Psychotherapy Blogbriefs

Sacrifice In Healthy Relationship

2011-12-28T06:38:00.002-07:00

I keep being reminded, or is it confirmed in my conviction that, in order for an intimate relationship to be successful and for it to last - you can call this "marriage" if you're so inclined, or "partnership", or whatever other designation seems meaningful to you - the two parties involved will need to come to understand the nature of commitment. And then, having developed a new understanding of commitment, they will need to be motivated to learn how to provide for the "care and feeding" of the relationship as a living, vital, vulnerable organism which has needs and requirements that at times will be different from those of either of the individuals involved in its care. Understanding this concept leads quite naturally to the idea that a sustainable and healthy committed intimate relationship requires sacrifice. For some, perhaps nowadays for many, this will be the kiss of death.

There. I said it. The "S" word. If we think of sacrifice at all, perhaps we think of it in terms of service to country. Of course there's a lot of emotion connected with the sacrifices that members of the armed services make. They are, in our national rhetoric, "heroes". Their sacrifices are matters of public record and laudability. They epitomize the very nature of sacrifice. Then there are the religious figures who make sacrifices in terms of poverty, chastity, celibacy and service to others, and again, we tend to be able to recognize these, and to respect them, or even to be awed by them. While both of these examples clearly represent qualities of sacrifice, they may also seem removed from our every day lives. They may seem remote or extreme.

The sacrifices that I'm referring to in terms of intimate relationships consist of a range of behavioral and emotional responses and interactions that might not automatically occur. They might not automatically occur because we tend to become positional when there is conflict; because we feel strongly the need to be right; because we aren't able to defer our own immediate gratification in the service of the larger picture; because we are all conditioned, and this conditioning very often works counter to healthy relationship rather than in its service.

Example: This couple likes to drink. They have always done so, and often they drink to excess. When this occurs they not uncharacteristically devolve into meanness, saying things that they later recognize as destructive and hurtful, and that they regret. This pattern is long standing, and much damage has been done to the relationship. They are presented with the idea that they cannot continue this pattern and also expect any improvement or repair in the relationship. The idea of a new commitment arises: they are both clear that they will not give up drinking, but they are both willing, for the first time, to articulate a commitment to drinking moderately when they are with each other in social situations, which is where the destructive behaviors occur. An agreement to try this "experiment" for two months is made. The good news is that they both recognize that when they do not drink to excess, they are much better able, routinely, to communicate well, to nurture the relationship, and to experience the benefits of these behaviors.This new agreement can be said to constitute a sacrifice on both of their parts, in that they will need to give up something - excessive drinking - that they like to do, in the service of the health and welfare of the relationship, which is coming to be seen as a higher priority than it has previously been.

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Occupy Wall Street - The Revolution Is Love

2011-11-22T14:25:00.000-07:00

Here's a video that you might want to see. It articulates, in a brief clip, the connections between the social/economic disaster that our culture has permitted, and the psychological/spiritual foundations of a sane society. Have a look.

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Trauma 101, Part Three

2011-11-16T06:51:00.000-07:00

So we have some context. Nothing happens in a vacuum, does it. No one is immune from the effects of his/her culture, even though many people believe that they are. And this applies whether that culture is one's country, one's religion, one's family, one's social network, one's vocation, one's friends, one's economic class.

But let's take these in turn, or the whole thing can become a bit overwhelming. People are used to thinking in terms of family when they think of psychotherapy, and this is for some good reasons, of course. We are born, most immediately, into a family context (defining "family" rather loosely), and it is this immediate and original context that will have some of the most influential effects on us. Some of the most personal effects. Even though the family is a carrier of the culture(s) within which one operates, a microcosm of the macrocosm of larger culture, the relationships between family members is the most intimate and effectual, right from the start. We are fed, cleaned, warmed, protected - or we are not - by some person or persons who constitute our original "family". We are completely dependent, incapable of survival without this connection.

Child rearing practices vary. Relationship dynamics vary. Mother/child and father/child norms vary. Expectations vary. Values vary. Ideas about what constitutes health and propriety and right and wrong vary. A look at some of the historically normal treatments of children in Western culture might suggest that children - like women - have been considered possessions,
liabilities or assets, depending on what work they could or could not be put to, just another mouth to feed, sent out to fend for themselves or to contribute to the family's survival as soon as possible. This sort of thing has multiple and often damaging implications.

We are accustomed to giving great lip service to the value and care of children, but the realities seem to tell the true story of our basic values. We dump our children into industrialized pre and public schools even before they can sit up on their own. We chronically under fund our public educational system and under pay our children's teachers. We squirm at the thought of providing basic, decent housing, health care, food or higher education to our children. Etc., etc., etc. Just look at where the money in our society goes, and where it does not go, and the value system we operate by becomes pretty clear.

All of this has profound implications for families, and thereby for children, and thereby for you and for me. I'm calling the value system that we operate by a system of inherent trauma. A value system that inherently traumatizes. A value system that undermines the fundamental psychological, emotional and spiritual needs of all of us. And we are all effected deeply, and negatively, by this.

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Trauma 101, Part Two

2011-11-15T10:18:00.000-07:00

This is by way of pointing to the unidentified, every day traumas that we routinely experience as an integral aspect of the culture in which we live. I was once asked what I thought the most common unidentified trauma in American society was. I didn't have a ready answer, but the questioner suggested that it was medical trauma. You know, those routine and not-so-routine medical and dental procedures that we've all experienced throughout our lives. Those assaults to the body-mind that we're not supposed to be bothered by. (The one that comes immediately to my mind as one of the most disturbing medical traumas that I've experienced in the last few years is a prostate biopsy. When I asked the urologist who would perform the procedure if it would be painful, he said no, it wouldn't be any worse than a rubber band snapped on your wrist. Why then was I unable to sit up on the table when the chipper nurse assistant said "You can get up now"?. My reply was "No, I can't").

Having a tooth pulled or a cavity filled. Any surgery. Pokings and proddings of one kind or another. "Screenings" of various kinds. Of course, there are any number of other, non-medical every day traumas that we live with. I might suggest that even the very pace of life in the modern industrialized/digitized/cyberized world is itself traumatic. Have you ever stopped to think about the effects on your body-mind-spirit of driving your box of metal on the high speed freeways? We simply assume that this is somehow "healthy". But what kinds of psychic, mental, physical, emotional and spiritual adaptations are required in order to be able to do this regularly? And is it possible that at least some of these adaptations can be understood as traumatic? I would say yes.

This doesn't get close to the nature of intimate family relations, for example, which, given our cultural values and priorities, tend strongly, in my opinion, toward being abusive, neglectful, injurious, and, yes, traumatic. Yet we take this all for granted. We assume that our cultural mores are healthy. After all, isn't this the land of the free and the home of the brave? Isn't America (for example; the kinds of things I'm talking about seem to be at least somewhat universal) the best country on the planet? Isn't it the land of opportunity; the destination of the planet's disenfranchised, poverty stricken, sick, rejected and oppressed? And as the entire world has become Americanized, as our culture has become the model of desirability for the rest of the world ("The American way of life MUST be preserved!", we were told by our illustrious Secretary of Defense upon the impending invasion of Iraq), as the levels of industrial and consumer waste and environmental destruction have grown exponentially around the world, as the levels of air, water, and atmospheric pollution have risen to planet-obliterating proportions, are we still willing to assume that our "norms" are healthy?

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Trauma 101, Part One

2011-11-14T23:21:00.000-07:00

Well, it's been a long while since I've posted anything. It now seems like there's something about getting "back to basics" that's important in making a new blog entry. The basic theme that I refer to is that of trauma and its effects, as well as the virtually ubiquitous nature of emotional, physical, and spiritual trauma in our culture. I see it as the elephant in the living room that doesn't get mentioned. Or, perhaps it's more like the unnoticed object which is hidden in plain sight. It's so "normal" that we don't identify it for what it is. Rather, we surround it with priorities, values, expectations and accepted norms so that it disappears from view. If it effects nearly everyone, it goes unnoticed as anything other than what's ordinary. We lose any reference point which would allow it to stand out from the background. The emperor is stark naked indeed, while we all insist that he is wearing the most stunning new set of clothes.

Boys don't cry. Girls are emotional. Families keep their private business to themselves. Spare the rod and spoil the child. Don't be so sensitive. Everything you need to know is in a literal interpretation of the authoritarian version of the Bible. An eye for an eye and a tooth for a tooth. Patriotism means my country right or wrong, before all else. National geographic boundaries and borders are to be taken very seriously. Police are here to protect us. What's good for business is good for America. Right and wrong are obvious and simple, and something we can all agree upon. Etc.

A friend of mine who is a retired journalist, and with whom I frequently disagree about the importance of following the latest news reports, replied with "that's not considered news" when I pointed out that all we seem to get from the media is negative information, while there of course are other things going on in the world - positive, inspiring things. These other things are "not considered news" by our illustrious media, and are therefore not reported. Just take a moment to consider the implications of this "norm". It isn't difficult to see what a constant barrage of horror, war, violence, greed, corruption, crime, brutality, scandal, and other forms of power grabbing and self indulgence might produce. Did I say "might"? Sorry. I mean to say
"will".

This alone is a form of psychic trauma that we live with every day, simply by keeping up on the news. Do we call it that? Of course not. Do we recognize it for what it is? No. Do we take steps to protect ourselves from it? Mostly, we do not. Culturally we do not. In fact we do the opposite. Like my friend, we believe it is important to continue to abuse ourselves with this important information. We need to "know". We need to be informed. It's our civic duty. And so who in their right mind would suggest that we are being repeatedly traumatized by reading/watching/listening to the important news of the day? Nonsense.

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Proper Limitations of Talk Therapy, Part 2

2011-06-07T16:57:00.000-06:00

Not everyone is suited, in my opinion, for success in talk therapy. One of the essential elements of successful talk therapy, perhaps the single most essential element and the single most important factor in determining therapeutic success, is the establishment of a strong therapeutic relationship. This is something that the therapist is responsible for fostering, and it is also something that the client must be capable of entering into. If a client is not so capable, or is capable only in significantly limited ways, the likelihood of successful therapy is reduced.

If a client is not especially capable of developing insight, or reflective self awareness, the likelihood of success is reduced. If a client is not particularly given to introspection; is deeply and powerfully invested in a particular world view; is committed to having to be right; or only wants to be told what to do, the success of talk therapy, at least as I practice it, is less likely.

Perhaps such people would be better served in seeking help through another of the modalities available, such as the ones mentioned in Part 1 of this post. Nothing wrong with that. And it might save disappointment if the best suited modality is entered into, instead of believing that only talk therapy can help.

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Proper Limitations of Talk Therapy, Part 1

2011-06-07T16:26:00.001-06:00

It seems to me that over the last 25 years or so, with the onslaught of the managed care invasion of psychotherapy, one of the results has been a widening expectation of what talk therapy can do for people. It has come to be seen as a remedy for everything from front line crisis intervention aimed at perhaps saving people's lives (or preventing them from taking their lives), to rehabilitating people from the destructive effects of chemical addiction, sexual addiction, process addictions, work addiction and more, to providing solace and skills for dealing with grief, to healing the effects of trauma, to re-educating people who have problems controlling their anger, to providing a cure for domestic violence, to managing any number of socially frowned upon "aberrant" behaviors, to
teaching couples how to be in relationship in mutually satisfying ways, to keeping people with very serious mental illnesses from completely ruining their lives. Etc.

This is surely not an exhaustive list, but one that I hope helps to give an idea of the breadth of the expectations that have grown up around talk therapy.

Other kinds of therapies have grown out of talk therapy, because some of the inherent limitations of talk therapy have been recognized. We have the somatic (body inclusive/body centered) therapies which are aimed, often, at helping people resolve the effects of trauma; we have shamanic "therapies"; we have group therapies and psycho-educational "therapies"; we have movement and music and art therapies; we have "intuitive" therapies; we have the energy psychologies; we have all manner of body-mind therapies, including hypnotherapy, EFT, EMDR, and others.
Then there is always pastoral counseling; or talking to a priest; or making confession; or visiting a curandera.

I'd like to make an argument for the proper limitations of talk therapy as a healing modality. I don't think it's suited to the treatment of every kind of personal or relational distress, even though there seems to be at least something of this expectation now in the culture at large. For example, it's not at all uncommon - it is in fact the norm - for mental health agencies, and even for private treatment centers, to load up therapists with impossibly brutal case loads, expecting that somehow, some magic will occur that will allow these therapists to properly "treat" inordinate numbers of clients, presumably based on the assumption that talk therapy is a magical process whereby people are readily, easily, and probably painlessly "cured" of what ails them. The public, largely I believe because of the obscenely profit driven agendas of the gargantuan insurance monopolies, has come to believe this nonsense too.

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My Ideal Client

2011-06-05T19:45:00.000-06:00

When you first are about to finish your masters program, the one that will lay the foundation for you to practice counseling, or therapy, I think there is a tendency to think that you can help everyone and anyone. There is, naturally, a combination of enthusiasm, hope, naivete, and maybe even confidence that conspire to support this illusion. I was fortunate enough at that time to have a supervisor who told me straight out that that would not be the case. Even so, it took some years of experience in the trenches, and of personal development, for me to understand really what he meant. I think I have a pretty good idea now.

One hopefully learns more about one's own limitations, one's real skills, one's personal preferences and needs; about the real nature of a variety of dysfunctional behaviors and conditions, about the importance of client motivation in making any meaningful changes at all - and let's remember always, that psychotherapy is about making meaningful changes, and not about maintaining a status quo.

My professional experience suggests that making changes isn't something that most people look forward to, or embrace enthusiastically, or even understand the need for. If I could tell clients that I could and would help them to remain exactly the same as they are, and still experience whatever benefits they think they're after, I'd have the busiest practice on the planet. A waiting list years long. People ready and willing to pay any fee I cared to charge. You see the point.

Of course (I say "of course", but I don't actually believe it's obvious, or readily understandable), this is never the case. I underline "never". So the older I get,
and the more experience I have, the more I sometimes feel that I perhaps ought to publish a list of criteria, of pre-requisites, or qualities that my ideal client will be able to meet, or will possess. This will avoid encouraging people who really don't want to make any personal changes, people who want someone else to change but not themselves, people who seemingly lack even the most basic insights or understandings about themselves or about their circumstances, from looking to therapy for help. Why encourage what is extremely unlikely? Why offer promise where there is virtually none?

So here's a list; a work in progress. I'm writing this as much to see what I'll come up with as to be of service to others. I admit my selfishness and my simple curiosity. Here goes:

A certain degree of humilty
A certain degree of willingness to explore
A certain curiosity about oneself, about people, about life
A certain recognition, even if vague, of the possibility of healing
Something less than a phobic avoidance of the likelihood of having to change
An ability to see oneself, even if only partially, as no better than anyone else
A certain awareness, perhaps, of the essential structural reality of relationship
A value system that includes concern for people beyond oneself and beyond one's
narrow circle
Ideally, at least a sense of the possibility of a Reality, a Truth, a Meaning, beyond one's small self serving agenda in life
At least a budding awareness of the importance of including one's feelings in one's life, as well as one's ideas
Some degree of capacity for and disposition toward the truth

This is enough for a start, I think. And of course, this is only my bias. Give me a call if you can relate.

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It's ALL About Relationship

2011-05-26T04:35:00.002-06:00

In the end, at the end of the day, in terms of the bottom line (can you think of any other cliches along these lines?), it's all about relationship, and it is the force of something that might well be called love that holds the universe together. This is basic physics now, and maybe basic biology, ecology, sociology, psychology, medicine, neuroscience, and on and on. Of course it has always been basic spirituality, but not many have cared to hear this, and perhaps still not many care to hear. When I say "hear", I mean "structure their lives according to these fundamental truths".

More usually, or so it seems judging from the condition of the world, people are busy being ideologues, or chasing wealth, or accumulating stuff, or building the machinery of power over others, or showing off, or imposing rules and regulations, or missing the most essential points of what a genuine life consists of in any number of similar ways.

Relationship. Of course there's relationship well and truly done, and then there's all the rest; the "norm", or relationship conducted cluelessly, self-servingly, manipulatively, dishonestly, selfishly (in the worst, not the best sense of that word).

Cooperative relationship. Collaborative relationship. Interdependent relationship. Mutually successful and supportive relationship. Win-Win relationship.

If these concepts are confusing, or totally foreign, or amusing, or ridiculous, or dismissable, or embarrassing, or in any other ways out of reach to you, I'm not sure what benefit you might derive from therapy with me.

I'm not talking about just being nice. This has value, of course. And it is far from enough to capture the meaning of the fundamental nature of the essential universal structure of relationship.

"Love" is a summary and an essential truth of life. It's not sappy, or sentimental, or mushy, or stupid or weak. It's the glue of all of existence. Including human and non-human existence. Including of psychological and emotional and spiritual and physical well being. Including of happiness. Everyone ought to be setting themselves the task of learning everything they possibly can about love, and most importantly how to implement it in their lives.

Loving relationship. With others. With self. The "stuff" of existence. Make it the center of your life.

http://www.youtube.com/user/dragomirnet86#p/a/u/0/Vw4KVoEVcr0

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I AM, The Movie

2011-05-16T20:31:00.000-06:00

I recently saw the documentary movie I AM, written and directed by Tom Shadyac. This film explores questions about the neurobiology - the hard wiring - of the human brain and nervous system as it relates to violence, competition, cooperation and compassion, how the natural world functions regarding these qualities, as well as other questions pertaining to the development of human culture, economy, values, the good life, happiness, spirituality, and the state of the world. If this all sounds ponderous, I suppose it is, and yet the film manages to do all of this in very human terms, and with very personal and accessible meaning.

One of the interviewees in the film is Thom Hartman, a radio talk show host, former psychotherapist, progressive political thinker and author. Given my biases, I was especially able to relate to Thom's perception and language in identifying the view, among indigenous peoples, that behaviors such as the accumulation of more than one needs are a form of "mental illness". In the context of the film, and its examination of the rabid consumerism of contemporary developed society along with its implications and its consequences, this characterization makes a lot of sense.

Shadyac himself has become a reformed insane consumer, selling off his gargantuan accumulations - he had been an enormously successful director of mainstream box office smash hit comedy films - giving away much of his fortune, and pairing down his global and social footprint to include such things as moving into a mobile home park, and riding his bike to work. Here's a guy who is walking his talk.

So, we learn in the film that we are indeed hard wired for compassion and cooperation, and not, as we have all been taught to believe, for violence and greed and narrow self aggrandizement, and that Nature functions primarily according to these principles as well.

Oh, see the movie, and get a good idea of what mental and spiritual health consists of. Then do what you can to make the necessary changes in your life

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An Original Life In The Making

2011-03-20T13:58:00.000-06:00

There is something deeply inspiring when a client realizes that she is on a course that will break fundamentally from some of the basics of what she has been taught and conditioned to, and that in spite of the difficulties that this presents, is committed to the journey at hand. Imagine, coming up against your history, your training, what is familiar to you, what you have seen and felt and heard modeled to you all of your life, and understanding that these norms cannot work for you if you are to be healthy and true to yourself, if you are to be able to experience the kinds of intimate and meaningful relationships you know you want.

At this point you are an artist of the highest order, engaged in creating your life in a form that is entirely new, unique and original. As with any deeply original creative process, there will be challenges, obstacles, and setbacks along the way. This is not a fantasy of some brilliantly easy and spontaneous creative inspiration, but something more along the lines of Thomas Edison's declaration that genius is 10% inspiration and 90% perspiration. You're going to have to work at it.

And play at it, if I might add. Not to give the impression that this wonderful creative enterprise is a grueling, relentless exercise of gargantuan effort alone.
The ability to laugh, to play, to tend the fledgling creation gently is of paramount importance as well. And, of course, it may well be to your benefit to have the proper guidance on the way.

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Grief, Vulnerability And Love In Marriage

2011-02-05T21:03:00.000-07:00

She had just learned that an old friend, with whom she had had no contact for many years, had died 16 months ago. She was in shock. Why had no one told her, or her family, with whom this woman had also been close, that she had died? She was dis-oriented, vulnerable, confused, and, of course, sad. How could this great opening be a catalyst for the expression of love and support in a very troubled marriage? Or could it be?

If you've ever been present at a birth, or a death, you will know that these experiences and these times are portals into the realm of the sacred. What did I mean by that, he wanted to know? What did I mean by "sacred" in this context? An opening so raw and so deep that it brings you to the depths of your very being. A whisper's breath from God. Yes, he said. That was something that made sense to him. That was something he could feel in this experience of his wife's having been torn open.

How then could this shared experience be honored as an opportunity to provide some element of healing in this troubled marriage? How could it be embraced as a moment, and as a process in which to express the truth of the sacred in the form of the love these two people acknowledge that they have for one another? It would require the exercise of extra care and tenderness between two highly defended people who have a long history of violating one another's trust and boundaries, and of emotionally injuring one another.

I will try to be present for you, to be patient with you, and to not lash out in anger, he said. And I will try to ask for what I need, she offered. The empathic connection was there in session. Could they sustain it outside? Could the power of the sacred, and the power of love supercede the habits of defense and of anger that have dominated the relationship between these two sensitive people, even for a while? That is my prayer.

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Happy 2011

2011-01-02T18:06:00.000-07:00

I'd like to offer my wishes to you that 2011 might be one of the best years you've ever had. Along with these good wishes I offer my prayers for an ever deepening awareness of the inescapable inter-connectedness of all life, of the universality of pain and distress, and of the most sane response to these awarenesses - compassion, for self and for all others. Also, may these awarenesses engender a broader and deeper
realization and practice of justice in an apparently unjust world. May we come to see and to experience ourselves more fully as responsible not only for what we each say and do individually, but as having a certain human responsibility for the welfare of all, as well.

It's ironic, and sad really, even deeply troubling, that people often believe that they can achieve happiness by focusing exclusively on their own well being, thinking that this focus need have nothing to do with anyone else in the world. In my work I see people who are in distress of one kind or another, and these people naturally want relief from their distress. It may or may not surprise you to know that whatever the nature of the distress you, or someone else might be experiencing, their is (almost?) always a common element. That element is about relationship. This is true to such an extent that some people go to the extremes of total, or nearly total avoidance of other people in order to try to diminish or eliminate their distress. Others of course go to the other extreme of seemingly limitless and indiscriminate interactions with so many people that a true sense of order is impossible, this also in an attempt to control and/or avoid their own distress.

What both groups of people, and many people in the middle zones as well, fail to see or to understand or to value, is the inescapability of relationship, even if it is "only" the relationship one has with oneself. In the colloquial formula, wherever you go, there you are.

For 2011, may we all come to see, to understand, and to value, the incomparable richness of, and the inevitably present nature of relationship, and may we all come to understand that the only sane, rewarding, viable, sustainable, life affirming, happiness promoting approach to all relationship is one of love and compassion, in the strongest and most liberating meanings of these words.

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"In Treatment", Part Two

2010-11-21T08:24:00.000-07:00

Whew! I'm very happy to say that I am much relieved after watching episode two of season two. Paul has been transformed! In any case, his professional performance has taken a dramatic and wonderful turn for the better. Maybe I shouldn't have worried? Maybe I should have understood that the requirements of TV drama were at work, and that in some way, all would return to a happy homeostasis. Of course, and no doubt, these very same requirements will give us other moments of tension regarding Paul, in both his personal and his professional life. (Those of you already into season three, please indulge my time warp experience of what is now well in the past for you. Perhaps all is well now, in a future that I cannot see. But probably not. Not if the series is to continue, eh?)

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"In Treatment" on HBO

2010-11-15T11:15:00.000-07:00

It seems that so many people, including me, enjoy this cable tv show, now in its third season. I have to wait a year after the season ends to get it on netflix, since cable isn't available where I live, so I'm just now starting to watch season two. I was talking with my wife about the first episode while and after we were watching it recently, and there is a point that I feel almost compelled to make.

My concern is that most people who are watching this series - that is to say, the lay audience - might not be aware, unless they may have experienced some good therapy themselves as clients, that this series is presenting a portrait of a therapist in crisis, both personally and professionally, and that what the viewing audience is witnessing is a practitioner who is significantly compromised in his abilities to provide good therapy. In other words, we are seeing, often, the delivery of "bad" therapy.

I confirmed this just yesterday with a good friend who also enjoys the series. He acknowledged that he was not aware of this, and that it hadn't occurred to him that "Paul" was not doing a good professional job of it. My friend's partner however, who has experienced long term therapy of her own, did have more of a sense of some of Paul's shortcomings.

I'm concerned about this because people may well view this brilliantly produced and acted series thinking that what they are seeing is what good therapy is like, when it is not, or that they may indeed be turned away from therapy because they might sense or feel that something is "off" in Paul's work, but think that this is what therapy consists of. Yikes! Of course, there is already enough stigma, still - imagine that here we are in the 21st century, and there is still an enormous bias against "mental health" treatment; it's very nearly incomprehensible, but there it is nonetheless - when it comes to therapy. We don't need any more.

The hopeful bit is that at the end of episode one of season two, Paul recognizes that he needs to be back in therapy himself, and plans to begin again with his long time professor, mentor, friend and, now, therapist, Gina (This relationship, by the way, raises other important questions which I won't go into here and now). Good for him. We all hope, of course, that he will benefit personally, and improve professionally as a result. His patients deserve, and require, no less.

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Psychotherapy: A Place To "Dump"?

2010-09-19T13:41:00.001-06:00

So is this beneficial to me?, she asked, after a long session of sharing her life and work. I'm not inside you, I said, I can't say. What do you think? Yes, she said, it has been beneficial. It's helpful to have a place to "dump".

I confess: A part of me cringes when I hear this. Is that what psychotherapy is about? A place for people to "dump" their "stuff" (or more graphically, their "shit"), as in, turn it over to me so that they imagine that they are now free of it? Well, I know how I answer this question: of course not. And yet...............

there is clearly some benefit for people, initially at least, in realizing that they can talk candidly and in some depth about their lives, about what they struggle with, about, for example, being sometimes morally compromised on the job, and that they will not be judged or criticized for this. For new clients especially, this experience is often unique and perhaps unprecedented in their lives. As an early step then, it has benefit, and this benefit is palpable. Also, it helps to set the stage for a pattern of exploration that will no doubt go deeper
as the therapeutic process proceeds, and can provide (almost) immediate feedback about the potential inherent in this process.

I suppose I can relax some about the implications, to me in any case, of "dumping".
My fear is that a client will imagine or assume that this dumping is all there is to it, and that by doing this, they have actually done meaningful therapeutic work, when, in my view, they have only introduced themselves to a possibility. Really though, when there is sufficient motivation to continue, the nature of therapy will become more and more clear, and the necessity to participate in other, perhaps more challenging ways will become so also.

Online appointment scheduling for Psychotherapist

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A New Look At The Role Of Psychotherapy In Society

2010-09-16T13:57:00.000-06:00

OK. I'll go out on a limb. I'll say that "mental health", in its deepest sense, cannot exist without an active psycho-spiritual orientation toward the welfare of others.

This would then logically extend to an active political and social orientation in this direction; and to an active "environmental" orientation of this kind as well.

Mental health in this deep and broad sense cannot exist in a psycho-spiritual, socio-political, environmental vacuum. Is it mental health for a species - in this case humans - to actively and knowingly destroy its own habitat, its own means of pro-generation, and the possibility of its own continuation? I'd say it is not, and in fact that it is a form of insanity.

Now, in light of the way I am defining mental (psycho-spiritual/emotional) health, what then is the role of psychotherapy? What is its legitimate scope? What are its legitimate questions and concerns as regarding the individual, the couple, the family, the species?

If you suffer from anxiety, for example, and you do not see yourself as a small manifest extension of a much larger and much greater system of existence, a system which has direct and inevitable effects on you, the small individual, it will be more difficult, I suggest, to 1) understand your anxiety, and to 2) do anything genuinely healing/remedial about it. If you suffer from depression, and have not been able to achieve relief through bio-chemical treatments alone, and also do not understand your depression in a cultural/experiential context, it will be more difficult (impossible?), I suggest, to 1) understand your depression, and to 2) do anything genuinely healing/remedial about it.

If your marriage is strained and struggling because you and your spouse don't seem to be able to talk to each other without slipping into another self defeating argument, and you lead your lives dedicated to a system of values and beliefs that by its nature opposes collaborative relationship, how will you be able to remedy this dysfunction?

The idea of systems in psychotherapy is nothing new. I think we have not taken this idea far enough, nor understood its implications thoroughly enough.

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Who Are Your Heroes?

2010-09-16T12:53:00.000-06:00

Of course we are motivated and inspired by those we admire most. Who are the inspirations in your life? And what is it about them that inspires you? Who are your real heroes? Who do you aspire to emulate?

The prospect of mental health, happiness, or wisdom is more or less likely depending upon the kinds of people we truly look to as models for our own lives. Some models will serve us well in this quest, and some will not. It may be obvious that having, say, the Son Of Sam, or Hitler, or Lindsay Lohan as a role model will not lead to mental health. It may be less obvious that having, say, some of our parents, our civic/political leaders, our religious leaders, or our business leaders will also not lead to mental health. Indeed, it may be shocking to consider that having some of the most respected and revered members of society as our models might contribute to mental illness, foolishness or even insanity, rather than to health.

Without looking for perfection, we might still be on solid ground in looking for some sustainable commitment to integrity, to compassion, to tolerance and to genuine caring about others and about the world at large, in our healthier heroes.
We might do well to look for heroes who have the capacity to make sacrifices in the service of humanity. We might look for heroes who even make service to humanity a real priority in their lives. When I say service to humanity, I don't mean service to a privileged few - that ever touted but highly suspect value of "enlightened self interest". I mean something more along the lines of a real consideration of what some Native American peoples are said to call the well being of the next seven generations. All of humanity, not merely me and mine.

It is my opinion, professionally and personally, that the latter possibility is much more likely to lead in the direction of health, happiness, wisdom and well being than is the former.

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Psychotherapy And Values, Part Two

2010-09-16T07:58:00.001-06:00

1) Mental health, in the way I wish to explore it, is not something that is defined by a majority vote; that is, consensus does not define health, it only defines agreement (and the emperor may still, indeed, have no clothes on, regardless of his kowtowing subjects agreement to the contrary).

2) Mental health may not be a given in any set of cultural or social circumstances.

3) Mental health may exist only relative to what is True, regardless of opinion.

4) If this is so, then it becomes necessary to search for and to discover what is True, and then to align oneself with this Truth in order to become mentally healthy.

5) Since what is True is not variable from culture to culture, mental health takes on a larger meaning than previously thought.

6) It is therefore possible to be situated well within cultural norms and expectations, and at the same time to not meet criteria for mental health. Hence the state of the world.

"An eye for an eye makes the whole world blind", said Mahatma Gandhi. This is a succinct expression of the difference between consensus and health; and of the foolishness - we might even say of the insanity - of merely following the crowd, or the cultural norm, or the prevailing value, when these are contrary to Truth.

The thing about the Truth is that, while it is the same everywhere, it becomes confused with relative, local, specific cultural forms of expression, and then these forms of expression are mistaken for the Truth, defended to the death, and imposed upon others. Confusion, rather than Truth, prevails.

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Psychotherapy And Values

2010-09-13T15:03:00.001-06:00

How do you combine/reconcile spirituality with psychotherapy, I was recently asked.
What's the problem, I wanted to know. To me, they seem to be moving in the same direction; asking the same, or similar questions; aiming at the same, or similar conditions. Why would they be exclusive of each other? Where is the conflict?

Of course, this presupposes a rather broad and somewhat universal understanding of spirituality. I don't mean religion, or religiosity. I don't mean a dogmatic belief system. I don't mean particular rituals or ceremonies or styles of worship, or attendance at this or that house of worship. None of these things are of any particular interest in distilling the essence of what constitutes personal spirituality or mental health, happiness and well being. If you are engaged in something along these lines, and you want to continue to be engaged, go right ahead. Only be willing to notice where and when any of them might be leading you into distress, rather than toward health and freedom.

You must believe that Jesus of Nazareth is GOD, the only GOD, that he died on the cross and rose from the dead, and was immaculately conceived, etc., etc., etc. OR ELSE!!!

Nonsense. And equal nonsense with any other set of beliefs from any other religion.
What possible difference can it make, when you get right down to it, whether you believe this or that, while you are unhappy, unhealthy, behave badly, abuse yourself and others, go to war with anyone who believes differently from you, take advantage of those "weaker" than you, steal, kill, lie, and live an inner life of hatred, jealousy, rage, greed and self indulgence?

Give me an honest thief any day over a conniving, pin striped, neatly shaved and coiffed, self centered, power addicted public pillar of society. Woe unto you, hypocrites!
Etc.

And so we have health, and we have sickness. And sometimes one has to choose. And sometimes one has to make sacrifices for the former. So would you rather be healthy and happy and genuine and living a life of integrity, and relatively "poor" financially; or would you prefer to be one of the wealthy rapers of natural resources and pillagers of people throughout the world? For example.

Is the good life the American model of ever expanding affluence for the very few and now, ever expanding hardship for the many? Is it the ownership of government by mega multinational corporations and increased power and privilege for the wealthiest one percent? Or is it something different perhaps? A more equal distribution of resources; health care for all; education for all who want it; basic decent housing for all; care for all citizens?

This is, ultimately, about fundamental values of course. So, does psychotherapy limit itself to helping people adjust better to a profoundly dis-functional social and economic system, or does it dare to concern itself with the basic values of the life well lived? Hmmm.

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Living Sanely In An Insane World

2010-09-07T20:20:00.000-06:00

Let's start with a premise: the world as we know it macro-cosmically is pretty messed up.

By this I mean that so called civilized humans throughout known history have not behaved much better, or at all better, than we do now. Greed, hatred, genocide, unspeakable violence, have been the rule, and not the exception. Wars are "normal" and constant throughout the world, and throughout history. Politicians are almost universally corrupt and duplicitous ("diplomatic"). Business (empire) leaders are universally corrupt and duplicitous ("self interest"). The so called strong take lethal advantage of the so called weak. None of this is new, or uncommon, or "abnormal" or aberrant. The fact that we are surprised by these things is astounding, given their virtually universal repetition throughout time and place.

So, it is perhaps not surprising then that people draw the conclusion that it is human nature that makes it impossible for things to be any different. So it would seem. I'll propose a different view: it is not human nature that leads to the repetition of all of this madness. It is in fact the shared delusion that we are in line with human nature that causes it. Human nature, if it be known, would give us the opposite of what we typically see. It would give us kindness, love, generosity, compassion, kinship, collaboration and cooperation, tolerance and appreciation.

The question then becomes: How can we live sanely, in genuine alignment with our real human nature, in an insane world? The world at large is insane. Leaders are insane with power and greed and control and avarice. Ordinary people buy into this insanity and conduct their lives as though they were models of health and goodness.
The real madness continues and spreads.

Doing something different then will not be an easy task, or a lightly assumed responsibility. Who will rise to the occasion?

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What Do People Want From Psychotherapy?

2010-09-07T16:11:00.000-06:00

Why seek out a psychotherapist? What do people want and expect from such a thing? Here's what I think are the two reasons people seek therapy:

1) Relief of distressing emotional, behavioral or psychological symptoms; 2) help getting troubled relationships on track toward happiness and fulfillment.

That's about it. If there are no distressing symptoms (difficult/challenging/painful/confusing feelings; problematic/destructive/dangerous/self defeating behaviors; or some kind of serious and frightening distortion in one's thinking or perceptual processes), and if relationships are happy ones, people do not seek therapy. Why would they? It would be analogous to going to the doctor for treatment of a healthy body with no symptoms of illness.

In the broad field of psychotherapy generally, we like to use words like "distress", or "difficulty", or "self-defeating", rather than always saying "mental illness". This is pretty easy to understand, isn't it? People don't like to be identified as mentally ill. There's way too much stigma attached to this condition. Of course, sometimes it may be an appropriate term. I tend to think it should be reserved for extremely serious conditions. Otherwise, there is no need to overly pathologize people, or their states of being.

It is possible to expand the scope and meaning of psychotherapy to include explorations of distress from a more philosophical perspective. That is, something more analogous to wholistic healing, as distinct from conventional, symptom/crisis oriented allopathic medicine, which generally fails to consider the "whole person", and can thereby potentially create as many problems as it appears to resolve.

A more wholistic approach to psychotherapy would want to look at underlying psycho-spiritual causes of distress, as well as attempting to temporarily relieve symptoms
with partial remedies.

For example, is a person experiencing depression because of a chemical imbalance only, or might there be other important factors involved, like their world view, or unacknowledged, unrecognized, and unaddressed trauma or grief? One could take anti-depressants alone, and may or may not experience real relief, either temporarily or perhaps even more long term. Usually, however, anti-depressants alone won't do the trick. The combination of drugs and therapy has been shown in numerous research studies to provide the best outcomes.

But then we run into the problem that many people, maybe most people, want that all mighty Quick Fix, and then the prospect of self reflection, of self inquiry, of self knowledge elicits anything but enthusiasm. Oh what to do?

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"Start Where You Are"

2010-09-07T08:26:00.000-06:00

One Buddhist(American) teacher, Pema Chodron, has a book called Start Where You Are.
This title says quite a lot about the nature of a psycho-spiritual approach to well being and wisdom that is in some fundamental way radically different - and I would say much healthier - from our more familiar way of experiencing the world and ourselves.

In this Buddhist view, the implication is that we can well afford to stop and look closely at ourselves, and that if we do this, we will probably not find something essentially evil or corrupt or bad. This is very different from our Western/Christian view of ourselves, which often is precisely the opposite; that is, that if we stop and look closely at ourselves, we will indeed find something evil and corrupt and bad. In the Buddhist view, we are essentially good, though ignorance and mis-guidedness can make things appear differently. In the Christian view, often, we are essentially corrupt, evil, "fallen", and our very existence is an affront to God.

It may not be too difficult to grasp the different psycho/spiritual/emotional implications of each of these world views. I have routinely seen the devastating results of the Western view in my work. Imagine the difference inherent in a more positive view of man, or get to know someone who's world view includes a more positive view of man, and a new world of psychic possibilities opens up. It might be appropriate to actually relate lovingly toward yourself, for example, instead of being burdened with a bottom line experience of self hatred.

What would change in your world if you were worthy, and felt that you were worthy, of love? What would change in your world if you were absolutely worthy and deserving of, and felt that you were worthy and deserving of nothing less than respect and consideration?

We like to think that our psychological and emotional makeup is difficult to understand. In fact, it is rather easy to understand. A follows B, so to speak. The implications of being treated this way or that way, of internalizing these messages or those about ourselves, of believing this or that about the world and about ourselves, are very clear. If you believe that you are most fundamentally bad, cosmically bad, bad in the eyes of God, you will feel and behave in certain fairly predictable ways, and these ways will not be conducive to your health and well being or to the health and well being of anyone or anything else.

Start where you are, even if where you are is pretty awful. The implication is that you can, ultimately, trust that because you are in fact good, good will come from your humble, confused, terrified starting place.

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Allies Along The Way

2010-09-03T10:01:00.000-06:00

If you are a very sensitive person, and experience yourself as fragile at times, ie., easily affected by circumstances and by people, anxious, off balance, take heart. When first you can accept that you are indeed sensitive, it then becomes possible to employ allies in your efforts to regain a more balanced and easeful stance. At this moment I'm thinking of the use of flower essences or remedies as potentially very strong allies. Of course there are pharmaceuticals, and at times these are necessary and can be welcomed also as allies. I'm also thinking about meditation practice, yoga, regular exercise, and nurturing self care that is a regular part of your daily life.

Part of what can make implementing any of these aids more difficult is the resistance to accepting oneself as a "sensitive" or (perhaps more difficult) as a "fragile" person. These can be experienced as discouraging or demeaning terms. That's unfortunate, because that makes it more unlikely that you will take the next steps to help ameliorate these circumstances.

Think in terms of the idea of suspending judgment about yourself. If you can experiment with doing this, even a little, you will then be able to take a step forward toward self care. Don't expect an all-at-once solution. This is all on the order of step-by-step, over time. This of course implies the necessity of some discipline, some perseverance. Again we run into the effects of the industry of quick-fix propaganda, and the resistance to commitment.

But try, at least. Experiment. Have support for your efforts. Love yourself.

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The Necessary Grounds For Happiness

2010-09-01T08:34:00.000-06:00

Self inquiry. Self awareness. Self knowledge. Let's not confuse these endeavors with simple self indulgence, or with narcissism. The former are inescapable if we hope to have any depth of happiness or inner freedom. The latter are forms of escape from the Self, and so lead to, or compound ones' confusion and despair and entrapment by the insatiable demands of one's personality or ego. Liberation from these demands, to any degree, furthers one's well being and one's experience of contentment and peace.

What do you think freedom consists of? Is it the freedom to choose from 117 different kinds of bread in the supermarket? Is it the freedom to amass wealth beyond anything you or your descendants will ever be able to spend, at the inevitable expense of numberless other people, and the environment? Or is it the freedom to "express" yourself completely, even when to do so would be harmful either to yourself or to others?

In (north) America, we like to take certain kinds of freedom for granted, like the freedom to not be a slave. Or the freedom to vote for "the candidate of your choice" in what now amount to bought and paid for elections/illusions. Or the freedom to experience financial ruin because of a health related crisis. Or the freedom to choose the person we will marry (unless we happen to be gay, of course).
Naturally, these sorts of freedoms, what we might call political or social freedoms, are important and valuable, and yet we see all too clearly - don't you? - that they do not, in themselves, in any way at all guarantee, or create the grounds for, happiness.

So there must be something else involved. (Back to paragraph one). Without self knowledge, only the illusion of happiness is possible. Yes, it may be a luxurious illusion, with all the trappings of "success", of (physical)comfort, of pleasure.
And yet, again, we see repeatedly - this may be the greatest gift of the information age; the ability to see over and over again how material affluence alone fails to deliver the promise it makes - how these things don't deliver what we believe they will.

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Psychotherapy As Applied Philosophy

2010-08-31T00:56:00.000-06:00

Philosophy: literally, the love of wisdom. Wouldn't this seem to be a natural component of "mental health"; of a happy life; of relationship well being? I sometimes think of the practice of psychotherapy as "applied philosophy"; that is, translating the insights and questions of philosophy into the practical domain of a lived psychology of health and happiness.

I'm depressed, one person says. I feel anxious, says another. My relationships don't work out the way I want them to, says a third. I can't stop drinking. I can't get over the death of my spouse. I'm afraid all the time. I lack direction. I'm consumed by anger.

To the extent that any of these conditions are not simply chemical imbalances that can be successfully and happily treated with allopathic, herbal, homeopathic or other medications, or with changes in diet, or with other bio-chemical or neuro-biological interventions, we are left with the necessity to engage in some form of self inquiry in order to seek out and discover where we are lacking in wisdom. Where we are living our lives in ways that promote psychological (and emotional and spiritual) imbalance and distress instead of balance and well being.

So let's think of psychotherapy - applied philosophy - as dealing essentially with self inquiry, and inquiry into the nature and experience of wisdom, along with the methods for translating the discoveries of these inquiries into pragmatic action and behavior in the service of providing the lived experience of happiness. Some actions are likely to produce unhappiness, and others are likely to produce the opposite. And more than that, we encounter the subtleties of "not black and white", or the art of happiness, alive, dynamic, shifting, vital and vibrant and complex.

Wisdom is more than mere knowledge. It is not enough to have information at our disposal (even, I'm afraid, in this, the great Information Age); it is necessary to truly understand, to truly see into the nature of Reality, so that we can live our lives in accordance with this Reality, in harmony with It. This is wisdom, and this is the way to happiness and well being.

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Depth Of Feelings And The Fear Of The Inner World

2010-08-30T11:18:00.000-06:00

I was told by a friend this morning that my voice on a phone message I had left him recently sounded so sad! So sad in fact, that he was certain upon hearing it, and before hearing the rest of the message, that someone must surely have died. This morning also, when I called to wish my mother a happy 90th birthday, she told me that I sounded "better" than I had a few days ago when we spoke.

I'm sharing this with you because I see these two feedback offers as indicative of something larger than themselves. It's true that a few days ago I was feeling more
emotionally challenged. That is to say, my mood was not effusive, or up beat, or light. It was instead internal, tired, suggestive of needing a break from some personal health challenges that I've been dealing with for the past two months. On one level it might be correct to say that I was not a "happy camper". This, however, would be a shallow interpretation of my experience.

From the inside, I was simply feeling what I was feeling. It didn't happen to project a fun or jovial energy. This is important because it points to a powerful cultural bias against feelings that are other than ebullient. We worry about, and we don't know how to related with "heavier" feelings, like sadness, or frustration, or even with insights that may carry with them strong feelings of any kind.

One way of understanding this bias is through the lens of the extrovert/introvert dichotomy. Culturally, we prize and reward extroverts and extroverted behaviors. We tend to condemn and fear introverts and introverted behaviors. Introverts tend to be more comfortable with feelings in general, whereas extroverts may spend a lot less time with themselves and with their internal experiences, and are therefore less familiar with and less inclined toward these experiences. Hence the judgment and the fear of the unknown, and the generally less developed skill sets when dealing with internal states, and with feelings.

You introverts, please learn to appreciate your inner lives without fear or judgment, and you extroverts, please learn to appreciate not only your own, but others inner lives, also without fear and judgment.

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Life IS An Art

2010-08-29T11:49:00.001-06:00

If Life is a work of art (in progress), I like to think of, and relate with the various stages and episodes within that work as poems writing themselves in the daily realities of our experience. Of course Life is an art. It can be done well, artfully, skillfully, with discipline, with grace, with wisdom and insight and compassion, or it can be done poorly, lacking these qualities. Just as there are skilled and inspired artists of music, literature, painting, sculpture, performance, paper, spirituality, leadership, building, design, etc., there are those who are skilled in the art of Life. Conversely, there are practitioners of all of these who are, well, lacking; and therefore uninspiring. More importantly perhaps, these latter practitioners may be wandering lost in the inner and outer worlds, wondering why. This is usually quite a painful condition, both for the wanderer, and for those sensitive enough or caring enough to be moved by their struggles.

Calling artists and artists in training. Those of you who may have a willingness to explore as well as to wander; to discover as well as to seek; to learn as well as to study; to grow as well as to move.

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Courage And Safety In Deep Inner Work

2010-08-27T08:30:00.001-06:00

Safety is a big concern in psychotherapy. People want to feel safe to enter into what they may well have regarded as dangerous psychological and emotional territory, and they want a guide to help them do this. They want this guide to be experienced as a safe person too, naturally. Someone who will understand and appreciate them; who won't judge them for their weaknesses or their prejudices or their "failures"; who will, if the truth be told, love them carefully and well.

All of this is appropriate and wonderful in what is sometimes and generally called a "person centered" approach to therapy. Deeply respectful of the rights and freedom of each individual. Not imposing. Patient. Welcoming.

The other side of this coin is the necessity for courage in doing any meaningful psycho-spiritual work. Courage to enter into unsafe inner terrain. This is where the importance of the therapeutic relationship comes into play. This is where the necessity to develop trust and willingness becomes important. If you're going to step into danger, or at least into perceived danger, you want the person helping you with this to be trustworthy, to guide you skillfully, to not abandon you in the wilderness. These needs are relationship needs, and they are met in the context of the therapeutic relationship.

Paradox: safety, and courage, or skillful and appropriate risk taking. Both are needed for deep psychotherapy to live up to its potential.

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Simplicity, Quick Fixes, And Disillusionment

2010-08-26T10:37:00.000-06:00

This is The Land Of Everything Is Easy And Quick. It may startle you to realize how deeply this craziness takes hold in your psyche. After all, it's everywhere you look. It's impossible to not be affected by the cultural messages. Then, this becomes your expectation. Failing to encounter basic reality that actually conforms to this insane propaganda, the natural conclusion is that something is wrong with you. A certain precursor to unhappiness. And a certain method of keeping you off balance, dis-stressed, blinded, addicted, spiritually and psychologically adrift.

How difficult it is to make a commitment. Any commitment. How difficult it is to dedicate oneself to a path of effort and longevity. Immediate gratification is what you require. The All Holy Quick Fix. To everything. And according to the propaganda, it ought to be that way. This is after all a realistic expectation. The fast buck. The "quicky" sexual encounter. The instant soup. The magical instant transformation complete with the Hollywood style dramatic "experience" that makes everything right all at once and forever.

No wonder then that the bad news, the disillusionment of how deep psychotherapy might work is hard to take. All those insurance driven managed care companies must be right, no? 3, 4, maybe 5 sessions of "brief" therapy is all that's needed, right?
Oh, woe is you. If what you want are some "tools" to help you "fix" your life, maybe you ought to read a simple self-help book and save your time and money. Having that information should enable you to make things work pretty much over night, shouldn't it? Funny how it doesn't tend to work that way, in spite of all the advertising hype.

Anyway, deep psychotherapy is transformative, and it does take time. But who has time? Time is money! Hurry up! Don't waste my time! Part of what I enjoy doing in my work is de-mystifying therapy for people. It's really a lot simpler - not quick and easy - than you think. And as we all know, or need to know if we don't yet, the simple is generally the most difficult to achieve.

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Unhappiness In Troubled Times

2010-08-25T20:43:00.000-06:00

These are difficult, dramatically changing times. It may seem as though personal unhappiness - frustrations, dis-satisfactions, confusions - is increased without understanding why. Part of what is happening is much beyond the merely personal. The entire world is in upheaval, from economic crisis, to environmental crisis, to human rights crises, to wars upon wars and abuses upon abuses. These realities effects your personal equilibrium whether you are aware of it or not, and increase your experiences of dis-stress.

Why is it so difficult to befriend oneself? To treat oneself with deep respect and love? To truly care for oneself? To honor one's heart's longings and callings? What do we imagine the risks of doing these things to be? What do we fear losing if we did? How far might you be willing to go in the service of your truth? How do conflicting desires prevent you from serving your true purpose?

Who are you, anyway? What are you doing here? What master are you serving? How are you contributing to the welfare of the world? Or are you? If you're not, you'll no doubt be diminished within yourself, and will feel this in any number of self diminishing ways. The reality of happiness and sanity requires an orientation that is not merely selfish. The reality of happiness and sanity requires something other than the worldly wisdom of dog eat dog, and every man/woman for him/herself.

This is, of course, risky business. It does, of course, go against the grain. It does not conform to the "norm". It requires a certain courage, a certain willingness to swim up stream, if you will. Oh, this is nothing new, yet translating this understanding into "mental health" reality is and always has been a challenge, seemingly reserved for the relatively few. Yet in these times, there seems to be the necessity of expanding from the few into something more. Maybe it always seems that way.

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Know Thyself: Depth Therapy And Basic Life Skills

2010-08-24T07:24:00.000-06:00

Know Thyself. After all, this is what depth psychotherapy has to offer. Related to the classical quest for the good life, for wisdom, for happiness. It is in knowing oneself that one enters the possibility of true happiness, of liberation from the pettiness of selfish ambitions, and of escape from the tyranny of egoistic demands.
To know thyself is to know God, to know Truth, and, as one master told us, the Truth will set you free.

Psychotherapy has the potential to blend an understanding of basic life skills, with the exploration of deep identity. Making relationships work well; learning to work effectively with one's own mental processes; developing insight about and understanding of one's behaviors, language, thinking, and feeling; having and making choices beyond what one thought was possible or available; addressing "symptoms" and manifestations of distress and unhappiness; accessing real meaning and value in one's life; re-connecting with the lost deep ecology of one's right place in, and one's right relationship to the (natural) world; being able to love.

Basic life skills: how to relate properly to oneself; how to relax and renew; how to align one's behaviors with true (ie., substantive, satisfying, grounding, beneficial) meaning and value; how to be effective in controlling oneself, rather than trying to control others; how to most effectively and beneficially change thoughts and feelings; how to develop humility, courage, and trust; how to release attachment to what one thinks one needs; how to experiment and explore intelligently and beneficially; how to cultivate the true precursors of happiness; how to surrender.

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A Note of Appreciation

2010-07-12T08:58:00.001-06:00

"Thank you for your heartwarming email.
I did not expect such understanding and was touched.
Please take care and continue to be blessed!"

I just wanted to share a recent communication from an intermittent client. Why? Aside from the fact that it says something good about me, it also illustrates the kind of recognition, reflection, appreciation, and client support that good therapy ought to include. As a client, you have the right to expect these things from your therapist, and they will provide the foundation for a fruitful therapeutic relationship and therapeutic experience for you.

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Client Motivation In Therapy

2010-05-16T11:15:00.004-06:00

What's the likelihood that therapy will have any beneficial effects for a client who is not motivated to undertake the journey involved?

Motivation here would include things like: being aware that you are somehow in distress, or that you are not functioning as well as you'd like to be, or that you behave in ways that are counter productive/destructive/injurious; recognizing that you need some help to "sort things out", that you have not been able to "fix" things on your own, even though you may have tried repeatedly; and then, with all of this awareness and understanding, actually seeking help.

This would be different, for example, from a man who, when asked what brings him to therapy, answers that he is doing it because he told his wife that he would. (Did his wife threaten to leave him if he didn't? Does he expect that he will be able to appease her - and maybe get her off of his back - if he appears for a couple of sessions?)

This would also be different from someone appearing for therapy because they have been court ordered to do so, while their only motivation is to avoid going to jail.

Of course, it is possible for someone in the above examples, while they may not be motivated initially in the sense that I have described, to develop some level of motivation on their own behalf if they only appear with some regularity, but this would be, in my experience, an exception, rather than a rule.

So how ought such a client (I use this term somewhat loosely here, since such a person is, by definition, not a "real" client at all) and such a situation, be approached? Of course there is no single correct answer to that question, and different therapists will indeed answer it differently. Let me then answer it only for myself.

As a bit of background information, there was a time, much earlier in my professional career, when I was willing to try to motivate unmotivated clients "for their own good", so to speak. I believed that I could indeed somehow convince these clients that the process of therapy, and in particular, the process of therapy with me, was just what they needed. It could and would truly help them, and they ought to become converted to this view.

What I discovered over some time with this approach was that not only was I wrong in my expectations, but that the process of attempting to motivate someone else to do what I believed was going to be helpful to them succeeded only in exhausting me, and did not do much good, if it did any good, for this "client". I have since settled into what I consider to be a much more realistic and intelligent approach. This consists of being fully available to any client whom I believe I can actually help, as long as they are sufficiently motivated to be helped. To put it another way, as I was taught long ago, and as I have come to appreciate as sage wisdom, the therapist should never work harder than the client in therapy.

If you are considering therapy, also consider your level of motivation for being helped, for making positive, healthy and rewarding changes, and for being willing to work at this, rather than expecting your therapist to miraculously fix you through their own efforts. I'm not sure that I see any point in beginning something that you are not able or willing to invest yourself in.

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A Ramble Into Change Making

2010-05-03T11:11:00.001-06:00

It's been quite a while since I've posted anything, so I thought I'd visit and see where an aimless ramble might lead; or as one client calls it, "babbling". In reality, this "babbling" always leads to something meaningful, and unforeseen. Maybe that will be the case now.

The theme of how change might be effectively facilitated is an interesting one, and there seem to be at least two very divergent views on this. One being what I'll call the more common view, that change is best facilitated by some kind of active "assault", or effort in the direction of the desired outcome. If you want to feel less anxious, for example, you set about to reason with yourself, and even argue yourself out of the irrational ideas that you harbor that actually create and cause your anxiety. When once you've seen the light of this reason, and have managed to actively and even aggressively replace your misguided thoughts with more realistic ones - one's that accurately reflect a set of circumstances and conditions which would not lend themselves to distressing levels of anxiety - you will, naturally and automatically, so to say, feel less anxious. This strategy does indeed work, for some people, in some situations. I like it, and I use it, when appropriate.

Then there is the much less known or understood method which says that it is possible to take a more "passive", or, more accurately, a more contemplative or reflective approach to the situation, in which one learns, through practice, and through the development of the capacity for a heightened tolerance of distress, to be more accepting of oneself in all of one's moods and qualities, allowing the inevitable process of organic change to take place without too much interference.
There are some keys to the successful implementation of this approach, and they include the aforementioned capacity to tolerate distress, to "sit with" -as in sitting meditation, for example - one's experience, while learning how to let go of judgments about it and about oneself, and to relate with oneself and with one's experience more tolerantly, more forgivingly, more compassionately.

This method or approach makes certain working assumptions, of course, among them being the one that says that desirable change will occur in a context, in an internal environment, of kindness and gentleness with oneself, perhaps more easily, but certainly more gracefully than under aggressive terms. You could say then that this approach gives a higher value to this context/environment than the former one does. I like this too, in that the metaphor is closer to something like organic gardening than to field maneuvers. Let's pay attention to the soil in which we are planning to grow something wholesome and delicious. Let's cultivate it, prepare it with the proper healthy supplements, tend it and it's produce. Like raising healthy children. This will significantly increase the likelihood of a desirable outcome.
This method, it seems to me, is much more in accord with the urgently needed concepts of sustainability and conservation.

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Paradox: Beauty And Liberation

2010-04-03T07:08:00.000-06:00

These days I seem to be more keenly aware of the necessity to be able to appreciate the reality of paradox, not only in life, but, of course, in therapy. Just yesterday, for example, I found myself talking to a couple about the fruitfulness of being able to recognize and somehow truly get the gist of this experience in their relationship. I'm not talking about an abstract conceptual understanding only, but an experiential understanding of what it feels like - liberating, if truly "grocked" - to embody the reality of paradox. A simple, yet, I think, powerful example: the necessity to be able to accept oneself (and one's partner for that matter) in a deep and loving way, with all of one's foibles and imperfections, while fully embodying the willingness, and even the necessity to make (healthy) changes. (Dr. Marsha Linehan has articulated this paradoxical imperative perhaps most formally in her Dialectical Behavior Therapy).

To me, this "truth" has a philosophical, ontological ring to it. It speaks somehow to the way things are in the universe, including how they are in relationships and intra-psychically. So, coming to appreciate this view of the way things are has important psychological, relational, and therapeutic implications, and might be used very effectively in these contexts. This relates to the notion that the truth actually does set one free, psychologically, emotionally, spiritually, if it is fully integrated and experienced.

How different it feels, how freeing, to deeply understand that apparently contradictory elements in one's life, elements which normally create a psychological tension and distress, do not need to be "reconciled" or eliminated, but that they are in fact true simultaneously, and may both be allowed to be. A mundane, yet sometimes critical example of this in relationships: it is possible to love and relate harmoniously with a partner who has attributes and behaviors that one does not like, without feeling that one must insist that these attributes or behaviors disappear, and feeling perpetually frustrated when they do not. (There are, of course, limits. If the attributes or behaviors that one does not like happen to be something like abusive actions, or destructive addictions for example, then it may indeed be appropriate to insist that these change or "disappear").

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Existential Terror and Safety

2010-03-20T09:56:00.002-06:00

There is a felt terror that underlies many common efforts to avoid contact with the deeper dimensions of the self. This can be called the existential terror surrounding death - or, more descriptively, I think, the sense that one will disappear, and cease to exist - or the terror which attends early experiences of neglect or abandonment by primary caregivers (which is, after all, the reflection of the very real possibility, known by the body in its wisdom, of its own demise). However one wishes to name it, this terror is a primal experience which requires a certain direct attention, and even some significant degree of conscious surrender or acceptance, on the way to re-establishing the total commitment to and reconnection to oneself that will be the basis for psychological integrity.

It is terrifying to approach this core, and the prospect is often associated with a belief that one will be swallowed up by the immensity of the experience. This fear is an exaggeration. One does not disappear, but one is transformed, which may be tantamount to the same thing in one sense at least. Who one has experienced oneself to be may indeed change very significantly.

In other words, with the proper understanding and the proper commitment, and, I will add, with the proper guidance and support, it is possible to approach this terror safely, and to not only survive this approach, but to learn to experience a depth of psychological freedom and wholeness that perhaps no other process will offer.

And yes, this does enter into the realm of the "spiritual", but let's not be too quick to define that realm in simple terms.

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How Is Change More Likely To Be Made?

2010-03-15T13:53:00.000-06:00

The structures of personality are strongly built. They do not tend to be very flexible, or subject to easy change. Instead, they provide a concentrated base upon which a life can be established, developed, grown and understood. This is not to say that these structures are altogether desirable, or altogether admirable. They have their purpose.

When it is determined that these structures are not serving one as happily as one might wish, questions arise as to how they might best be approached, worked with, influenced, transformed or shifted. A typical response that one sees in therapy is the expectation, the hope, the desire, that they will be amenable to being discarded, and that this strategy will be, or ought to be, relatively easy, if only it is conceptualized properly, and the right intention is set into motion. This response is not usually explicit, or even conscious. It can be surmised though without too much difficulty, and brought into awareness so that it can itself be examined and reassessed for its relationship to reality.

Here's how that reality tends to look: in line with the first paragraph, the typical response, with its attendant expectations and hopes and desires, will need to be abandoned, and in its place what will be needed is a set of more appropriate and realistic expectations. Central to this new set of expectations will be the willingness to cultivate and develop a new kind of relationship with the offending personality structures. This new relationship will be one of friendliness and acceptance, forgiveness and humility, with regard to all of one's imperfections and flaws, all of those aspects of oneself that one instinctively wishes to discard out of hand.

This new relationship is actually motivated by very pragmatic considerations in the therapeutic context. It embodies the wonderful paradox that the kinds of changes one might wish to make will in fact be facilitated by an attitude of acceptance, rather than by hostility and aggression toward oneself. Indeed, the very act of acceptance and forgiveness loosens the inflexible structures of personality and renders them more amenable to the kinds of reshaping one might desire, while a strategy of aggressive self criticism elicits an internal and rather automatic response of defensiveness and tightness, thereby further strengthening the very structures one wishes to alter.

This is a surprisingly radical concept at first, and so is not as easily undertaken as you might imagine it would be.

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A Bit Of Reclamation

2010-03-06T09:05:00.000-07:00

I had a client recently talk to me about how he is re-claiming an essential aspect of who he is, an aspect that he has been ashamed of, and that he has tried, for many years, to bury, or deny, or cover up with an assumed persona. The shame he has felt regarding this foundational dimension of his personality is in part the result of a rather abusive fundamentalist religious upbringing, the hell fire and brimstone variety, which although he could never truly accept it, still it had a profoundly formative effect on his relationship with himself. He has felt, all of his life, in some inescapable and horrifying way, BAD, or perhaps even evil - the orthodox terminology is, of course, sinful. Hopelessly sinful.

Now that he is in the process of learning to truly appreciate and even love himself - not egotistically, but with a genuine caring and kindness toward himself - he is becoming able to re-view his past, his family, his culture, and to begin to appreciate some of the qualities of this culture that are indeed central to who is really is, while at the same time, he is becoming able to separate out those aspects of his past that have been injurious, and to not, as it were, throw out the baby with the bath water.

Re-integration. Discernment. Healthy psychological and emotional - and, yes, even spiritual - boundaries.

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An Expanded View of Trauma

2010-02-24T21:08:00.000-07:00

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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The Dynamic Balance in Couples Therapy

2010-02-21T09:23:00.000-07:00

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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Brain Plasticity and Meditation

2010-02-18T17:34:00.000-07:00

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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A Troubling Dilemma

2010-02-13T20:05:00.000-07:00

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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A Little Love Story

2010-02-11T15:29:00.001-07:00

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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A Therapeutic Paradox

2010-02-08T19:52:00.000-07:00

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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A Second Premise Of Contemplative Psychotherapy

2010-01-28T19:41:00.001-07:00

Another operating premise of contemplative psychotherapy is that there are two basic requirements which will create the most advantageous environment for encouraging the changes you may wish to make. These are the cultivation of
1) an attitude or relationship of acceptance of where one is right now; and
2) an attitude or relationship of compassion regarding oneself, as well as others.

Through cultivating (there's nothing instant about this) both acceptance and compassion toward oneself, it is possible to create a cauldron into which all of one's concerns and imperfections and questions and doubts and troubles can be cooked into workable ingredients for a tasty and healthful stew of transformation.
On the other hand, if one attempts to make real and beneficial changes while starting from a place of hostility, criticism and judgement toward oneself, it will be extremely difficult, if not impossible, to proceed fruitfully. You may already have some experience of this.

There are different ways to cultivate these qualities within oneself, and in the contemplative approach, various meditation techniques and practices can be employed
toward this end, as well as utilizing the power of the therapeutic relationship itself as a catalyst and as a tool for this cultivation. The process in either case is an experiential, and not a theoretical one.

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A Starting Premise Of Contemplative Psychotherapy

2010-01-28T19:26:00.000-07:00

How might one approach working with ("treating") anxiety, or depression, or really any number of concerns, from a contemplative perspective? Before we can answer that, we need to establish some basic understanding about the working assumptions and basic premises of contemplative psychotherapy. For example, perhaps the bedrock assumption is that we are all fundamentally, essentially, at our core, both good and healthy. This sounds simple doesn't it? In fact though, it flies in the face of the virtually inescapable Western Judeo-Christian world view with which we have all been infected to one degree or another, which assumes just the opposite: that we are essentially "bad" or "fallen" or "sinful", and that we are also, perhaps as a direct result, somehow doomed to illness as a punishment for this condition.

This is not at all a simple matter, psychologically, emotionally, somatically or spiritually. The implications are profound and usually traumatic. Think about it for a moment. If you have been raised in a culture which has taught you, explicitly or implicitly, that you are sinful, and that there's really nothing you can do about this, and that you will have to be punished for this sin even though you may have had nothing to do with creating it; and if you have internalized these teachings, as children naturally do, and they have now become, perhaps, the unconscious template for life from which you are functioning, how do you imagine this would affect you? Your view of life? Your moods? Your inner conflicts? Your (probably hidden) beliefs about yourself?

If, on the other hand, you begin with the notion that you are, in your very nature, good and whole and healthy, even if you might not be living up to this truth at all times and in all things, how do you imagine this view might affect you?

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Psychotherapy And Self - Realization

2010-01-25T16:30:00.002-07:00

If psychotherapy isn't only about relieving symptoms or diminishing overall or specific distress, what else might it be capable of? In the spirit of an integrated approach to well being and to happiness, psychotherapy can also be a process of spiritual awakening, of Truth seeking, and of Self - Realization. Any insight oriented or awareness based approach to therapy is, by definition, a process of finding the truth behind appearances, of exploring the unconscious or the hidden, and of relying on these discoveries to promote healing and happiness. The Truth will set you free, if it is recognized, appreciated, and properly integrated into one's psyche and one's life.

The search for meaning; for understanding; for self knowledge; for wisdom.......all of these classical endeavors are inherent in the exploratory therapeutic process. It's no leap at all to recognize the potential for a path to self realization within this process. The actualization of this potential depends on the client's intention and desire, and on the therapist's understanding and ability.

This is one of those instances where the skill of the therapist may include the ability to guide the client along the path of self inquiry, and the ability to help the client make important and fruitful connections linking the psychological, emotional, cognitive and spiritual dimensions of self. In order to avoid the pitfalls of "spiritual bypass" (a condition wherein there is some genuine spiritual achievement, while a lack of integration of this achievement remains active, thus creating both internal and external imbalance and distress in thinking, feeling and behavior), the process of psychotherapy as Path includes the means for integrating, balancing,and harmonizing advancement and development across all dimensions of self.

Clearly, not everyone who enters therapy will be either aware of or interested in this potential in the process. For those who are either aware or interested however,
the rich soil of possibility, along with the skill of the therapist/gardener, may yield a surprisingly abundant harvest.

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Relationship Intimacy: Making A Real Connection

2010-01-23T18:44:00.001-07:00

Here's an example of the sensitivity, the awareness and the insight required to make a real and intimate connection with another: a married couple is working with me because they are aware of certain differences and stresses and conflicts in their new union that are presenting problems for them. We talk a lot about more effective communication of course, and about strategies for increasing the feeling and the experience for both of them of being connected, rather than so much struggling with conflict and anger and frustration.

One of the issues between them has to do with the kind of order created in their house. For her, certain kinds of order and cleanliness are extremely important. This gives her a sense of safe-haven. For him, these concerns rank about 5 on a 1-10 scale, so the priorities are very different for each of them. In the course of exploring the importance of being able to learn how to value and accept each others different realities - not agree with, but accept the real differences - as a basis for negotiating a compromise, it became clear that this idea was very distressing for her. Somehow, it was not ok to accept his experience. No. What he valued and wanted was unacceptable. It had to be her way.

We continued to explore the meaning of this vehemence, in what, on the surface, would seem to be a rather banal, and therefor manageable difference. But it wasn't.
Turns out that compromising in this area in particular would mean, for her, losing the symbols around her of how far she had come from the very painful, chaotic, frightening and humiliating experience of childhood poverty - an experience that she wants never to come close to again.

The feelings involved in what appear to be a simple and very mundane set of circumstances reveal a much deeper and more powerful set of experiences and motivations for one's behavior, and in this case, for one's insistence. Learning how to tune into this level of experience and feeling, how to be sensitive to "what's really going on" behind the obvious, becomes a crucial set of relationship skills, both within oneself, and between partners.

The outcome of this insight in session was that she could much more clearly and surprisingly understand where she was coming from, could enter into the feelings of vulnerability that were being aroused, and he could, now also understanding the real meaning behind her inflexibility, and witnessing her vulnerability, offer equally real nurturance and support. A true connection had been made, where previously there was only conflict and bad feelings.

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Contemplative Psychotherapy Intro

2010-01-19T10:13:00.001-07:00

Contemplative psychotherapy is defined, at least on the official Contemplative Psychotherapy.net website that I show on, as a blending of Buddhist awareness practices with Western psychotherapy. The term "mindfulness" has achieved a lot of currency in the last 20 years or so, what with Dr.Jon Kabat-Zinn's work on mindfulness based stress reduction, and now mindfulness based cognitive therapy, as well as with the growing presence in the culture of various meditation practices and techniques, and Dr.Marsha Linehan's extensive development of Dialectical Behavior Therapy with its "teflon mind" core, based on her years of practice of Zen Buddhist meditation.

So then, do you have to adopt Buddhism in order to benefit from contemplative psychotherapy? No, of course not. This is not a religion, or a dogma, or a cult that you have to join. It is simply an incorporation into the experience of psychotherapy of very practical and scientifically based attitudes, views and, if one wishes, practices, that have been shown to clearly aid in developing a more kind relationship with oneself, as well as with others. This is important because we now know that, and I have talked about this in previous posts, one's relationship with oneself and with one's experiences is a key factor in how one ends up feeling, and functioning in the world.

Contemplative psychotherapy aims to use the therapeutic process to help the client learn how to accept and love oneself in the best sense of the words, while also learning how to facilitate for oneself the kinds of changes that are desired, and that, depending on circumstances, may also be required in order to live a more healthy and happy life.

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A Simple Clarification

2010-01-17T10:41:00.001-07:00

What about second, or third marriages? Or if not yet a marriage, what about the relationship after a divorce which has the potential to become a marriage?

One partner is pushing for the marriage, the commitment, while the other is holding back. This other, the one holding back, comes to see me, presumably to try to gain some insight about the situation. When, after some introductory banter and "reading" of the environment, I ask what has brought him in, he answers: "My girlfriend!" with a chuckle. From here we begin to explore the nature of the relationship from his perspective, some of the history that has led him to this point (they're both divorced), and what his feelings and wishes are regarding entering into another marriage.

Turns out that, on a scale of one to ten, he's at a nine when it comes to not ever wanting to experience again the pain of what he's gone through with his divorce. This doesn't bode well for another marriage with (having happened once, it could clearly happen again) the same potential. He's "committed to the relationship", but "not to a marriage". So is he then committed to the relationship? In light of his stated preference for ending the relationship rather than entering into a marriage, we might have to conclude that he is not?

Sometimes it just helps to talk with a professional to get a little clarity about where you're really at.

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Still Crazy After All These Years

2010-01-10T17:12:00.002-07:00

What does it actually mean to be "doing well" psychologically? To be functioning happily; to be feeling good; to be alright?

The idea that I usually encounter is that to meet the above definitions, you have to be some version of perfect. Perfect in experience; perfect in behavior; perfect in thought and in feelings. This perfection takes on different shapes and sizes according to the individual involved, but there always seems to be a way in which whatever it is that they are doing and being is not it, and this in itself is cause for significant concern and distress.

Try this view on for size: perhaps it's not so much what you are being or doing or thinking or feeling that is the entire problem. Perhaps it is at least equally, and maybe more so,how you are relating with the above. So Paul Simon can sing about how he's still crazy after all these years, while he is perhaps able by now to relate more gently and compassionately with his imperfections and his foibles and even with his problematic ways.

This is not to say that one needn't make changes. It is to say that much unhappiness is the result of the self hatred, or self judgement, or self criticism that we perpetuate, and not the direct result, necessarily, of what we are otherwise doing and feeling.

A corollary to this view is that, by developing this kinder relationship with yourself, you then automatically open the possibility of making desirable changes in other areas of your life. This occurs naturally you might say, because this ability to accept and to nurture yourself creates the context in which the basic and fundamental self that you are can emerge; a self that is responsive to caring and to love, and that is itself caring and loving.

You make changes more easily and more gracefully in an environment of love than in one of judgement and criticism. And in the meantime, you benefit from the kindness of yourself toward yourself.

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The Nature Of Following One's Heart

2010-01-09T10:02:00.001-07:00

What is this path of Following One's Heart, anyway? I equate it with committing oneself to Truth, or to God, or to the Real, etc. In other words, it isn't a light, airy fairy, simple or easy thing to do. It is, indeed, the hardest thing one might ever do. If this is true, then it will require tenacity (as one client recently recognized), determination, willingness: to work, to make effort, to face challenges and obstacles, to learn and to grow. It is not, as some would like to convince themselves (and others), a matter of "simply letting go" (which should, by this approach, be experienced as the easiest thing in the world). Oh darn!

One must understand that in following one's heart, it is virtually inevitable that the path will put you in conflict with cultural, family and internalized personal misconceptions, values, lies, and manipulations. Oops. It will, virtually inevitably, be a painful experience at times. Just seeing through one of your own illusions (becoming "dis-illusioned") can be quite painful, don't you think?

This path will be frightening; it will scare you. It will give you access to what will feel like extremes of emotion and thought. You won't understand what's happening to you at times. It is of great help to have a companion along these byways to help guide you. Someone who has traversed the territory and is familiar with it. A good therapist is one possibility.

If you thought that following your heart ought to be easy and sweet, please excuse me for suggesting otherwise. Get ready for the ride of your life.

Online appointment scheduling for Psychotherapist

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I Love Saunas

2009-12-23T09:19:00.000-07:00

It's striking to me to experience a repeated set of behaviors on a regular basis, virtually every time I go to use the sauna at our local Community Center in Santa Fe. I love saunas, and have been using them with some regularity for, oh, a good 35 years. I like to sweat, and I especially like the dry heat of a good sauna. I used to, if the opportunity was there, follow the sauna with a cold plunge of some kind. I don't do this now so much. Now I mostly jump into a warm-hot shower and rinse off.

The sauna at the Genoveva Chavez Community Center is pretty large as saunas go, maybe 12 feet by 5 feet, and maybe 7 feet high, with a long bench along one of the 12 foot walls, and a couple of additional benches, at two heights, along the rear 5 foot wall. When possible, I use the highest bench along the rear wall. That's where it's the hottest. But when necessary, I'll use the long bench along the 12 foot wall, and hopefully be able to sit right next to the electric heater.

Here's what happens routinely in the sauna: someone will comment on how "it's not very hot in here today", and then someone else will offer as how it's a good idea to throw some water onto the top of the electric heater so as to create some hot steam. If they happen to have a water bottle with them, they will indeed proceed to do just this, perhaps with a cursory inquiry about whether anyone would mind (with no real intention of letting that stop them, I always feel, unless there were to be a particularly strenuous objection, I suppose).

So this routine has been going on for literally years there at the Center, and what happens periodically is that the heater breaks down - it's not the kind of heater that is designed for water to be thrown into it, or onto it, as some types of electric heaters are, and so the electric elements short out - and then the sauna is closed for a period of some weeks usually, while whatever steps need to be taken are taken to repair/replace the heater elements, and everyone is thereby deprived of the use of the sauna during this period. The management puts up signs prohibiting the use of water on the heater, which go routinely ignored, and has even, finally, covered the thermostat inside the sauna with a wooden plate, since one practice among users is to throw cold water onto the thermostat, thereby cooling it down, which presumably then tells the heater to gear up into a hotter zone. It's all very bizarre, and the cycle repeats itself on into the eternal, or so it seems.

All of this is very much like what people do much of the time within themselves, which leads to one form or another of distress and unhappiness. That is, people behave based on mistaken, inaccurate, and even completely contradictory sets of assumptions, expectations and understandings, expecting a certain set of outcomes which are unrealistic, yet continuing to do the same mistaken things to attempt to bend reality to their mistaken ideas, rather than troubling to learn the ways of reality as it applies in the circumstances, and adapting expectations and behaviors accordingly.

If you don't understand the functioning of a dry sauna, and expect it to behave as if it were a steam room, and if you don't allow enough time for the dry sauna to function as it is meant to do, and if you are expecting it to do its magic on you in the 5 minutes you can spare, for example, then you will inevitably and forever be a disappointed sauna user, and you will wander off into the wilderness of your erroneous ideas never knowing what the actual problem is. All the while the sauna will be working just as it should, and you will continue to believe that it is faulty. You will continue to blame the apple for not being an orange, rather than enjoying the sweet (or sour) taste of the luscious apple in front of you. Sounds simple doesn't it? Yet how difficult it apparently is to adjust one's dearly held beliefs and expectations to accommodate reality.

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The Real Work

2009-12-22T12:59:00.000-07:00

Cultivating an ability to tolerate distress (Marsha Linehan's notion of "distress tolerance") in the form of uncomfortable, difficult, painful, frightening feelings;
developing a capacity for "sitting with" these kinds of experiences without necessarily doing anything about them (like trying to "get rid of" them; or even change them, for example);
learning to see the problem as this compulsive need/desire to "do" something about distress/discomfort, and NOT as the mere fact or reality of the presence of these experiences. These kinds of feelings and thoughts are by now part of the conditioned package of who you are. They aren't ever going to simply go away. Oh, too bad you say? Not really, I say.

Again, the real problem is in expecting and believing that you can somehow, magically as it turns out, make them disappear. THEN you'll be ok. This is simply a misdirected effort and a mistaken set of beliefs in action. The real work is about how to relate with these experiences, how to work with them creatively and constructively, so that more deliberate and conscious choices may be implemented, rather than remaining victim to what are automatic responses.

Oh yes, patience is required. And a much more accepting and compassionate relationship with yourself. But I can't do that, you say? Well, that's where the work lies. You'll have to learn, and practice, and make mistakes and get better at it over time. Most assuredly, it can be done.

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The Real Client In Couples Work

2009-12-13T13:39:00.000-07:00

Today I saw a google ad when I did a search for "couples counseling", that told readers to BEWARE of couples therapy, and not to get involved with it before reading the "guide" to be found on the linked website. I decided to click on the ad and have a look. A "former marriage counselor" talks about the shocking truth regarding marriage therapy, which is that there is, according to him, a 75% failure rate when working with these "experts", and that, no better than the un-helped national averages, a full 50% of couples seeking therapy will end up divorced.

Why is this so? Because, we are told - and this is the "real" core issue in couples therapy, not, as is usually believed, problems with communication - most therapists have had no (not even a single course) training in marriage counseling, and they are in fact trained to treat individuals, and so when working with couples they fail to have as their client, the marriage/or the relationship, and instead have two individuals as clients, thus leading to inaccurate understanding, and to ineffective (at best; damaging at worst) treatment.

While I'm not too fond of the semi-hysterical presentation of this person's ad, I have to acknowledge that he has an extremely valid point to make: in working with couples, it is, in my experience, and in my opinion, of critical importance to be sure to emphasize that the success of the relationship will depend on the ability of each of the people involved to conceptualize the relationship as the focus of their attentions and of their efforts, and not exclusively, or even so much, their individual agendas. Another way to put this is that, if the relationship is to succeed and to flourish, both parties will need to be able to transcend their exclusively personal agendas, preferences, needs, wants, and priorities, and to deliberately decide to make the relationship the top priority.

Of course this can get tricky. There has to be some degree of balance in terms of personal needs also. Asking someone just to give up their personal needs in favor of the needs of the relationship is to over simplify the complex dynamics of good relationships, and to devalue to an extreme the needs of the individual. We're not looking to make martyrs here, but to find ways to grow into a deeper understanding of the realities of successful long term relationships.

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Who's Who Anyway?

2009-12-05T18:43:00.000-07:00

By which I mean, who is it that we are really relating with and reacting to in our intimate or "significant other" relationships? Who is it that is triggering our reactions? Is it the person in front of us, the one with whom we are interacting, or is it really our parent or other early childhood caregiver. You know, the one who has had such a profound and lasting effect on us; the one who has shaped our thoughts and needs and feelings and expectations and unconscious goings on regarding close interactions with a very close "other"?

And the answer is...........................
Number Two!

It would be a very serious mistake to believe that you escape your conditioning, or that you haven't been conditioned by your early experiences, for better or for worse, or that you somehow, miraculously, and alone in all the world, function according to simple, known, or chosen beliefs and values and decisions. In order to be able to approach doing this would require years of self reflection, insight, wrestling with habits and established patterns of behavior, and not a little bit of good luck and grace. In other words, it don't come naturally (or automatically).

Given this then, learning to recognize our reactive patterns, and to make desirable changes in these areas, and to separate our "automatic" responses to old relationships from what's going on in the here and now, and from who is happening in the here and now, becomes essential to relationship and to personal health. Just insight alone won't do it. Oh yes, I'm a modern, liberated, self sufficient so and so. I know all of this. I wouldn't dream of holding my husband/wife/girlfriend/boyfriend/partner/lover to those old, outdated gender roles, etc. Why is it then, that when I don't get things the way I expect them, I get so frustrated, or angry, or condescending, or judgemental, or afraid, or shut down, or hurt, or feel so out of control?

Because I am reacting based on probably unconscious and well established patterns of thought, feeling and behavior, and not on what I have begun to integrate in the way of self understanding, emotional and spiritual healing, and real choice.

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Shame

2009-11-21T09:00:00.000-07:00

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Shame is a paralyzing force. In fact, it's so difficult, so painful for most people that it gets buried very deeply within the psyche so as not to be experienced in any conscious way. Then of course, it works its diminishing magic more subtly, more insidiously, out of view, but no less active and damaging for that. This seems to happen automatically, as a necessary strategy for survival and for some level of "acceptable" functioning in the world and in relationships.

Too bad. Yet at the same time there is the possibility of growing into a conscious approach to this horrible sense of oneself, and when this can happen, and when this self identity can be approached and worked with therapeutically and compassionately, the shifts in one's experience of oneself, the grace with which one can begin to relate with oneself can be astounding and wonderful.

If you are feeling stuck in therapy - or in your life for that matter - or if you are finding yourself repeating patterns that you thought you'd "worked with", or that you can't seem to get a grip on, or that are destructive or damaging or...........
it's possible that a more focused exploration of shame in your being could open things up for you in ways that will be very beneficial.

The Intersection Of Spiritual And Psychological Health

2009-11-13T21:02:00.003-07:00

Carrying on from last post about forgiveness, we begin to see how the principles of spiritual development and psychological health intersect. It is understood that we are not talking about religion in any organized sense, or about any rigid set of beliefs about this or that. Isn't it telling that on any given street of significant size there might be several different churches, synagogues or temples, each offering the real "truth" as only its teachings can provide, each believing that it has the "right" way, probably the only right way to that truth, and each sure of its special place at God's side. Of course this assessment can be carried around the world, with each country and each religion claiming that oh so special place in the scheme of right things for itself.

This is not what we're interested in here. We are instead interested in the core spiritual principles and teachings of many of the world's wisdom traditions. These, not surprisingly, tend to be very similar, if not exactly the same. I'm willing to conclude that these principles and teachings are rooted in an understanding of the human condition and the human psyche, so that when we are instructed to practice, for example, forgiveness, it is not simply in order to meet an arbitrary and perhaps nice, if naive "be good" agenda - or to be controlled by the power of the State for its own nefarious purposes, as in religion as the opiate of the people - but because it is understood that this experience is central to the deepest levels of health, or wholeness, or healing that the human psyche can achieve.

"I'll give you everything I got for a little peace of mind" sang Mr. Lennon. I recently read through most of a biography of Marlon Brando - I couldn't finish the whole thing. It was, frankly, too painful and a history of too much self-indulgence to be altogether tolerable. One of the themes running through the book was Mr. Brando's endless search for some peace of mind, a quest which he did not succeed in (despite, incidentally, decades of psychoanalysis). At one point he is quoted as saying to a fellow actor that he - this other actor - could never portray a certain kind of experience because he, the other actor, had never hated the way he, Mr. Brando, hated. The sense of this hatred is palpable throughout the book, and I don't think it's any accident that Mr. Brando failed to achieve peace of mind in its presence. The two are indeed mutually exclusive, as we have been instructed over and over again.

If psychotherapy is to be able to help clients achieve some experience of relaxation, of peace of mind, of happiness, then it seems all too obvious that certain principles and practices which have been discovered to lend themselves to the attainment of these experiences will need to be, at some point in the process, employed.

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A Little On Forgiveness

2009-11-12T18:35:00.003-07:00

So let's talk about forgiveness, or more precisely, self forgiveness. If the thesis that you are punishing yourself is accurate, then in place of a punitive relationship with yourself, a relationship of forgiveness, tolerance, compassion and acceptance of your humanity becomes the antidote, and the key to your liberation from the heavy psychological hand of this internal prison guard/enforcer.

You understand of course that we are entering the realm of spirituality, but not only spirituality. This is also the realm of psychological health, happiness, freedom and well being. It may not be just as simple as "love is all you need", or it might be just that simple, as long as we distinguish between the principle and its implementation. The simplistic notion that one needs to just "let go" has to be abandoned, and in its place the realistic practice of actively cultivating an integrated, felt experience of self love will be undertaken.

How to do this? You can use whatever methods work for you: visualization, self soothing, self hugging, self talk, self parenting, singing to yourself, etc. Welcoming the inner part of you who has transgressed. Practicing an understanding and supportive relationship with that part of you.
Treating yourself gently rather than harshly. Engaging a new belief that says that you will be a better person for offering yourself forgiveness than for imposing punishment.

Oh yes. There is the element of time. While "just let go" is supposed to happen instantly, the reality is that forgiveness develops over time and with effort and intention.

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Being "Bad"

2009-11-11T18:54:00.003-07:00

What about those very deeply established feelings and beliefs that many people live with, sometimes knowingly and sometimes, maybe mostly, unknowingly, that they are "bad". This often takes the form of struggling with "inner voices" of self judgment, self criticism, and shame.
Shame being about who you are, as distinct from guilt, which is more about what you've done.
Sometimes there are no identifiable "voices", just the gnawing feelings of badness, of imperfection, of failure to live up to some internalized - and generally impossible - set of moral standards. There is usually no wiggle room; after all, these are matters of MORALITY, and so no room for self forgiveness, understanding, tolerance of one's flaws or mistakes, or acceptance. One must, typically, be punished in some form for one's transgressions, and people are incomprehensively creative in inventing ways to see that sentence is carried out, usually from within, without the need of external authority.

This can range from relatively mild self denigration to complete self denial in the form of severe dissociation or amnesia. Mostly we live in the mid zone, with addiction, neuroses of one kind or another, co-dependency, non-nurturing relationships, power struggles, varying degrees of physical, emotional and spiritual violence, both self imposed and imposed by others, self hatred,
malaise, anger, anxiety, depression and despair.

Oh, and let's not forget the inability to apply to oneself all of the consideration, understanding, tolerance and forgiveness that one can more readily and naturally extend to virtually anyone else. At this point the situation becomes slightly bizarre, if common.

To be continued......................

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A Work/Life Dilemma

2009-11-03T06:38:00.004-07:00

What if you are youngish, have a well paying job, with good health benefits, and flexibility insofar as seasonal down time is built in, which you like, and now you have a primary relationship which, of course, needs attention and nurture, and you work 60 to 80 hours a week which makes this nurture impossible, and indeed you get lost to yourself in this job, by which I mean that you do not now know what your actual needs and wants are and you are not doing the things that you can identify as central to your deeper passions and creative fulfillments, because you simply operate on automatic pilot, though you do the job well? (Breath).

What you get is some feeling of financial security, and this is important to you because you grew up poor and didn't like it, the possibility of creating a small nest egg, a feeling of control, and of course the health benefits, which you may actually need to use because you also haven't felt really well for several months now.

What do you lose? Yourself, your relationship, the possibility of having a family, maybe your health, your passions, your joy, in some meaningful way your happiness.

What would you do in this situation?

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Enhanced Functioning In The World

2009-10-31T13:15:00.006-06:00

How to be more functional and effective in the world? In relationships, in marriage, at work, as parents, as partners, as individuals. How to discover and identify who one truly is, in terms of one's needs and wants, in terms of one's souls' desires, in terms of what is of fundamental importance, and what isn't. How to trust others to truly be present for you, especially when this has not been a common experience in all of your life? How to find the kind of balance in life, among all of the various areas of demand and desire, that is a prerequisite for real satisfaction, fulfillment and happiness? How to live as though your depths actually mattered?

Hmm. As I like to say, on at least one level, none of this is rocket science. That is, it's not so difficult to understand the basics. Be true to yourself, as in, listen to your heart and soul, and follow their lead. Show up, that is, be present to yourself and to those you care about. Be willing to take meaningful risks in order to be true and real. Ask for and accept the genuine support of others who care about you. Learn to set your priorities in order, and to apply your energies in proportion to those priorities. Choose you battles: not everything is worth a big effort. Pace yourself.

Don't imagine that you will wake up one morning and somehow, miraculously, be "finished", that is, free from all of your old patterns; re-born into a new person who has no neurotic tendencies;
a person for whom everything now is easy and fluid and fresh and without conflict and without difficult feelings and without aspects of self that you don't like. Instead, understand that whatever changes you want to make will require consistent application of skill and awareness. Understand that your old patterns will indeed continue to present themselves, on a regular basis, and that that doesn't mean that you are failing. It simply means that you are now aware of them, and this awareness opens the door to possibility.

Step One: Awareness; Step Two: Acceptance; Step Three: Choice; Step Four: Application
Something like that. Quite orderly, really.

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A Bit More On Cost

2009-10-29T13:17:00.009-06:00

So here I am with a client who has been unemployed for about 4 months now, is three months behind on the mortgage payments, and is awaiting the "call" from the previous employer who has promised a job "next week" for a couple of months now (there is a huge bureaucracy involved, so this sort of delay is not surprising). Therapy is truly helping this person. It's not a "brief" therapy. This could go on for quite a while. By now I'm carrying a back bill of 6 sessions. Not tremendous, and not nothing either. This affects my income, which, in case you wonder, is not large. I enjoy working with this client, not least because I see the steady progress that is being made in some pretty significant areas, and because of the commitment that this client has made to healing.

I'm willing to "carry" this client. I expect to be paid some day, but who knows? In spite of today's headlines that declare that the recession is officially over, this client is caught up in the same financial circumstances that literally millions of other Americans face: the highest unemployment rates in decades; unprecedented home foreclosure rates; a general economy that, before today it seems, has been shrinking. Yesterday, when a check was offered at session's end, after we had talked about the relationship between client's shame and the lack of money, I gave it back and told this client to go buy food instead.

I'm not telling this story to garner praise for my generosity. To me this situation seems obvious and inevitable: one does not take money for therapy when one knows that the client has had to borrow money for food, and when there is an established therapeutic relationship in place that is benefiting the client.

When people I feel a connection with ask me about my work, my stock answer is that it's a good thing that my wife has a real job. We certainly wouldn't be able to live on what I make. And partly, this is because of personal decisions I've made regarding my fees, my non-relationship with insurance companies, and situations like the one described above. Also, I'm not a very good "business" person, not unlike many creative people, so "marketing" isn't something I do. Oh well. C'est la vie.

I know there are "high powered" therapists who make huge incomes because they are good business people, because they approach their private practices as businesses first, and, not insignificantly, because they see largely wealthy clients. This has never been my approach, or my motivation for practicing as a therapist. It's not where I come from, either personally or professionally. So what about every one else? The "average" person, or the poor person needing therapy? A client at a private, expensive residential treatment facility that I used to work at once said, in expressing his gratitude for his situation, that while he was fortunate to be able to pay for his treatment, "poor addicts just die". And so it goes.

Or does it have to?

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The Cost Of Therapy

2009-08-24T13:01:00.003-06:00

Typically, psychotherapy is pretty expensive. This is because it has its roots in an aristocratic white social environment, and because it developed out of a western medical milieu where professional medical people held high status and commanded high fees. Nowadays, "psychotherapists" include medical doctors (psychiatrists), psychologists (PhD's, PsyD's, or EdD's), and Masters level practitioners including clinical social workers (MSW, LISW, LCSW, etc.), and clinical counselors (LPCC's, LCPC's, etc.).

The debate about the cost of therapy is never ending, and there does not seem to be any clear cut way of resolving the dilemma. I say" dilemma" because many people who would benefit from good therapy will never have the opportunity to do so because the cost of the service is out of their reach. This is no different in many cases from the costs of medical and health care in general in our current economic system and insurance/(obscenely) profit driven health care system.

So what to do? There are community "mental health" agencies that are supposed to pick up this slack, and make therapy (or more commonly, "counseling") available to the masses. The reality however is that these agencies are typically government funded, and we all know what happens to funding for all "non-essential" services as a general rule: it is, of course, drastically cut. This means that many of these community mental health agencies go out of business. The ones that remain spend most of their time and energy struggling to survive, to raise funds, to meet ever increasing paperwork demands, and to provide direct services to ever growing numbers of people. It is not uncommon, for example, for a therapist at such an agency to be expected to see 25-30 clients a week. Plus do all the paperwork involved. Plus attend meetings. This is not possible if it is also expected that the therapist will be able to remain healthy and to provide quality service.

Then there are the private practice therapists. If insurance is funding the service, it may also not be uncommon for a therapist to see 30 clients (or patients) a week. If insurance is not funding the service, this number is likely to be considerably lower. Still, we all know that there are millions of Americans who do not have health insurance, and so are left to fund therapy services out of pocket. This is where the high cost becomes problematic for many.

The dilemma is extended when you factor in the legitimate need of the therapist to be able to make a living. So what does "make a living" mean? Of course this is different for every person.
Is the British surgeon who makes a million dollars a year under the socialized health care system, and living very well, being deprived because she or he is not making the 2 million she would make in unregulated America? You see how this goes.

So it becomes a very personal moral, ethical, practical and spiritual consideration for each practitioner. How much do I charge for my services? What are my legitimate needs? What are the "customary and usual" fees in my community? Are these within my personally acceptable parameters? Are they too high? Too low?

To be continued......................

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It's Not Rocket Science

2009-08-19T14:03:00.006-06:00

Not infrequently I hear myself saying this to clients: "It's not rocket science."

What I'm referring to are the concepts involved in understanding how the psyche generally works.

I'm not even talking about the subconscious, or the unconscious, collective or otherwise. I'm simply talking about the basic rules of the road that seem to apply to everyone. For example, when we're afraid of being judged, we often employ a defense strategy - a "mechanism" - that will keep us protected from feeling the painful feeling of being judged by another. We might decide, internally, and probably out of consciousness (ok, I AM talking about the unconscious) that we don't care what anyone thinks or says about us, and present to the world, to other people, an outward demeanor that looks carefree and confident.

If it's too difficult - embarrassing, shame inducing, contrary to our image of our self - to admit that we were not able to be truly present for an intimate when they really needed us to be, we might offer any number of "rationalizations" or justifications, or just plain excuses, rather than feel the depth of the anger or the betrayal or the pain that our intimate is experiencing.

These sorts of things are very common. We have all learned and invented personal versions of them, and other strategies, to protect ourselves from unwanted feelings or thoughts. It's this sort of thing that I refer to when I say "It's not rocket science". Coming to understand these common psychological behaviors isn't all that difficult. What becomes difficult is to learn to see how they operate within ourselves, to learn how to "bust" ourselves when we're doing them, and to learn new ways of seeing and behaving that will contribute to freeing us from our own self defeating ways of doing things in relationship with others and with ourselves.

It does indeed take time, and effort, to learn and to establish new habits, and more self supporting ways of being in the world.

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Simple In Principle, Maybe Not In Practice

2009-06-27T06:55:00.004-06:00

Here's the principle: you can experience whatever you want to, if only you'll focus your "consciousness" on that, or "put it" there.

Example: if you want to experience the ever present energy of love, you only need to choose to focus your consciousness on that energy within yourself, instead of on whatever else you may be experiencing, like fear, or anger, or sadness, or any train of thought. As long as you're focusing on the thoughts, or the feelings other than love, you won't be able to experience the love. So it becomes a matter of desire, and of re-focusing whenever you move off track.

Sounds simple enough, in principle. And I agree that it is simple. So what is it that prevents people from being able to do it easily? Is it, simply, a matter of different desires? If I'm depressed, and struggling with hopelessness, and an overwhelming sense of powerlessness to change anything, is it simply that I don't want to change this strongly enough? Are there other operative factors?

I'm quite certain that there are other factors in operation as well, and yet there may be a way in which it is possible to consider the simplicity of this principle as real. One factor that I come across with some frequency in my work is just that people don't understand that the changes they're after will come about in steps, over time, and not all-at-once in a flash of transformation. This implies that it will be necessary to "practice" certain new ways of understanding and of doing things, until a new experience is stabilized, or learned, or established. An obstacle that can then present itself is that people don't "want" to have to make that kind of effort, and so don't, and so don't experience the changes they say they "want".

Disappointment may then follow, and a belief that therapy doesn't work, and resentment may develop on top of that, or a client may come to believe that they themselves are just not good enough, not deserving enough, not strong enough, not capable enough, etc. It can become quite complex, whereas the principle we started with remains in itself, pretty simple.

www.matthewdavid-lpcc.webs.com

The Risks Of Therapy

2009-05-28T18:06:00.005-06:00

It would be nice to think that therapy will make you feel better all of the time. After all, that's why people enter therapy, isn't it? I mean, who enters therapy if they think it's going to make them feel worse than they already do? Well, maybe a masochist would do that; would even count on it. But short of that, I think it's realistic to suppose that people enter therapy because they believe it will help them to feel good. There have even been therapy self help books written with titles like "The Feel Good Book".

It may come as a surprise then to discover that the therapeutic process can elicit difficult, painful, frightening feelings also, and that every session will not end with you, the client, feeling better than when you arrived. Along these lines we have other therapy related books with titles like "I Never Promised You A Rose Garden", and "Love Is Never Enough".

If we conceive of therapy as a journey of healing, as a process through time, we will be better able to imagine that this journey might have down's as well as up's; bumps and turns in the road;
bad weather as well as good; and a guarantee of changes along the way. From this point of view we can say that the process of therapy requires a certain amount of courage; a certain adventurousness of spirit; a certain willingness to be surprised, disappointed, challenged, and ultimately strengthened by our experiences.

Not much different from a life well lived, you might say. And you might be right.

www.matthewdavid-lpcc.webs.com

Give An Hour.ORG

2009-05-21T15:36:00.003-06:00

Give An Hour.org is a non-profit, non-partisan service organization established to help provide free counseling/therapy services to returning veterans from the Iraq/Afghanistan wars. Services are also being provided to veteran families. Many of these men and women, as well as their children, are affected adversely by the experiences of combat, family disruption, and the often very difficult re-integration process following deployment.

Here are just a few astounding facts to consider:

According to the DoD Taskforce on Mental Health, among troops returning from Afghanistan and Iraq, 40% of soldiers, 1/3 of marines, and fully half of National Guard members are suffering from psychological problems following deployment;

children from military families are twice as likely to die from severe abuse as other children are, and rates of abuse and neglect rise dramatically (40%) during the time of deployment;

a recent Rand Corporation study reports that some 300,000 US troops returning from Iraq/Afghanistan are suffering from Major Depression or Post Traumatic Stress Disorder, while another 320,000 are suffering with brain injuries. Only about half of all of these women and men have sought treatment;

there are an average of 18 suicides a day, among America's 25 million vets.

I've taken the step of signing up, along with some 4,000 other therapists (so far) across the country, with Give An Hour, in order to be able to contribute something in the way of compassionate care to some of these men, women and children. This is not an issue of politics or party lines, but a matter of offering some measure of help to people in dire need.

If you'd like more information on Give An Hour, please click on the title of this post to visit their website.

www.matthewdavid-lpcc.webs.com

Reality Tends To Intrude

2009-05-14T07:29:00.005-06:00

For a while, things are going much better. Insights have been gained, new and considerably more compassionate relationship dynamics are being employed with oneself, self care is becoming a real and active part of everyday life, and as a result, you're feeling "exited about life" for the first time in many years. You're experiencing genuine hope for the future, a more open expanse of possibilities, instead of the dark tunnel of despair and depression that has been your abode for so long.

Then, it's as though the wrathful hand of God has slapped you across your beseeching, uplifted face. Not you! it seems to say. Did you really think I'd let you feel good about yourself! Who do you think you are?!

To make matters worse, you are, without really knowing it, the one playing God. It is actually your own self judgment and self criticism, along with your own unrealistic expectations about your recovery, that is exacerbating your slide back down the slope of old behavioral and emotional habits. You were doing things right, you figured, and the results were real. I've arrived! It's been a long journey, but I've finally arrived! Whew!

What you haven't accounted for is what I like to call your "defaults". Those patterns that are simply programmed deeply into your personality, and are the places you will tend to "default to" under stress. The familiar. The well established. The original. Everyone has them, and learning to live with them in more creative and loving ways is a key to continued recovery and development. The reality of "two steps forward, one step back", has to be understood and integrated as a natural part of the healing and growth process. Especially in the early stages of recovery.

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What's Normal?

2009-05-03T17:51:00.000-06:00

"I'm stuck", she tells me, a little tearfully. This is an utterly unknown condition for her. She doesn't recognize herself lately, and neither do her friends, who are encouraging her to "snap out of it" and get back to the familiar, capable, get-things-done person they know. She doesn't understand why she can't seem to do this, and she believes they're right: she should be able to simply snap out of it, whatever "it" is.

In the course of our first conversation I learn what the last three years or so of her life have been like: major stressors, family emergency, a medically predicted child death (which didn't happen), uprooting and moving across country, a challenging new marriage. She's always been the "strong" one, doing whatever needed to be done, taking care of others, having no time to stop, or to fail, or to be needy herself. A survivor.

"I don't have time to break down" she tells me, so instead she has become depleted emotionally, physically and I suspect spiritually. She is experiencing multiple symptoms of depression, and can't "move forward" with her life as she's known it. She cries easily and "all the time", and feels that something inside of her has died. She derives no pleasure or satisfaction from anything, and her creative activities have dried up. Coming to see me is the first time in her life that she's ever talked with anyone about her distress, and it's because she feels scared, powerless ("For the first time in my life I'm dealing with something I can't handle on my own") and defeated that she has finally sought help.

One of the first things I have started to do with this client is to begin to frame her experiences in ways that will tend to "normalize" them, that is, help her to see that, given the challenges she's been up against, and the circumstances of her current and past life, her responses are pretty predictable, if not guaranteed; connecting the dots between circumstances and "normal" human needs and reactions; validating the sense of overwhelm that exists; reassuring her that she's not going crazy, but rather is needing to learn what it means to have a complex emotional life, and what it might look like to begin, very probably for the first time in her life, to have good support, and to take good care of herself emotionally.

\There is hope.

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Surprises Happen

2009-04-21T07:15:00.001-06:00

I continue to be surprised by clients who, at times, seem to be able to find solutions to very distressing problems that simply wouldn't, or didn't occur to me. Not that I should be finding these solutions. After all, it is in the client's best interests, and it is the most liberating and the most empowering when they find their own solutions. Following the principle that each of us somehow knows, ultimately, what we need in a given situation, it shouldn't be too surprising when this sort of insight occurs, yet it is.

I can allow myself to experience my own biases as they arise in any situation, and I can allow myself to observe my inclination, my desire, to inform a client of what I think they ought to be doing, and it is part of the art and skill of good counseling not to do so at the wrong time. This is not to say that there are never situations in which it is appropriate to "direct" a client. There clearly are, either because the client is simply unable to "protect" her or himself, or because this is the most likely strategy to yield good results with a particular client. These "directions" are often delivered in the form of "suggestions", but sometimes they are more blatantly "instructions".

But when a client arrives at what seems and feels and looks like the right solution for themselves, this is a lovely and important moment in therapy and in life. And when it is outside of my own thinking on the subject, it is a sort of secret delight, and a pleasant surprise as well.

For me, it is one of those things that serves to bolster my faith in humanity, and in the potential of good therapy. Let the surprises begin!

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Choice Points

2009-04-11T08:27:00.001-06:00

There are times in therapy, and they are very challenging times, when we arrive at what is sometimes called a "choice point". This occurs when, as a result of therapy progress, or life events, or a combination of factors, a client arrives at a juncture in their life; a crossroads. The question becomes then: "which direction do I take?" The options can be starkly differentiated. Often, one road represents the "old ways", a continuation of the direction from which one has come. The other road represents the "new me", a progression of the healing work that has been taking place in therapy. While it might seem an easy, or perhaps a simple choice to make, it is actually, typically, frought with inner conflict and turmoil, clashing loyalties, fear of the unknown vs. the comfort of the familiar, and direct challenges to one's courage and commitment to self.

Taking the road that continues the past can mean a dangerous journey away from healing, away from one's truth, away from one's Self. It can amount to a denial and a rejection of what one has come to experience as one's healthy core. Contemplating the "new" road comes with numerous difficulties of its own. It might mean turning away from what others in one's life want, or think is best. It might mean taking a leap of faith into unchartered psychological, emotional and spiritual territory, without even the comfort of what one has known all of one's life. It will certainly mean testing one's willingness and ability to trust: to trust oneself, as well as to trust the "bigger picture", or "higher power", or God, or The Universe, or simply what one has begun to tap into in one's own journey of health.

In a universe where there are few, if any, absolutes, we can perhaps take some consolation in the thought that nothing is absolutely right or wrong, and that whatever choices we make, while they will certainly have their effects and their consequences, might not be absolutely un-repairable. We can afford, perhaps, to make even serious mistakes, if we are willing to learn from them. While some people seem to need to be "hit over the head" by reality in order to learn from their mistakes, it is also possible to follow, or to learn to follow, more subtle cues. This, of course, requires practice and experience, and choice points are examples of opportunities which can provide this experience, and which can be built upon as we journey through life.

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Being Present

2009-04-01T09:58:00.001-06:00

There are virtually inummerable ways to "check out". We all do it. In its more extreme forms, this checking out takes the form of dissociative states or disorders, such as multiple personalities, or losing track of place and time. In its more common forms we can think in terms of ordinary activities like spacing out on TV, over eating, risk taking behaviors, any of the possible addictions or compulsions from drugs and alcohol to running or exercise. In other words, anything can be used as an escape.

And what is it that we need, or want to escape from? Could be anything from the routine and tedium of everyday life to extreme trauma. There is good reason to conclude that the need or desire to leave ordinary reality in some form is hard wired in our brains. It would be impossible, I suspect, to find a culture, current or historical, that did not incorporate an understanding of this need, and provide methods for its satisfaction. So, given the fundamental human experience of "escape", or altering consciousness, what can be said about the importance of "being present"?

While "taking a break" from the stresses of life can be both healthy and productive, making a (bad) habit of it ultimately creates more stresses and multi-layered problems. Cultivating the capacity to be present with one's experience, to "show up", to "be real", to be "in the body", is necessary in order to be able to work effectively with our lives and relationships, and to experience true health and happiness. The term "real time" takes on a significant meaning when it comes to mental health. Of course, cultivating this capacity involves cultivating the ability to be present with, to experience, and to manage or modulate difficult, intense, or distressing feelings.

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The Importance Of Listening

2009-03-28T09:45:00.002-06:00

One of the striking hallmarks of the new Obama administration, at least to me, is the repeated references one hears to "listening". Mr. Obama instructs his State Department emmissaries to listen to what the leaders abroad have to say. Yesterday, in his meeting with bank CEO's, he is reported by one of them to have done a lot more listening than talking. In his response to the students to whom I referred in my last post, and their video "Is Anyone Listening?", he assures them that he is.

Although skillful listening is a basic of good counseling, and learning how to listen actively is a basic of good communication for everyone, every now and then I am reminded in a session of just how powerful and inescapable this ability is, and how essential it is in helping people to connect, to heal, and to make desirable changes. What careful listening says is that: I care about you; I want to understand you; I respect you, and what you have to tell me; I want to engage with you so that you can feel acknowledged, appreciated, and, of course, heard.

This speaks to a fundamental need that, I think, all people share: the need to be received; to feel that they are in some way welcomed and valued. There are those, of course, who will say, and who may even believe, that "I don't need anyone." "I don't care whether you approve of me or not." "What you think of me doesn't matter." In fact, these sentimeents are considered sexy, especially for men, but also more and more for women. Just spend 15 minutes looking at the images in any movie theater, in any magazine, on TV. I went to a movie just the other day, and was struck, again, by the movie posters in the lobby, advertising current and coming films. Almost every one of them, maybe 4 or 5, featured images of men with scowling, hard, penetrating, threatening faces. Real men. Men who don't give a damn what you think. Men who clearly don't need any one. The "sexiest" images of women, especially in "fashionable" media, are all of pouty, aggressive, sometimes cadaverous looking models. They don't need you. You need, and want, them, and they know it and thereby have all the power.

But really, we all want, and need, to be genuinely welcomed. Listening carefully is one of the most potent ways to give this welcome. Amazing things are possible from this basis.

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Follow Up On Grief

2009-03-21T08:36:00.001-06:00

I happened to catch a piece on 20/20 last night about the realities of my last post. The piece was called "Living On The Edge", and it was about the crisis of ordinary people who have, or who are at serious risk of, losing their jobs and homes. These are people perhaps very much like you and me, that is, they are educated, solidly middle class families with children, who a short time ago were nicely employed as accountants, managers, even surgeons, and who are now either living in homeless shelters, or very close to losing their homes and to exhausting whatever savings they may have had.

Some of the children of these families made a video with the help, and at the request of their high school teacher. They called it "Is Anyone Listening?", and posted it on Youtube. It was a video of them sharing their feelings about what was happening to them and to their families, and it caught the attention of President Obama, who referred to it in one of his speeches, and who subsequently visited these teenagers at their school, to let them know that, indeed, someone was listening, and was trying to do something about fixing the disaster that was affecting so many people today.

The feelings expressed by these kids in their video certainly included the grief that I referred to in the previous post. They spoke openly, cried on camera, and or many, the experience of being able to share what was going on for them - which they had never done before - allowed the arousal of a new hope, and a sense that they were not alone, and that they no longer had to hide what was happening to them and to their families.

Please take this as an object lesson. Getting support for your feelings, even when you are not in as desperate a situation as these families are, is of the utmost importance in these extraordinary times, as it always is.

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Heightened Grief In Extremely Stressful Times

2009-03-14T12:19:00.001-06:00

These are difficult times. There have been other times of difficulty, of course. Right now, given the enormous collapse - it's hard to over state the situation - of the world's economies, there is new suffering of a magnitude which is unprecedented certainly in my lifetime. Not tens, or scores, or hundreds, or even thousands, but many hundreds of thousands, or even millions of ordinary Americans have lost, or will lose their jobs and/or their homes. I don't know where they are exactly. Are they living with more fortunate relatives? Are they in homeless shelters? Are they on the streets? Remember, we're talking about entire families, including the sick and the very young.

These are the kinds of situations that we, in this country, are more accustomed to hearing about existing in other places in the world, places usually far distant from us, either geographically or at least psychologically. People old enough to have lived through the Great Depression of the thirties will of course feel not-so-distant from current events. For the rest of us though, how are we effected now by what's going on all around us, even if we ourselves have not yet been directly affected in the most challenging ways?

One of the effects, for those who are sensitive enough, or self-aware enough to recognize it, is an experience of heightened grief. For others, even if they are not aware of it, there is, without doubt, a "subterranean" (ie., unconscious) exposure to more fear, more loss, and more grief.

Not being aware of this however usually means that these emotional experiences play themselves out in ways that might be unrecognizable as what they really are. For example, people will somaticize their fear or grief, so that they develop physical symptoms in place of clear emotional experiences. Or, some people will express a lot more anger, when what's actually happening on a deeper level is fear or grief, which goes unidentified and unacknowledged, as well as unresolved.

I'd like to encourage everyone to recognize the unusually intensified emotional and psychological stresses that we are all subject to in these times, and to be certain to find or create the best possible networks of support that they can.

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Money And Partnership

2009-03-09T11:43:00.001-06:00

Money represents all kinds of things for different people: power, security, freedom, happiness, love, equality or the lack of it, self worth, control, success. It should be no surprise then that money issues are one of the most contentious subjects for couples trying to find their way together.

"I want our expenses to be shared equally, and I don't feel that this is the case now".

"I want the freedom to spend some money on personal things without having to report every penny to my wife/husband/partner".

"I make more money than he/she does, so I should be able to do what I want with it."

"I think we should have separate checking accounts and manage our personal money separately."

"I think we should have joint accounts and pool our money."

"I'm the breadwinner, so I get to control how the money is spent."

These are just some of the kinds of issues that are common when starting to explore how money fits into a relationship. Ideally, couples can come to see and understand what money means to them, and so begin to see how their own relationship with money is played out with their partner. Then, while working to get support for the emotional meanings and vulnerabilities that money has for each of them, they can also begin to define real needs and areas where each can support the other in a truly collaborative, healthy, and rewarding partnership, whatever form that may end up taking.

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On-The-Job, On-The-Spot Meditation

2009-03-07T13:47:00.001-07:00

You're used to being in charge. You've led an enormous organization and done a heck of a job at it too. You've seen what needed to get done, how it could be accomplished, and made sure your team was equipped with the knowledge and the tools to do it. People praised you; appreciated your abilities; showered you with great respect and admiration.

Now you find yourself in a position of "advisor" to a group leader. You have no real power to take charge, but can only make suggestions, or share your observations. On top of that, your boss now is someone you do not admire, and who's abilities you find serioulsy lacking. You know you could do the job much better, and you find yourself experiencing extreme frustration and even a kind of psychic/emotional pain because the organization is in deep trouble and you care about it deeply.

Oh, and by the way, you're a Buddhist whose "real" agenda, whose most profound motivation is the cultivation of an enlightened mind and heart. You haven't been able to practcice formal sitting meditation for over a year now, because of a certain intense anxiety that grips you whenever you even think about sitting. All of this is confusing and, of course, distressing.

Can the real life arena you're in provide you with meaningful opportunites to practice on-the-job meditation? Of course it can. In the midst of your every day activities, off the cushion, you are being given the contexts in which to cultivate the mindfulness and enlightened heart you so appreciate and desire. The only challenge? Why, your ego, of course.

How do you let go of the ego that has served you so well-at least professionally-in the past? How do you cultivate the ability to surrender to a higher truth, when you clearly see the truth of what you could be doing if you were only in the right position? How do you practice "turning it over" when you begin to recognize the compulsive/addictive/self destructive quality of your drive?

This situation, and others like it, have a kind of fire-like potential for transformational practice.

Not for the faint of heart though, there are many paths to enlightened mind.

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Being "Different" In A Cookie Cutter World

2009-03-04T16:46:00.001-07:00

Without making too much of it, I think it's fair to say that, for the most part, people find it difficult to be different from the "the norm". There's always a great deal of pressure, from without and also from within, to fit in, to be one of the guys (or gals), to conform. If it turns out that you are unlike the "norm" in any significant way, this can create a considerable degree of tension, distress, uncertainty, self loathing and self doubt. When this happens, it is of crucial importance that you find people who can support and celebrate your differences, or simply somehow give you permission to be who you are.

Learning to accept oneself is a difficult enough challenge under the best of conditions. Throw in being a bit "odd", or unusual, or just a little "out of the box", and this developmental task can take on seemingly impossible proportions. I'd like to encourage all of you "differents" out there to take hope. Instead of waiting for the world to catch up to you, and berating yourself in the meanwhile, try on the idea that the rest of the world will not be likely to catch up, and that you can move forward blazing new paths without that happening.

I'm not recommending being isolated in your difference - although some of this may be inevitable because of rejection and misunderstanding. I urge you instead to cultivate the appreciation and support of those who can see you for who you are. Having the right kind of reflection of yourself from these people will help you to soar, or simply to feel at home in your own skin.

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Not An Option: Make Time To Go Inside

2009-02-07T19:31:00.001-07:00

I suppose it might be more important for those who think of themselves as introverts, but then again it might not be. It might be just as important for just about everyone. What's "it"? Some version of time alone. Down time. Personal space. Reflection. Meditation time. Retreat. A break from the demands of every day. Time to go inward and connect in depth with one's spiritual core. Re-creation, independent of "what you do" and "who you think you are" in the world. The necessity of renewal from within.

It's a cliche, but I'll say it anyway: oh, how easy it is to lose track of oneself amidst the demands of daily life. By "oneself" I mean of course one's essence, one's beingness as distinct from one's doingness. The Source. God. Self. The One. And, how essential it becomes then to allow the times and the places to tune back in. This ought to be something one does every day, but I'm realistic enough to admit that most people don't; and even when people do some form of meditation or other "centering" practice, it is still of importance to allow special times for more intensive, focused, extended bathing in the Pool.

How are busy people, or poor people, or distracted people, or neurotic people supposed to be able to do this? I won 't pretend to know. I'll only say that, to employ another cliche, where there's a will there is indeed a way. So it really is, in my opinion, a matter of will, and not so much a matter of particular circumstances. Virtually any circumstances, short, I suppose, of the most extreme, can be worked with effectively.

Do yourself a favor: make the time to retreat back into Yourself. Make your spiritual practices more of a priority. You'll be glad you did.

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Gradual Steps, Practice, And "Small" Successes

2009-01-28T10:15:00.002-07:00

Working with the pressures we put on ourselves to "perform", to be what we "should" be, to do things the way they're "supposed" to be done, even when trying to do these things creates enormous personal and interpersonal distress, presents some challenges. One of the most considerable of these challenges has to do with recognizing the larger cultural context within which pressures like these arise. In other words, this sort of distress isn't just "something wrong with me". It is also, and in a sense primarily, "something wrong with our culture", which then becomes one's personal story as well.

"If I could just muster enough self discipline to _________________", fill in your own blanks:
work a job, go to school, manage a household, shop, clean, study, socialize, pay bills, excel, take care of the kids, exercise, eat right, be sensitive to everyone else's needs................................

And when I fall short of these ridiculously and unrealistically high expectations, I manage quite well to feel terrible about myself. I'm not strong enough. I'm weak. I'm not smart enough. I'm not creative enough. I'm just basically no good. I'm certain many of you can relate easily with these feelings, and the mental messages that go along with them.

Here's an alternative strategy, which on the face of it might seem simplistic, or obvious: practice relating with yourself more kindly; more gently; more forgivingly; more realistically. I know, easier said than done. Of course. That's why I said "practice". Like the development of any skill, relationship skills - including the relationship with ourselves - require practice and cultivation. Some consistency, rather than a great, forceful push of intensity. Think in the long term: gradual, slow development over time.

I know this goes against virtually everything the larger culture presents to us. I know this is opposite to the "quick fix" mentality and set of expectations we're "supposed to" live by (even while great lip service is paid to the other, more "virtuous", more "wise", and indeed more realistic values of gradual progress). I recognize the contradictions, and I hope you will too, because recognizing them will play an important role in your being able to learn how to care for yourself in opposition to them, and to their representative voices in your head.

If you can't have your optimal set of circumstances, for whatever reasons, allow yourself to utilize smaller aspects of the things, people, and conditions that do in fact work for your benefit. Example: you'd really love to be living in a more natural, nature based environment, but currently this isn't possible because your needs - things that you've freely chosen, let's say - require you to be in the city, or in town. Not only that, but your current financial circumstances require you to live in a low-income part of town, which among other things, means that it isn't necessarily very safe, so you're afraid to go out and walk in your neighborhood.

OK. What can you do that might actually be helpful, healing, nurturing for yourself, within these constraints? Instead of concluding that there's nothing that you can do, how about implementing the above "smaller aspects" strategy? Can you create, inside your space, an environment that is composed of natural elements? Can you drive to a part of town, or even a ways out of town, to an area where you can feel safe walking in Nature? Can you have people whom you feel some closeness with into your space? In other words, try not to get caught in an "all or nothing" condition, where you become paralized by the sense of seeing only what you don't have, and nothing of what you might be able to have that would help.

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No Couples Counseling Yet

2009-01-24T10:13:00.000-07:00

There are times, and situations, which warrant a "no couples counseling" approach to working with couples. Perhaps the most serious of these is when there is active, ongoing, and serious domestic violence between the individuals. The potential for danger is thought to increase if the couple is to be seen together, because things will be said in sessions that are likely to later be used as "ammunition" by one or both parties, thus fueling the violence.

Under these circumstances, it is advisable to engage both parties in individual therapy, not with the same therapist. Both parties need help, guidance, support, and facilitation in education and self examination. Without this, there is little hope of things in the relationship getting better. It may even be advisable for the couple to separate for a time. Of course, this idea may be vehemently resisted by one or both parties, for a variety of reasons.

When there has been violence in a relationship over an extended period of time, the psychological and emotional dynamics between the parties are deeply dysfunctional, self destructive, controlling, confused, and, of course, dangerous. The unfortunate reality is that these relationships not infrequently end in death for one or another, or sometimes for both people. Over time, the violence tends to clearly escalate without meaningful intervention. It simply is not the case that things will "get better" on their own.

If you know people for whom this situation exists, or if this is true in your relationship, please find a way to look for and ask for the help you, or they, need.

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Careful! There's A Baby In That Bath Water!

2009-01-19T07:40:00.001-07:00

Having had some negative experience with health care, it becomes increasingly important to be able to experience care that is genuinely supportive and beneficial. Otherwise there is the very real danger that you as a client in therapy might be inclined to "throw out the baby with the bath water". In this situation that might mean closing yourself to information or strategies that could be helpful to you, because you associate them - perhaps mistakenly - with your previous unfortunate, or even damaging experience.

An example: a client has had unsupportive medical experiences regarding his very real disabling health condition. He may have been told, or it may have been implied that this condition was "all in his head", and that there was nothing "really" wrong with him. As a result of this treatment, and perhaps other previous experiences, he concludes that anything associated with the conventional medical establishment is worthless, and cannot possibly be of benefit to him. Instead, he spends years exploring and working with "alternative" practitioners, to try to get some relief from his debilitating health distress. This in fact IS beneficial, both medically and spiritually, the client feels supported and validated, and does indeed gain some measure of relief.

This same client now finds himself in need of psychotherapy, and through a set of circumstances not altogether of his choosing, finds a therapist who uses an eclectic approach, incorporating some fairly orthodox, mainstream treatment models with other, more cutting edge ones. While the more "alternative" models are appealing to this client, he has, even before meeting with the therapist, decided that certain methods, because they are "mainstream", cannot be useful to him. This is unfortunate, because some of these more conventional methods are actually very powerfully therapeutic, and can in fact be presented and implemented in ways that are comfortable, supportive and effective.

After a few sessions of therapy, when a good therapeutic relationship has been established, the therapist is able to skillfully explore all of this with the client, and the c lient is able to begin to recognize his bias, and that it may in fact be more hurtful to him than helpful in his therapy.

In general, it is the case that a black and white approach to just about anything, while in some ways understandable, will prove to be more harmful than helpful.

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A Little On Power In Therapy

2009-01-15T09:43:00.001-07:00

It's not all that unusual for clients, especially clients who've had previous experience with therapy, or with health care in general, to come into therapy with well developed biases against what they believe to be "ineffective" or simply "wrong" approaches to therapy. At least "wrong" insofar as their benefit is concerned. This is usually the result of bad health care experiences, even traumatic ones, in which the client may have been ignored, disbelieved, bullied, or in some other way not given the full respect they need and expect.

Imagine how you might feel if you were to be treated with condescension, with skepticism, with arrogance, or with any other form of disrespect, when you are in a particularly vulnerable condition, and when you are actively seeking help. Not only will such an experience be harmful to you, but it will also tend to sour you to methods and practices which can, when done well, be of significant benefit to you.

This is where the nature of the therapeutic relationship between client and therapist is of paramount importance. Regardless of how well your therapist may understand theories and techniques, the healing potential of any of these are likely to be lost if the relationship between the two of you is insensitive, or aggressive, or in any way expresses its inherent power differential unskillfully. In short, no one wants to be treated badly.

Just a couple of days ago I happen to see Mr. Bush on TV at one of his farewell press conferences, in which he was asking, rhetorically, if it isn't "pathetic" to hear or witness someone expressing "self pity". It's safe to say that, whatever else Mr. Bush may be good or bad at, he would most certainly not make a good therapist with an attitude like this. If a client in therapy were to be related to with this kind of insensitivity, aggression and arrogance, we can rest assured that the experience would be a damaging one.

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Informal Mindfulness Practice

2009-01-07T19:52:00.001-07:00

One of the very popular "techniques" in psychotherapy today is "mindfulness". There's the very well known and evidence based successes of MBSR, or Mindfulness Based Stress Reduction, founded and elaborated by John Kabat-Zinn; there's the "teflon mind" mindfulness of DBT, or Dialectical Behavior Therapy, developed and researched by Marsha Linehan; and there are numerous other strategies and offshoots utilizing the fundamentally Buddhist practice of mindfulness, or "bare attention".

Typically when we think of these practices, we think of sitting meditation, or formally structured periods of practice, the benefits or insights related to which can then be carried into everyday life situations. There is another approach however, which doesn't get as much press, so to speak, and that is the practice of mindfulness IN everyday situations, without, necessarily, the added participation in formal meditation periods.

Consider: a successful senior executive, now in a subordinate role as a member of a task force to which she is very well suited, and for which she is supremely qualified. Since she is not the "leader" of this task force, she finds herself observing situations which, in her former roles, she would readily have addressed and guided, but in which she now "holds back", thinking her thoughts, making her judgements, feeling the sensations of frustration and impatience, but "doing" nothing. She is "forced" to observe all of this, while not, at least at times, directly acting on any of it. This is the practice of bare attention, or mindfulness.

It is a struggle for her, because she is accustomed to being in charge, and to taking the proverbial bull by its horns in order to wrestle the "problem" into a "solution". Now, she has to "sit with" situations which every fibre of her body/mind wants to "tackle". An interesting dilemma, and a wonderful opportunity in support of her Buddhist practice.

Finding a balance between form and formlessness is an essential Buddhist dilemma, as well as, in one way or another, a meaningful therapeutic challenge.

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Whatever The Problem, You're Basically Good

2009-01-05T15:19:00.001-07:00

This is a fundamental Buddhist tenet, as contrasted with, for example, a fundamental tenet of many (most?) forms of Christianity, which declares that we are, due to "original sin", basically bad, or sinful, or in some way damaged and in need of Divine redemption. The first view allows us to belive that we can make mistakes but that we are essentially worthy. The second view allows us to believe that we can try to do good things but that we are essentially unworthy.

I'm not a theologian, so I won't spend time trying to debate or detail the subtleties of either view. As a psychotherapist though, I see the psychological, emotional and spiritual injury and damage that the latter belief system creates for oh so many people. Whatever your religion may be, or if you have no formal religion, which system of beliefs would you prefer? What if it's actually true that we are, us humans, fundamentally good, even when we behave despicably? What if our despicable behaviors are the result of a deep seated ignorance, and not of an essential evilness? I'm also not interested in debating the question of whether or not "evil" exists. Suffice to say that "evil" behavior certainly seems to exist.

The point I'd like to make, from a therapeutic point of view, is that healing options and possibilities are considerably more accessible from the first position than from the second. If I can somehow come to believe, not simply because I want to, but from direct experience, that I am, and you are, and we all are basically whole and healthy and good, then I can take better care of myself, I can allow myself to be gentler and more compassionate with myself (and with you), and I can learn to forgive myself for the mistakes I've made and for the injuries I've caused. All of these traits contribute essentially to mental, emotional, spiritual and psychological health.

I can see myself, and you, as a fallible but good human being, and I can cultivate a level of acceptance that breeds wellbeing and happiness. Seems like a no-brainer when you think about it, yet it is remarkably difficult, often, for people to do. Old beliefs, and ways of relating, do indeed die hard. This is just one reason that it is very useful to have help making healthy changes.

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An Opportunity For 2009

2009-01-01T10:22:00.002-07:00

First, let me wish everyone a healthy, happy, blessed and meaningful new year.

We face enormous challenges in these times, personally, relationally, culturally, as citizens of the world. There is no need to list what these are. Almost everyone now is aware. There are of course, as there always are, a few people who somehow manage to keep their heads comfortably buried in the sand. Insane Nero's, fiddling obliviously as Rome burns?

Our president elect tells us candidly, and his views are backed up by the "experts", that things will get worse - economically - before they get better, and that there are no quick or easy fixes on the horizon. "Sacrifice" is now a national theme. "Vision" is another one. We have to think in terms of sustainability regarding energy, the environment and the ecology; we must re-establish America's severely compromised moral stature in the world, by removing support for torture and other heinous behaviors, for example; we must work toward basic health care, employment, affordable college education and decent housing for all; we must be willing, whenever and wherever possible, to communicate respectfully and intelligently with our adversaries.

These agendas will be coupled with, and served by, corporate accountability and political transparency. We have seen how a lack of these qualities has created disaster, at home and abroad; disaster which has touched everyone, or which will, soon enough.

In my work as a therapist, I find the parallels between personal/relational concerns and the issues that play out on the grand scale of international and domestic politics, to be striking. I'd go so far as to say that unresolved personal issues are, to a large extent, responsible for the travesties we witness repeatedly on the world stage. How can we expect skillful, collaborative, respectful relations between countries, for example, when we can't even communicate well with our partner? We can see our personal struggles as a microcosm of the very same struggles that we see occurring politically around the globe.

I invite you to use 2009 as an opportunity to do your personal work. If you are among those who hope for a better world, you will be able to make a much more significant contribution to that world by addressing your own areas of wounding and conflict. As they say, peace begins with me.

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Meditation, Therapy And Control

2008-12-31T16:08:00.002-07:00

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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How Long Will This Take?

2008-12-18T08:13:00.001-07:00

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

2008-12-11T17:52:00.001-07:00

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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Getting Involved With Teen Age Boys And Anger

2008-12-08T16:36:00.006-07:00

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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Addiction And A Healthy Life

2008-12-07T10:30:00.002-07:00

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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A Little On Forgiveness

2008-12-01T19:01:00.000-07:00

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.

Taking Small Steps

2008-11-29T13:53:00.000-07:00

Sometimes the smallest of steps in a particular direction can begin, or further, movement toward a desirable outcome. Example: a client has for decades been struggling with feelings of shame, embarrassment, anger, fear, and self doubt, based on early traumatic experiences with his parents. His primary coping strategy through all of this time has been humor, or attempted minimization of the impact of these experiences. He says that he's "aware" of his real feelings, but hasn't been able to, or doesn't know how, to do his life differently. He continues, for the most part, to be sufficiently paralyzed by his feelings that his life - including his primary relationship - remains largely suffocating and unhappy, despite his "insights".

What do you think is a primary therapeutic theme here? What is this man not doing that needs to be done? What might you be doing similarly in your own life?

In spite of having some awareness of his real feelings, he continues to use very old "survival" strategies decades after the events in question. These strategies have in fact done their job - they enabled him to survive virtually impossible circumstances. Their job was done, though, decades ago, and their continued use serves to keep him trapped in a loop of feelings and behaviors that were no longer useful, or needed, 30 years ago. If he continues to use these same strategies, he'll continue to get the same results. Something has to change.

I ask him to find a way, or more than one way, to somehow give three dimensional form to his real feelings. I ask him to find ways to begin to honor and to respect not only his real feelings, but the real experiences he lived through. In effect, I ask him to begin to work with what is really going on for him, rather than to continue to "deflect" (his word) from this with his humor and minimization. Not until he can respect and accept his actual experience can he respect and accept himself. "How do I do this?" he asks.

Sometimes the smallest of steps in a particular direction can begin, or further, movement toward a desirable outcome. Begin right where you are. Pay attention to what you're actually feeling, be it shame, anger, grief, confusion, or anything else, and do something to acknowledge and honor that feeling. Draw it. Sing it. Write it. Speak it. Praise it. Thank it. Don't, of course, act it out in destructive ways. Whatever will allow you to begin to accept it rather than run from it. There's no one way. Each of us is capable of inventing ways that will work for us. And, importantly, have the right support for your taking these steps, even if they seem small.

Gratitude And Mental Health

2008-11-28T09:03:00.000-07:00

Thanksgiving is my personal favorite holiday. This has nothing to do with what one friend of color called "the Pilgrim's Pillage" here in north America. It has everything to do with gratitude, feeling and giving thanks, appreciating the smallest as well as the largest of blessings in our lives, and coming together with those we care about to mark this occasion.

In the 12-Step model of recovery and wellbeing, the "attitude of gratitude" is promoted and lauded as a necessity for real health. There's other evidence from spirituality and mental health that this is true. Even in difficult circumstances, if you can remember and put some focus on whatever it might be that you have to be grateful for in your life, and certainly if you can actively cultivate a remembrance of and a practice of acknowledging the people, circumstances and things that you have to be grateful for, this goes a long way toward building and sustaining happiness and health.

Sometimes it's important to see the wisdom of being grateful even for difficulties. The Dalai Lama is well known for having said that his enemies are his greatest teachers, and the people in his life that he is most grateful for. Why would this be so? Because, he says, they provide him with the best opportunities to cultivate and practice patience, non-violence, compassion, and loving kindness. And it is these qualities that, from the Buddhhist view, lead most directly to happiness.

We can say that these qualities are clearly also important for mental health. And all of them are linked to gratitude. In this time of thanksgiving, let's try to remember the gifts in our lives, and make it a day to day practice to humbly give thanks for the true blessings that are ours.