Blogging on Good Therapy

By Jeanette Raymond, Ph.D.

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Flora was proud of herself. Her stomach felt flatter. Her new diet and exercise regimen was paying off. She ate things she liked and found exercises that fitted in with her energy levels- not the self flagellation she inflicted on herself in the gym the last time she tried to lose weight. She was amazed at how easy it was to follow her program and how much she was enjoying it.

A couple of weeks into the project Flora was part of a decision making team at work. There were disagreements and heated opinions flying around making her feel uneasy. She wanted to let them know what she thought but couldn’t fight her way into the conversation. She didn’t want to be the center of attention by yelling her way into the debate. Nor did she want to be ignored. Suddenly Flora sensed something was missing. She grabbed a pillow and put in on her abdomen. What a relief! At that very stressful moment Flora missed the ‘padding’ that her fat had provided. The cushion smothered her conflict, removing the need for making a choice. Driving home she felt annoyed that no one had invited her to comment or made room for her opinion. Demeaned and diminished Flora’s anger frothed up. She stopped at a store and bought a quart of vanilla ice- cream and a large bag of corn chips. (more…)

By Patti Desert, LCSW-C, CEMDR, CP

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Many men have a difficult time recognizing that they are depressed. Men often interpret the word “depression” as describing a state of helplessness or hopelessness, accompanying a general sense of feeling fragile or vulnerable. In many ways our culture conditions men to ignore these states or to experience little awareness of them. Men are taught “boys don’t cry,” and are uniformly rewarded with praise and validation when they “act like a man” instead of tearing up or expressing fear in response to a harshly distressing encounter. After years of this kind of persistent reinforcement these boys grow into men with a form of blindness whereby they often do not see or understand the nature of depression and they can become bound by painfully repetitive behaviors and feelings with no knowledge that they can change.

What men do recognize is the feeling of stress and they will commonly describe situations as stressful with no awareness that those situations are the triggers stimulating an internal state of dis-ease that often leads to depression. The following are some of the less recognizable experiences that men commonly describe as stressful and that are symptomatic of depression. (more…)

by Jennifer B Baxt, LMFT, LMHC

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While it is understandable that most people have a natural tendency to feel uncomfortable with their own aging and mortality, there are a few in the crowd who are horrified by the natural process to the point of having a phobia. The phobia where people are terrified of aging is called gerascophobia. Though, to say it is simply a fear of growing old can be a little deceiving. Gerascophobia is perhaps more the fear of what can happen to a person when they grow old. It could mean a loss of independence they value, the wrinkles they will develop, the loss of hair (mostly in the case of men), any diseases that can come from aging, or even a retirement they don’t know what to do with. For many people, these thoughts briefly cross their mind and are quickly brushed away with reasoning; aging is a natural process that happens to everyone and they will deal with it when the time comes. Unfortunately, for the few who suffer gerascophobia, it is something that brings on anxiety and fear about something they really don’t have any control over. Perhaps the lack of control is one of the major worries for these individuals as well; a lack of control whether they will end up in a nursing home, for example. (more…)

by Sarah Jenkins, MC, LPC

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Therapy for Traumatic Stress: The Container

To keep the memories of abusive experiences aside, some lock their emotions, thoughts, and experiences away. Some describe their disturbing memories as if they are in a file folder, hard drive, cabinet, on a shelf, or out of the body. For others, the “containers” are described as being hidden from view, out of sight, maybe out of mind. Despite being sealed shut by these distractions, each container wants to be unopened, despite the person’s fear of opening them. Trauma therapy means opening the containers, carefully, and with appropriate and clinically sound support. Releasing trauma’s hold on the body can be a gift, albeit one to open with awareness.

Your Body Has Memory

As you remember from part one of this article, the nervous system remembers trauma. The posttraumatic stress symptoms that it gives you are its way of telling you, “Hey, deal with this!”

Therefore, if you start trauma therapy, it is important to understand that your body has memory, and will react. Because your body “holds” the memories, thoughts, emotions, and images of what happened, it is very possible that you will experience them in and or outside of your sessions. (more…)

by Sarah Jenkins, MC, LPC

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One of Many

No one ever told her that the memories would come back to haunt her. Time had tucked it all away when no one believed her about the abuse. Drugs and alcohol were the only things that listened. They believed in her. Concealed from view, in the darkened corners of her mind, they were patiently waiting. Waiting for just the right time to jump out at her, surprise her, and catch her off guard. Like an unexpected movie, suddenly flashing across her mind, her memories, they presented themselves to a reluctant audience. As they created soundtracks, images, and body sensations, she was overwhelmed and alone. She walked into my office, not knowing what to do, or where to begin.

She is one, of many, who share their harrowing stories with me. The numbers are staggering of women and men who have survived sexual, physical, and emotional abuse, sexual and physical assault, let alone deaths, accidents, violence, war, catastrophic events, even traumatic loss like divorce.

You May Have Already Stopped Reading

I know that for you, this article may not apply. I may have already lost you by now. Perhaps there was no event in your life that you would define as “traumatic.” Or, it’s in the past, right? I know that what one person may consider traumatic, another may not. Perhaps you know someone who understands it all too well.

Nevertheless, it is important to recognize that the perception of being in danger, unsafe, or threatened, defines it as such. Know that if you have had a sense of being unsafe or threatened, your nervous system will remember. Even if you do not define an experience as traumatic, unconsciously, your brain and nervous system can still perceive that you are in danger. When they do, their automatic functions take over, which can lead to traumatic stress. (more…)

by Jeanine Austin, Ph.D.

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I once read a static that said many people die each year choking in restaurant bathrooms. Apparently, people in public places are often embarrassed that they are choking and they run to the bathroom to hide. This got me thinking about the fact that many of us are tempted to hide out when we are ashamed rather than seek help.

Healthy shame may help us to recognize when we need to change our behavior or adhere to healthy social norms. When we hold onto shame and begin to over-identify with our shameful feelings or behavior we move into toxic shame. Toxic shame can cripple us emotionally; it may keep us from moving forward in our life and we often find ourselves on a downward moving spiral to self-doubt and ultimately self-hatred.

Some people who tend toward perfectionism will react with shame when anything manifests in their life that looks unpleasant. Their pain is often doubled in that they have to deal with the pain of the situation and also the pain of shame. If they hide out with their shame they may also miss opportunities to be supported and loved by those whose love is unconditional. (more…)

by Jeanine Austin, Ph.D.

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“Big ego is lack of trust in your own soul.” ~ Lauren Brownell (Vermont Artist)

We all know exactly what people mean when they describe someone as having a big ego. They are describing someone who is very self-referenced and self centered, often with mind-bending hubris, and perhaps someone who thinks we should worship gratefully at their feet. For some of us, a big ego may call to mind the “big ego anthem” You’re so Vain by Carly Simon. (On an ironic note-it was rumored to be written about Warren Beatty who I happened to say hello to last Saturday. He was warm and friendly. No trace of ego!).

When we talk about this type of ego, we aren’t using Sigmund Freud’s definition of the ego. In his seminal work, he defined three aspects of the self: the ego (the core self), the superego (the conscience) and the id (the primitive and impulsive self). In our current vernacular, we talk about a big ego in the way that A Course in Miracles describes the ego. In Marianne Williamson’s classic A Return to Love, she writes, “In Course terminology, our entire network of fearful perceptions, all stemming from the first false belief in our separation from God and one another, is called the ego. The word is used differently here than the way in which it is often used in modern psychology. It is being used as the ancient Greeks used it-as the notion of the small, separated self.”

When anyone is running around with a big ego, we can be assured that the person is operating from fear. (more…)

Would You Marry Yourself— Or Someone Like You?

by Debra L. Kaplan, MA, LAC, LISAC

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A glance at many magazines today will offer practical advice and “how to” strategies for the pursuit of the man or woman of our dreams. Let’s face it—sexy tag lines and catchy subtitles make for good print copy but do little for building healthy and sound relationships. Projecting our wants, expectations or intentions onto our partners-to-be only serves to foreshadow the inevitable relational demise. It is as if we build in our own obsolescence from the very start.

How is that possible you may ask, “when I’m doing all the right things, paying close attention to selecting my partner, and looking at what he or she has to offer the relationship?” I admit that these words sound counter intuitive, however, first consider this proposition.

Would you marry yourself or someone like you? Do you like the person you are and what you have to offer, enough to marry yourself? (more…)

by Sarah Jenkins, MC, LPC

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“Well, when one’s lost, I suppose it’s good advice to stay where you are until someone finds you. But who would ever think to look for me here?” - Alice “Alice Adventures In Wonderland” by Lewis Carroll

“I warn you dear child, if I lose my temper, you lose your head. Understand?”
- Queen of Hearths “Alice Adventures In Wonderland by Lewis Carroll

You know her. You have met her before. Curious and unsuspecting, Alice goes down the rabbit hole, following the ever late, white rabbit. Her naivety gets the better of her. Tumbling down a dark chamber, Alice falls and finds herself facing temptation. “Drink me,” it instructs. She complies, without question, doing the very thing it compels her to do. Regrettably, she then notices, it is too late. There is no return. She is small, too short to reach for the key, the very key to open a way out. Then, a piece of cake presents itself to her, “Eat me” it instructs. She complies, astonished and horrified as her body stretches to become nine feet tall.

How many times have you just “known” that something was not good for you, and you did it anyway? How many times have you said to yourself “this time it will be different” or “I won’t do that again,” to find yourself doing the very thing you don’t want to, yet again. Why do we do this to ourselves, even though we want something different? (more…)

by Edward W. Wilson, Ph.D., MAC

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As a family member becomes increasingly alcohol dependent, most families find themselves wishing they knew what to do. Initially we all tend to look the other way and hope that we’re wrong, but eventually most of us will start getting angry as the side effects begin to spill over into our lives. Then were also, probably, going to feel guilty about being angry. It is, after all, a disease, isn’t it? How can we be mad at someone who is ill?

Lewis Thomas, M. D., essayist and late Director of Memorial Sloan Kettering Cancer Center, once wrote that in medicine the most difficult part is knowing that “frequently the best we can do is to stand back and quietly wring our hands.” For many of us, that is how we respond as the problem grows. And sometimes it is the best that can be done. (more…)

by Andrew Walen, LGSW

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When you look at your body in the mirror, two things occur. First, you see the body’s physical structure; its size, shape, texture, curves, and nuances – great and small. Then comes the part that’s hard to control – the thoughts and comments that swirl about our brains concerning the body in that mirror. Oh man, can those cause trouble!

It’s usually at this point when most of us look at our bodies and berate ourselves for not having that flat stomach, or shapely thighs and buttocks, or taut breasts and biceps that many of us crave. But these thoughts are not just passing emotional blows to the psyche. For nearly 60 percent of women and over 40 percent of men in the United States, they are constant barrages of hatred and self-loathing. They are statements that bend and distort the reality of our perceptions about the body and its abilities, and thus the core beliefs we have about our worth as human beings. (more…)

written by Debra L. Kaplan, MA, LAC, LISAC

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Not too long ago, a client who I was treating for prescription drug abuse, looked at me and said, “It’s my desperate need to silence my feelings that drives me to want to use.” She went on to describe what it felt like to live in her skin. “It’s as if the people in my life are at the controls of this rollercoaster called my life and I’m trapped and I can’t get off. I like or hate the ride based on how I feel about them at that moment; in my mind you’re either with me or against me. But I can’t fire them from the controls!”

Unbeknownst to this woman she was verbalizing what was part of her underlying issue—Complex Post Traumatic Stress (CPTS). For the uninitiated CPTS, is classified as long-term traumatic stress that may impact a healthy person’s self-concept and adaptation. The exhibited symptoms range from struggles with mood (depression, manic-depression, anxiety); fear of real or imagined rejection or abandonment, and a spectrum of addictive, self-defeating behaviors including; bulimia, anorexia, compulsive spending, sexual compulsivity, and, perhaps self-injury. (more…)

Written by Lisa Brookes Kift, M.A

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Adult anxiety has many faces, manifestations and levels. The type of anxiety I’ve had the most contact with in my experience as a therapist is Generalized Anxiety and from here on when I speak of “anxiety” I will be referring to this. I work from a family of origin perspective, in that, I believe that people’s emotional and/or psychological distress as adults can partially be the result of problematic core beliefs developed in early childhood. A primary hallmark of anxiety is pervasive worry. “Fear of the fear” is how people have described the feeling. If I look back far enough in a person’s history I’ve typically found a childhood experience laced with chaos, high expectations and/or a highly anxious parent.

When children are born into this world, they are physical beings with no developed sense of self. Young infants begin to develop their core self as they interact with their primary caretakers. Ideally, their nest is a safe, loving and attentive one. It’s in this nest they can begin to believe that they will get their needs met and they have value – what they do impacts the world. This is the beginning of a very healthy self concept – or relationship to self. If all things are right, the growing infant will also develop the idea that others can be trusted. Barring any seriously negative life experience along the way, the baby becomes a toddler who becomes a child who becomes an adult with good feelings about his place in the world. “I am lovable,” might be a core belief born out of this situation. Other possible healthy core beliefs are, “people can be trusted,” or, “the world is a safe place.” (more…)

Written by Mitchell Milch, LCSW

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On the evening of the 6th anniversary of 9/11 I watched the heart wrenching television images of children of those whose lives were tragically taken on that ill fated morning in 2001. These images stirred me to write about the topic of survivor guilt that is never too far from my heart as a psychotherapist and an American Jew.

One doesn’t have to lose a loved one to a tragic and unnecessary death to suffer survivor guilt. This symptom for lack of a better description is a recipe for chronic unhappiness. It is in simplest terms feeling guilty about being happy with one’s lot in life. It is not necessarily induced by the experience of a tragic loss of a parent or parental surrogate. It is nonetheless, the legacy of what I do consider to be tragedies if the victims do not get help in adulthood to treat their problems. They are tragedies because generations of family members may go through their lives with countless blessings from which to derive meaning, joy and happiness from and yet, not feel entitled to enjoy any of them. They do no better than survive.
Misery is as much who they are as their right arms and they feel that they have no choice but to suffer if they are to have even a temporary respite from feeling guilty and experience some happiness.

This article will explore the types of experiences that shape survivor guilt and what those of us who suffer from it must do to move toward overcoming it. (more…)

Written by Sarah Jenkins, MC, LPC

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Sit down, and let me tell you a story, a fable that tells of a wolf in sheep’s clothing. It is a fable, written by Aesop, that you may be curious to learn, and can tell us of addiction’s common deceptions. Perhaps you will find the lesson in the beginning, or even at the end, but you will be curious about what you will soon learn, as you read on.

“A wolf found great difficulty in getting at the sheep owing to the vigilance of the shepherd and his dogs. But one day it found the skin of a sheep that had been flayed and thrown aside, so the wolf put it on over its own pelt and strolled down among the sheep.

A lamb began to follow the wolf in the Sheep’s clothing. So, leading the lamb a little apart, he soon made a meal of her. For some time he succeeded in deceiving the sheep, and enjoying hearty meals.”

What’s Underneath: The Wolf (more…)

Written by Tanya Vallianos MA, LPC, ATR

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The holiday season can be a challenging time for most anyone as the stresses of finances, increased demands of time and tasks, and unrealistic expectations show themselves in a grand way. Furthermore, if you are a person that is working through feelings of grief at this time, everything can become compounded.

The holidays can create feelings of depression, loneliness, and anxiety for the bereaved as they remember past events. Holidays by nature are filled with nostalgia, tradition and ritual, but for those grieving, this can bring up conflicted feelings of both comfort and distress as the absence of the deceased becomes more apparent. As the rest of the world is celebrating, it’s important for grieving individuals to acknowledge their emotional pain and get through the season with a minimum amount of stress. Being able to express ones grief verbally can be difficult. Art expression, as a non-verbal modality, can be an effective way of working through and containing grief when words fall short.

Throughout history, art making has been a means by which humans have expressed their grief. Whether through burial ceremonies, shrines, or memorials, the symbols that represent loss have been important for coping and relieving emotional distress.

Creativity can be a way to feel the sadness, anger and loss as well as the remembrance of times past in all their imperfections and grace, while taking time to understand oneself in the context of the whole. Overwhelming thoughts and feelings can be captured in the images thereby creating a new sense of control, organization, and containment. Focusing on the images or symbols enables a person to express stressful emotions without having to refer directly to details surrounding the loss. (more…)

Written by Connie Miller MS, LPC, NCC, TEP

Today there is a universal spiritual movement in the field of psychology that cannot be ignored. The awareness of mystical experiences is becoming more and more common. As various holistic healing practices become more accepted, the trend is to integrate psychology with other methods of healing.

In twelve-step programs, people heal through the telling and sharing of their own stories. It is through the sharing of the trauma and pain and the subsequent healing that people form common bonds that unite them. Then, to get beyond that connection of pain, they need to go further by sharing their soulful moments, their hopes, and their dreams. This requires re-establishing a relationship with their creativity and, through their higher awareness, connecting with others on a spiritual level.

During my practice, which has focused on co-dependency and addictive family systems, I have found that one of the most difficult tasks for a counselor during a client’s healing process is to break the bond of abuse. It is difficult to teach a client to open his heart to experience love so that he might be able to move on to live in a loving, healthy relationships, doing meaningful creative work. Souldrama® provides a technique to move these clients past resistance. (more…)

Written by Edward W. Wilson, Ph.D., MAC

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For decades the research, both formal studies and informal observations, has shown that some alcoholics could return to moderate or controlled drinking, and that many do. However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn’t an alcoholic - not matter how obvious the evidence to the contrary.

While their traditional conceptions and definitions have caused the AA/12 Step organizations to reject the mounting evidence, they haven’t been alone. The treatment “industry” also has a vested interest in keeping definitions and solutions narrowly defined and simple. There is, in their lexicon, only one “disease” and one “cure.” Since 95% of providers are wedded to the 12 Step model, and have nothing else to offer, suggestions that other outcomes are possible are very unwelcome. In the United States even those programs describing themselves as “alternatives to the AA/12-Step models” generally adhere to abstinence-only outcome criteria.

But individuals and providers alike would be better served by the different picture painted by an analysis of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Based on a sample of 43,000 U.S. adults, the study found that more than one-third (35.9 percent) of those with alcohol dependence (alcoholism) that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism). (more…)