Being "Bad"

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

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

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

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

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

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

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.

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