A GoodTherapy.org News Summary

One of the leading principles of modern positive therapy practices is the lending of one’s own skills and support to another, and the seeking of harmonious and effective support networks for those going through difficult times emotionally and mentally. For most mental health professionals, it’s a joy to be of service to clients, whether it’s extending a favor or working towards the gift of mental well-being. But a new study has revealed that some people, especially in times of distress, are averted to gifts and favors, particularly for the sense of social obligation that these things carry.

The research, carried out by Jean-Sébastien Marcoux at HEC Montreal, was a long-term effort conducted over the course of ten years, and presents an impressive array of subjects and circumstances. Marcoux focused his data gathering on a certain situation in which we are frequently both distressed and involved in an activity where favors and gift-giving are common: moving. The researcher pointed out that while not all moving experiences are negative, most are stressful by their very nature, and a large percentage are necessitated by unsettling events such as a divorce, the loss of a job, or death. In these stressful situations, Marcoux found that people tend to decline offers of help and exhibit an aversion to gifts, often because they don’t wish to experience the social pressure and sense of obligation involved. Read the rest of this entry

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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

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

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

It is customary for a therapist to facilitate a client’s thinking and feeling “outside the box”, to “wake up and smell the coffee”. Therapists want to assist clients to release the constraints of what is “customary” or “normal” for them and explore the world of thoughts and feelings that have been taboo or off limits. The other end of the spectrum is also, sometimes, the therapeutic focus i.e. learning to self regulate and develop the skills for expressing feelings such as anger in socially appropriate, non-abusive ways. Certainly there are clients who need such therapeutic assistance.

I remember a colleague commenting “I make it very clear to each and every one of my clients that I will not be sexual with them and that my office is not a place for expressing rage and anger.” Sometimes, in some situations, for some clients such clear and definite boundaries are appropriate or necessary.

Years ago I had a television set with rabbit ears for an antenna. The signal was often blurred and I would get headaches as my eyes tried to reconcile the blurred images. It often is the distress of blurred boundaries and tangled experiences that brings people to therapy.

Some states credentialing requirements or guidelines or those of some professional groups may require a therapist to include in his or her office policy very clear language about, for example, sexual boundaries. Heeding such directives or advice may be legally necessary and professionally appropriate. In the intricacies and dynamic processes of the therapy session what was printed in an office policy is likely to fade out of awareness for the client. If a therapist recognizes that a client is having romantic or sexual feelings for the therapist it would not be appropriate for the therapist to kindle the client’s affections for the therapist. In the interest of properly tending professional boundaries, throwing the proverbial bucket of cold water on the client may be “safe” but counter therapeutic. Read the rest of this entry

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

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

Recently a client described an icy meltdown she and her husband had with one another. This is not an uncommon event in the lives of couples I see. I noticed I began to consider a variety of therapeutic frames I could utilize and directions I could take to facilitate the client’s self exploration and find a way to understand such a difficulty and find acceptable alternatives. Then something else happened.

I noticed I am much more familiar with this “icy meltdown” experience than I’d care to admit. I so often fall short of the expectations I have of myself as husband, human and therapist. Then I recalled a line I heard in a workshop conducted by Stephen Levine, “Have mercy. Have mercy.” Pema Chodron also addresses this in her book “The Wisdom Of No Escape”.

We are all so human, so incomplete, so flawed and often have such high expectations of ourselves and others. This can set the stage for a life of unmet expectations and a long and painful traverse of life. Certainly there are instances where we cut ourselves or others too much slack.

Often we want so much from others and ourselves. What would “have mercy” actually look like. It could mean compassion for myself and others. I realize that I want to help my clients be free of suffering and to be happy. Sometimes this is a noble veneer covering my desire to have my clients think highly of me and refer people to me so I can have the prestige, the income, the life I fantasize. Read the rest of this entry