Called up to the Big Leagues

Good news. 51 weeks and 19 blogs after Being in Therapy started I got a lucky call from the Bigs - as far as the psychology mass-market goes. I submitted a pitch to Psychology Today to write this blog for their site, and their editor gave me the green light last week. So, I'm packing my bags at Blogger and pitching my tent at PT. With any luck, I'll use the opportunity to write consistently, get my book proposal together and move on toward publication in due time.

This blog played a big role. As part of my proposal, I sent a link to BIT and based on these writings they invited me into the fold. I'm grateful for this space, the readers and the comments (the ones that weren't solicitations). It's ironic that the week I decided to add consistency and structure to this blog, I was invited to PT. Ironic? Providential? The power of positive thinking? I don't have a clue. I'm just happy it happened.

So come on over and take a look. I have every intention of continuing my quest of empowering clients to get the most out of therapy. Just more frequently, to a larger audience.

Thanks for everything. Come pay me a visit.

Sincerely,

The Insighter

New Project

I'm taking on a project. I'd like to write a book helping clients get the most out of therapy. It will cover the same areas I've written about in this blog, and much more.

Understanding my own needs to stay motivated and make this a managable project, I'm going to attempt to write the draft here, in 52 (or so) weekly installments. Below I have a list of proposed topics; areas I've found important for a healthy, productive course of therapy. I plan to tackle one each week.

If there are any readers out there, please take a look at the list and let me know if there's anything you'd add or subtract. I'd appreciate it! Then, starting next week, I get rolling on this book.

Here's my proposed outline -

Intro: Keys to being in therapy

Preparation
Authenticity
Relationship
Risk

52 Chapters

Before Getting Started
Beginnings
Rules
Roles
Attitude
Resistance
Transference
Money
Symptoms
Resources
Liabilities
Core Issues
Family of Origin
Mom
Dad
Siblings
Friends
Lovers
Family of Choice
Self
Role Models
Heroes
Intimacy
Solitude
Creativity
Adaptability
Ritual
Habit
Organization
Affiliation
Communication
Authority
Motivation
Worst Day
Best Day
Regrets
Accomplishments
Body
Mind
Spirit
Soul
Emotions
Sad
Mad
Glad
Afraid
Love
Sex
Daydreams
Fantasies
Dreams
Endings

Therapist-Accomplice?

First, take a look at this article.

Then, if you're the brainy type, take a crack at this book.

I love it. From a human interest blog in Self Magazine to hardcore psychiatric discourse, the message is the same: human beings need to feel their emotions.

Of course, we don't want to. We use distractions and defenses and addictions to stay away from feeling the pain. And what happens if we don't let ourselves feel the pain? More problems - physical, relational, emotional, even occupational can result. Scroll down a few blogs - I wrote my thoughts on the importance of emotional release a few months ago.

But here's what really strikes me about the issues mentioned in the article and book: if the crime is the avoidance of emotion, the accomplice is my very own mental health profession. Psychiatrists, psychologists and other therapists who encounter significant emotion in their patients and jump to medicate the problem. As if emotion is the problem.

In the case of true depression, medication is a valuable tool to help regulate neurotransmitters, elevate mood and help the afflicted become more receptive to psychotherapy. In the case of "normal" grief, stress, sadness, anger, anxiety, excess energy, low energy, self-esteem issues, relationship issues, life changes, etc., medication serves only to mask, inhibit or postpone a natural emotional process.

It makes me wonder why this is. Are the drug companies so powerful and influential that mental health professionals have been brainwashed into prescribing an antidote to every uncomfortable feeling? Does society preach a sermon of "feel no pain" as a desirable and achievable goal? Or are my fellow therapists uncomfortable sitting with emotion, so they medicate it to make their job less stressful? Or is it something else?

Human Development

Here's a little something I found and thought I'd spread around:

AUTOBIOGRAPHY IN FIVE SHORT CHAPTERS
by Portia Nelson

I
I walk down the street. There is a deep hole in the sidewalk I fall in. I am lost ... I am helpless. It isn't my fault. It takes me forever to find a way out.

II
I walk down the same street. There is a deep hole in the sidewalk. I pretend I don't see it. I fall in again. I can't believe I am in the same place but, it isn't my fault. It still takes a long time to get out.

III
I walk down the same street. There is a deep hole in the sidewalk. I see it is there. I still fall in ... it's a habit. my eyes are open I know where I am. It is my fault. I get out immediately.

IV
I walk down the same street. There is a deep hole in the sidewalk. I walk around it.

V
I walk down another street.

Say the Odd Thought

They say some things are better left unsaid. If you're in church, court or a board meeting, this is probably true. But not in the therapy session. It's all fair game here, no matter how odd it may seem.

This is one of the best ways therapy is different from other types of relationships. Censoring your words is not necessary - in fact, I'd recommend you don't.

Sometimes these odd thoughts give us great information. You're talking about a co-worker and suddenly your sister's face pops into your head. Whenever you think of your hometown you get a lump in your throat. You just had a fantasy about yelling at your therapist. Whenever someone mentions the ocean chills run down your spine. You've been zoned out for the past couple minutes and didn't hear a word the therapist said. In the rest of the world, these thoughts, feelings and impulses would be kept quiet. But in therapy, fair game.

These odd thoughts can help us understand deeper parts of you - parts of your self few people see. If I had to summarize the function of therapy to one single element, it would be deeper understanding of ones self. Not just the stuff on the surface, the deeper material too. Some odd thoughts have deep meaning, even deeper than you might be aware of. Kind of like dreams.

You've heard of the concept of the "Freudian Slip"? That's when the deeper thought sneaks out past our censors and into our speech. Like telling a love interest you like their sex, when you meant to say socks. This odd thought thing is similar, only you're discussing all the slips you thought about but managed not to say.

It's a little risky sharing these thoughts you normally keep to yourself. But soon you'll see how helpful it is. Give it a shot.

Intimacy Starts With "I"

A little something for couples (written to men, but applies to everyone):


The most vital, passionate, intimate relationships are experienced by two people who know who they are as individuals and who have a deep desire to share their self with their partner. Intimacy is not about being dependent on one another or completely independent. It involves true interdependence: two people coming together to support and love each other deeply while still maintaining their own identity.

Think back to the beginning of your relationship, when you first got serious. You couldn’t keep your hands off each other. It didn’t matter if you were in the car, in the movie theater, or in her parents’ living room. You were thinking about being with her, and she was thinking about being with you. School, work, friends, sleep—nothing else mattered.

Let’s explore the circumstances for a moment. You had your life, and she had hers. You had your own place; so did she. You had different friends. You had a deep, rich history that was brand new to her, and she had her own interesting past. You talked about all sorts of things, agreeing on some, disagreeing on others. You were different people with different lives, and that’s part of what made your courtship tantalizing. You were crazy about each other. Her stories fascinated you, and you were eager to tell her yours. The two of you looked forward to all the incredible things you were going to experience together, especially sex. You were free to be yourself, and she was mesmerizing.

As your relationship progressed toward marriage, the two of you drew closer to one another and you shared more and more of your lives together. You may have found that you were willing to spend less time with your own friends, and she was too. Instead of “I,” “me,” and “mine,” the language of the relationship changed to “we,” “us,” and “ours.” Because of your love and desire to make each other happy, you occasionally put your own needs and wants on hold to accommodate her. These personal sacrifices are some of the most loving acts we do for one another.


Over time, however, this accommodation can have its downside. Surrendering your own wants is not always best for the relationship. For example, it may not be a big deal for you to agree to spend your vacation with your mother-in-law this year, but spending every summer with her for the next forty years may cause some problems. As a couple, you face numerous situations that require each of you to state your honest opinion rather than to acquiesce. Issues such as where you’ll live and how many children you’ll have require both of you to express your opinions. When you develop a habit of accommodating rather than stating your feelings, resentments build and the passion can start to fade.

Accommodation and diminished passion are normal in marriage, and many couples accept these patterns as facts of life. But you want more than normal or average. Passion comes from taking the risk to be emotionally vulnerable in your relationship. Therefore I invite you to be open and honest with each other, to be who you really are, to rekindle the flames of your romance. When you hold back, you are cheating yourself of the joyful, passionate intimacy that keeps love alive and makes sparks fly in the bedroom. This active, alive, intimate, and honest connection is called a vital marriage and is possible only when a couple is willing to face their fears of vulnerability.

Transference

You were bitten by a dog as a kid, and dogs still frighten you. The lady working at the deli reminds you of your third grade teacher. The guy next to you on the plane looks like your college buddy Stan, so you start telling him the kind of obscene jokes Stan would love. But he's not amused.

This tendency to relate and equate past relationships with current ones is normal. In order to make sense of new information we look to a related template already on file and examine similarities and differences. For example, based on your experience with your wise, gentle and physically limited grandmother, you would tend to treat all elderly women in a manner similar to her initially. You might see one at the corner, and with arm extended and a big smile you offer to help her across the street, only to find she's neither physically limited nor gentle. Whoops.

Part of the work of therapy is exploring this very issue. We all transfer our templates from prior relationships onto new ones - and from the first phone call you begin transference with your therapist. The structure of therapy encourages it.

Therapists typically maintain a stance of objective neutrality. This means they usually don't share a whole lot of information about their personal lives or their privately held thoughts, feelings or judgments about the material you bring up. This varies from therapist to therapist, of course, and different psychological theories do this to a greater or lesser degree. But generally speaking, the therapist is a blank canvas. They do this because what you transfer onto them says something very important about you.

John (a fake client) has been in therapy three months and comes into his session looking agitated and suspicious. I ask him how he is and he answers with "oh, wouldn't you like to know?!" It turns out John was laid off from his job, and he's assuming I will be angry with him. He entered the session preparing himself for the lecture I would give him about his failure to accept responsibility. By further exploring this, we find that he experienced his dad as critical and unempathic, and assumed I would respond the same way. In fact, I felt sadness and compassion when I heard his news, and I shared this with him. By pointing out this inaccurate assumption, John was able to understand why he tends to withdraw whenever he gets bad news: he expects other people to criticize him like his father used to, even though this has rarely proven true. He transferred his father's response onto me.

It seems we start with a limited number of templates at our disposal, the most powerful ones coming from our early caregivers. We tend to assume most new people will respond in ways similar to these original templates, even when there is evidence to the contrary. Some of the most important work in therapy is examining these old molds to see how they've shaped our relationships and our development. Challenging, difficult growth comes when we try to develop new templates.

Not all dogs bite. Not every old woman wants our help. Not everyone responds like John's dad. Therapy and the therapeutic relationship is one of the best places to check our assumptions. We might be playing according to rules that no longer apply.