Simply put, when it comes to traumatic experiences, there is no hierarchy of pain. Many survivors believe—or want to believe—that trauma is scalable and therefore more or less extreme than that of someone else. While this belief is understandable and does offer some benefits, it is ultimately more flawed than accurate.

For many life events as well as emotions, it is possible to create a hierarchy and use it to determine if event/emotion A is more or less than event/emotion B. One can look at happiness and stress to see how this scaling occurs. For example many would agree that receiving the perfect gift on your birthday falls below the happiness you feel on your wedding day, while the stress you go through on your wedding day exceeds the stress you have on your birthday. This scalability can add perspective, meaning, and depth to happenings that are within the realm of ordinary, expected, and standard.

Yet trauma lies at the utmost extreme of human experience; for the individual, there is nothing ordinary, expected, or standard about it. The severity of trauma, the danger, horror, and fear involved cannot be compared—regardless of what the content of the traumatic occurrence was. Regardless of how much or how little was endured, all traumatic experiences lie within the category of utmost extreme. Therefore, creating a hierarchy of traumas is not possible, since every trauma is an extreme life event. Once something is extreme, ranking its extremeness is a futile exercise.

Phrased another way, trauma is trauma; how you sustained a traumatic event does not alter the fact of the trauma. Imagine for a moment, a gorgeous glass vase, which becomes shattered; how this vase shattered—by wind gusting through an open window, a child bumping the table the vase sat on, or you dropping it while changing out the flowers—is of no import to the shattered vase.

Many survivors of traumatic life experience(s) find comfort and protection in maintaining the belief that because he or she did or did not experience certain components in the traumatic event(s), then the trauma is less than someone else’s. And, if it is less, it is a minor, even inconsequential moment in time that does not need to be acknowledged, let alone healed through. Despite the apparent protection that this belief brings, sustaining it prevents you from engaging in your healing, and healing is the only means by which to detoxify trauma.

In addition to blocking your healing journey, this belief robs you of self-compassion. The reason this belief precludes compassion, is that compassion requires reckoning. This belief prevents you from truly acknowledging and owning your hurt, pain, and suffering. It is only after acknowledgment has arisen that the second component of compassion can come forth: turning toward distress. This turning toward allows you to potentially alleviate your pain. Self-compassion not only validates your wounds, but it also opens a deep reservoir of gentleness. Holding and extending gentleness toward yourself, as well as regarding yourself through a compassionate lens, provides you with unshakeable stamina to engage in as well as endure your development into a thriving post-trauma individual.

Believing in a hierarchy of human suffering and pain seems to grant you peace as well as protection, but in the end it shortchanges you out of the health and wellbeing you have an inherent right to. Feel free to slowly begin letting go of this belief and replacing it with a more accurate acknowledgment of your past, and while you do this, aim to grow compassion as well as gentleness within yourself. If you want or need a compassionate guide to help you through, know that there are many qualified professionals who believe in your inherent right to compassion, gentleness, healing, and growth who can and will assist in this undertaking.

Many of the partners or loved ones (POLOs) of those struggling with addiction often seem reluctant to get help for themselves. I’m not sure why that is, but I’m hoping this article provides some answers.

These beleaguered folks are often fixated on the behavior of the loved one who struggles with drugs or alcohol (or other compulsions). Of course, it’s hard not to fixate on rampantly destructive behaviors. It often seems as though families where addiction is present are always struggling to either avoid or deal with addiction’s collateral damage (financial, emotional, professional, etc). I’m coming to the conclusion that because the behaviors surrounding addiction are so darkly magnetic, a constant pull on the family’s attention, it may be hard to understand why focusing on oneself is important. (more…)

This article contains detailed information and accounts of suicidal ideation & behavior. If you or someone you know may be considering suicide, get help now.

To continue to discuss the very different types of experience people have with depression, this is one that most people don’t experience, but is important to address, since some do. Suicide is not in this case a tool to get people to do or feel what the suicidal person wants; it’s simply the ultimate way to make unrelenting emotional pain stop.

I believe people’s experience of the emotional pain of life varies tremendously. Some of this is due to genetically influenced brain chemistry and resilience, but much of it is due to how much trauma and emotional hurt, loss, injustice, abuse, and other painful experiences people have experienced. We have beta endorphins in our brains to numb pain and create euphoria, so we can handle both physical and emotional pain. But people are born with varying amounts and life events can influence our supply as well. For people with very little of this chemical, life is much more painful. (more…)

Many people in relationships feel this way, exasperated because they are doing everything they know how to do to make their partner feel loved. Couples come into my office usually at the end of their rope because they have tried, and tried, and tried to make the marriage work and nothing they have tried seems to be making it better. This is so frustrating for couples. It drains the life out of many marriages and relationships. It pushes people so hard sometimes they end up convincing themselves they just can’t make this marriage work anymore and they end up leaving. This can be frustrating and maddening for people who want to love each other but can’t find a way to do that.

Everyone starts off with the best intentions. Good people work their hardest to make a marriage or relationship work. Usually people have lots of successes in their lives.  They look at their histories and they say to themselves, “Heck, I know how to achieve things. I am a success at school and work. I am good at getting things done. I can accomplish things. I can make this work.”  The best intentions drive people to do things for the other person. That’s our nature. If we choose to be in a relationship, we have decided to do what we can to make it work. (more…)

Therapist: “Sounds like you’ve been busy.

Sonya: “I have. I feel like I’m always busy… too busy. I never have time to just enjoy life. I can’t remember the last time my husband and I had any quality time together. I worry about our relationship sometimes, but we rarely find time to talk about anything other than our kids.

Therapist: “You’re worried about your relationship, but you’re both more focused on your kids than each other.

Sonya: “Yeah. It scares me that we can’t find any time to focus on each other. We just can’t seem to make our relationship a priority.

Therapist: “You’re scared that your relationship isn’t a priority.

Sonya: “I am. I don’t know what I would do if our relationship fell apart. I can’t even imagine life without him.

If you read the above vignette and felt like Sonya’s therapist was just paraphrasing and repeating everything she said, you’d be right, sort of. Sonya’s therapist isn’t repeating her statements because she’s disinterested or bored, however. The above conversation is a perfect example of the Rogerian technique called restatement. Restatement is a basic counseling intervention and one of the hallmarks of Rogerian psychotherapy. This technique involves capturing the essence of a client’s statement and then restating it. The most rudimentary function of this approach is to provide an opportunity for clarification. If a client hears something in the therapist’s restatement that differs from what he or she meant to convey, the client can clarify and make sure he/she and the therapist are on the same page before continuing. On a deeper level, the technique can also serve as an effective way to probe clients’ statements– when clients hear their words repeated back to them, they know their therapist understands them. This understanding often encourages clients to delve deeper into the issue at hand.

Although often effective, restatement interventions can sometimes leave clients asking the question, why does my therapist sound like a parrot? Why am I paying someone to repeat everything I say back to me? How can this possibly be helpful? And even if it is helpful, why can’t I just ask a friend to repeat what I say?  To better understand how powerful a therapist’s restatement interventions can be, let’s take a closer look at one of the most basic tenants of Rogerian psychotherapy: the client is at the center of the therapeutic experience.

Rogers’ theory and approach to psychotherapy places such value on the client that Rogerian therapy and Client-Centered, or Person-Centered, therapy are terms that are used interchangeably. At its core, this means that clients are viewed as the experts on themselves. The therapist’s role is not to interpret clients’ experiences or make suggestions by giving them direct advice, but rather to serve as a mirror to the client, allowing them to see themselves, as they are, and to use this self-awareness to inspire changes.

Take the example given above. If Sonya were talking to a friend, the friend’s response to the first statement would probably have been one of commiseration. Her friend might have reviewed the events of her equally grueling day, complaining about her difficult boss, her overscheduled kids, and her forgetful husband. Alternatively, the friend might have shared some of the strategies that she uses to manage her time. In either case, the friend would have jumped into the spotlight and the focus would have shifted to the experience of two people, rather than remaining centered on Sonya. This is absolutely fine, and even valuable, within the context of a friendship, but it does not allow Sonya the opportunity to look more deeply into why her harried days are so distressing. A therapeutic relationship, rooted in Rogers’ theory, on the other hand, creates an environment and the dynamics necessary to explore issues at the deepest levels.

While at first glance, the Client-Centered restatement approach seems easy, even lazy, and it takes a great deal of training and practice to do it effectively. It requires considerable discipline to sit and listen– not to interject your own agenda, not to offer advice, not to tell your own story–but to hold up a mirror so clients can see themselves and determine whether the image they see aligns with who they wish to be. It also requires therapists to trust that clients have the answers within themselves. When clients are given the time and space allowed for by Rogerian therapy, they develop the insight necessary to move toward real, life-changing action.

Families are amazingly resilient relationship groups. While many of us have enduring trouble with some aspect of our families, past or present, all of us are part of some form of family all our lives. Most of us organize our lives around the needs, priorities, goals, and problems of our chosen family. Whatever differences and conflicts we may have with other nations and peoples around the world, the human family is the way all of us organize.

Family therapy is a form of psychotherapy that seeks to understand, theorize, and imagine ways to help families function better with more flexibility, healthier communication, and more functional roles, responsibilities, and shared connections. When family relationships are strained beyond the members’ capacity to respond, having a trusted, compassionate, and trained relationship coach or mentor can really make life happier, easier, and healthier for all involved. Licensed marriage and family therapists (LMFT) have specialized education, training, and supervision in helping families increase their ability to function in a positive, enjoyable way—at least, that’s the goal.

As helpful and healing as family therapy can be, there are certain life problems that are so detrimental to individual functioning that they should be addressed in individually therapy before family therapy can begin. These include:

1. Addiction. Major, active addiction is so distracting and distressing to personal functioning, that the condition must be in treatment and under stable recovery before family therapy can be helpful. Most LMFTs will expect that drug, alcohol, and gambling addictions, and eating disorders get identified and treated before the whole family is under care. Sexual addictions, in my experience, are often only identified when a couple or family is well into therapy, and so may be initially hidden. However, they too are best treated individually if the addiction has been identified in the beginning.
2. [fat_widget_right]Severe mental health conditions. Major mental health issues such as bipolar, severe depression, anxiety, schizophrenia or other disabling conditions should be under treatment before family treatment is begun.
3. Family violence. Chronic anger, violence, and abusive behaviors are so threatening to family life that attempting family therapy can actually cause more hurt unless the violence is first prevented, controlled, and stopped.
4. Affairs. Secret or not, ongoing emotional and sexual affairs unbalance a family so that therapy is not possible unless they are completely stopped. Most family therapists will ask about affairs in their initial phone conversations or meetings with couples and the adults of family groups and will defer family therapy in cases of ongoing affairs.

Even if your family may be in the midst of one of these problems, a family therapist may be a great local resource for finding the help you need. If you are worried about your family, have run out of your own ideas, and energy for making a change is running low, please consider seeking out the professional help you need to get your closest relationships back on track.

When we think of sex therapy, we generally assume this takes place with (and is for) adults or couples. This neglects the importance of helping our children understand sexuality and their bodies.

If you are a parent, an aunt or uncle, or a much older sibling, you know that when it comes to the subject of sex and children, we walk around on eggshells. Children are sexual beings from the day they are born, though, and in depriving them of sexual knowledge and their own natural expressions we do them an injustice, often stunting their sexual development and growth.

We worry about overstimulation: that we are somehow being voyeuristic when we encourage kids to talk about sex. We worry that we might encourage or victimize them by educating and informing them. As educators, we worry about not having the parental permission. We assume, also, that many children live in a world where they are protected from sexually explicit material. I think we know that even the most protected child is exposed to sexual material in one form or another. Parents cannot monitor everything, but we can provide kids with tools to make informed choices and to process what they see, hear, and read.

[fat_widget_child_counselor_right]

It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. This is normal behavior and should not be shamed or shunned. I am referring here to masturbation and mutual exploration (i.e. playing “doctor” or “house.”) Please note: I am not referring to sexual play between two or more youths of disparate age, or an adult with a child. Age is key here. A child is naturally inquisitive and curious about his or her body; an older individual should not exploit this. It is important to know, however, that same-age or close-in-age peer exploration is a part of natural and normal sexual development.

It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. 

An example I make is of two girls, age 8, who are found being sexual in bed. The parents decide to punish the girls, separating them from future play dates. The parents are confused and shocked, perceiving this behavior to be wrong.

It is important to know, also, that exploration is often done with a peer of the same sex.

Punishment and shunning of normal and natural behaviors, including masturbation, may lead to shame and guilt about sexuality in adulthood, and confusion and embarrassment throughout development.

A great book to read on this matter is Sex, Therapy, and Kids: Addressing Their Concerns Through Talk and Play, by Sharon Lamb. If you are feeling ill-equipped, under-informed, or worrisome about talking about sex, it is important to know that when we’re silent, kids aren’t getting the adult guidance and help they need.

When we are silent in response to sexual material brought up by children, we mimic and reproduce the world the child is exposed to every day, one that excites and confuses him or her and provides little space for processing. As adults, it is important for us to take the lead and teach.

Seeking a trained psychotherapist in the area of sexuality can also be a great place to start.

Have you ever been in a relationship that challenged your assumptions and beliefs about yourself and the world around you? If so, then you know how powerful and life changing some relationships can be. Imagine then, forming a relationship with a professional who is trained to develop relationships that encourage self-exploration, insight and positive change. Carl Rogers, founder of person centered psychotherapy, outlined three essential ingredients of  a successful therapeutic relationship – unconditional positive regard, genuineness and empathy.

Therapy can be a difficult, and even painful, process, wherein clients explore the good, the bad and the ugly within themselves, perhaps for the very first time in their lives.  As clients explore, the therapist’s attitude towards them will either encourage them to continue the exploration, regardless of what comes up, or the therapist’s attitude will shame them into shutting down. Therapists who have unconditional positive regard for their clients accept them as they are without conditions or judgments. Unconditional positive regard is paramount in the therapeutic relationship; it not only allows, but encourages clients to explore parts of themselves that they have never been permitted to explore. Free from the fear of rejection, clients can fully and honestly explore themselves, past and present, and their desires for their future.

The concept of genuineness in the therapeutic relationship, simply put, calls for therapists to be themselves, and to interact authentically and sincerely with their clients. Genuineness requires therapists to have a high level of self awareness, coupled with a willingness to share the experiences of their clients in a way that is beneficial to the clients. For example, if a therapist is feeling disconnected from a client as he reports the events of his week, the therapist might say something like, “I’m feeling a little disconnected from you right now.  I hear the events you are reporting, but I’m not hearing anything about how you experienced them, how you felt about them, or how they impacted you.” Chances are if this is how the therapist experiences the client, this is also how other people in the client’s life experience him. However, people rarely provide such frank, insightful feedback to one another in everyday life. This genuine statement from his therapist may lead the client to develop some insight into why he feels a distance and lack of connection in his personal relationships.

Perhaps most central to the development and maintenance of the therapeutic relationship is the concept of empathy.  Empathy goes well beyond the more common notion of sympathy. Sympathy is simply feeling badly that someone is going through a difficult time. Empathy on the other hand is the ability to put yourself in another person’s shoes, and to view, feel and experience the world as that person does. Imagine, for example, how powerful it is to have a therapist take the time to actively listen to a client who has lost her mother.  The empathic therapist, who has worked hard to fully understand her client might say something like, “It sounds like your mom was the only person who ever made you feel taken care of, and now that she is gone you’re feeling very alone and scared.”  Until this point, people have probably told the client that they are “sorry for her loss.”  Through empathy, however, the therapist has offered something much deeper– something that makes the client feel understood and solidly connected to the therapeutic relationship.

Beginning therapy can be a very difficult step to take. You may be concerned that your interaction with the therapist will be cold and clinical, or that the therapist will judge you harshly. These concerns are quite common, but also quite contrary to the Rogerian therapeutic relationship. If you are considering therapy and believe you would thrive in the kind of relationship described in this article, consider seeking out a person centered therapist near you.

The alphabet soup of degrees, licenses, and various organizations related to all things EMDR (Eye Movement Desensitization and Reprocessing) is confusing to be sure, but it is imperative that you review your therapist’s level of training.

As I have addressed before, contrary to popular belief, EMDR is not an intervention, but rather a full and comprehensive modality, one that includes eight phases, each phase with its distinct functionality, process, and methods. An EMDR therapist will approach your case, treatment goals, and your progress through the eyes of that model as it were. EMDR is a way of conceptualizing what you are working on, how your arrived at the symptoms you want to change, and what you want the future to look like.

Knowing your EMDR therapist’s training level will also enable you to determine their experience and knowledge base regarding this modality. While this information may be a little dry, it will give you the tools to ask what you need to of a potential EMDR therapist. You will know what your therapist means when he or she tells you what their level of training is. Remember, most of all, look for someone who has attended an EMDRIA Approved Training.

The Basics

Prior to 2007, the EMDRIA standards for EMDR Basic Training came in the form of an independent two-part training model. EMDR therapists who are trained prior to 2007 would, therefore, identify having been trained at Level One or Level Two. Each workshop took a weekend to complete and in contrast to the current training standard, did not include any consultation hours in between trainings. The EMDR therapist was trained in EMDR and able to identify him or herself as being EMDR trained with just the Level One training, as the Level Two training was not required. Nevertheless, please keep in mind that being Level Two EMDR trained was strongly recommended. From a client’s perspective, Level Two heightened the EMDR therapist’s understanding, provided him or her with additional tools within the EMDR model, and provided skills for processing more complex trauma cases. If your EMDR therapist chose to complete both trainings, he or she would have completed 34 training hours in EMDR.

After 2007, as I previously mentioned in last week’s article, the EMDRIA training standards for EMDR practitioners evolved. What was once Level One and Two EMDR training became a Basic Training model, one that required the completion of both independent trainings in order to identify oneself as having completed the Basic Training that now constitutes 50 total training hours. The lecture and supervised practice portions are conducted over two weekends at 20 hours each weekend. What this also means for you is that your therapist can start using EMDR after Part I, and is encouraged to, while their Basic Training is still in process.

Furthermore, as part of this 50-hour Basic Training, and to receive a formal Certificate of Completion the therapist must also complete a total of 10 documented consultation hours. Five hours must be conducted after the first weekend, and the final five after the second weekend.

Considering Certification

For those seeking to refine their knowledge and utilization of EMDR, there is an option of becoming an EMDRIA Certified In EMDR. Essentially, the goal of the certification process is for the EMDR therapist to demonstrate fidelity to the EMDR protocol and increase his or her knowledge, expertise, and experience with the modality.

To become certified EMDRIA requires that a clinician who is EMDRIA Certified in EMDR has been licensed or certified in their profession for independent practice and has had a minimum of two years experience in their field. They have completed an EMDRIA approved training program in EMDR, have conducted a minimum of fifty clinical sessions in which EMDR was utilized, and have received twenty hours of consultation in EMDR by an Approved Consultant. In addition they must complete twelve hours of continuing education in EMDR every two years.

Working with a Consultant

The EMDR therapist seeking certification completes those 20 consultation hours with someone called an EMDRIA Approved Consultant in EMDR. Or, an EMDRIA Approved Consultant In Training can provide 15 consultation hours, and an EMDRIA Approved Consultant completes the remaining 5.

As an individual seeking EMDR therapy, think of an EMDR Consultant as one who helps EMDR therapists further enhance and assure their understanding of EMDR. To be classified as such, an EMDRIA Approved Consultant must already be EMDRIA Certified, have a minimum of three years experience with EMDR after completion of Basic Training, and have conducted at least 300 EMDR sessions. In addition, the Consultant must continue to obtain at least 12 CEUs, specific to EMDR, every two years.

Whew! Now, keep in mind, you may also run across someone who, on top of being an EMDRIA Approved Consultant in EMDR, is also EMDRIA Institute Facilitator, EMDRIA Approved Training Provider or EMDR HAP Trainer. EMDRIA Facilitators or HAP Trainers conduct and facilitate the actual Basic Training that therapists must complete to begin their EMDR journey. In addition to actually conducting the training, they also provide the consultation hours that are required in between the Part I and Part II of the Basic Training. For those completing the Basic Training through HAP an EMDRIA Approved Consultant or Consultant In Training can conduct those consultation hours in between Part I and Part II.

So, that all being said, I know it can be very confusing. But, I hope that this article has given you an idea of what those EMDR training levels mean! Best of luck to you as you travel your healing journey.

So, you made it through the hardest part– you made the decision to seek therapy. You asked for recommendations, sorted through therapist profiles and websites, maybe even spoke to a few. Finally, you selected a therapist who you believe can help you, and you are ready to get started. You think you’re on your way to feeling better, but then a strange thing starts to happen; you find yourself feeling worse. How can this be? You’re seeing a therapist and working hard to get through things. How can you be feeling worse, rather than better?

Believe it or not, this is a common phenomenon in the beginning stages of therapy. Taking a deeper look at the situation, it is easier to understand why you might feel worse before you feel better. When you make the decision to enter therapy, it is often because you haven’t been able to work through a particular issue yourself, and your friends and family haven’t been able to help you come to a resolution, so you call on a professional. This probably means a couple of things; the issue is complex and it has been troubling you for some time. Now that you have entered therapy with a trained professional, you are for the first time, exploring this issue and perhaps other issues in a deeper, more meaningful way. Therapy often involves cutting through the defense mechanisms you have used to protect yourself from difficult feelings, and this can be a painful experience.

At this point, you’re probably asking yourself, why should I go to therapy if it is just going to make me feel worse? Good question. And the answer is that while you may experience more pain in the beginning, this process is necessary in order to fully explore your situation in a way that will lead to new insights. These new insights often come with some much needed relief. But wait, it gets even better. Once you’ve made it this far, your therapist will be able to help you parlay your insights into action. Now, you’ve hit the jackpot. You came into therapy feeling lost and overwhelmed and now, with a deeper understanding of your situation, you are actively taking steps towards improving it and moving on to live the life you desire.

Certainly, if therapists began each initial session with new clients by telling them that they should expect to feel a whole lot worse before feeling any better, they probably wouldn’t keep too many clients. However, one of the most critically important elements of therapy is the development of a relationship between the client and the therapist. Skilled therapists can usually establish a solid rapport with clients within a few sessions. Once this rapport is established, therapists should warn clients that the process of psychotherapy can be very painful, especially in the beginning. This conversation may be a difficult one to have, but when a client is really ready to embark on the therapeutic journey, truthful dialogue opens the door to a secure therapist-client relationship– a relationship in which the client knows the therapist will be honest with him or her, even when it is not easy.

“It feels heavy right here,” Rebecca* said, crying and touching her chest, “like a huge rock is sitting on me. It’s like that old cartoon, where a boulder would fall off a cliff and pin the roadrunner to the ground—it feels like I can’t move.”  Rebecca, a 32 year-old successful marketing professional whose older sister had recently been diagnosed with a psychotic condition, had come to see me last year. She seemed lost in grief. Fluctuating bewilderment, sadness, fear, anger, tenderness, and love were tying knots in every part of her.

I thought that untying some of the knots in her body, with the help of mindfulness practices, might help her begin to lift the boulder.

Growing up, Rebecca’s sister had provided unconditional loving support which protected Rebecca from demanding, neglectful, and painfully critical parents. She had always relied on her sister to guide and comfort her; they had always been best friends. She said that now it felt like she was standing at the edge of the ocean, watching her sister sit on a raft drifting out to sea. She had been crying uncontrollably off and on for days. What made things even harder was that her sister sometimes acted like her old self, then became delusional again. Rebecca’s emotions were rising and crashing along with her sister’s state of mind.

Mindfulness of the Body: Body Scanning and Stretching

The first foundation of mindfulness is mindfulness of the body. It is cultivated with body scanning and movement practices, like yoga and walking meditation, anchored in feeling the sensations of breathing. A body scan involves directing one’s attention to different areas, one at a time, and focusing on the sensations in each place. A scan can begin with feeling the moisture on one’s skin, sensations of warmth or coolness, pressure or tingling. Then we scan the interior of the body, noting muscle tightness or ease near the surface and going deeper, where emotions express themselves as inner physical sensations.

Building brief body scans into a sustained stretch can begin to soften tight muscles—created from strong emotions—and release the mind from thinking for a while.

Prior to entering therapy, Rebecca had taken an 8-week course in Mindfulness-Based Stress Reduction (MBSR) from me. MBSR is based on the work of Jon Kabat-Zinn at the University of Massachusetts, and is taught in hundreds of hospitals, corporations, and schools in the US and around the world. Rebecca had done many body scans as part of the course. She knew how to locate and identify the physical sensations accompanying her emotional states. The following intervention was natural to offer, and easy to do with her.

Untying Knots in the Body

As Rebecca continued to cry, we talked about the benefits of recognizing and allowing her grief. But after 20 minutes of repeated bouts of intense sobbing, she asked me to help her stop. I asked if she would like me to guide her through some breathing and mindful stretching; she immediately said yes. We did a four- or five-minute sequence of stretches, while she remained seated on the couch. I guided her to stretch gently, to her limit, with each pose, holding it for 20+ seconds, and remembering to breathe. While holding each stretch, she scanned, place by place throughout her entire body, for unnecessary tension—inviting it to soften (without insisting) wherever she found it.

“Psychotherapeutic approaches that utilize mindfulness offer well-developed non-verbal exercises that enable the individual to dip into direct sensation beneath the veil of words that may often conceal the mind’s pain. This sensory immersion enables the individual to disengage from those bottom-up enslavements at the root of suffering….” (Siegel, 2007)

“Our poses can strongly influence our emotional states. For instance, because of the expansive inhalation and opening of the chest, backbending, traditionally a stimulating practice, can elevate a low mood. Exhale-intensive poses such as forward bends tend to calm an agitated mind. In any balance practice, both inhale-oriented and exhale-oriented postures are executed in order to create equilibrium in the body and breath and to gain emotional
harmony.” (Gerstein)

Untying Knots in the Mind and Heart

This practice creates a state of non-thinking in the midst of strong feelings. Non-thinking helps release habitual, reactive thought patterns as attention is redirected to the body—what is called the neutral ground of attention. If, in the heat of raw emotion, we give free rein to thinking or emotions, our familiar and deeply grooved cascades of mental and emotional activity take their usual course, often intensifying the emotions, or cordoning them off from awareness. Instead, if we direct ourselves to notice “what am I feeling in my big toe right now?” the cascade slows, or even stops, for a while. Awareness remains intact, and new, more balanced, and less distorted thoughts have a chance to arise.

When she sat up again after her last slow, deep forward bend, Rebecca’s face had softened, her breathing was quiet, and she said “it’s gone, the heaviness is gone.” She said she felt sad, but less afraid and overwhelmed. She began to speak with compassion for herself and her sister, while remaining more relaxed for the duration of the session.

Before ending, we rehearsed the practice again: she brought the feelings back into her awareness on purpose, then, increasingly independently, guided herself through stopping, breathing consciously, body scanning, and stretching/releasing tension.

Rehearsal increased the chances that she would remember to use breathing and stretching in the days ahead. Later, she reported with some relief that she had remembered and been able to stop and practice, and that it had helped sometimes. Directing focus away from thinking, and into the body, gave her a sense of independence in calming herself, and also helped her to use her considerable intelligence to understand her sister’s situation, and to face the frightening challenge of becoming independent of her sister for the first time in her life.

Practices like these are not intended to offer an easy fix for difficult emotions or life experiences. Mindfulness, at its core, involves observing things as they are and not fighting them. One formula used is Pain x Resistance = Suffering (PxR=S). Paradoxically, allowing ourselves to be with our pain, sadness, fear, or anger, frees us to go beyond them for a while. And, according to Daniel Siegel, when practiced enough, “… an intentionally and repeatedly created state can become an effortless trait of our being.”

Is prior training required for this intervention to be effective?

A person must be open to locating and feeling different body sensations. Not having this training is a limiting factor. In my experience, however, the breathing, stretching and scanning practice can lead to a similar shift in people who are receptive, regardless of having prior training in mindfulness.

*Names and identifying information have been changed for privacy

Resources:
Center for Mindfulness—Stress Reduction Program
Jon Kabat-Zinn’s Guided Mindfulness Meditations site

http://drdansiegel.com/

References:

1. Gerstein, Nancy. (n.d.). How Yoga Affects Emotions. OmPlace.com. Retrieved from http://www.omplace.com/articles/Yoga_Emotion.html
2. Siegel, Daniel J., M.D. (2007). Reflections on the Mindful Brain. New York: W. W. Norton & Company
3. Siegel, Daniel J., MD. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration. New York: W. W. Norton & Company

Sometimes people ask me why they should bother seeing a therapist when they can just talk to their friends. Friends know your history, you’re comfortable together, and you trust and care for each other. Friends don’t expect to get paid either, and you can meet socially instead of making an office appointment. That’s all true and wonderful.

What Can a Therapist Do that a Friend Can’t Do?

First of all, therapy is completely private—you can speak freely, without fear that your story will go where you’d rather it didn’t. Maybe there are things you’re afraid of or that embarrass you or make you feel sad, and you feel a need to talk about them. You can discuss them with friends or family, that’s true, but you might like the confidentiality that a therapist provides.

[fat_widget_right]

Next, a therapist is trained to see your patterns, both good patterns and those that don’t work very well. As a therapist, I can point these patterns out to you, and then together we can employ and enhance the good patterns and identify and avoid the not so good. For example, many people who continue to have the same kinds of relationship problems over and over can learn to make better choices in their behaviors and in finding suitable partners. Other people may have trouble getting along with people at work, difficulty making friends, or feelings of loneliness. Therapy is really good at helping people with all kinds of relationships, because it is a kind of test relationship—you get to receive feedback while trying out new ways of being in a safe environment.

Friends, on the other hand, may not be totally honest with you, because they don’t want to hurt your feelings. I don’t want to hurt your feelings either, but I know how to be straightforward and direct and how to say things in ways that won’t be so painful. And if they are painful, we can slow down, continue at a pace that helps you to feel safe, and use techniques that will help you feel less anxious or depressed.

Can’t a Friend Provide Advice or Help You Figure Things Out?

Certainly, a friend may share ideas of what’s best for you and tell you what to do. I may have ideas about what’s best too, but I will help you figure things out for yourself. A therapist can help you look deep inside to find your own solutions and teach you to remember that pathway so you can find it again when you need it. Therapists encourage self-reflection and empower people to find solutions on their own; these techniques can help people live more rewarding lives.

How Do You Know You’ve Met the Right Therapist?

As with any new person, when you first meet a therapist, you have to get to know and learn to trust the therapist.  Most often, you can feel it in your gut. Do you like each other? Do you think you could get comfortable with this person?

It’s scary to begin treatment, and it’s awkward talking to a stranger about your personal life. All therapists have ways of helping people feel comfortable. As an object relations specialist, I pay close attention to the unspoken feelings revealed in your body language. I’ll let our conversation develop naturally, and I’ll invite you to ask any questions you might have, especially if they seem silly. I’ll probably make a joke, or try to, because therapy can also be playful.

Don’t People Become Too Dependent on Their Therapists?

You might feel dependent for a time, but therapists measure their success by people’s abilities to learn and move on, allowing them to leave therapy with healthier strategies to make better lives for themselves.

When you think it might be time to cease treatment, the best strategy is to talk it over with your therapist and review your original goals. Have you met them? Are there new goals you’d like to work towards?

If you both agree that it’s time to bring your relationship to a close, it can help to set a date for termination, so you can say a full goodbye to each other. Goodbyes are just as important as hellos, you know.