Wednesday, December 31, 2008

Meditation, Therapy And Control

A client tells me that she experiences a sense of urgency regarding the need to make and sustain certain changes. These changes have to do with being able to meditate - she's a Buddhist - something she hasn't been able to do for some time now, because of a dreadful fear that if she sits to meditate and focuses on her breath, she'll never be able to stop focusing on her breath. This will, of course, drive her insane.

We talk about this sense of urgency, and desperation that she feels. We have identified that it stems, at least in "family of origin" terms, from a childhood in which she was burdened with many adult responsibilities, because the adults - her parents - were incapable. The strategy that she developed in order to ward off chaos and immanent disaster was to be able to focus intensely, and to build psychological and behavioral structures that would provide her with some sense of order and control. These strategies worked very well in accomplishing what they were designed to do, and she in fact survived the chaotic environment, and even thrived professionally, later, using these qualities to great advantage.

Now however, the baseline anxiety behind these control strategies dominates her life in ways that no longer work for her. It has gotten to the point of preventing her from doing things she wants to do in her personal, and spiritual life. What to do?

Since she is a Buddhist, we talk about meditation regularly, and a primary goal of therapy now is for her to be able to return to the formal meditation practices that she used to enjoy, without the debilitating fear of becoming trapped in a madness of breath watching. Something is going to have to change in the way she used to approach her meditation though. You see, she used to approach it the same way she approached everything else: desperately, as though her life depended on it, and with a focus, force and harshness that enabled some experience of control, but lacked real grace or peace.

To put it simply, she's going to have to practice letting go of/transforming the control, in favor of relaxing, trusting (a leap of faith, she calls it), and bare attention to her experience. She'll have to practice being considerably more kind to herself, after all.

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Thursday, December 18, 2008

How Long Will This Take?

Clients often wish to know how long they'll need to be in therapy in order to get the help they want. This is an understandable question, of course. We all seem to want to be able to "get a handle on" whatever it is we're getting ourselves into, especially when it's a strange, new, or potentially scary situation. I don't know though, maybe some therapists are able to answer this question with assurance: "We'll need to meet seven times (or 107 times), and then you'll be just fine." I don't know any of those therapists however.

My answer is usually derived from my previous experience with clients, and might be something like: "Well, that's a really hard thing to know for certain, but my experience has been that sometimes one session provides something a client needs, and they consider themselves done, while I've worked with other clients literally for many years. Let's see how things go for a few sessions, and re-assess at that time."

While this might be more vague than a client had hoped for, it is, in my experience, realistic. There are simply too many variables that go into how successful, or how quickly successful, therapy will be, to be able to provide a definitive answer up front. Some of these are: therapist skill; client motivation, willingness and commitment; the nature of the issues being addressed; client's support system, or lack of it; previous experiences with therapy; age; and
defining what it is that client and therapist think the therapy is about, or to put it more succinctly, goals.

If you're considering therapy, my suggestion would be: try to remain open minded regarding how long it might last. The question itself can certainly be re-visited with your therapist during the therapy process. Initial expectations might have shifted, goals might have changed, previously unconsidered issues might be asking for attention, and unexpected benefits might be getting realized. In the final analysis, you, the client, will decide whether or not to continue with therapy.

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Thursday, December 11, 2008

A Little (or Not so Little) Hole In The Soul

One of the things that will cause this hole to form is the emotional absence of a parent during your childhood, even when they are physically present, and even when they are not actively "abusive". The child's needs for the parents are multi-layered. They need physical sustenance, they need to be held and physically nurtured, they need to be cleaned, they need to bond with the parent as a way of establishing a sense of security in the world, they need the parent to reflect for them who they are and who they are becoming, they need encouragement, limits, information, and instruction.

If the parent isn't able or willing to be there for the child, an empty psychological space forms, a hole in the soul or in the self where there needs to be substance, and in some ways, inevitably, the child - and later the adult - will make attempts to find or to create that substance when it is absent. Usually these ways are "negative", or misguided, or impossible, since the child does not understand what it is doing, or what it actually needs, and is acting out of an instinctive drive toward fulfillment at which it cannot succeed. As one of my professors once said, it is in relationship that we are wounded, and it is, after all, in relationship that we are healed.

The way we know that this hole in the soul exists is by inference, by observation of behavior, and by what our bodies tell us by way of our emotions and other somatic clues. We feel sad, we feel hurt, maybe angry, maybe we feel the emptiness where that hole is, maybe we feel somewhat lost or insecure or anxious or depressed. We know that something isn't what it's supposed to be. Our early needs have been neglected, and we live with the effects. And, in some form, these needs continue to exist, and continue to seek satisfaction. They must. It's simply the way we're made.

In spite of the fact that we may believe that we shouldn't have needs, or that at least we shouldn't have "childish" needs, or that we ought to be "grown up" (usually another way of saying we should be needless), there they are. Learning to acknowledge and to identify, to accept and to meet our needs are crucial steps in actually growing up.

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Monday, December 8, 2008

Getting Involved With Teen Age Boys And Anger

Today I had my first experience working with an at-risk group of middle school boys, around the theme of anger. All of them had expressed that they wanted help with their anger, so my wife, who is the school's Wellness Counselor, and the creator of the group, asked me if I'd talk with them. She asked me because I have considerable professional - and personal -experience working with anger issues, and she thought I could help them.

You have to understand that I've spent my entire professional life saying that I don't work with teens, and in fact I haven't. So I was curious about how this would go. Why was I open to it at all, you might be wondering? Nancy and I attended a one day conference very recently, about the kinds of emotional/psychological/mentoring services that New Mexico boys are needing, and very often not getting. I've been finding myself, in the last couple of months maybe, becoming more open to the possibility of working with teens. I don't know why exactly, and this conference contributed to my willingness and to my interest, so I said I'd try it when Nancy asked.

I was delighted to experience this group of 13 boys, very sweet really, adolescently antsy, and virtually all of them willing to open up and share with me, a stranger to them, about their experiences with anger, what it looks like for them when it arises, and what they'd like to be different about it. I introduced them to some new ideas about the spectrum of anger possibilites, some basic information about the bio-chemical connection between anger and adrenaline, some corrections about some misconceptions regarding anger (like the unreality of wanting to "not get angry at all"), and some introductory encounter with the range of basic human feelings.

I'll be visiting with them again next week, and will invite them to do some role playing regarding the themes of anger in their lives. Of course, hands-on is a necessity with a group like this. The more they can be directly involved, the easier it will be for them to learn.

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Sunday, December 7, 2008

Addiction And A Healthy Life

It's important to look behind the scenes a bit, when you're dealing with substance abuse or addictive behaviors. Asking "why" a person is drinking, or using, or acting out in other ways is necessary in order to get a more accurate read on what the "real" issues are. For example, is a person drinking excessively because they're grieving, because they're depressed, because they're anxious, or in order to cope with other difficult and challenging feelings? Is there trauma behind the scenes that has never been resolved? If so, is there Post Traumatic Stress Disorder?

The most well known view, these days, of addiction, is that it's a disease, like diabetes say, and that it can be treated, or managed, if never cured. This view has a lot to recommend it, and can be useful in working with and understanding addictions. I won't presume to know whether it is the definitive approach or not. So, if you're an alcoholic, you'd probably be best off if you just didn't drink at all. Avoiding alcohol provides the groundwork for avoiding the stimulus that will trigger all kinds of dangerous, and potentially fatal effects.

We also know though, that "just" avoiding alcohol, while it might very well improve a miserable situation, often isn't enough to stimulate other, perhaps equally important changes in a person's life situation. The term "dry drunk" is used to describe an alcoholic who isn't drinking, but who still behaves as badly as when he was, or thinks just as inaccurately, or who conducts his relationships just as poorly as before, and who has never done any of the important psychological work necessary to address the background issues behind her addiction. While there is clearly an improvement is some sense, much of what still goes on, especially in relationships, hasn't improved much at all.

If staying alive is the only goal, then avoiding alcohol, in this case, might be enough. But if a healthy life is a goal as well, then clearly this step alone will not suffice.

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Monday, December 1, 2008

A Little On Forgiveness

How difficult is it, really, to forgive? My experience would suggest that it's considerably more difficult than we like to think. "Oh, I've forgiven her for that." What this often means is that I'm not thinking about it anymore, or I've succeeded in pushing it out of consciousness, so this must be forgiveness, right? Well, no.

Ram Dass's guru, Neem Karoli Baba, is quoted in one of his (RD's) books as saying: "Forgiveness is a saint's most powerful weapon. With forgiveness he can let go of anger instantly." I think it's this desire, or a cultural or family or personal bias against anger that leads us to think that we've forgiven. What is more often the case is that: I don't want to feel angry, or, I'm not supposed to feel angry, or, I'm afraid of anger, so I'll pretend that I'm not angry and call this forgiveness.

Neem Karoli Baba's words let us know that there is a hand-in-glove relationship between anger and forgiveness. My experience confirms this. Where there is anger, even if it's out of awareness, even if we have convinced ourselves that it isn't there, even if we've skilfully removed it from our sight, there can be no forgiveness. Where there is anger, there is fear, and there is self protection.

Truly forgiving though involves becoming, again, more vulnerable; it involves a decision to put oneself at risk, again, a decision to re-open one's heart again, knowing full well that it will, inevitably, unavoidably, somewhere, at some time, be, again, injured. Forgiveness requires the capacity and the willingness to sustain this injury and this re-opening again and again, without losing oneself in the process. Perhaps it's not as easy as we like to believe.

The practice of forgiveness, however, as awkward and as imperfect as it might be, is really essential to wellbeing and to health in every dimension.