While I can't speak for other psychologists or therapists, I can share my own experience. I remember telling interns that sometimes therapy is as simple as saying, "Tell me more." In other words, just giving a venue for people to think things through without facing lots of udgment can be therapeutic. It can be hard to justify the need for an advanced degree in that case and sometimes a beautician or bartender do the same thing, but the education really helps for knowing what NOT to say, how to avoid harmful interpretations and when to pause or encourage. Good listening is an art.
Then, there's the therapy which requires good analysis of language and thinking, as well as observation of gestures, facial expressions, posture and interactions (with a partner, family members or with the therapist proper). Looking carefully at behavior and gently guiding the patient to see what's happening and/or directly teaching new skills does take a lot of finess and education.
Sometimes, role playing or acting out different ways of behaving, or relaxation and use of imagination or even hypnosis, art, or story-telling become a major part of therapy. Deciding when, what and how depends on the particular patient and the skills of the therapist. These methods are some of my favorite with children, engaging them completely.
Therapy is interesting, helpful, loving, growth-producing to the patient and therapist. No matter how bad the conditions with which we therapists deal, a good therapist finds it a privilege and a pleasure to help.
Now, that doesn't mean there can't be frustrations, as when patients are resistent, project anger onto the therapist, or misbehave in various ways. I've had fewer than one handful of unhappy experiences in working with people and I've learned that patience wins out. In the couple of bad experiences, the patients came in angry and ready to prove that therapy was not for them. They didn't give it a chance.
So, realize that people who do this work love it and that's part of why it works.
]]>First example is one in which a child becomes physically ill, such as having stomach inflamation. The mother gives the child every medicine and more and every food which exacerbates the condition without disclosing to anyone that she is doing it. Gradually, the mother becomes like a nurse to an increasingly ailing child. Her family and friends marvel at her patience and martyrdom, as the child continues to suffer.
Example two consists of a husband who is a doctor. His wife suffers from Depression of a clinical nature, having bouts of crying, self-pity, lack of joy and no motivation for days at a time with no legitimate trigger. He substitutes meds for her prescribed ones which worsen her mood and feeds her herbs, claiming their helpfulness, which also lower her mood. He is a criminal. In this case, this horrible manipulation served his needs to maintain an affair on the side. Had he not been caught, he could have become a murderer.
Now, my last example is that of a parent who defines her average child who has some learning disability and attentional issues as rejected, injured, and further disabled by by almost everyone else in his life, including all agencies, schools and institutions. If she doesn't catch on, she believes that everyone is against her and that she is a failure. The parent fashions herself as somewhat of a savior and the only person who understands, playing out her own complex familial issues all the while.
These cases are tragedies and become like a mental and/or physical health problem shared by perpetrator and victim alike and by the system as a whole.
]]>The person with the worst sense of direction complained most about her CPS malfunction and was largely placated and then ignored by the dealership. The enabling parent complained a ton about everyone who should have helped the child, just a tad about herself and not really about the child, citing his disability for all his wrong choices. Facing their own failures would be too hard, of course. The system may be wrong, but so are the people who did the wrong deeds. The husband complains about the wife's nagging but doesn't realize what a lazy jerk he was to provoke her. The wife complains about the husband taking off time from chores without admitting how worn out she has him. And on it goes.
Wouldn't it be good if we would take into account the difficulties of the task we want done, the complexity of satisfying our needs, the intentions of others and our own responsibility in whatever goes on?
]]>My contention is that everyone is so different that we could all claim not to have enough in common with friends or family members, but everyone has something in common with everyone else, too. Our focus is our choice. When we choose to care about someone, we focus on the similarities and accept, understand, or even relish the differences. That's how we offer more to each other. Not all friends are at the same income levels, pal around in the same other circles, have similar professions, are alike in their family or non-family life or share many interests or beliefs in common. Yet, there must something which draws them together. It could be their heart, their mind, their ability to understand, their stories, some of their opinions, really...almost anything.
Just like the husband who is handy and practical and the wife who is intellectual and not street savvy, or the partners or friends from different countries and cultures, they feel a connection and like each other. They may find each other interesting or just comforting. They may have some of the same needs but certainly not all.Maybe they just need love and caring, attention and sharing. Take the husband who is very neat and the wife who is a slob, or the partner who loves to travel and the other who doesn't, or the artist and the scientist. There are compromises and they get along because they don't demand too much of each other. a doctor and they don't demand too much of each other. They don't challenge each other's individuality but support it.
Next time we think we couldn't like someone because of their politics, their appearance, their social position, their problems, let's open our minds and find the human commonalities. One caveat, though. There are some exceptions, such as criminal, extreme addictive and immoral behavior, which would allienate most folks.
]]>Unfortunately, many a partner does not recognize this pattern, until the relationship is distored and out of whack. The handyman husband resents taking care of all the household details without realizing that be being so efficient, he has enabled his wife to become dependent and helpless at household stuff. The great billpayer and accountant in the family has enabled the others to rely on her resources without learning to be responsible financially. The big sister manages social life for her little brother and he doesn't learn to make friends on his own. The more they stay in these positions, the more glued to them they get. Rather than end up in a position of difficulty, one person needs to back off, so the other can grow into the gap.
The anger will dissipate as the balance improves. The wife who learns some household chores and fix-it maneuvers beomes more self-sufficient and there's a certain modicum of respect she gains from the husband, who feels grateful, as long as he does not feel displaced. The spender pares down his purchases and the cheapskate eases up. The avoider is a little more friendly and the pursuer backs off or vice versa. Balance is important. Maintaining it is a dance with constant adjustments, as needed. Each person has to be aware of the pattern and his/her own contribution in order for the it not to be a dance of anger.
]]>What I sometimes forget is that the abused aren't just the people we see in the office. She stated that one in four people has been sexually abused and more have been physically or verbally abused or bullied. They are all around us. Most people don't even report the abuse and are never treated for post-traumatic stress. Some people may survive well, due to unusal resislience or great auxiliary support. Some people suffer phobias, panic attacls. depression, lack of self-respect, poor concentration and underachievement throughout their lives. Many people disguise their shame, fear and anxiety and depression behind substance abuse, false bravado, obesity and eating disorders and a wide variety of compulsive behaviors.
You wouldn't normally think of asking a friend or even a relative whether or not he/she has been sexually abused, for example, but wouldn't it be good if we could talk about such traumas openly and offer people support? Think of the lifetime of silent suffering a person wouldn't have to endure, if she/he just could "come out" and get help without societal embarrassment.
If you find out or suspect that someone you know has been or, worse, is being abused, please say that it's common and show acceptance, nonjudgemental caring and say there's help. See if you can steer the person and/or family to a mental health agency, or, at least a professional in a school or religious organization.
Professionals can help the abused person and family be safe, learn to relax, understand and handle feelingsbetter, understand and process thinking without distortions, face their trauma with dignity and perspective, overcome anxious situations, communicate well within the family, and learn to protect herself/himself in the future in a healthy way.
]]>However, the partner often has other ideas, at the worst - maybe involvement with someone else, or, less severe- wanting some space or a greater sense of self-determination or freedom or a sense of choice or control. So, the pushiness doesn't work. It backfires and makes things worse.
The best procedure is to back off respectfully and lovingly, letting the other know what he or she has to offer, that he or she feels affection or love and understands empathetically where the more distant person is coming from. Being a sweet and kind friend is a turn-on. Not demanding but suggesting and then giving an opportunity to choose leads to appreciation. If love is there, it will more likely come around. If it's not, at least, the results won't be bitter. There's more of a chance that they'll stay in touch and either reconnect or end with peace.
]]>Thoughtlessness comes in all kinds of formats, too. How about the student who aces courses through sheer memorization, stepping through the grades mindlessly, yet maintaining a high level of ignorance? Or the doctor who ascribes to the "most common diagnosis" or cookbook, el cheapo form of medicine? That's how people end of more sick or worse. A friend says something hurtful based on thoughtless stream of ideas, or a parent does, giving a child a lifetime of self-doubt.
On a political scale, countries thoughtlessly improved their economies, while killing its people through pollution. People kill others based on poorly-thought out, or totally thoughtless, religious or otherwise prejudicial and hostile assumptions.
You get the gist. Let's stop and think about all the ramifications of our decisions, the pros and cons, not just what feels good, what looks good, or what others tell us to emphasize. Think actively. Think what if everyone said or did this sort of thing. Think about others. Think about the future. Active not passive decision-making. Thoughtful not impulsive behavior.
]]>Picture the kid who is supposed to do chores or homework with his arms folded, or finding anything to do but the task. Then, ask yourself, is he angry, frustrated, or afraid that he cannot please if he cooperates. There could be a reason for the passive-aggressive behavior. The partner or spouse might have a reason, too, holding a grudge about some perceived injustice, feeling like no amount of cooperation is enough or appreciated, or being irritated at a surpl us of demands. Some folks don't have the background to know how to give attention consistently because they haven't had proper role models.
If the passive-aggressive behavior continues to the point to leaving the recipient unfulfilled, empty and hurt or to the point that the noncooperative person, especially a chld, is getting away with rudeness or not doing what is in their best interest, it needs to be addressed. A gentle, honest conversation with suggestions for how to help each other feel comfortable and do the right thing may help.
]]>What he has accomplished is no help to the relationship. Does he secretly want to end it? Does he feel inadequate and want to declare himself one up? If the partner has any self-respect whatsoever, she/he invalidates the angry claims and/or or acknowledges any kernal of truth therein. Soon, the mad partner feels like a bad guy or like it's impossible to win. Usually, they make up, but these types of repetitive spats and tamtrums can easily wear down a relationship, creating cracks that make bigger real issues count more towards possible undermining the whole deal.
When hurt feelings build, whoever is most savy first might well ask why Partner A feels so hollow in the first place that a tirade becomes a sad attempt at power? Is she losing her memory or other faculties (such as hearing), affected by alcohol or drugs, comparing herself to smarter and more successful peers and feeling inferior, tired, scared of aging, suffering from mental illness, feeling guilty about something and wanting to displace blame, or reminded of painful prior experiences and overreacting on that basis? Brainstorming, a little detective work and repair in the relationship could help prevent future episodes/ It's important, unless you don't care.
]]>Recently, an article in a newspaper, for which no one ever interviewed me, so the info was from an attorney about a case and, therefore, third-hand, called me a psychiatrist. Once in a while, I do get a phone call, also looking for a psychiatrist. My friends mentioned that they saw the misinformation and an erratum later. However, someone who obviously doesn't like me, or maybe herself?, sarcastically asked, "So you're a psychiatrist now? That takes a lot more education....." (I'm may not have the exact wording.) Anyway, I explained that it was a misprint and psychologists generally have a doctorate in psychology, while psychiatrists have a medical degree. She stopped me and we ceased to converse.
However, I feel stimulated to explain more for all those of you, and it's very common, who confuse the two professions. They are certainly related and usually work well together.The psychiatrist learns psychology from practice during residency mostly and knows more about the body and diseases and medications than the psychologist. The psychiatrist prescribes medication and may or may not treat with therapy. The psychologist, on the other hand, has spent more years studying psychology than the psychiatrist and knows many evaluation procedures which the psychiatrist does not plus learning from experience during clinical courses and interships.While some psychologists now are certified to prescribe medications, too, that is rare. However, they do learn about medications enough to consult with medical doctors about that aspect of patient care.
In any case, the psychiatrist is a medical doctor who deals with psychological problems and mental illness. The psychologist is a doctor of psychology who deals with psychological problems and mental illness, who usually does not prescribe medication.
]]>All week, I heard malpractice stories. People who came out of surgery worse off than they went in told of missed work, unhappiness, pain, inability to function in the small talks of living, dependency on others and other such misery.
A doctor decided to do back surgery in a different way than initially planned. It made things worse. He tried to fix it. That operation made things even worse and totally unfixable. That man is more disabled than ever. Another doctor failed to listen and respect his patient's knowledge of her condition, an intelligent and well-educated patient who had lived with her damaged limb for a long time and know her body well. He wrecked things for her and the only hope is that she can improve with some other help. Then, there were two infections in the hospital due to poor sanitary conditions. Unforgiveable. Lastly, a woman survived surgery well but her poorly-monitored position on the operating table caused nerve damage, which may never heal. What a travesty!
Even worse psychologically, the doctors take no responsibility, no admission, apology or accountability, due to fear of litigation. My wish is that these patients will recieve an appropriate apology, help in whatever way necessary and a reasonable settlement to make their lives easier. Mostly, I hope the doctors involved will humbly learn from these mistakes and institute policies to prevent them in the future.
]]>
Or, take the widow who can hardly function, as opposed to the widow who grieves but courageously starts a new life. The former woman had a history of dependence, abandonment, insecurity or the like. She came by her vulnerability honestly and the death was the last straw. The strong widow had reserves of love and support in her past and present. She knew how to cope.
The angry man who over-reacts to slight mistakes which family makes normally has a history of criticism from his father and feels terrible about himself, so he projects his problems on others, so he can believe that he's better than they are. Nitpicking becomes his false superiority. It's not just a matter of personality, or "just the way I am." It's the results of years of conditioning.
Anxiety provoked by an event leads to a tense reaction which is workable or severe panic, depending on the sum of experiences and conditioning which preceded it. So, someone might say that losing a job triggered anxiety, but the reaction may really be about remembering every failure along the way, rather than crediting the economy and real factors which influenced the situation. So, someone would really be remiss in treating the person for "job loss." That's what some counselors do. The job loss can be addressed but the whole person needs work because the over-reaction in his case stems from many problems along the way, such as failures in school and socially which haunt him.
By now, you get the idea. The problem isn't just the problem. It's what's on the surface. The problem has roots and depth. People have histories and are an accumulation of developed strengths and weaknesses from their innate tendencies, but especially from their life experiences.
]]>So, while one person lives to watch TV, eat meals, play cards, and lie in the sun, another enjoys meeting new and interesting people, seeking out cultural opportunities, world travel, and helping people. To each their own. No judgement. Of course, when there's a couple and one craves simplicity and the other craves meaning, they make compromises usually to keep things happy and vital in the relationship. The person who likes to keep things simple needs avoids some activities but participates in others and the one who wants to do everything learns to relax and vege out more.
Then, there are many people who find balance between simplicity and meaning in their lives by combining the approaches. For example, they may choose one or two meaningful activities, such as volunteering at church or joining a charitable organization and singing in a choir, and mostly keep their lives simple in terms of how many possessions they maintain and how relaxed their daily schedules are.
Next time you think about whether your life is satisfactory, consider whether you want simplicity, meaning or balance of the two.
]]>However, unmet needs, small intolerances, disappointments, and irritations build up. Some marriages disintegrate to the point where they can't be saved. Others repair in couples therapy or with some major paradigm shift, like the shock of an impending or real affair, illness or near loss of the other, or some experience which sheds new light on what's important in the relationship. Then, the couple reminds themselves to overlook the differences.
Most often, couples recuperate by small and significant repair work on a regular basis, such as apologizing, forgiving, accepting, making love, doing favors, buying gifts, and having fun with each other and mutual family or friends, thus, resolidifying their bond.
When big things interfere, however, such as addiction, abuse or infidelity, then, serious work must be done before it's too late. Both have to want to save their love desparately enough to make big changes and sacrifices.
]]>