Wednesday, February 24, 2010

An Expanded View of Trauma

Let's clear up some of the wide spread misunderstanding about what constitutes trauma. For most people, it seems, trauma means war, or personal violence, or a car wreck, or rape, or other heinous treatment of one kind or another. Of course, these are indeed traumatic circumstances. Similar effects derive however from other, more common, more insidious forms of experience as well. Growing up with controlling caregivers, or with addicted caregivers; being neglected in essential ways as a child; being made to feel consistently wrong or bad; being consistently and offensively criticized; being shamed; being ignored or "tolerated". These and other everyday forms of traumatic experience can result in a personality that exhibits many characteristics of the trauma survivor, including chronic feelings of shame or abandonment, anxiety, depression, anger problems, compulsivity or obsessive thinking, low self esteem, confusion, sexual dysfunction, and fears of intimacy.

The traumatic profile can be subtle or it can be dramatically obvious. The effects of trauma can be sudden and acute, or they can be chronic and long established. Identifying trauma is not a matter of making comparisons (oh, that person has gone through so much more than I have), but of being able to recognize the effects in your life of previous experiences, and being able to name what is actually taking place. This then opens the door to a realistic assessment of causal links, and to a more realistic, common sense approach to treatment and to recovery.







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Sunday, February 21, 2010

The Dynamic Balance in Couples Therapy

On the theme of the proper "client" in couples therapy, let's talk a bit more about
the challenge of finding the dynamic balance of needs, preferences, personality styles priorities and dreams in a healthy committed relationship. Since we have proposed that the proper client is indeed the relationship, and not merely accommodating two individuals, finding this dynamic balance is an ongoing creative process requiring attention, awareness, willingness, commitment and skill, and not, as is sometimes imagined "automatic". In other words, it takes work.

Example: he often feels abandoned, unappreciated, disrespected and dismissed in the marriage, and as a result becomes either withdrawn or angry or both. She has a need for a lot of structure and personal space, and can be quickly reactive and curt when things aren't done the way she imagines that they need to be done. This dance goes on with slight variations, and it is difficult for this couple to catch themselves in the midst of it, in order to see the dynamics as they exist, and negotiate desired changes,

Negotiate. This is a key. Almost everything, we might say, is negotiable, in a fundamentally loving and caring relationship, and it is in these negotiations that the balance we're after will be found. So, in session, he drops down into the most emotionally vulnerable place I've seen him, and cries deeply while talking about his desire to be "held" by her, literally held, rather than experience the distance that he often feels from her. She is receptive, but also somewhat cautious or reserved about her receptivity. As we explore, she shares that she doesn't always want physical contact between them to have to end up in sex, which she says is pretty much what he wants.

I assure them both that the terms of contact can be negotiated so that both parties can be satisfied, and that there can be the win-win outcome that we always ideally seek. This will require enhanced sharing/communication between them, compromise, self awareness, realistic needs assessment and skills for meeting these needs, as well as a developing recognition of which needs can be met within the relationship, and which, perhaps, cannot.






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Thursday, February 18, 2010

Brain Plasticity and Meditation

Dr. Marsha Lucas, PhD. has on her website rewireyourbrainforlove.com
a short video on the brain effects and relationship benefits of mindfulness meditation. It's very straightforward, and clearly and simply explains what neuroscience has discovered about the process of creating new brain connections through meditation. Highly recommended.






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Saturday, February 13, 2010

A Troubling Dilemma

Seems to me that any thoughtful person would have to be curious about what it is that would allow someone to remain in a relationship when there have been multiple betrayals within that relationship. Why wouldn't that person simply pick up and leave the betrayer behind? Oh, yes, we can assume that there is love in the relationship, on both parts. Yet this clearly isn't enough to either prevent the infidelities, or to create a happy situation. Then, of course, in the aftermath of these betrayals, there is broken trust, and this breach runs in both directions now, since the betrayed party has taken to secretly spying on the betrayer by looking at emails and texts.

So what would allow this situation to continue? Is the betrayed party simply a masochist, addicted to being hurt? Maybe they feel that they don't deserve anything better. Maybe their self esteem is so low that it somehow feels right that they should sustain these injuries, and that they should forgive them repeatedly, rather than taking good emotional and spiritual care of themselves.

In any case, unhappiness abounds, and it becomes clear that something will need to change. How can effective and healthy changes then be made?






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Thursday, February 11, 2010

A Little Love Story

I'd been seeing this complex client for a couple of years probably, and had reached a point in the therapy where I was ready to conclude that he wasn't truly interested in making any meaningful or beneficial changes, but was habituated to and desirous of having an audience for his sometimes cynical soliloquies and various dramas, and so would not on his own terminate therapy. I had decided to broach the subject in our next session, and to in fact strongly recommend that we terminate, at least for the time being. Strangely, this session kept getting postponed and rescheduled due to one thing or another coming up in his calendar.

By the time we finally met again, after probably three postponements, everything had changed. My client reported that he had met someone, that they'd been talking and texting multiple times a day for, at that time, several weeks, and that he was beside himself with confusion about what was happening to him in this new relationship. He wondered if he might be in love, since he felt himself, for the first time in his middle aged life, caring about someone else's feelings at least as much as he cared about his own, and experiencing a tremendous fear of losing this person.

While this client's experience was not easy, while it was confusing and even painful and frightening at times, he was in the process, before my eyes, of being transformed by love. Nothing short, I propose, of the inner tektonic force and upheaval of falling in love could have opened this man into his next and necessary stage of healing and development. His world had indeed been turned upside down, and his psyche had been thrust into a spiritual awakening that nothing besides love seems to have ever been able to accomplish. Now, out of sheer necessity, the deeper work of therapy continues.





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Monday, February 8, 2010

A Therapeutic Paradox

There's a paradox that operates in therapy which consists of the attitude of what has been called "radical acceptance", along with the understanding that there is at the same time a necessity for change. Both are true at the same time, and both, if therapy is to be as successful as it can be, need to be cultivated and engaged.

This understanding is often very different from what people come to therapy assuming. It is almost universal that people think they need to "get rid of" something about themselves, or of some part of themselves, or at least that they want to get rid of something. Of course this misses the necessity of acceptance, and focuses, often prematurely, on the idea of change.

Example: a professional woman comes to see me, assuming that there are some things about her personality that are causing her problems in relationships, and wanting to know how she can go about changing these parts of herself. As we talk and explore her concerns and her ways of being in the world, we begin to discover that she has learned many forms of self judgment and self criticism. She believes, for example, that she is not gregarious enough in social situations, and that she is not good enough at small talk and "mingling", and that this is why her primary relationship is faltering. She wants to, or thinks she wants to, change these qualities of hers, thinking that if she does so, her relationship will be better.

I introduce the idea of putting changes on the back burner, while focusing instead on the idea that it would be very helpful to her to begin to understand her inherent personality qualities; to think about how she might relate with these qualities if her self criticisms of them could somehow be put aside; to discover if it might be possible to actually find ways to appreciate these qualities of hers, to value them.

Making changes will come much more easily and naturally from a position of self appreciation than from one of self hatred.






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