Saturday, November 30, 2013

Casual Saturday #2


On birthday no. 62, I feel pressed to wonder why my sister thinks there is a connection between us that goes either way.  Always less troubled than I (this is my generous assumption), and with what always seemed a gentle-superior air but which I came to see as her unconscious fusion of concern (a purposely ambiguous term), lack of affection, and anxiety (and some solipsism, where it is terribly difficult for one beleaguered sibling to “empty out” and have empathy for the other), she has long fooled herself into thinking something exists.  While it may seem preposterous of me to suggest that someone does not feel affection who claims she does, I know very deeply that through all our formative years and well beyond, I was absolutely unlikable.  My own fusion of alienation, seamless neurosis and developmental abort even in the midst of the latency years, created a revolving gun-mounted turret of toxicity that would have shot away any touch, blink, laugh or word of affection, and created distaste in the other party.  And anyway, I would remember if there had been even a stroke of fondness from any of the other three in the house.

And so, I’ll say this is as good a time as any to state a terrible but obvious truth: There was never a family when families become, so there can never be one now.  Despite the fact that we may want it, it can’t happen.  Strangers may quickly like one another, eventually love.  Ruiners cannot.

Wednesday, November 27, 2013

Inner child deluxe


It may help those therapists who are dedicated to roots, causes and relative resolution of problems to give new respect to the idea of the inner child – that personification of our ungrown identity – but to see it in a different way. It is to conceive that persons with neurotic or psychotic dysfunction do not “have” an inner child – they are their inner child. This conceptualization goes even further than the Primal understanding that personality is a constellation of defenses, and asks you to consider that the adult life in its countless aspects is often the necessary fallback adopted to carry our crippled child into the future.

To see essentially a deluded child (who believes, that is, that he or she is actually grown up) in the chair doesn’t mean you must hold her or sing her lullabies or accept all his bad behaviors. Adultness is like free will: We must act as though it is genuine despite all the logical evidence against it (https://www.youtube.com/watch?v=pCofmZlC72g), and accept that it contains imperatives of social behavior. What's essential, though, is that you see the ultimate child beneath everything and therefore have compassion for irrationality and immaturity, and understanding that his confusion is not ignorant or willful. The depressed and repressed little girl cannot know.

You will see that the haughty narcissistic police officer is a bitter child whose father kicked him around. That the philosophical young phobe fell upward into his mind early on to escape unsustainable pain. That the psychotic woman has, as Modrow describe it, “undergone terrifying, heartbreaking, and damaging experiences, usually over a long period of time, and as a consequence [is] emotionally disturbed – often to the point of incapacitation.”* I have found in myself an extra quality of compassion, which I could call universal, that sees our adultness as a fix we are in, as translucent discolored lenses through which we try to see a bright and crystal clear world.

This perspective has helped me work with men who present with domestic violence or other rage reactions. They are boiling inside as there has never been any justice in their boyhood. Get slapped often and be ordered to be mature. We need to see – probably for the first time in the man’s life – that boy, to reach a hand out to him. I see him whenever I get angry -- deeply and disintegratively angry – at a computer screen that refuses to refresh as quickly as I require.

I, in fact, don’t understand how therapists work with the adult as the primary field. Beyond some weeks or months of support, education, reasoning and persuading –

“When years of interpretation have failed to generate change, we may begin to make direct appeals to the will: ‘Effort, too, is needed. You have to try, you know. There’s a time for thinking and analyzing but there’s also a time for action.’ And when direct exhortation fails, the therapist is reduced [. . .] to employing any known means by which one person can influence another. Thus, I may advise, argue, badger, cajole, goad, implore, or simply endure, hoping that the patient’s neurotic worldview will crumble away from sheer fatigue.” (Irvin Yalom, Love’s Executioner, pp. xvii & xviii.)
– what is there left that you do? But more: To look at the grown man or woman and see an entity simple – changeable by a new or “rational” idea; or shallow – bendable by the brute force of necessity, as in anger management; or appeasable by soothing – DBT “mindfulness,” EMDR “installation,” or imagery, is to limit yourself to such a foreshortened horizon! A newspaper instead of a history book! The inner child – the real self – is the field as deep as time, and capable of extending intimacy into the past, where we felt the endless horizon.

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* John Modrow, How To Become a Schizophrenic, pg. 9.

Sunday, November 24, 2013

Casual Saturday #1


A client, today, asked me how to become stronger than her parent, how to not melt to her powerful mother.  This is a bright twenty-something with a fifty-something whose power consists of having been sick long enough to infect the children by her solipsistic dark energy field.  She asks the question of maturity, or maybe the question of happiness.  Maturity means to be separate from the other.  A happy view of life means that she will not see her mother as a drowning dying person but as someone who, allowed to fall on her face once the daughter steps away, can feel good enough to get up, heal and walk on.

I sometimes talk of people having from birth a “positive core.”  Though not a scientific idea, it makes sense if you accept that most babies are born much more positive than negative.  That is, they are curious, seek happiness and love and help from pain.  Even most of those born in trauma who recoil from touch still had the blueprint of positive potential.  (My “theory” says that psychopaths are different – their heart burned out from the beginning.)  If my graduate student has this core of positivity underneath her weakened and diminished self, then if she grieves the pain of so much loss that surrounds it, the core’s quiet light will shine through.  Sometimes I ask a client to find her core while still troubled, as a lighthouse in her dark ocean.

As to maturity, we talked about natural self-esteem, logical self-esteem and fake self-esteem (the first two borrowed from “natural” and “logical consequences”).  Natural self-esteem is what grows in the young person organically in a loving respectful and basically content atmosphere.  You simply feel OK to be yourself.  I remember, early 1960’s, three young-teen second cousins sitting around the den with their asbestos litigation attorney father, Harry Jr., all farting up a storm and resplendently free of shame.  That was self-esteem!  Logical self-esteem would be to know and cherish that you are worth what other people are worth; to take pride in your surviving your childhood; to respect the quality of your competence – all this despite bad self-feeling or existential emptiness.  Fake self-esteem – which we may mix with the logical – would be narcissism.  I can’t, though, tell the young woman how to acquire this.

Two things we’ve settled on: It will be best for her to depart from home and start her life elsewhere; but, that it won’t be better for her: still the same person, still afraid of people in power, maybe afraid of everyone (we haven’t investigated that possibility).  Yet I picture her going away, growing, then coming home but being too big to fit into her parents’ house anymore.  “So sad when that happens!” Mrs. Doubtfire ironically said.

I’m sure there are many things better than psychotherapy to metamorphose one’s character in a sea change way.  I’ve wondered about the Outward Bound program that sends kids and others into nature, into beauty, to struggle and bond.  Hitting the end of the road may lead to character change, as it did for me.  Still, I put my money on deep grieving and the irreducible kernel of life force, the core of positivity that can kick fear’s ass, heal the sick and sing a love poem all together.  It is quite ambidextrous.



Friday, November 22, 2013

"Anxious Personality Disorder"


I’m thinking of nine former clients whose presenting problem was anxiety, whose fear – the original source of anxiety – had good solid reasons in birth or childhood, and who have remained fearfully developmentally immature in various ways.  A*, who could only make fleeting eye contact, had always been afraid of people.  By age thirty-one he’d stumbled his way through an uninspired college major and now followed the path of least resistance by getting cashier jobs.  He lived with an uncle who threatened on whim to cast him out.  B, seventeen years old and raised by an “old school” martinet father and an “always rushed” mother, works a roster of cleanliness obsessions and has the life sophistication of a fifth grader.  He’s never dated, assumes “everyone” finds homework “boring” and “flat-out” refuses to do it.  C, another obsessive-compulsive teen, has convinced himself that school is worth anything only to the extent it is “fun” and social; despite school has a near-reversed sleep cycle; and is faux-blithe and lite-fatalistic about his future.  D, mid-twenties and shaking like a leaf, lives with an unsympathetic relative, always feels he must give elaborate explanations of his behaviors, always feels he did something wrong, remains in thrall to his father who controls his money, and fears being abandoned by him if he were to get in trouble.  Like a surprising number of young lost souls, he is interested in pursuing a career in culinary arts.

E, pressed by her father never to bring attention to herself, has long been unable to stand up to any authority, is afraid to tap on the door of her uncommunicative husband, and by home-schooling her three daughters is cultivating hot-house flowers who don’t date, speak no unkind words and make no waves.  F, sexually abused by a neighbor child and ignored by his parents, now in middle age plays with nostalgic toys, fears people laughing at him, has a contemptuous son who shoplifts and steals from the family, and suffers floor-shaking psychomotor agitation.  G and H, young men, are in abject fear of their elderly fathers, have given up seeking employment owing to extreme psychosomatic reactions, live in the frail ivory tower of their thinking and worrying.  I, age sixty, suffers chronic anxiety, is scared to drive beyond her neighborhood, complains “I hate having to be strong for myself,” and nurses a reversal-of-parenting self-pitying rage about her adult son’s failure to love her.  “Why can’t he be loving?” she asks.  The notion that she, the parent, might be the magnanimous one is shot down.

By its Axis I status, anxiety is tacitly conceived as a “pure” problem – as if it struck an otherwise hale or lucid individual from the outside by traumatic event or environment or bad chemical – and not as if it were character.  But the clients described here show not only a disease incursion but a personality, as each one’s anxious dependency and immaturity are ego-syntonic, a term that means “in harmony with one’s self-view.”  Just as one would be hard pressed to find a Narcissist upset that he feels so good about himself, or a sociopath who wishes he had a conscience, so these frightened people do not hate their passive, or dependent, or non-mature natures.  Hatred might be power that laughs a cruel father into his corner, or a clean loud laugh that says I’m moving out and let the damned chips fall where they may.  Instead of hate, they timidly dislike, or even “love” and roll their eyes.

Fear has through the developmental stages kept them immature, and immaturity then keeps them fearful.  What do we make, then, of The Anxiety & Phobia Workbook and all the techniques that one applies, like lessons or lotion, to someone whose fear is an integral feature of their regressive development?  Are breathing exercises and “positive counterstatements” – “I am confident and calm about boarding the plane”; “I’m lovable and capable” – going to help a scared-to-death lonely child?

Later I’ll write about deep help for anxiety.  This will include the question: Can we “heal” immaturity, the loss of critical times and growth within us?


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* Names are eliminated and identifying facts are discombobulated, yet I can picture each person very clearly.

Tuesday, November 19, 2013

Silence


Therapists know from their training that silence can be a powerful factor in the session.  Somewhere it was written that heavy moments of silence can, under pressure, draw from the client profound chunks of self insight, as the first words brought from the dark to light.  It is true.  Often I value the silence itself, knowing that for many people quieting the ever-talking head can bring someone to a new, deeper universe.  Anything found in that forgotten place must be valuable.

Other silences, though, have other meanings, may be less helpful or not helpful.  I’ve sometimes indulged – that is, let the client indulge – in these silences.

A twenty-two-year-old man, naïve and even somewhat cardboard in character, sat in doe-eyed silence for forty minutes, and again in the following session.  What kind of resistance was this?  There is, of course, fear to know oneself, fear to show oneself, defiance, and what Levenkron* and others call the client’s “emptiness.”  During a parents-only session, I learned that he has lied to them about his academic goals in college, lied about a relationship, lied about expenses he'd incurred.  Already known, through earlier meetings, was that as a youngster he’d been complaisantly compliant to a “busybody” mother.  What was this silence?  I believe it was the emptiness of the undeveloped emotional soul plus his way of standing up to me: Like lying to his parents, age twenty-two going on twelve, he could lie to me by omission – complete omission.

More recently I allowed a seventeen-year-old boy to stonewall for most of the hour.  He not only performed complete silence with no eye contact, but made sure not to move a muscle, not a finger drumming or a neck straining, for fifty minutes.  (The final ten minutes, I talked to him about his silence, about the loneliness possible to one who remains silent before friends and help, and cited Yalom’s group therapy intervention: Imagine this was your final meeting, you’ve said goodbye to the other members and are heading out the door for the last time.  What would you regret that you never said?)

This client had already had several sessions that, helpful in the face of his floaty numbness, I had filled with compassionate education and a few questions.  He was quite troubled sexually, reactively and proactively, had been lifelong overpowered by a revenge-filled father, let down by a passive and fey mother.

What was silence doing with these boys?  I’m not sure I could even allow them to say it was painful or angering or a waste of time, or boring.  I think we all need silence.  It brings us closer to our real self.  We stop and sense what we’ve been walking past, eyes averted, our whole life.  We also quiet our psycho-agitated body.  Then, the tension that supplies all the tics, squirming, leg tremor, repositioning is now felt for what it is: the message of life’s frustrations, always importuning.  If this tension-frustration could be translated back to what it is, at once, we might hear the screams of a million losses; we’d feel the impossibility of it.  This would be a kind of psychosis: How did I survive this?

The question of allowing too-long silences (most are only a minute or two) raises again the matter of what healing means.  While something narcissistic and benevolent in the therapy room causes me to value, each time, all possible gradations of help – intent listening, a piece of music, ratifying the client’s suspicion that his wife should stop supporting her addicted son – I love the deep journey the best, the moments of truth and drastic feeling.  These must take place in a quiet room, even “quiet” of bright light.  Long quiet is the clocks being stopped, the running stopped, the treadmill through forty years stopped, everything stopped but who you are.  So let it be uncomfortable.


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* Steven Levenkron, Obsessive-Compulsive Disorders

Thursday, November 14, 2013

Psycho-religion, part two


I am happy with my wife, but I know that a part of her original allure was that she colluded with and did not challenge my defenses.  Here is the grim logic:

I grew up in the 1950’s to an emotionally detached mother and a solipsistic (see earlier post) father.  He would tell me, time to time, that “I feel good just knowing you’re somewhere in the house.”  His one concern was, “Are you warm enough?”  Add suspected perinatal trauma and the result was a childhood of repression, burial of all real feelings, an impossibility to communicate.  I remember being possessed of the certainty that to be unhappy was shameful, so I could never show unhappiness and never acknowledged it to myself.  In a cordial, fake and unwarm home, I remember being averse to the word “love” and any signs of affection between my friends’ parents or others.  Thirty-five years later, but only a few of them growth years, I see a woman in her cubicle at Child Protective Services who appears quite still and focused.  She looks up at me . . . without expression.  I am smitten.

So much of our motivation distills to this paradox: We seek to meet our childhood needs, but we must not find them.  Defended against pain, we will not and cannot find that hopelessness, that regression to an abortive start of life.  Instead, we see things that substitute and distract, like food or married love, approval or achievement or music.  We go to what supports our defense, as that jail has become our haven.  The unloved street kid thinks his emotional scar tissue is toughness and strength.  The boy who was never given the gifts of life but had to earn everything joins the Marines: “Earned.  Never Given” is their battle cry.  Defended against the loss of happy spontaneity in my boyhood, I was attracted to emotional reserve.  Girls with cold, unloving fathers may later crave the excitement of the bad boy but run from a nice man who threatens to touch their child’s heart.  And so many children who had to escape from terror into their analyzing, solving, spiritual and surviving head, gravitate to the cognitive psychotherapies.  Feeling would be imploding.

Our psychology bends the light of our intelligence to protect us from pain.  That is why “mental health” is defined in personal ways – it is to think right; it is to be spiritual; it is to be functional; it is to be happy; it is to be moral – while outside facts are more rarely bent.  The most neurotic or depressed scientist still knows that water is made of hydrogen and oxygen, salt of sodium and chlorine.  In this way psychotherapy and religion are similar, coming not from the world but to it from the pained heart.

Sunday, November 10, 2013

Psycho-religion, part one


Psychotherapy is a relativistic universe.  While I am not familiar with all schools and subtypes of therapy, I’ll chance a guess that each one’s creators and practitioners feel theirs is valid in theory and substantiated in practice.  And, in their heart of hearts, that the other ones can be and have been debunked by wiser minds.

The Pessimistic Shrink generally stands by a “primal,” holistic-historical approach that finds the roots of most psychobiological health and dysfunction in the impressionable template of the fetus-baby-infant-child.  “Feeling” as emotion and sensation is the sine qua non of this approach because it is one with the infrastructure of the body-mind, unlike thinking which comes with the neo-brain and is a late-comer and derivative.  (I’ve addressed this in earlier posts: A child “knows” by means of feeling that pain is pain, while the adult may “reason” pain as “deserved” or “for my own good,” and the self-mutilating adolescent may construe it, perversely but legitimately from her feeling-warped field, as a kind of nurturance.)

Regardless of my allegiance to it, primal “scream” therapy, at least in its orthodox form, has been derided and relegated to the fringe of the psychology pantheon.

Janov, its creator, has written a book disproving essentially every other kind of therapy: http://www.primaltherapy.com/GrandDelusions/GDcontents.htm.  I, myself, find cognitive therapy, the most respected methodology in this country, fundamentally invalid and useful only as a consolation prize.  Just recently I reviewed Jay Haley’s “leaving home” theory.  Haley, one of the legendary figures in family therapy, believed the psychotic young person fails to launch into the adult world in order to “unconsciously . . . stabilize a family in danger of falling apart should he or she actually leave. The object of therapy was to put the parents in charge of making tough rules that got the kid back on track as quickly as possible, and then deal with the fallout at home” (http://www.psychotherapynetworker.org/populartopics/leaders-in-the-field/173-the-accidental-therapist).  But libraries of research predating our psycho-pharmaceutical era implicate the parents – their “tough rules” and pathogenic ways and being “in charge” of their child’s psyche – in the formation of the psychosis.

New Age therapies (est, rebirthing, past life regression) rise and float off to mountain retreats.  Specialty approaches (neuro-linguistic programming, thought field therapy, holotropic breathwork) may be looked at respectfully, askance, and ignored by most practitioners.  Freudian psychoanalysis has been modernized, partly to avoid embarrassment.  Gestalt, hypnotherapy, Bioenergetics, existential psychotherapy, EMDR and the rest have champions and detractors, research and its discrediting, even success stories that are denied: disproven by different definitions of “success.”

It makes sense, therefore, to ask: Why is psychotherapy – which feeds off the sciences of psychology – like religion?  Why do we see different truths?  Why are all of us (except for one) delusional?

Thursday, November 7, 2013

"Negatives" marital questionnaire


The following is a questionnaire I devised for troubled couples; or more accurately, for each troubled individual in the couple.  My hope – possibly over-idealistic, or stupid but hopefully sound – was that it would grease the wheels of marital healing if each spouse recognized his or her own imperfections, prior to or outside of conflict.  Part-inspiration for the idea was Hendrix’s Imago Dialogue, which enables compassionate, healing communications by the factors of reflective listening (mirroring), validation and empathy.  A “sender” names, in an “I-statement,” a message, need or grievance that the receiver then attends to by means of these three qualities.  Though the process is excellent, and can open one’s eyes and heart to the hurting separate personhood of the other, it still “sends” a negative evaluation to the partner, who may feel too vulnerable to receive it well.  So it seemed to me it might be better if a person were to discover, in his own space and time, his own flaws, before being assailed with them by the partner.

I’m reproducing the questionnaire here to help others, but also to be helped: I’d value some feedback as to the possible usefulness, destructiveness or irrelevance of it.

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“Negative Questionnaire” for Couples
This is admittedly an unusual questionnaire, as it asks you to “accentuate the negative” about yourself.  Once we focus on the disappointments caused by our partner – their sarcasm; nonchalance about piles of dirty dishes; sense of entitlement; their assumption that getting angry means they’re right; failure to communicate clearly; failure to listen; doing sex without love or love without sex; terrible with money or too anal about money; stuck on stereotypical male/female roles or too “liberated”; immature interests or general immaturity; silence; narcissism; disproportionate time at video games or TV or with the kids; tendency to focus on my flaws; too attached to parents, alcohol, job; lacking empathy or interest in me; too independent – off on his own track; need I go on and on and on? – our own flaws immediately recede in importance to us.  Or we never see them in the first place.
There can be big positives in facing our negatives.  An obvious one is that we may want to change a flaw – to improve.  A less obvious one is that I see this marriage is – because of me! – not going to be perfect and so I must grow (up) to accept some limitations.  Sometimes we reach an interesting, if sobering, realization: We both have the same flaw, but his (her) version of it is a little worse.  Another way of seeing that is: We both have the same need (love, to be touched, sense of being a true partnership), but she (he) needs it a little less – and that can really hurt.
There are good and better ways of understanding our own deficits.  “Good” is to recognize the flaw as it exists in the present: I’m a dud of a handyman; I don’t plan vacations; I drink excessively; I’m not ambitious; I blow up “hysterically”; I need to know where she is all the time, and to control her.  The better way to understand is to see why we are like this, to see our childhood roots and the soil they grew in, the whole person we are whose past can never go away because it’s our substance and cause.  Look inside your present feelings and thoughts and behaviors.  You will, with some effort and “psychological courage,” see the underground route they have traveled to get here.  I control her because another abandonment after mother’s abandoning absence of love is impossible.  I will disintegrate.
Another factor involved is that the flaws we have are not simply habits, idiosyncrasies that we should accept as part of human “diversity,” war wounds to cherish or genetic structural weaknesses that we must accept.   They are the expressions of our childhood pain and injury or our defenses against the pain and injury.  And we shouldn’t love and nurture them any more than we should love the injuries we suffered.  We may, however, have compassion for ourselves as we heal and improve ourselves – and our part of the marriage. 
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These questions overlap and create some redundancy – no matter.  And don’t worry: They won’t all pertain to you.
In accord with the best of the human spirit – and with principles of good parenting – we should first acknowledge that spirit, the best we have.  So . . .
 1.            What good thoughts, feelings, qualities, acts, do I bring to my adult life, and to my partner?
2.            What is not the best about me?
3.            What about me probably (if I were to think about it more) causes my partner pain or frustration or loneliness?
4.            What do I do to get revenge for the past?  Things such as demanding “respect” from my children because no one ever respected me; angry attitude; refusal to bend and need to have things my way.
5.            What aspects of my child self – such as cumulative frustrations or humiliations – have caused me now to feel right about being an indignant or explosive “hair trigger” of felt injustice?
6.            Can I see that childhood depression manifests in my quiet or spiritless or withdrawn personality or failure to express wants now?
7.            Am I much better at taking than giving?
8.            Do I hold my partner and children to high standards of performance or perfection that really have nothing to do with love but with lovelessness in my childhood?
9.            Pampering in childhood is effective neglect, and also may contain a lack of love: A parent may be stuck in his/her own “caretaking” world, doing everything, and not seeing the individual child and her need to be her own self-sufficient person.  If pampered, do you now feel entitled to attention, to things, to “sit there”?
10.         Were you known by your parents as the actual, specific person you were, or through the tinted lens of their needs and expectations, their anger or fear?  Do you know your partner, your child as her actual self?  (If he fails in school, do you care primarily about the grade or about the why, the heart behind the behavior?)
11.         Frankly speaking, did deep abuse and neglect through much of your childhood and adolescence make it difficult to feel grown-up, or feel undesirable to be an adult?  If so, what are you fighting within yourself to be one?
12.         Look inside and see if you carry with you at all times an emotionalized attitude about self, life, people.  Like a racial prejudice that distrusts or hates all individuals of a group including the countless ones you will never know, a global ‘background’ attitude is a self-protective delusion.  Contempt, superiority, self-as-victim, distrust (paranoia), futility – such an attitude grows from childhood and can poison a relationship, while feeling so right.  Look inside.

Wednesday, November 6, 2013

Simple therapy



Some years ago I held a workshop for therapeutic foster parents titled The Bright and Dark Sides of the Wounded Healer. In it, I defined therapy as “the response the child needed when she was first hurt.” I hold to this definition, which contains several meanings. One is that the essence of healing is neither science nor art, but nature: the good relationship that takes away a child’s pain. Another meaning is that dysfunction grows from pain and injury and that these must be “felt through” rather than reasoned, tough-loved, bright-thought, spiritualed, drugged or behaved away. And another is that this definition doesn’t change across the lifetime.

Look at the powers that help a child recover. The mother’s care and deep listening, full patience, the buoyant “arrived” strength to hear and contain pain and not flinch, believing her child not spinning his story, and her power to strive for real justice, or at least emotional justice.

Why should healing be any different for an adult? Especially when so many have been waiting all these years – since childhood – for it?