Blogging on Good Therapy

by Delyse Ledgard, MA, RCC

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

In this article I will address some common attitudes that I see preventing people seeking assistance from therapists, and how they represent interpersonal fears that are related to the work one does in therapy.

Therapy is a commitment to improve your emotional health. In the end you have to make the changes you want in your life, and considering therapy as a way to help you create the life you want is a courageous decision. If you see yourself in the following attitudes I would encourage you to take a closer look at where these beliefs are coming from.

There are a lot of people who would gain from seeing a therapist who have difficulty perceiving the benefit. Here are some of the typical attitudes: (more…)

By Beth Patterson, MA

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

In my work with grieving children and adolescents, it is important for me to keep in mind that the child’s age and stage of development at the time of the loved one’s death will strongly influence the ways in which the child reacts and adapts to the loss. “Besides cognitive understanding, a child’s degree of separation-individuation, along with the developmental maturity of the child’s ego defenses and ego functions, will influence his or her psychological reactions to bereavement” (Baker & Sedney, 1996, p. 115). Cognitive development is also of paramount importance (Worden, 1996, p.10). Thus, an understanding of the child’s emotional and cognitive development will enable me to determine how best to communicate about death with the particular child, to understand and empathize with the child’s experience and guide the child through the grieving and healing process with appropriate interventions. It is also important for me to be aware of my own triggers around death and loss in order to stay present with the child’s process and deal with the death directly, since shielding children from death deprives them of the ability to grieve and ultimately heal. (more…)

By Barbi Pecenco, MA

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

Before I received training in marriage and family therapy, I was extremely blaming and critical of my husband. I truly believed everything that I felt was all his fault.

Through my schooling, I learned that I needed to take a look at what was being triggered in me when he did certain things. So if he went golfing and surfing for a few hours on the weekend, all I could see was how he was depriving me of attention and his time, and not how enjoyable and nourishing these activities were for him. And I certainly didn’t see that maybe I needed to get some outside activities of my own!

And since I was completely CERTAIN that he shouldn’t be depriving me of his time and attention like that, I felt very justified in saying such things as, “You never want to spend time with me,” or “You care about your hobbies more than me,” or “You are a huge jerk!” I had no idea that this sort of blaming and attacking only triggered him to feel like a bad husband and made him shut down. So when he got quiet or defensive or needed to get away from me, that just confirmed what I already thought I knew, which was that he just didn’t really care about me.

I finally realized that I needed to look at myself and why I immediately jumped to the conclusion that he didn’t care just because he had some hobbies that didn’t include me. I was finally able to see that what was being triggered in me was a deep down, unconscious fear that I was unlovable. On a conscious level, I did not know that this was a fear that I had. If anyone asked me, I would have insisted that I felt just fine about my lovability, thank you very much. It’s hard to know what is lurking below the surface of our consciousness. (more…)

By Colette Dowling, LMSW

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

Joann was thirty-eight when she was freed of a depression that had plagued her, off and on, for her entire adult life. Before finally getting help, she felt lower than she’d ever felt before. “I was in agony, caught up in an excruciating, unrelenting mental anguish that worsened with each day. I could see no end to the blackness that engulfed me, and I knew I could not endure much longer.”

Another woman, describing her depression, told me she felt like there was a big black bird hovering over her from the minute she woke up in the morning.

While a particularly stressful event might trigger the blackness of depression, it can appear from nowhere. Or, as in Joann’s case, it can creep up so insidiously that the illness is never fully seen for what it is.

“Nothing had happened to make me feel so terrible,” Joann says. “Yet every drop of color had been slowly drained from my life–so gradually that I didn’t notice it happening. Then, all of a sudden, there was no joy left in my day. There was no pleasure in getting up to a new morning, in being with friends, or in doing any of the million and one things I love to do. All that stretched in front of me was an aching loneliness and emptiness. Nothing had meaning. Nothing brought pleasure. I wanted desperately to laugh and have fun again, but the pain grew worse. (more…)

By Delyse Ledgard, MA, RCC

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

Intimacy speaks to something shared between individuals who trust and respect each other. A connection that is transparent and honest, that takes courage. Feeling close to someone can be manufactured out of illusion and characterized by a disquiet that leaves one feeling unsure of the closeness. Sharing similarities can be part of developing closeness and intimacy as long as it is not a habit to avoid differences. Self-differentiation, defined as the ability to stand in one’s own space with out taking over the other, is commonly viewed as an important aspect of intimacy. On the other hand, spiritual intimacy involves dissolving boundaries and ego identity into a cosmic oneness. Perhaps this speaks to the way intimacy cannot occur with a strong protection of the ego. There needs to be a ‘taking in’ of each other.

My particular definition of intimacy states that it is a shared physical and/or emotional space where there is an exchange that furthers an understanding of each other and your connection to one another. Intimacy results in an experience of being known by the other. This exchange occurs at it’s deepest when there is a focus on what occurs between you. In other words, being a confidant while it may produce a feeling of closeness has much less impact on your personal understanding of each other or your relationship to one another. So in this exchange we could say that the deepest intimacy occurs when you are able to say to the other what you cannot say to anyone else. This relates to the intimate dialogue. (more…)

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

Click here to contact Mary Ellen and/or see her Profile
Click here to contact Ed and/or see his Profile

Have you ever been told a person has to “hit bottom” before they can begin to recover? What do you suppose that even means? Exactly what is “hitting bottom?”

Do you suppose it’s really a good idea to wait until you’re divorced, or bankrupt, and/or facing another DUI before looking for an answer to your drinking problem? We don’t think so.

The concept of waiting to hit bottom isn’t just useless – it’s dangerous. How? Consider how that tenet would play out in the case of a real disease, cancer.

“Well, you know,” they’d say, “you really can’t do anything about cancer until it’s metastasized.” Huh?

But that’s most alcohol treatment providers’ party line.

Let’s look at alcoholism as if actually were a disease. What do we know about real illness? Well, first there’s prevention, then there’s regular checkups, then early detection, then… Oops. Early detection? What happened to “hitting bottom?”

Of course that’s the problem. With illness, we don’t wait until the patient is nearly dead before beginning treatment. Effective treatment is begun, good follow-up maintains the progress, and changes in the patient’s life are instituted that will sustain the recovery. It shouldn’t be surprising that this same model works well for diverting a client from alcohol abuse and dependence. The trouble is people have been discouraged – by mythology, stigma, and “lifelong recovery” - from getting help in the early stages when remission is not only possible, but likely.

How did that happen? (more…)

By Sarah Jenkins, MC, LPC

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

I knew, several months ago, that I would write about April being Sexual Assault Awareness Month. Nevertheless, after the short amount of time that it took to write it, the original article sits, alone in my office trashcan, tossed aside. The cold hard facts about sexual assault, the statistics, they all had their place. They cried out like an overwhelmingly loud and obnoxious alarm clock, desperately trying to wake you as you slumber peacefully. But you see, statistics always do. Numbers always do. Facts always do. We hear them every day and yet, they are not heard. Ironically, just like the voice of many victims of sexual assault, their cries go unanswered. So, I rewrote it.

Sure, you may know that every 35 seconds, a child is reported to be abused or neglected (NCVC, 2008). You may even know that 1 of out 6 women and 1 out of 33 men have experienced a completed or attempted rape (RAINN, 2008). But the difference is that you don’t know statistics. You just know people. You would truly know, and you could feel that statistic, if it was your child, your friend, your sister, your brother, your father, your mother, or you who were assaulted.

I struggled with this writing because sexual assault and abuse is tough to write about. Like the analogy a friend recently told me, it’s like being the town crier. You have a difficult announcement to make, to call out, but the message is ugly, painful, and shocking. Let’s face it. Who really wants to hear that their family and friends are more likely to abuse their child than strangers? Who really wants to acknowledge that you are more likely to be raped by someone you already know? But, someone does want you to hear it, and those are the people who already know. (more…)

By Delyse Ledgard, MA

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

Fusion is defined as the desire for two people to merge into one another in personal relationships, and refers to an immature connection to the other fueled by a fear of separation. The desire for this type of connection is motivated in part by an unconscious fantasy of bliss through unity. Eric Fromm in ‘The Art of Loving’ talks about immature love being like the symbiotic relationship between mother and infant. Perhaps it is a desire to retreat into a safe haven from the world that creates such a strong pull in all of us for fusion.

Society encourages this type of unity by popular romantic notions of two halves make a whole, and finding the perfect fit. If we are to assume that society expresses our collective unconscious then we are all struggling with this desire for fusion to escape the ravages of life and the dangers of being alone in separation.

In the beginning of romantic relationships partners turn a blind eye to the differences between them. It is all about the similarities and connection. This blissful state of being in love is often described in the language of a symbiotic fusion. For example, “I’ve found the perfect fit”, “ we are so connected it is almost like he knows what I am thinking”, “finally someone understands me.”

In addition to a desire for a symbiotic fusion we also have a need for independence. As the relationship progresses partners’ individuality begins to become more evident and relationship struggles occur as they come to terms with their differences. Relationships continually flow between connection and separation. The desire for fusion is therefore, not the only force between partners, but is the one I am focusing on in this article. There are two main ways in which fusion is expressed in relationships – the first is by a dominant/submissive dynamic where there is only one person in this relationship and that is ME! The second is a dependant dynamic where you are the head and I will be the tail – together we will make one body. (more…)

By John Petersen, Psy.D.

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

As a family psychologist, I’ve found a common concern parents have about their children, even more common than the ubiquitous Attention Deficit/Hyperactivity Disorder (ADHD), is “disrespect.” From talking back to “having an attitude” to refusing to listen, disrespect is often at the top of the problem list parents bring to my office. I typically search for ways to move “disrespect” down the list some.

It’s difficult to suggest putting the topic off until later, because respect is important, very important. But we parents too often fall into demanding respect and forcing children to comply. With threats, punishment, shaming, bribes, and rewards, we use our power in various forms to get kids to respect authority and the powers that be. Our success has been our downfall. We’ve unwittingly taught kids to respect the power and control of authority, losing sight of the more important goal of respecting relationships and respecting each other as individuals. (more…)

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

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

Following last month’s brief notes about Altruism and the Soul, this piece focuses on the development of morality and the ethical values and behaviors that accompany this developmental process. Part III will talk about the Power Paradox and its relationship to the Power Differential. The Power Differential, as mentioned in an earlier column, is the foundation for the need for ethical codes and guidelines for people in professional positions of power and authority. The Power Paradox derives from research pointing to the need for increasing sensitivity to the impacts of the Power Differential on professionals themselves.

Ethical use of power begins in empathy and altruistic pleasure. We are born with a basic moral compass, based in empathy and the natural desire to take action on behalf of others. This is most obvious in the outpouring of care for a family member or a situation in which one is directly involved. Simple moral decisions activate a straightforward brain response. The Snyders have spent a lifetime studying young children as persons. They have consistently found that children have an inborn pre-disposition for justice and caring. “Unless they have been dehumanized by adults….children reveal the capacity to be empathically attuned to each other, to co-create a ‘justice culture,’ to support fairness, safety and the restoration of relationship, and to be naturally interested in what works for the well-being of all.” This is what we would expect from our brain wiring. Of course, when this brain wiring in the frontal lobes is damaged or inoperative, people suffer from a complete lack of empathy and conscience, clinically labeled psychopathy. While not all who meet the definition of psychopath are violent, they live with a lack of the normal empathy and conscience that guides behavior. When in leadership positions, and they are there, these people are particularly difficult if not impossible to deal with.
(more…)