A GoodTherapy.org News Update

href=http://well.blogs.nytimes.com/2009/03/13/the-12-most-annoying-habits-of-therapists/?hp”>The New York Times has put together a list of the top twelve annoyances endured by therapy clients, and in addition to harmless mistakes or one-time slip-ups, there are some upsetting trends.

A fairly common and sometimes unavoidable issue reported by clients is the problem of therapists showing up late. Whether by a few minutes or a few hours, the message seems to ring out that the client is not important or worthy of time or attention — not a nice message to send. Eating and yawning or even sleeping in front of clients also made it on the list; one reader reported that their therapist took the initiative to use their session time — around noon — to have their lunch. Being self-centered or focusing on the minute details of their own life is one therapist behavior that appeared anathema to client preference. Distractions including ringing phones, computer use, and in-office pets ranked high on the list of grievances as well. Making it hard for clients to make contact via phone or email was reported as a major problem, as was discussing the therapist’s personal racial, sexual, and religious preferences; music and lifestyle choices also made the list, though these seem to become an issue only when they are the focus of a session’s precious time.

Clock watching and excessive note taking seem like fairly obvious no-nos, and uncomfortable hugging or touching was noted as a problem. One reader mentioned that her therapist, seemingly very concerned with whether the patient cared for her, would frequently ask for an opinion and give small gifts to the client. A final item well worthy of its place on the list is flamboyant displays of wealth or of flesh — behavior not suited to the therapist’s office.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Portland Bureau - All Rights Reserved.

By Lois V. Nightingale, Ph.D.

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Often when we think of forgiveness we think of letting someone, “getting away” with something or, “getting off scott-free”. Forgiveness is not about ignoring the fact we were hurt. It is not about setting yourself up to get hurt again. Forgiveness is not reconciliation or changing your mind about what is best for you. Forgiveness is not even something we do to enhance the life of another. It is, in one sense, a very selfish act.

A wise man once said, “Resentment is a poison one takes hoping to harm another.”

If we really look at what the lack of forgiveness does to us, we notice the emotional internal pain we inflict on ourselves. Long-held resentment can lead to physical symptoms as well; muscle tension, migraines, high blood pressure, poor concentration, sleep and appetite disturbances, and a suppressed immune system, to name a few.

Another important reason to learn to forgive is as a model for children. Children do as we do, not as we say. If you can’t forgive for yourself and your own serenity, then forgiving as a life-lesson for your children may be the reason you need. When children see us do things that are extremely difficult, it makes an impression. Children then believe that they also are able to overcome difficult emotional situations and find the best possible solution for their own peace of mind. Most of the movies and games children are exposed to glorify retaliation and holding grudges. Your real-life modeling can have a great impact on their own ability to forgive and not carry insults and betrayals throughout life.
Forgiving is not endorsing what the offender did, or pretending that consequences aren’t deserved. But in forgiving we place the quality and serenity of our own life above what may be warranted for another. It is difficult to put down resentment. It is not in our nature to accept when things are not “fair”. Sometimes we fear we will be placing ourselves in vulnerability again if we forgive and try to forget. Read the rest of this entry

A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW

Imagine that a friend is having a heated verbal argument with his wife. You’re watching from the couch. He turns to you and asks for your input. You hesitate, and then say you really don’t want to be involved. It doesn’t seem to you that there’s any solution that would be acceptable to both people or that is otherwise possible. Friend and spouse then tell you they really want your input, so you think for a moment and suggest they look instead for alternative strategies to resolve the matter. The couple then comes up with a few different ways of resolving the issue. Ah, you think, that was a good idea. You throw in a few more possible strategies. They nod in agreement and proceed to use several of the approaches. Yes, you think, now we’re getting somewhere — but wait a minute, their voices are rising. They’re using all of their own strategies and yours too, but look angrier than ever!

What happened?

Well, according to researchers at Arizona State University (ASU) – and counter to what we might consider the common logic of using many strategies for conflict resolution — people in conflict may actually become angrier and more frustrated the more strategies they use. A new ASU study suggests that limiting strategies is less likely to result in escalating anger, when the conflict seems unresolvable, even though we may believe that to be unhelpful rigidity.

This shouldn’t be confused with the idea that we should limit our options for solutions. No one is advising that. It also doesn’t mean we shouldn’t try various strategies when it seems like a resolution is possible.

Instead, if there doesn’t seem to be a solution that would be acceptable to both parties engaged in an argument after they’ve used one or two strategies already, it might well be best to let the argument go. According to Danielle Roubinov, an ASU doctoral student in clinical psychology, “Although being flexible in how you respond to different situations may be beneficial, continuously trying different ways to work out the same situation may lead to greater anger, frustration, and an unhealthier biological response.” Read the rest of this entry

A GoodTherapy.org Featured Column written by Judith Barr, MA, LMHC

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This Must Be Healed!… Recently, I learned from a friend, that his company was taken over from the inside. This was political. It may have happened in a company, but it could have happened in an educational institution, a religious institution, or in a government. My friend shared with me that his company was taken over from the inside, that people who had been in the company, partners in the company even, for 30 years, were let go . . . all that mattered was money. That the values of the company collapsed . . . all that mattered was money. That the humanitarian efforts the company had so embraced previously were tossed aside . . . all that mattered was money. That the people who had devoted themselves to the company were thrown out . . . all that mattered was money. That the people who remained only mattered in relation to how much money they could bring in . . . all that mattered was money.

At the root, people’s relationships with money and feelings about money preceded the current market turmoil by a long, long time. Those feelings – whether they appear as anxiety, fear, anger, greed, power, helplessness – will be here long after the chaos of our economy right now is calmed down. In fact, the feelings at the root of our relationships with money exist all the time. They are not going to go away, certainly not as a result of things we do on the practical level in the outer world – not by selling our assets, getting another job, destroying the company to which people have been committed for decades, making nothing matter but money! Read the rest of this entry

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Research by psychiatrists at Columbia College of Physicians and Surgeons suggests a link between thinning of the cerebral cortex and a family history of depression. Whether the physical difference in the brain is genetic, or is rather a result of environmental factors associated with familial depression, is not yet clear.

What is clear is that brain imaging is providing more evidence that depression affects the brain, is affected and the brain, or both; individuals aged 6 – 54 years who were identified as “high-risk” for depression had an average of 28% less thickness in the right cerebral hemisphere than people identified as low-risk in this study.

Brain imaging may also help screen for individuals at risk of depression, and help understand their needs; the right cortex is associated with reasoning, planning, mood, and reading social and emotional cues – all areas that would be affected by and contribute to a depression.

The study, to be published in Proceedings of the National Academy of Sciences, was primarily the work of by Dr. Myrna Weissman and Dr. Bradley S. Peterson. “You’re seeing it two generations later, and you’re seeing it in both children and adults,” said Dr. Peterson, “and it’s present even if those offspring themselves have not…become ill.”

©Copyright 2009 by GoodTherapy.org – All Rights Reserved. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Daniel and/or see his GoodTherapy.org Profile

A GoodTherapy.org Featured Column written by Dennis Thoennes, Ph.D., ABPP

Click here to contact Dennis and/or see his GoodTherapy.org Profile

The song says, “Sorry seems to be the hardest word.” Well… that depends. There is a bounty of research that tells us about the impact of trauma such as mugging, rape, burglary, war, genocide etc. No doubt such activities inflict pain and leave scars. What is too often missed are the scars that are not there. That might well be because this scar is the imprint of neglect.

Alan Schore Ph.D. has done a masterful job of educating us about the neuropsychobiological effects of interpersonal relationships including the dyadic regulation of affect. Right there on the screen, evident for anyone looking is (or could be) an FMRI (functional magnetic resonance image) that shows us a person’s brain. We can see differences between the prefrontal orbital cortex of a person raised with a healthy degree and manner of attunement and one who had less than that. This is evident in many of the children found in Romanian orphanages or those here in the US. One such orphanage was depicted in the movie Cider House Rules.

There is a long and storied history of the tough, silent guy, the “John Wayne” type. The difference though, between that silent type and the adult we might see in our office, the adult who grew up neglected and unattuned to, is that the former is more likely to care about other people, society and relationships. The adult who was profoundly neglected as a child is more likely to display a generalized indifference, disconnection from others and a diffuse visceral reaction and feeling unrelated to others and thus feel, think and behave like a stranger in a strange land. This has many of the hallmarks of depression: anhedonia, isolation, poor self care, and lack of future plans and ambitions. We might see these symptoms.

To some therapists this person may appear to be in need of social skills training or direction and encouragement to get involved in life activities such as gardening, exercise or a drumming circle, or an antidepressant. The benefits of these treatments are most likely to be short lived or prove insufficient. The lyrics in Elton John’s song ask these questions “What have I got to do to make you love me? What have I got to do to make you care?” Read the rest of this entry

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

There are countless challenges that therapists and counselors inevitably face during the course of their professional careers. Ranging from the small and passing to the immensely difficult, these challenges help to shape not only the experience of the professional, but can shape the profession itself, as well. Jim Cates of Topeka, Indiana, is one mental health professional with a challenge that truly reveals the ability of psychotherapy to transcend traditional use and setting.

As Alix Spiegel of National Public Radio related this week, Cates has found that the majority of his clients are those belonging to the local Amish community. A group known for its reliably manual labor and farming, along with seemingly strict or outdated lifestyle mandates, the Amish would seem at the outset to be an unusual subject for psychotherapy. But Cates’ practice has been useful in treating Amish teenagers, many of whom are assigned to Cates after running into trouble with the law for drinking or other related misdemeanors. The Amish rite of passage known as Rumspringa allows teens approaching adulthood to break free of their traditional constraints and experience life as a “regular” American teenager. Often, the teens find that a return to their familiar Amish customs is a positive choice, but some find themselves caught up in the excitement and intrigue of alcohol, drugs, and other potentially harmful things. Read the rest of this entry

By Jennifer Lehr, MA, MFT

Click here to contact Jennifer and/or see her GoodTherapy.org Profile

Sue and her husband Dave were talking in the morning before leaving for work. Dave mentioned that he had made dinner plans with a friend later that week. Sue immediately bristled. “You never make plans with me, everyone else is always first”, she hissed. Dave sighed. “Here we go again,” he thought to himself. He tried to reason with his wife, but she was already upset and angry. Dave got quiet and pulled back rather than get into a fight. Sue got angrier as she felt more and more abandoned. Dave said that he had to go and left for work. Later that evening when they were both home, there was a chill in the air. Neither of them brought up the morning’s fight. Eventually things went back to normal again, and although the dinner with the friend came and went, this dynamic between them would come up over and over again, causing distrust, resentment and fear, and over time eroding the bond between them.

Victim hood is a self-concept, a way of seeing ourselves. It is not the same as being a victim of real circumstances such as a natural disaster or a crime. We all know people who are emotional victims. Emotional victims look at the world through a lens of past injustices without seeing the link in all of the situations: themselves. Read the rest of this entry

By Anne Ream ATR-BC, LPC

Click here to contact Anne and/or see her GoodTherapy.org Profile

Many people confuse the feelings involved in attraction or relationship addiction with the feelings involved in love. Attraction is the first part of growing toward a love relationship. I use the phrase “growing toward love” because the idea that any one “falls in love” is a fallacy. Although attraction is an important part of a relationship, it is just the beginning and cannot carry a relationship for a long time. We all change with time. Part of attraction is the adrenaline rush many confuse with love. That adrenaline rush can be addictive. A lasting relationship cannot be based on physical attraction or addiction to an adrenaline rush.

Our highly commercialized, capitalistic society has romanticized attraction to an extreme. When we believe the messages in “their” music, tv shows, movies and more, “their” income increases. “They” are opportunistically trying to make money, whereas many (naively, sadly), believe “them.” Yes, we know that, but are we always conscious of how much we believe their psychological sales pitches and how deeply it affects us? Self awareness grows with practice.

Relationship addiction can easily be confused with love. A person can be addicted to another without knowing it. A persons lack of self-awareness and self-understanding often results in denial their thoughts, feeling and behaviors. This can be misleading and confusing for the recipient of the addictive relationship behaviors. A few warning signs include; Read the rest of this entry

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

In modern society, where academia is an integral aspect of professional fields, and a constantly growing body of bright minds and researchers, it is unsurprising that a veritable sea of academic journals are published each month, quarter, or year. Rounding up the prominent studies and touching upon extant wisdom worth revisiting, these journals create the basis for understanding and cooperation within professional communities. In the field of psychology, an impressive number of journals focus on everything from adolescent development to Alzheimer’s. Yet when it comes to schizophrenia, the selection is limited to journals that grapple with what little we understand about the condition and its etiology.

The entrance for Psychosis, then, couldn’t be more timely. The journal, which will focus on “psychological, social, and integrative approaches” to the treatment of schizophrenia and related disorders, is being published in the United Kingdom. The first issue, recently released, features a review of the scarce yet valuable studies performed to ascertain the effectiveness of psycho-social support, rather than anti-psychotic medications, on patients diagnosed with schizophrenia. Read the rest of this entry