Monday, May 6, 2019

Anxiety help for some


I recently watched six TED Talk lectures on anxiety. As you probably know, there is an aura about TED Talks of deep personal usefulness, of real moment and of extreme sincerity and meaning. In the case of these presentations on anxiety, this is regrettable, as each one of them was more or less effete. The audience could not be helped, beyond hope’s first blush, by the ideas of these gentle wisdom messiahs.

Olivia Remes advised responding to anxiety by “feeling like you’re in control of your life,” and “overcoming something by doing it badly.” This “catapults you straight into action.” Two other recommendations were to “forgive yourself” and have “a purpose and meaning in life.” Jordan Raskopoulos has mitigated her chronic anxiety by indulging in “a lot of hobbies,” controlling her environment, and engaging in a therapy which “takes you out of yourself” so you can “analyze your own behavior.”

Angela Ceberano sees her “fears, worries and my anxiety as a good thing. I take on fear.” Steven Zanella conquered his anxiety when he became a father and realized he had never given himself the caring advice he would give his daughter, were she to ever become an anxious and panic-prone person. “What if I showed myself the same love and support that I felt for my daughter? I had always approached anxiety with anger and negativity. I needed to let go of that anger. I retrained that voice in my brain to speak to me in the way that I imagined it would speak to her – with patience, love and kindness.” Colin Bien found “the key”: to “acknowledge and accept the attacks. Then you can change your reaction to an attack” which can “shorten” and make it “less intense.” He also improved his diet, substituting fruit and yogurt for toast and croissants. Mel Schwartz, a psychotherapist, found that “anxiety is due to our relationship with our thoughts.” We are, he said, “trying to ward off uncertainty. When our thoughts are constantly seeking certainty, wanting to know the future in advance,” we are made anxious. His solution was for us to embrace the “uncertainty” of the quantum universe. “Invite what we fear in (and) and the fear starts to dissipate.”

I have not been terribly successful helping against a person’s entrenched anxiety when that anxiety has come out of a fearful-dependent child-parent relationship. Much anxiety is created in that way; see my earlier post – https://pessimisticshrink.blogspot.com/2013/11/normal-0-false-false-false-en-us-x-none_22.html.* I have treated quite a few adults who cannot go to that formative pain to pour it out because they remain the frightened child. They can’t bring themselves to question the grafting of their heart to their cold, solipsistic mother’s or father’s.

Here I want to present an answer that worked for one highly anxious woman – but not one of those regressive souls. She could not travel by plane or be a passenger in any vehicle. From the session note:

“Possible historical sources of client’s anxiety were set aside owing to her insistence that she is ‘very independent and content.’ I offered her a ‘technique’ that I have used with success. Happy and secure as she is at her ‘base,’ she should be able to ‘invoke a real sense of serenity from your history.’ This could be called ‘uncognitive therapy,’ as she would be asked not to create bright or rational thoughts or reframes about herself, but to find true feelings embedded in the best parts of herself.”
This deserves a bit of clarification. The idea, which I had theretofore proven in myself, is that while the anxious feeling can bend us to tunnel-vision thinking, there exists for many people an immanent, if not subterranean, sense of positive life feeling that is richer and wider than that tunnel vision: laurels of personal expansiveness we might rest on. A positive self-feeling – a basic goodness and power – that may come from birth, a golden time in childhood or simply one’s nature, it will be soothing, even smiling, like a loving mother who, in enveloping us, grows our heart “with gladness.” We simply have to remember it, find it where it’s been sleeping. When I have summoned it, anxiety has evaporated, as a worried child is instantly aright when his parents have returned home.

Unfortunately, many of our clients do not have this sense. They were undermined too early, and developed a personality disorder-type ego syntonicity about their fears:

“This session’s approach was to focus on the constant anxiety-regenerating factor of client’s nearly infantile attachment to her ‘crazy’ mother. This connection is, we understood, a source of what might be called ‘toxic comfort’ to her. I related an anecdote in an Alice Miller book: A little girl ran away from a kindly old lady who showed her some affection, to return to the cold comfort of her mother’s neglect. Client and I, from this perspective, discussed an idea that she herself has entertained in the past: moving away, possibly far away, and setting up adult-style boundaries with her mother. A bit further afield, I likened her panic episodes to the ‘grim, monotonous play’ (L. Terr) of a trauma victim, where – as she described her self-induced fears – she appears to ‘need to panic.’”
I know that many of our clients never healed from fear in childhood. Presenter Zanella described a moment when he had been required to make an impossible choice. His parents were fighting, and his mother had locked her husband out of the house. Reaching out to him, father ordered: “Open the door and let me in.” His mother told him not to. He froze, unable to know what to do. How difficult is it to grasp that he has remained frozen even now, his voice breaking during a TED Talk, in that anxious dilemma? How easy to see that all the cognitive legerdemain of all the worriers and lecturers in the world couldn’t move that child to a safe place?

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Friday, May 3, 2019

After you've seen abreaction, everything else is pleasant


Several blog posts here* describe or illustrate deep-feeling purging: the real self’s buried truth explosively emerging from hiding. On the way up and out of the mouth, eyes, chest and stomach, it chemical-washes the brain and gives the person back his or her original reality. I just wanted to point out here that while this may seem, on paper, unique, an impactful but discrete moment, when you see it before you, you realize this is the essence, the gold standard of therapy. You realize the person is supposed to feel all her set-aside history, is supposed to stop running from herself (the definition of the adult), is supposed to recapture her imprisoned and forgotten identity. This is what happened when a young lesbian woman, realizing that she “stopped being myself” prior to age ten under repeated humiliations, felt and was embraced by her buried-alive gay, true life, and screamed and cried, and found then that after so many years she had shaken herself awake.

Though I facilitate these moments, they are so unpredictable** that I only sit in mild anticipation during sessions, wondering when or if. Of course, many other things go on. They can be meaningful in pleasantly moving ways. But at the deepest level they are babysitting. Or rather, adult child-sitting.

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** Setting aside orthodox Primal Therapy, where this process is the daily bread.

Thursday, May 2, 2019

Psychotherapy without the bushy tail


Picture yourself as the ocean. There are many apt likenesses. A known object, an identity from a distance: "person," "ocean," but up close, heterogeneous, and inside, infinite. Our eyes are the whitecaps and waves frolicking or calm, warmed by the sun or cold, while our depth remains dark and still. In that depth are sharks and treasures, countless death and countless life, driven "sea change" movement yet with undertows, riptides that contradict.

History is almost meaningless: The present and the past are one. Even beneath the sea floor (our birth), the molten forces (our first nine months) erupt through. Those lava extrusions influence those whitecaps.

I often prefer, in therapy, a tree analogy. Picture a forty- or a hundred-year-old oak tree. Use your x-ray vision and see the roots: They are "the past." Yet they continue to feed every leaf and branch on the tree.

In today's quick-fix TED Talk culture, we believe we are the waves and the branches and leaves. We feel something very special about our perceptions, our head. Like our confidence in questionable beliefs such as free will and the necessity of a beginning to the universe, our mind feels, ipso facto, wise, commanding, controlling, creating. We create happiness by thinking right. We grab the reins of our childhood problems by understanding them. We find in our anxiety that we are thinking, thinking, thinking, racing thoughts with no finish line.

But psyche and soma are always being fed by the roots, by the lava. We are the elaborate accretion upon them. Picture floating upright in your ocean. You gaze on the fantastic panorama, the sea birds circling in the sky. But with sharks and invisible unknowns below your feet, can you be free of depression or anxiety?

Psychotherapy, originally psychoanalysis, began over a hundred years ago in pseudo-scientific adolescent arrogance, the pontifical dogma of Freud. In the intervening decades, one might have thought maturity would be reached. But like many troubled adults, therapy continues to embrace self-soothing certainties. It acts, in its "Cognitive" methodologies, as though we live in our head, not in our body and our history. It believes that the many du jour techniques one learns in workshops and webinars can change the homeostatic, oceanic self. It assumes that my empathy, your action, my confrontation, your insight will alter your inner terrain to make you a different (or better) person.

The psychotherapy that has the best chance of helping a person must embrace the holistic self: mind, body and time through three dimensions: core injury, core vitality, and emotionalized attitude (I borrow this term from Virginia Axline's classic Play Therapy). Injury: We are impaired because we've been hurt at our root, our most formative, defenseless era. Therapy that doesn't see, stay with and work through childhood injury is like a surgeon who applies a Band-Aid instead of a scalpel. Vitality: We own -- most of us do -- the birthright of life-love and curiosity. It may have been in hibernation from our first moments, but the indestructible kernel is there. Attitude: The complex chemistry of strength to weakness, hate to love that accrues through our life and informs our philosophy and our possibility. In therapy, strong convictions, reasoning and positive thinking won't be sufficient: Those frothy whitecaps will not move the sharks. Catharsis and abreaction may leave us doubled over, unable to get up. The core of health will lie dormant until we've reached the splinters in our child heart. A therapist, finding or hoping for that core, will help you guide yourself to those splinters. Then, your desire and sense of life will decide if we pull them out or only respect and keep them company.

Effective psychotherapy must teach you to scuba dive, and hope you'll trust the deep.