, NPR, gmail, twitter, facebook all have to go away for a little while everyday. Processing experience comes more naturally when you are walking in the woods, taking rhythmic breaths in the pool, doing yoga without the radio on (my personal downfall).

Taking note of our dreams, by keeping a log of them, sitting with them for at least a few minutes every day, increases clarity. There very well may be meaningful cues that are coming through our dreams that can be guiding us. A patient reports that as she was sifting through old journals she found notes of a dream that almost exactly predicted the location and manner of detection of a malignancy in her breast, a malignancy that would be discovered many years later.

Meditating on a regular basis also increases the accessibility to cues, often within the body, that are signaling us as to which moves are prudent, and which imprudent.

Sometimes I have the experience of feeling upset without really know why. I know my nervous system is buzzing, my body is sending signals of distress, but I haven’t a clue as to what this is about. I have to get quiet to have any chance of getting a handle on what is really going on. More than likely, sitting quietly, patiently (for it may take awhile) with the question of what is it that is upsetting me, what is calling for my attention, will yield some clarity. The upset doesn’t disappear, but its power does diminish and I am less likely to be reactive to it, reactive in a way that will neither benefit me nor those around me.

Cultivating this inner voice yields great benefits. I think we all instinctively know this. I wonder what keeps us from actively listening.

Why some people get crazy when their children get married

noreply@blogger.com (May Benatar) — Fri, 15 Jul 2011 18:21:00 +0000

In 1987, when my children were quite young (nine and fourteen), I had an idea for an article that I wanted to publish in an academic journal. This was my first foray into academic writing.

Much to my amazement, my article was accepted. I look back on what I wrote and I have no idea how I knew back then, what I seemed to have known. Maybe it was channeled.

I was puzzling over a little noted developmental stage of adult life: “marrying off children.” Obviously my children were far from marriageable age, but I did have a front seat on my sister-in-law losing her mind as her son was planning a wedding with his fiancée. And a good friend was in mourning when her son became engaged to a lovely, completely appropriate young woman, her only flaw being that she was not Jewish.

A client of mine became unaccountably depressed when her daughter became engaged after many years of living with her boyfriend, to a young man who both she and her husband admired and felt close to. It was in trying to unpack this latter situation, which was after all my job, that I gained some insight into the red thread that ran through all these situations.

My client was in a profession wherein she kept thumping her head (hard) against the glass ceiling, which back in the 80’s was both thick and bumpy, particularly in her professional group. She could rise to only an “associate” position in her chosen and beloved field. She vacillated between rage at those in a position of power and feelings of inadequacy as she identified with the devaluation that was inherent in the failed attempts to advance in her field.

What became evident after several sessions of work on this issue was that her ambitions had been (somewhat unconsciously) shifted onto her eldest daughter, the one now engaged. My client had four children, but it was onto this particular daughter that she had placed her hopes for soaring achievement. Her daughter was very bright, ambitious, and in a profession where her talents could be appreciated. Her parents had been able to provide her with the Ivy League education that they had been denied and the network of connections that easily flowed from that advantage would help her throughout her career.

What was hurting my client was the possibility that by marrying this particular man, her ambitions might come to naught. The prospective groom intended to live with his bride outside of the country, far from the network of connections, and in a culture where a woman’s ambition was unlikely to blossom. This did not worry the bride, she thought she could overcome those obstacles. But it both worried and saddened my client, for bearing so many bruises from her own career made her exquisitely sensitive to the possibility, she thought probability, that her own narcissistic agenda was threatened.

The interesting thing about this agenda was that it was mostly outside her awareness. She knew she had tremendous pride in her daughter and hoped for her future happiness and success as she did for all of her children, sons and daughters. What was outside awareness was how invested she was in this particular daughter succeeding where she felt she had failed.

I call this her “narcissistic agenda,” but I do not mean to imply by this that my client was selfish, self involved and not loving or concerned for her daughter. Just that her own identity, her “self” needs you might call them, were very tied in to the imagined future of this daughter.

Narcissism is part of the package of parenthood. It comes with the layette.

First, a short exposition on “narcissism.” Narcissism, self-love, is really key to human survival and healthy development. It morphs over time, as we grow, from believing ourselves to be the center of the world as young children, to something maybe slightly less over-weaning, like being confident of our abilities, and having the instinct for self preservation. Having a good relationship with our narcissism helps one navigate adult life.

I know a five year old who confides to me that he is “super-good” at soccer, running off to kick the ball to kingdom come. He thinks he’s great, and this makes him happy, happy.

Over time he will probably come to evaluate his soccer skills in a more modest and balanced way.

Becoming a parent often gives us another stab at satisfying these wishes to be “super-good,” for we do become the center of our young children’s universe and for a substantial period of time, we get to vicariously enjoy their triumphs, their achievements, their incredibly rapid development. The besotted-ness that is the norm for young parents absolutely in love with their offspring, could be viewed as a very benign form of narcissism, the child as an extension of self.

This is mostly good. It facilitates the kind of adoration that young children need to grow. It is fertilizer, sunshine, and water.

That’s the good stuff.

The bad stuff comes in when they are just themselves, not us, not an extension of us. Inevitably they will frustrate our expectations, the ones we are aware of and the ones outside of our awareness. It is inevitable. I repeat, this deflation of our narcissistic agenda is inevitable. This happens in small ways, they don’t make the team whether its softball or the debating team, and later it will happen in larger ways: their career choices, their choice of a mate, where they choose to live, how they choose to live.

So, “marrying off children” brings with it a host of challenges. We can imagine the shape of the future for our children, they are making a choice that is fraught with consequence, where they will live, how likely they will be culturally or religiously like us, who will be in our extended family in the future, even what our grandchildren will look like (perhaps), or even if there will be grandchildren. It is a significant challenge to that narcissistic agenda, the one we may not even know about.

This is a moment in which we may feel enormous loss, depression, deflation. We are challenged on so many fronts, but a significant one involves having to face something of which we may not have been aware: the secret plan we never knew we had for these later chapters in our life.

Plans need to be revised, we may need to re-balance, re-write that agenda.

We may need to pause and acknowledge the upheaval and pain that this is all causing us, and, just for a bit, be kinder to ourselves and trust that in time we will re-write our agenda.

My sister-in-law found her mind, and even though she has not come to love the daughter-in-law she came to accept her and even welcome her. My sister-in-law is resilient.

The friend who needed to mourn the Jewish daughter–in-law who would not be, has a wonderful relationship with her daughter in law, decades after the engagement. They have become close friends over the years.

And my client, who I had the good luck to see again many years after the incident described above, lived to see that her daughter was right: she flourished in her career despite the transplanting, although the transplanting itself did become problematic over time.

Like all developmental stages: “marrying off children” is challenging, painful, and in the end, an opportunity for growth.

Notice to Readers

noreply@blogger.com (May Benatar) — Fri, 24 Jun 2011 16:35:00 +0000

I have a new piece in the Huffington Post, on Parenting.
Some of you have seen it before, in a modified form.

If you are someone you think might be interested, please take a look.
If the URL doesn't work, just go to huffingtonpost.com and search my name, it will pop up.

http://www.huffingtonpost.com/may-benatar-phd-lcsw/parenting-bad-feelings_b_871838.htm

Feel free to share and to comment.

Thanks for reading.

May

EMBRACING MYSTERY

noreply@blogger.com (May Benatar) — Fri, 17 Jun 2011 01:33:00 +0000

My friend Dr. D., a professor of social psychology at a very fine liberal arts college, told me that she quoted something to her class that I said a hundred years ago. She was lecturing to her class on the subject of “cognitive dissonance.” Wikipedia defines cognitive dissonance as “…an uncomfortable feeling caused by holding conflicting ideas simultaneously. The theory of cognitive dissonance proposes that people have a motivational drive to reduce dissonance.”

Dr, D. recalled asking me, way back then, how I reconciled my interest in astrology with my evidence based practice as a clinician. My answer, she remembers was “I don’t feel the need to reconcile them.” She told her class this was a good example of someone who could tolerate a fair amount of “cognitive inconsistency.”

I, of course, have no recollection of this conversation. But Dr. D.’s example does point to something that separates me from lots of folks I know—and that’s the room I make for “mystery,” that which makes no logical sense, cannot be seen, touched, tasted, smelled or proven directly or indirectly and yet seems to be there.

A vivid example of something not uncommon but no less mysterious is the testimony of many individuals working in hospice care who report that sometimes up to three days before death, their patients appear to be reaching for someone or seeing someone or hearing someone from “the other side.” My neighbor, a women who classified herself as non-religious, an atheist, not even spiritually inclined, reported that her mother, at death’s door raised her paralyzed arm to reach for someone, presumably her dead father. She had no way to account for how her mother who had suffered a stroke on one side several years before had lifted that arm. But it did happen.

In this culture we lack a paradigm that can embrace, no less explain such phenomena. But probably almost all of my readers can think of some example of “mystery” in their lives. If you can’t, perhaps its because you have too rapidly dismissed a phenomena that you could not explain. Without the paradigm we don't see, we don't hear that which we cannot understand.

For many years I had a client who claimed to be connected to another dimension. I knew her very well, she was not psychotic, she did not hallucinate nor harbor delusions, but she had been severely traumatized throughout her childhood. Psychic or paranormal phenomena are not uncommon among individuals who have suffered extreme cruelty. Clinicians report this both formally and informally.

My patient’s reported phenomena was that she dreamt of spiritual beings in another dimension who had messages for her. At other times it was during waking consciousness that she received guidance. They guided her and they chided her. They instructed her about her life, her therapy, her healing process. The counsel was invariably wise. If she followed the advice it led her in the direction of healing and wholeness. She frequently resisted. The counsel was difficult to implement and went against the grain, it would cause pain.

Of course one could argue these were her own wise thoughts, or an internalization of my view point. That, however, was not how she experienced it, and I had to make room that there really was a mystery here. More than once I wished I had thought of the counsel, myself. These beings seemed smarter and more far sighted than I.

My position as her therapist was to be consistently agnostic. I neither believed nor disbelieved. But I supported these “advisors”. And I was not above calling on whatever forces were at work here to support the direction we wanted to go.

What was much more challenging, however, was dealing with what my patient knew about me through the spiritual advisors. I had no explanation for these phenomena. She knew things she could not have googled or learned from any another source—news items that only my immediate family had access to. Sometimes the news was joyous, sometimes it was profoundly sad. I could never explain her clairvoyance. I did not dismiss it as mind reading either. I could only receive it, and I believe it enlarged my spirit to do so.

It has always seemed to me that dismissing mysterious phenomena, those that don’t fit our existing paradigms, is rather narrow minded, irrational, and at bottom unscientific.

Dr. D. tells me that people with a higher tolerance for inconsistency are considered more “open and oriented to flexibility in their behavior.” That seems like a good thing, right?

Being able to live with the mysterious only enriches us.

Huffington Post

noreply@blogger.com (May Benatar) — Mon, 23 May 2011 00:31:00 +0000

You can find a post on the Huffington Post at http://www.huffingtonpost.com/may-benatar-phd-lcsw/personal-narrative-healing_b_862285.html If that doesn't work, just pop in my name on the website
and it will come up.

Many of you have read this already in other forums.
Just wanted you to know I have not forgotten about blogging altogether
and hope to post more there. When I do, I'll let you all know.

Thanks again for following.

Coping with suffering: Lessons from the the Warsaw ghetto

noreply@blogger.com (May Benatar) — Thu, 10 Mar 2011 17:06:00 +0000

Today I want to tell you a story that I “heard” from Diane Ackerman.

I read a version of this story in The Zookeeper’s Wife: A war story, http://www.amazon.com/Zookeepers-Wife-War-story/dp/039333306X/ref=sr_1_1?s=books&ie=UTF8&qid=1299774100&sr=1-1, It was also included in The Best Spiritual Writing of 2010, http://www.amazon.com/Best-Spiritual-Writing-2010/dp/0143116762.

We know that at least 6 million Jews were killed in the Holocaust. What is less well known is that almost the entire community of Hasidim, religious Jews who, among other things, carried within them the oral history of centuries of Jewish mystical teachings, including meditation practices, were wiped out. Sadly the finer points of this deep tradition may be lost to us forever, for little was written down.

The diaries and writings of one Hasidic Rabbi, Reb Kalonymous Kalman Shapira, were found in the ruins of the Warsaw Ghetto after the war. He died in the gas chambers.

His writings describe how he led and ministered to the trapped and the doomed.

Reb Shapira could have left the ghetto, as others with powerful Aryan friend’s did, but he chose to stay, to teach, and to lead.

Beyond the heroism, the almost unfathomable altruism of Reb Shapiro, what caught my attention was his method. He taught his followers what in Buddhist and secular circles today would be known as mindfulness meditation. His flock were starving, they were beset by illness, constant fear of being shot and deported. They were unable to properly care for, educate, and comfort their children. Many knew that their future would hold even more dreadful suffering. What could he do for them?

He taught them to focus on the moment… to watch the stream of consciousness from a distance. He taught that noticing negative thoughts and negative character traits decrease their power and the suffering they could create. Dispassion and equanimity were the tools he used to neutralize the conditions that could not be otherwise addressed by his powerless flock. Be mindful when you eat and drink. Be mindful of all sounds, those of nature and those of humanity. Meditate on nature, a nature that could only be accessed through imagination and memory. No trees or birds or flowers or streams existed in the ghetto.

For Shapira this was a path to God, to the oneness of Heaven. Knowing who they really are, not their thoughts, not their suffering, their anxiety but something calmer and divine within.

Although the teaching of mindfulness in our world today, does not focus on the Divine,

Buddhism is a non-theistic religion and there are many forms of secular mindfulness training that populate our modern world, I believe the goal is the same.

From Ackerman:

Even when saturated by more suffering that we bipeds were ever meant to feel, by paying deep attention the brain enters a state of vigorous calm, especially if one can meditate on joy, compassion, or gratitude. In the ghetto meditation helped by tugging the mind from its sorrow and limiting rumination and by giving practitioners a sense of agency that was scarce, allowing them to take charge of their own well-being and to create moments of tranquility and wonder, and occasionally something even rarer: pleasure…. (Best Spiritual Writings, 2010)

NEWS

noreply@blogger.com (May Benatar) — Sun, 27 Feb 2011 16:40:00 +0000

Dear Readers,

Just wanted you to know that

Scientific American posted another essay by me, entitled "How conducting therapy changes the therapist": http://www.scientificamerican.com/blog/guest-blog/
(2. 26.11)

Also I was very pleased that the New Yorker cited the first essay published in ScientificAmerican.com in a recent article: http://www.newyorker.com/online/blogs/books/2011/...

My File Cabinet/Myself

noreply@blogger.com (May Benatar) — Mon, 21 Feb 2011 20:52:00 +0000

In recent days I have learned a lot about identity. Mine.

As we unpack our belongings: furniture, clothes, files, books, knick knacks, family photos, art, in our new home, many months and miles from our old home, I have experienced both the joy of reunion with my “stuff” and the profound grief over “stuff” gone forever.

Some of our “stuff” I haven’t seen for 3 or 4 months, some, almost a year. As we put our house up for sale we were required by various “stagers,” consultants to the real estate industry, to pack up beloved books, family pictures, and even art pieces that told too much about who we were (“too ethnic”). Though I thought this was highly unscientific advice and was incensed by the implied criticism, I acquiesced.

My house started to feel like an alien space. It looked more like a “model home” than my

slightly cluttered, but very personal and, I thought, warm and homey abode.

Due to a sluggish housing market and some bad luck, it took many more months to sell our house and move into our new digs here in Maryland.

The worst was the books, followed closely by family pictures. Both tell the story of our lives. I don’t see collecting books as a vanity project but rather a chronicle of where we have been with our intellectual passions our not so intellectual passions and indulgences, our journeys both geographic and spiritual. Some books go back to college and graduate school. The pictures and photo albums… well we all understand about the pictures.

What really threw me was my reaction to not having a place to unpack my files, old patient files, courses constructed and taught over the years, material from particularly treasured courses I took as a student, research for academic articles long since published, ideas for books not read, projects never launched.

I had already wrenched myself away from boxes and boxes of this stuff. This was the distillation of all that torturous weeding process.

My crummy metal filing cabinets were sacrificed on the altar of expediency and the knowledge that new housing would be substantially smaller. After all we were downsizing.

I was really bushwhacked by how horribly upset I was when there was no cabinet to hold this aspect of my identity. Where were my ideas, my life’s work, going to live if not in those battered, garage-sale-quality file cabinets? What would happen to them? What would I do? Who will I be?

This may all sound crazy. I guess it is a bit, but I really think this aspect of my work life

was and is much more central to my identity than I realized. My file cabinet and its contents contribute to what makes me feel whole, integrated, and worthy. Even if I never look at another piece of paper in those files their presence affirms me in a way that I really need. Still.

I think its worth thinking about what there is in our lives that fulfills this role. Sure there are our core people that play this role, spouse, children, grandchildren, extended family, good friends. And then there is art in all of its expressions that fulfills this function. Even pets.

What is it for you?

Start Where the Client Is At: My Client/Myself

noreply@blogger.com (May Benatar) — Fri, 21 Jan 2011 15:21:00 +0000

“Start where the client is at.”

Believe it or not that was the defining sentence in my clinical courses in social work school 4 decades ago (yikes!). It can always be counted on to elicit a chuckle in a contemporary who attended social work school around that time as well. We all remember this.

As ungrammatical a sentence as that might appear to be—and maybe even impenetrable to the un-initiated, it turns out to summarize a great deal of clinical wisdom, wisdom that has stood the test of time.

What does it mean to start where the client is at? It means that at least initially the clinician must eschew judgments, must listen carefully to discern what the client is feeling and thinking and not to step either too far away, or move too quickly ahead to where you think the client needs to be "at."

In reviewing my own long career as a clinician I am very aware of how hard this is, and always was, to implement, and how often I failed to do so. If anything this got harder as I gained experience and thought I knew where the client was going. I often was too far ahead, not putting enough effort into being in sync with people.

I sit down to write this now, not because I need to discuss basic clinical social work principles, but because I have just realized that this principle underlies a certain kind of mindfulness meditation training that I am pursuing with myself. And in general, I think it is a wholesome practice for all of us

Here in the DC area I have the very good fortune to be attending weekly meditation sessions and talks with the internationally regarded insight meditation teacher, Tara Brach (www.tarabrach.com). Tara has written a book Radical Acceptance, and she teaches “radical acceptance.” By radical acceptance Tara means we must accept where we are at, in order to even begin mindful practice. Mindful practice is not just about the formal meditation practice, but it extends to being mindful of other activities, paying attention to whatever you are doing: cleaning the bathroom, eating mindfully, taking care of children mindfully, all manner of daily life. And this extends to where we are at emotionally.

One of my mindful practices is to try to catch myself when I feel unhappy when it is not for any obvious reason. Just stopping, allowing myself the feeling makes it easier to know where I’m "at." Once I know where I’m "at," I can start the acceptance part.

So I feel yucky becomes, "I’m really very jealous of so and so, or angry, or disappointed or afraid." And those feelings are automatically judged by me. You know the drill: I shouldn’t be jealous, angry, afraid. Its probably the judgement, more than anything that creates the "yucky" feeling, not being a good person because I have this feeling. But that's how it is. And that is where I am at right now. Its okay. A gentleness, a compassionate acceptance is in order. And then we go from there.

What I found, when I was able to do this, was that my body “sighed”, there was an easing of my breathing, a release and a relief. Maybe I didn’t feel wonderful, but it all passed by more quickly and was less likely to ruin my day. And as a little time went on, my understanding of these feelings deepened. Starting where my “inner client” was and is "at," allows a spaciousness and a creativity in problem solving that is otherwise not there.

So once again: start where the client is at. And these days, the client is me.

P.S. Dear Readers,

Come visit me on a recent Scientific American blog:

http://www.scientificamerican.com/blog/post.cfm?id=psychotherapy-and-the-healing-power-2011-01-19

When The Worst Thing Is Not The Worst Thing: EMDR & Unpacking Meaning

noreply@blogger.com (May Benatar) — Wed, 22 Dec 2010 01:20:00 +0000

A couple of months ago I received a request from the Mesothelioma Cancer Alliance asking me to include a link to their organization on my website (www.maybenatar.com). My contact noted that she was specifically interested in reaching out to therapists who provide EMDR therapy, as research had shown this technique particularly helpful in helping individuals deal with illness and loss.

I have not seen the research but my own experience would confirm this finding.

One has to ask how and why this is so. The diagnosis of a life threatening illness like mesothelioma is devastating. How can waving your hands in front of someone’s eyes or other forms of bilateral stimulation change that?

It turns out, devastating illness means something different to every patient, just as trauma
means something different to every “victim.” The prospect of loss of function, painful treatments, and a premature death is coded differently in each of us. And unpacking that unique meaning seems to facilitate processing. Maybe we can’t even process loss without that first step, unpacking meaning.

There are many paths to understanding meaning. Psychoanalysis utilizes free association; relational psychotherapy uses the tool of the relationship as the main vehicle to meaning. Self psychologists focus on the state of the self; their major tool is empathy

In my, admittedly, limited experience the EMDR technique can provides a short cut to meaning.

The web of memory and meaning is an intricate, unpredictable one and EMDR can help one navigate the thicket.

EMDR is a technique that utilizes a very specific protocol that unpacks aspects of specific target symptoms and then stimulates, through the use of eye movements, taps, or alternating tones an internal process that seems to move individuals through a web of associations to the presenting images/symptoms back, back, back to some memories, earlier life experiences that may hold the key to unlocking the meaning of symptoms. This is free association on steroids.

See the following links for two short videos that demonstrate in pictures what would take me too many words to describe and describe poorly at that.

http://www.youtube.com/watch?v=gZ5MLn1Cc94

http://www.youtube.com/watch?v=bqbFIj5vwmA&NR=1

Sometimes the worst thing is not the worst thing.

One middle aged gentleman came to me when the lung cancer for which he had previously been successfully treated, returned. And it returned with a vengeance. He was at stage 4. Although he still had many treatment options and his doctors held out a great deal of hope, he was understandably devastated. He was alternately enraged and despairing. He was declining treatment, fighting with his doctors, unable to eat or sleep, alienating friends and family.

It would seem obvious that his fear of death was the primary cause of his suffering. At least that was what was obvious to me. But that is not what emerged with the EMDR treatment.

What emerged within one session was a memory of having wronged a good friend many years before, in his early 20’s. He felt enormous shame and guilt when remembering this during out EMDR session. The feelings were vivid, immediate, and intense. This one incident in which he had hurt and shamed someone else made him feel that he was a bad person.

Subsequent discussion over several sessions, revealed that some important part of him felt that he was being punished for his early cruelty. Lung cancer was the pay back.

Bringing this to light made it possible to process this event with the maturity now available to him. He found some compassion for his younger self. It was also now possible to reconsider that perhaps his misdeed had not caused his cancer. Cancer is awful. Facing death at 45 is awful. But feeling that you are a really bad person and that is why you are ill, that is worse.

Sometimes the worst thing is not the worst thing.

The False Memory Wars: A Short Primer

noreply@blogger.com (May Benatar) — Tue, 30 Nov 2010 19:31:00 +0000

Do you remember the false memory wars?

Probably not, but I do. Its effects continue to linger in a way that troubles me.

This was a “controversy” that consumed the field of trauma therapy throughout the 90’s

It did incredible damage to the field of trauma therapy. Therapists and patients alike were victimized by the charges of “the false memory foundation (FMSF),” that patients who were being treated by either misguided or malicious therapists were being guided to “mis-remember” childhood

events of sexual violence perpetrated against them. Therapists lost their licenses, patients lost their nerve, and the whole field of trauma treatment contracted in the face of the onslaught.

Unfortunately the media embraced wholeheartedly and uncritically the charges of the FMSF. There was a shocking lack of balance in the coverage of this controversy.

Interestingly it took the trauma of 911 and the treatment of psychological victims of that catastrophe to bring the field back to respectability. Trauma treatment programs proliferated after 911. Now trauma was and is about terrorism and war, not sexual abuse.

The phenomena that was being questioned by the FMSF was the way some individuals who in the course of therapy, or indeed just in the course of life, would be blindsided by previously unremembered events from their childhood of savage abuse usually at the hands of trusted caretakers or other family members. Jane Smiley, in her wonderful Novel A Thousand Acres has a wonderful description of the phenomena of being struck by such a memory. Jane Smiley does this so artfully that the reader is “assaulted” by the information much as the character is.

How can such a thing happen? Being literally assaulted in living color by a previously unremembered event.

We all know how unreliable our memories can be. I could swear that I hid my expensive jewelery in the freezer. Why isn’t it there?? Didn’t my oldest daughter walk at 9 months? I distinctly remember that she did. These might be distorted, they might be wishful thinking, or they might not. Plenty of psychological research has establish that memory deteriorates over time. Eyewitnesses to crime are notoriously bad witnesses. This is established science.

What isn’t so well accepted and understood is that traumatic memory is different. Through a mechanism call “dissociation” child victims of horror, torture, abuse, betrayal find a magical way to cope. Adaptation is well served by filing away, sequestering these memories, severing them from the mainstream of experience so as to be able to go on, grow up, continue to stay attached to important attachment figures who might also be perpetrators. By the way there is neuroscience to back up this understanding of "dissociation."

When it is safe, sometime in adulthood these “dissociated” memories can return unbidden. And when they return they are intact—they haven’t degraded at all. The smell of the room, the smell of the perpetrator, the texture of the rug, the cracks in the ceiling, they are all there.

This is the nature of traumatic memory. And almost always these are unwelcome events, the return of the repressed. The adult individual doubts their veracity, disowns them, tries to forget, hides them from the therapist. I have never known a victim of childhood abuse who didn’t try to run as far away from these memories as they could. Trauma therapy is a torturous enterprise because the memories are so unwelcome, so painful, at times almost unbearable.

It is not like my memories of where I hid my jewelry.

Which is not to say that there are not unscrupulous or poorly trained therapists who prime the pump and solicit “false memories.” There are also individuals who present a false narrative for some secondary gain in psychotherapy. Those are not so difficult to spot.

There have been a few and pretty small studies that have sought corroboration for their trauma patients narrative and have found a high rate of veracity. But for me the acid test has always been, is the patient getting better as you lend them your unqualified support in their attempt to remember. If the answer is “yes” that’s all the corroboration that I need.

EMDR: CAN WE CHANGE OUR PAST/FUTURE?

noreply@blogger.com (May Benatar) — Mon, 08 Nov 2010 18:45:00 +0000

I’ve just read a book that combines two genres: science fiction and historical fiction. In Galileo’s Dream, Galileo is teletransported in time and space—the time is 3020- the space: the 4 moons of Jupiter, known as the Galilean moons.

Much of the science, fictional or not, is beyond me. But the psychology is not If I understand correctly the purpose of these periodic teletransportations is to manipulate the outcome of Galileo’s life. In real life G. was tried and found guilty of heresy by the Catholic Church for, among other things, arguing for the correctness of the Copernican view of the universe, that the earth rotated around the sun, and not as the Biblical view had it, that the earth was the center of the universe.

The bad guys on Jupiter want G. to be burned at the stake. They think this would mark the end of religion and clear the way for the ascendancy of science. But not everyone agrees. The good guys attempt to teach G. about his life so that he can maybe even avoid the heresy charges altogether.

What caught my eye was the third millennial version of a psychotherapist or even psychoanalyst, a mnemosyne. In Greek mythology, Mnemosyne is the Goddess of memory and the mother of the Muses. With the help of a helmet-like device the Mnemosyne accesses nodal points in the brain where intense emotional memories are filed. The subject “remembers” in the deepest way.

If the, poorly remembered past could be vividly recalled, the theory goes, a person will be changed and their future will be changed, not just their current “symptoms” but their future. In the context of the book G. held a better chance of surviving what was in store for him at the hands of the Catholic church, if he knew himself better. What gets changed is not the past, but one’s experience of the past and thus the future..

One of many things that caught my attention was that the technology described in this imagined Jovian future already exists. Its called EMDR (eye movement, desensitization, reprocessing). The modern mnemosyne (read psychotherapist) uses the protocols of EMDR to access connections between the presenting problems and the past.

In EMDR one stimulates alternately the two hemisphere of the brain by way of sound, eye movement, tapping, or some such. Very little special equipment is necessary, maybe ear phones for sound, or a light bar with which the subject follows lights without head movement. This process seems to faciliatate both relaxation and a kind of free association, so one starts with a target image and quickly begins to link to other images, that are cognitively if unconsciously connected to the original target image and symptom. Typically what comes up in a session is an early memory that has set the individual up for the difficulties they are now experiencing. These image and the memories that arise are “re-processed” and the anxiety, the symptoms diminish. They really do.

The EMDR protocol is typically part of an overall treatment process, and my description here is barely adequate. For more information see http://www.emdr.com/briefdes.htm

My point here, is that with the aid of this technology we can help an individual revive the relevant memories from the past that can change the present: ameliorate symptoms and perhaps even change the future.

The Mnemosymes of Jupiter have nothing on us.

Consult Your Inner Wisdom: It Has All the Answers

noreply@blogger.com (May Benatar) — Sat, 02 Oct 2010 00:20:00 +0000

This past year, or two, in my clinical work, I experimented with a therapeutic technique that I cribbed from clinician/writer Sarah Krakauer. I found it useful both for my clients and for myself. I share it with you.

The assumption behind this idea is simple: at bottom, no matter how fractured our identity, or sense of self, there is within us a wholeness and a wisdom that we can consult as a sort of inner gyroscope. The theory goes that there is a unity within, and if we can gain access we can find a treasure trove of wise guidance.

I have worked with individuals who were highly “fractured” due to severe trauma histories, as well as more intact individuals. The technique worked well with all kinds of people but I found that individuals with these fractures had an easier time accessing the “inner wisdom.”

The technique involves a simple visualization. One woman with whom I was working is diagnosed with Dissociative Identity Disorder, formerly known as Multiple Personality Disorder. This means, simply, that her identity is complex and multiple: she has very distinct and separate identities within a seemingly stable “self.”

Each “part” of this individual has a discrete and often contradictory point of view on any matter you could imagine: what to buy in the supermarket, for instance, junk food or organic kale . Or on any particular day if I am perceived as benign or as a threat. So checking across parts as to what the inner wisdom might suggest on any given topic is relevant to our enterprise.

What surprised me was that when we went through the inner wisdom I got the same answer to the question of the day: no contradictions, no evasions.

With this particular client I was often uncertain as to how to go forward in any given session, which part to address, how much to push for the traumatic memories that were just outside of her awareness. They could either liberate her from painful symptoms and/or de-stabilize her. Actually I was almost always struggling with these choices.

The inner wisdom always directed me to the traumatic material: go for it, it seemed to say. Don’t pay so much attention to the complaining about the pain that this causes. And the inner wisdom was right. After a period of turmoil, which was always difficult to weather, my patient was more solidly grounded, more mature, and eventually more integrated.

Now this is not magic, if the client was in retreat, warding me off, defending herself from incursions, I might get nothing. But this was relatively rare.

I describe the technique belo. Do try this at home. Its perfectly safe. Its probably more effective to have someone read this to you, or record it yourself so you can hear the suggestions, not just imagine them.
Sit in a quiet place, close your eyes and visualize a corridor. This is a safe place. Off the corridor are doors. The door on the left is labeled “Hall of Inner Wisdom.” Open the door into a room that resembles a small movie theatre. The seats are comfortable. Sit down and see that at your finger tips is a keyboard. Type in the question that we are working on today: why does my hip hurt so much today, or what should I do about a troublesome relationship, should I change doctors, etc. Look up at the screen in front of you and there will be an answer.

Here you may see pictures or writing. You may just get thoughts popping up. If nothing comes, just sit quietly for awhile and see what happens.

I have tried this myself, going through the same steps of visualization. It feels a little like meditation, but with a very specific goal. Sometimes I get an answer. Not as frequently as my patient, alas. Often the answer surprises me. That’s what makes me think that this really is coming from a source quite different than my logical, linear, and deliberative mind.

What I think is going on here is that with the right tools and probably a bit of practice, one can have access to a part of the mind that is less rigid, less defensive, more intuitive, and more astute than the reasoning mind. I find it exciting and re-assuring that there is a guidance within with which I can make contact.

More on Story-Telling: The Cambodian Healer

noreply@blogger.com (May Benatar) — Fri, 27 Aug 2010 14:14:00 +0000

Phaly Nuon is a Cambodian survivor of Pol Pot’s killing fields of the 1970’s. An educated woman who managed to disguise her origins and her learning in order to survive the mass murder of the educated classes, she witnessed the rape and murder of her teenage daughter and the starvation of her baby. She survived for three years in the jungle, trying to protect her two surviving children, living in isolation, hiding and eating only what she could forage in the jungle. She and one child walked out of the jungle. Her baby died.

While in the refugee camps following the war she noticed many women whose mental state made them virtually inert, unable to care for themselves or their children. Their PTSD (post traumatic stress disorder) was going to kill them and their children. She set out to help them and developed her own system of psychotherapy which was remarkably effective. This woman has been on the short list for the Nobel Prize many times for her work with these depressed women as well as the development of an orphanage (the Future Light Orphanage), which the recovering victim/survivors run.

Phaly Nuon has a three part system of therapy (which actually has at least 5 parts).

1. She teaches the women to forget their atrocities. 2. Then she teaches them to work. Some of the work is with orphans who have lost their parents in the war. 3. Then, she says, I teach them to “love.’

Interestingly both she and Andrew Solomon (¬The Noonday Demon: An Atlas of Depression (http://www.noondaydemon.com/biography.html ). fail to notice that the first step is not the first step. The first step in her system of therapy, as Solomon recounts this, is the telling of the story of their ordeal. And then the re-telling.

I quote Solomon:
"First, she would take about three hours to get each woman to tell her story. Then she would make follow up visit to try to get more of the story, until she finally got the full trust of the depressed woman. "p.36

"Forgetting," involves getting them involved in their present life.

Step two, work, is an important part of that. And step three, teaching them to love, is all about focusing on relationship. The women that Phaly Nuon has ministered to have formed a healing community. Just as a footnote, Freud thought the ability to love and to work were the hallmark of mental health. Evidently Phaly agrees.
There is another step, by the way. This is teaching the women to give manicures and pedicures to each other (!) This is the final phase and as a lover of pedicures myself, I can testify to the healing potency of this process, which is both intimate and impersonal.

This step, perhaps, represents the importance of engaging the body, in the healing process

This story, I believe reinforces the importance of story-telling in healing. Phaly took it as a starting point and created something truly amazing.

I first heard Andrew Solomon tell this story on the Moth broadcast on WNYC. Here’s the link: http://www.themoth.org/

For more on Phaly: http://emailfosterparents.org/PhalyAutobio.htm

Why Does Psychotherapy Take So Long--Part 2

noreply@blogger.com (May Benatar) — Thu, 12 Aug 2010 20:32:00 +0000

An important part of the psychotherapy process, as I understand, and have practiced it, involves constructing a narrative of one’s life.

This may seem like a curious task given that we all know, or should know, the story of our lives. We’ve been imagining the movie to be made from that story, forever, right?

Well, that may be true of some us, but a surprising number of people actually don’t have a coherent story, something that hangs together, makes sense, and has some internal consistency to it.

There is some compelling evidence that the coherence of one’s story is a key component of sound mental health. I derive this from solid research findings that the quality of one’s attachment to one’s off spring is strongly influenced by said coherence. What researcher’s found was that the strongest predictor of stable, secure attachment in babies was the caretaker’s (read mom’s) ability to recount a coherent story of her own life. That story didn’t need to be historically accurate. It didn’t need to be positive. It was not necessary for her to have had a happy childhood. She just needed to be able to narrate the story to herself and the interviewer, of course, in a manner that hung together.

A baby’s “attachment” status reflects the ability of the young infant to bond with their parents, an important, maybe the most important, measure of their emotional well being.

Given the robustness of this research finding, frankly, I don’t understand why everyone who wants to be a parent, or is a parent doesn’t run to their nearest therapist. It would seem to be the best argument for undertaking this admittedly arduous and expensive process.

So back to what we do in therapy. We construct a story. This is the story of the client/patient. Its not mom’s story, dad’s story, or the story of the siblings, its not the therapist’s story, it’s the patient’s story.

So many of us have accepted, wholesale, someone else’s version of our lives. If you have been told forever that your childhood was idyllic you might be tempted to go along and not validate some of your own memories, or even weak suspicions that things were not always perfect. If you were always told that you were an overly sensitive child you might buy this wholesale. Never mind your own observations that people were actually pretty mean to you

This is tantamount to not being on your own side. Empathy for others, those adults who did the best for us growing up is a positive thing. But not if it’s prioritized over empathy for the self.

It is truly amazing how much fog, depression, confusion, and anxiety begins to lift when the story one narrates starts to be one’s own. It needn’t be a pretty story or even a wholly accurate story—just one’s own.

Sometimes the story is there but it is self-condemnatory and unfair. A woman who was raped at the age of 16 has told herself forever that she consented to sex with a man much older than her that she barely knew and was therefore a slut. All the adults in her family would agree (if they knew the story): a 16 year old is a grown up and responsible for her actions.

I had her look up the definition of “statutory rape.”

It took years for her to empathize with her frightened and confused 16 year old self and for her to re-structure the story to reflect her naiveté, her fear, her helplessness and her isolation at the time.

Story construction is central to the project of psychotherapy. Coherent stories evolve only slowly.

Parental Narcissism, The Good, The Bad, and the Ugly

noreply@blogger.com (May Benatar) — Fri, 06 Aug 2010 21:11:00 +0000

You might think the words “parent” and “narcissism” don’t seem to go together, right?

Actually, wrong.

First a short dissertation on “narcissism.” Narcissism, self-love, is really key to human survival and healthy development. It morphs over time, as we grow, from believing ourselves to be the center of the world as young children, to something maybe slightly less over-weaning, like being confident of our abilities, and having the instinct for self preservation. Having a good relationship with our narcissism helps one navigate adult life.

I know a 4 year old who confides to me that he is “super-good” at soccer, running off to kick the ball to kingdom come. He thinks he’s great, and this makes him happy, happy.

Over time he will probably come to evaluate his soccer skills in a more modest and balanced way.

Becoming a parent often gives us another stab at satisfying these wishes, for we do become the center of our young children’s universe and for a substantial period of time, we get to vicariously enjoy their triumphs, their achievements, their incredibly rapid development. The besotted-ness that is the norm for young parents absolutely in love with their offspring could be viewed as a very benign form of narcissism, the child as an extension of self.

This is mostly good. It facilitates the kind of adoration that young children need to grow. It is fertilizer, sunshine, and water.

That’s the good stuff.

The bad stuff comes in when they are just themselves, not us, not an extension of us. Inevitably they will frustrate our expectations, the ones we are aware of and the ones outside of our awareness. This happens in small ways when they are small and in huge ways when they are not so small.

A digression: The Simpsons. As popular as this TV show is, I have probably seen a half dozen episodes in my lifetime. Strangely I saw the same one twice, as if it were calling to me! This featured Lisa, the saxophone playing sister and the blue haired mother. I was blown away by how very smart was the script. As I recall, Lisa had the blues. She felt unpopular and rejected at school. She was frankly depressed. Marge, the blue haired mom, had trouble with this and kept telling Lisa to cheer up, it wasn’t so bad, don’t be sad, etc., etc. This drove Lisa further into her depression.

One night the mother had a dream, I don’t remember the content. But the dream woke her up to the realization that Lisa’s doldrums were making her, Marge, feel inadequate and she was not really thinking of Lisa when she told her to cheer up and get over her bad feelings. Man, how often does that happen in our lives, that we filter our children’s problems through our own injured narcissism. We can’t stand their pain maybe for lots of reasons, but one may be that it makes us feel we have failed to do our job, it’s a reflection on us. Lisa ended up feeling alone.

Marge teaches us an important lesson about parental narcissism, one that the writer’s of The Simpsons think is important to reflect on. How often are we motivated when responding to our children difficulties with school, friends, sports, whatever, with our own injured self pride forgetting to try to get closer to their trouble, their pain, their felt experience. That can transform a problem for both parent and child.

What do you think?

noreply@blogger.com (May Benatar) — Fri, 06 Aug 2010 18:45:00 +0000

noreply@blogger.com (May Benatar) — Fri, 06 Aug 2010 18:44:00 +0000

Why Does Psychotherapy Treatment Take So Long?

noreply@blogger.com (May Benatar) — Fri, 30 Jul 2010 23:28:00 +0000

This is a question I have heard, in one form or another, many times from my
clients/patients.

Sometimes the question is not posed explicitly, but the client assumes at the opening of our work together that he/she will be in and out in six weeks (said client having just told me that she has a long history of failed relationships, periodic dark depressions, and an eating disorder).

There are of course treatments that are shorter, but I tend to think in terms of years, if a client is suffering a great deal and has for some time.

Explaining why psychotherapy treatments are not generally brief affairs is complicated. My model of therapy is of course not everyone’s model. Models of short term therapy exist. I am not a practitioner, although I am aware of these modalities and have read their literature.

I think of the realtor’s motto—there are three things important in the sale of a home “location, location, and location.” In the kind of psychotherapy treatment that I practice, those three important things are : “relationship, relationship, and relationship.” What happens between therapist and patient is the cornerstone for effective change with and for the patient. The relationship is the crucible for change. Obviously building a trustworthy resilient (if not perfect), mostly predictable relationship takes time. If there has been a major betrayal at the heart of a person’s life experience, building trust can take a very, very long time.

In the ordinary course of events the relationship stumbles, there are crises, loss of faith, mistakes made, failures of understanding and empathy. As in life, so in therapy, it is in the repair of those rents in the fabric of the connection that hold the real promise of lasting change in the structure of the self. This is a basic tenet in many theories of therapeutic change.

Within the context of the mostly safe relationship, our clients have the opportunity to develop new skills. Most of us developed our coping skills early in life. We adapted to whatever conditions we faced with the best tools available to us at the time, that time being childhood. Checking out (dissociation), cheerful denial, taking care of others, distancing ourselves from others, controlling others, numbing ourselves, living in a fantasy world are only a few of the popular choices.

As circumstances in our life change we fail to update the toolkit. We go on automatic. This is true for all of us. If you have always been cheerfully unaware of thunderclouds on the horizon you will probably continue to be so, even if the consequences are dire. It takes a lot to get us to reconsider our choices or even to become aware that we are making choices(!) and to re-evaluate the appropriateness of our adaptations.

That’s where the therapist comes in. Its their job to identify those automatic choices and to help the client evaluate them. Dissociation, to take an obvious example, is wonderfully adaptive for a child trapped in an abusive family. Why not check out, if there’s nothing you can do to remediate the situation? Obviously this is not so adaptive for an adult who needs to find the wherewithal to get out of an abusive marriage, a heinous job situation, a sadomasochistic friendship. But now the dissociation is ingrained and it takes real work and real time (!) to turn that around.

So the blood, sweat, and tears that it takes to build a relationship and the difficulties of learning new tricks are two important factors contributing to the long term investment involved in change.

These are only two of several factors that make therapy very hard work. I will leave more commentary for another post.

CHOICE AND CONSEQUENCE: Terry Gross and One Life to Live

noreply@blogger.com (May Benatar) — Tue, 06 Jul 2010 18:05:00 +0000

We went to hear terry gross of NPR fame a few weeks past. It was wonderful. She is wonderful.

There was an interesting moment when she answered a question in the q & a period that was never asked by this particular audience. Undoubtedly she had been asked the question at some other time.

She never had children. It was a deliberate choice. She is probably 60 or close to it. But I guess she knew early on that her life as a journalist, whether it was on her current show “Fresh Air” or not, was going to be all consuming. What she said was (and of course I am paraphrasing as best I can), “I never could figure out how I could do it—do my job and have a child and raise that child well. I know other people do it, but I couldn’t figure out how I could do it.”

For those who don’t know Terry Gross, she has a wonderful interview show on NPR, 5 days a week, interviewing novelists, biographers, historians, political analysts, pundits, musicians, movie and theatre people, etc., etc. The level of conversation she promotes is unusually high for radio and other media. This requires intensive preparation, she reads and understands the books, she listens and understands the music, the theatre, the geopolitical situation under discussion. She facilitates conversation at a very high level. Her job is terrifically demanding.

What struck me about her disclosure was her humility, her maturity. She accepted, probably at a fairly young age, that she was a limited human being, that she could do this or should could do that but she couldn’t do both and she needed to choose.

Elizabeth Gilbert whose book “Committed” I just finished, said something similar about her own choice to remain childless.

This post is not about the decision to remain childless. Both Gilbert and Terry Gross helped me think about the omnipresent work life/balance struggle that so many, maybe all young parents struggle with; women maybe more than men. I certainly struggled with it. Coming to terms with the push/pull of career choices and family life style choices for those who indeed do have a choice (a privileged class, those who have a choice to work or not), requires humility.

We can neither do everything or have everything. Every decision has consequences: to have a child, to not have a child, to work full time, or to not work full time, to forego the career, to pursue the career full tilt, to have one child, or two, or many.

This is an obvious point I’m making, perhaps, but I have a sneaking suspicion that there is a barely acknowledged assumption buried in the heart of young parents, that if one does it just right, there will be no great pain or sacrifice. The children will not suffer, our careers will not suffer, our spouse will not suffer, our marriages will not suffer, we will not suffer.

I think there is always sacrifice, at the very least there is always consequence, and we can’t always forsee what that will be when we make our choices, or how we will feel on the other end. What’s important in my estimation is an acceptance of that truth.

Terry Gross struck me as surpassingly wise and humble when she decided she couldn’t have it all.