couple having problems“David, tell Randy you’re sorry.”

“Sorry.”

The mother takes 7-year-old David to another part of the playground. By the sound of the “saaaaawry,” I’m guessing that David was being obedient, but he didn’t really know what he did, didn’t feel like it was his fault, and wasn’t sorry at all.

As adults, we hear (or even give) apologies such as, “I’m sorry you felt hurt.” “If I did something that hurt you, I’m sorry.” “I apologize, but I was really distracted by something else.” “I’m sorry, but you should know that I really love you and you shouldn’t take it so personally. It’s just the way I am.” “I’m sorry, but you are really making too big a deal of this. It is just a little thing.” “I apologize, but give me a break.” “I’m sorry for the problem you had. My assistant is normally on top of things.” When we give such apologies, we can say, as 7-year-old David did, “But I apologized!” However, when the apology (as in the examples above) is an inauthentic or inadequate apology, it doesn’t heal, doesn’t resolve, doesn’t soothe, and the hurt remains unmoved.

[fat_widget_relationships_right]

Authentic and effective apology is the very core of healing, clarifying, and restoring relationships, from interpersonal to organizational to cross-cultural ones. A real and well-thought-out apology can, like forgiveness, cut the cycle of anger, revenge, and hatred. However, making a genuine apology causes the giver to be extremely vulnerable. You are admitting directly to another that you did something that caused harm. This is very humbling! Doing so is also challenging because it’s like leaping off a cliff into the unknown. You are not in charge of how your apology will be received. Your efforts could be harshly rejected, your hopes for healing thrown back in your face.

A client spent some months working with his shame about having abused his younger sister. From a most humble place, he wrote her an apology in the hope that this could be a first step in restoring their relationship. Several weeks later, the letter was returned to him, with “Rejected. You will not be forgiven.” written across his words. He was devastated. Over time he began to look at what he could do rather than grieving for the loss of his relationship with his sister.

His sister couldn’t accept his apology, but he could demonstrate that he had learned and changed by volunteering at a women’s crisis center. He also could be proud that he had broken many generations of family history by not abusing his own daughters. These actions, which he was proud of, had shifted his inner wound from the shame of feeling unforgivable to the fact of being unforgiven. He could now move on.

I asked a few of my friends to remember a time when they needed to and did offer someone an apology. Usually, we rightly focus on the feelings and needs of the hurt person, but I wondered what the apologizer got from the process. This is what I heard: “I got to let go of at least some of my guilt.” “The apology was accepted. It repaired the relationship, and the friendship actually got better.” “In the process of getting to being able to apologize, I went through all my defenses and finally got to see something about myself that I didn’t like and face the truth about a familiar and hurtful pattern I had been denying or at least had been unaware of. This was hard work. Once I got it, the apology was easy.” “Honestly, I don’t know if I got anything at all. It was really like just getting it out of the way.” “It was unbelievably relieving for me.” “It took such courage. I try so hard to be ‘good,’ and it was painful but freeing to be able not only to see but to take responsibility for doing a bad thing.” “I learned that it’s really OK to make mistakes. What isn’t OK is not to apologize for them and learn from them.”

Apologies open big doors. As John Kador puts it, “Apology is the bravest gesture we can make to the unknown. … Apologies unmask all the hopes, desires, and uncertainties that make us human because, at the moment of genuine apology, we confront our humanity most fully. At the point of apology we strip off a mask and face our limitations. No wonder we hesitate” (Kador, pp. 43-44).

What is the value of apology to the one who has been wounded? Opportunity for restoring relationship, deescalating conflict, rebalancing power, recovering dignity, letting go and moving on, stopping a cycle of resentment and revenge, and increasing trust in the human capacity for goodness and truth. This is a strong litany. From the biggest perspective, “quarrels often escalate into serious conflicts on the fulcrum of apology. … Throughout human history, endless cycles of revenge and untold suffering have resulted from the denial of effective apology. It’s a tragedy because apology has the power to defuse almost all human conflicts” (Kador, p. 45).

In my book Right Use of Power: The Heart of Ethics and in my ethics programs, I talk about resolving difficulties as one of the most important and challenging skills to learn as leaders and human beings. I describe five things that most people need to hear in order to for an injured relationship to be restored. Not all of these things will be essential in all situations, but at least one—and probably more—will be needed. Here they are (Barstow, p. 160):

  1. Acknowledgement
  2. Understanding
  3. Regret
  4. Learning
  5. Repair

Making “a genuine apology or/and authentic expression of … regret” is the complete description of No. 3.

Effective Apologies

With a deep bow to Kador for his excellent book Effective Apology: Mending Fences, Building Bridges, and Restoring Trust, I want now to suggest how one can make an apology with greater wisdom and skill.

Kador also names five dimensions in making an effective apology (Kador, p. 124): recognition, responsibility, remorse, restitution, and repetition. Here’s more about each of these.

General Considerations

Accepting Apologies

The other side of offering an apology is accepting one. On the receiving side, you must discern whether the apology is genuine and whether it feels satisfactory. Accepting is just accepting. It doesn’t automatically include trusting or forgiving. Rebuilding trust happens over time. Forgiveness is a separate process.

When you do accept an apology, it is important to make an acknowledgment. Responses such as, “It was nothing,” or, “Don’t worry about it,” or, “You don’t need to apologize,” or, “It’s too late” have the effect of dismissing the intended communication. They trivialize a vulnerable moment. Before learning about the apology process, I had thought that when I said, “It was nothing,” I was being kind, generous, and forgiving. I now understand it to be disrespectful. When the apology is genuine, it is best to say, “I accept your apology.” The interaction needs to be complete and acknowledged. A friend’s “I’m sorry I’m late; I know that caused you some extra work” deserves my recognition of her humility and awareness of her negative impact. “Thank you, I accept your apology” as a response in this case works well.

Apology can move mountains. A half-hearted one can make things worse. A sincere and well-crafted apology can restore relationships.

Thank you for writing. I am so sorry this happened to you. It frankly makes my blood boil. This breach and exploitation is exactly what therapists are never supposed to do. To me, it’s akin to incest. I’m glad you’re reaching out about it. Despite whatever conflicted feelings you might be having, please know that this was not your fault in any way. Maintaining that professional wall and keeping the boundary between healer and client is solely the responsibility of the therapist. Psychological safety and doing no harm is our top priority. It’s heartbreaking that your therapist so violated the sanctity of the relationship.

Of course, from a psychological viewpoint, this kind of gross violation of boundaries and trust will bring up all kinds of conflicted and traumatic feelings for the client. (This is one of many reasons that such a breach indicates the therapist has lost her way in the profession.) What’s especially tragic is that this experience may have parallel emotional resonance for those who were abused or neglected as children. One of the most common misperceptions by victims of such abuse is that they think, somehow, in a desperate effort to make sense of a painfully chaotic phenomenon, that they “caused” or “brought on” the abuse. Therapy is set up so that it really is all about the client; when this kind of abuse transpires, how can the client help but think (among other things) that the violation is somehow “about me”? Trust me: This is about a malpracticing therapist.

The feelings you’re having are quite understandable; however—and I hate to say this—they most likely won’t just go away on their own. You allude to this in your letter in that, five years hence, the pain lingers. In a way, it means you have a communicative psyche that needs some sustained, loving attention; you deserve the care and guidance of a competent therapist to help you heal. The fact other therapists wanted you to press charges may be a sign of how seriously we take our oath as healers—it’s enraging when we hear of violations of that oath. However, you are not obligated to do anything that feels too scary or overwhelming. You may want to press charges at some point, you may not. That doesn’t seem to be what you’re needing right now, and such a decision can come later, if ever. It’s not your job to “police” anyone. We don’t want to create a situation wherein we “blame the victim.”

The first step is a healing process wherein you can reintegrate and reconnect with whatever had to be dissociated or sacrificed to live with the hurt of this abuse. Other decisions will likely follow of their own accord.

I’m curious as to your statement that “most people don’t believe a woman can abuse another woman.” Since that falls outside the range of my own experience, I would want to know more about that, i.e. who “most people” are. Most people in your circle of family and friends? Potential authorities who would evaluate this case? Has your mistreatment at the hands of others ever been doubted?

You are alluding to what I call the double whammy of trauma—first there is the painful abuse itself, and then (and this is often what causes the real hurt and disruption) the denial or minimization of the abuse. It’s possible that we can heal from hurtful events if those who participated acknowledge both the event and their participation, followed by their amending such behaviors. With the repetition of abuse and denial, and no commitment by the abusers to cease, we begin to wonder if we are in fact “exaggerating” or even “crazy.” A painful split emerges between mind and body, as we doubt our own perceptions, memories, and physical reality. This takes a lot of time to heal, to reconnect with and trust our own emotional experience and intuition, but repair is possible. Your perspective on these events may shift once the fractures begin to heal.

You may need to tell your therapist—and I’m hoping you have one you trust, or want to find one—that you’re not interested in pursuing any reporting or recriminatory actions just now. It sounds like you need now to put yourself first, make sense of what happened, and engage in a healing process with someone who will cherish the trust you give to him or her. It is a privilege for us to be trusted, and it’s something we have to earn. Don’t feel in any hurry—in fact, I’d encourage you to go at a pace that feels right to you.

I’m sorry this happened, but so glad you wrote in. I hope this answer helped in some small way. Please don’t give up on finding the right person, in spite of this awful breach. Warmest good wishes to you.

Kind regards,
Darren

therapist-with-clientOnce, I invited someone to take my workshop and she replied, “Oh, I don’t need to take your right-use-of-power workshop. I won’t cause any harm because I have good intentions.” I want to talk about how good intentions are necessary but not nearly enough for ethical use of power.

The simplest reason is the profound fact that our impact doesn’t always match our intention. In the example described in this article, the therapist’s intention was to set good and ethical boundaries with her client. The impact on the client, as you will see, was that she felt hurt, abandoned, betrayed, confused, and wrong.

Other reasons include cultural differences, impact of the power differential, projection, shame, and trauma responses. These are subjects for another article.

In the paper the other day, I found a letter in the “Dear Abby” column that was a painful example of how good intentions plus lack of skill and awareness of impact can cause more harm.

A summary of the letter: The woman wrote about seeing a therapist for issues of abandonment and trust. They became friends outside of therapy. “I trusted her completely,” the writer wrote. “During our therapy sessions, she shared her life and problems with me to the point that I feel I know as much about her as she knows about me.” The therapist, after several years of therapeutic work, “suddenly decided that ethics had been breached and that she was setting new boundaries.” The new boundaries were for no contact outside the sessions, but during their sessions, the therapist would cry and talk about how much she missed this client. Next, she abruptly decided that she could no longer be this person’s therapist. “Now, she has blocked my number and expects me to respect her demands.”

We can guess that this therapist did the technically right and ethical thing: She set appropriate boundaries, and then when she realized that she was being unethical even in the boundaried sessions, she set another appropriate boundary and stopped seeing the person entirely.

However, although her actions were correct, they certainly were not skillful or compassionate. A skillful and compassionate therapist would have recognized that the client’s issues were about abandonment and trust, which would make the separation process especially delicate. The therapist would have apologized for her behavior in participating in a dual-role relationship and made it clear that this was her big mistake and her responsibility and not the client’s fault. She would then have carefully and personally referred the person to a trustworthy new therapist. It was her responsibility to resolve and repair this misuse of her power. It seems that she thought that setting the right boundaries was all that she was required to do to be ethical.

She seemed to have imagined that because this was a mutual friendship, both she and her client would take equal responsibility for managing their grief and loss. When there is a difference in power, the responsibility is not equal. I call this the 150% principle: Both parties are 100% responsible for the health of the relationship, but the person in the up-power role (the therapist, in this case) is 150% responsible for tracking problems and resolving and repairing them.

When there has been a relationship rupture, there are five things that most people need in order to feel resolved. They may need just one or as many as all five of these things:

  1. Acknowledgment: They want their experience acknowledged, understood, validated, and empathized. They want to be appreciated for their courage.
  2. Understanding: They want to know what happened, or what your intention was.
  3. Regret: They want a genuine apology, or an authentic expression of your sorrow or regret.
  4. Learning: They want reassurance that you’ve learned or understood something about yourself or how to better care for them. (This one was a surprise to me. People are extremely generous when they feel that their pain has served some good or some learning that will prevent future problems.)
  5. Repair: They want to reconnect and participate in repair of the relationship or in gaining clarity and letting go. (This one was also a surprise. It is a rare and amazing thing to hear that the person you are in conflict with actually wants to repair and be reconnected. Often just asking that question is repair.)

We all make mistakes. Had this therapist known about the difference between intention and impact, the 150% principle, and how to link power with heart, her client would not have felt so confused, hurt, and wrong; would not have had another abandonment and trust wound, and would not have written to “Dear Abby.” Doing the right thing without compassion and skill can cause more harm.

Maybe there’s some wisdom for you, too, here. Having a good intention is ALWAYS a good thing, but in human connections, your actual impact is what most needs your attention for the well-being of your relationships.

Friends share a cup of coffee togetherOn more than one occasion, previous clients have asked if we could remain friends during or after our therapy sessions. While I could envision being friends with some of my previous clients if circumstances were different, I usually refrain from doing so and explain why I don’t encourage it.

As clients, it’s wonderful when your work with therapists has developed a strong sense of trust and safety over time. You have successfully been able to open up, gain more insight, and work through the primary issues for which you initially chose therapy. Perhaps you saw the evolution of talking about intimate details to a virtual stranger who then became what feels like a friendly confidant.

Good therapists with appropriate boundaries often do not view the evolution and closeness of the change in the therapeutic relationship with the potential for a friendship after therapy concludes, as some clients may. It is not that therapists wouldn’t like there to be a friendship in some instances. Nor does it mean they don’t care about or are indifferent toward their clients.

Therapists are usually not friends with their clients for two reasons:

  1. To maintain objectivity in the clients’ best interests
  2. To avoid conflicting dual relationships.

While some dual relationships are inevitable, ethically and legally therapists must evaluate and avoid dual relationships that harm or hinder the work with their clients. Therefore, other types of relationships that evolve during or after the therapeutic relationship are not normally encouraged. As an example scenario, let’s say you are hosting a dinner and wine tasting party at your home, and invite your therapist to meet your new significant other. Your therapist declines, and you feel angry. How will this affect your next session? Will it affect whether you decide to show up or not?

In another scenario, maybe you have successfully terminated your sessions, and somehow remained friends with your therapist. But what if another issue comes up for which you would like to resume therapy? The nature of the relationship would then be clouded and the boundaries unclear.

The therapeutic relationship is not a symmetrical relationship where there is mutual sharing on both sides. There is a natural imbalance. While a good therapist is a caring and empathetic person who you feel became a friend, he or she is also an authority figure to whom you are choosing to turn for professional help and support.

In friendships, there is normally a two-way dynamic in which both parties get to know each other and can mutually share vulnerable information about themselves over time. In the therapeutic relationship, the client primarily holds the role of sharing vulnerable information with the therapist. The therapist does not usually do so in turn, especially on the clients’ time. When personal issues come up for therapists, they will often seek consultation, supervision, and even their own therapy when needed.

The role of therapists is to serve their clients through listening, empathizing, mirroring, offering a different perspective, and assisting their clients gain more insight into their situations and their reactions. They help their clients with coping skills and equip them with tools to deal with their situations or relationships in a healthier manner. The therapist focuses attention on the primary issues a client is struggling with, rather than the other way around.

It is never the responsibility of the client to take care of the therapist or to solve an issue a therapist is struggling with in his or her personal life. This is one of the primary reasons developing a friendship with your therapist outside the appointed session time is not highly encouraged.

Most good therapists generally care about their clients tremendously and want to genuinely see them improve. In order to do so, they will keep the therapeutic boundaries clear and intact.

Father and Son Shouting at Each OtherShouting, yelling, screaming. Nearly all parents have done it; nearly all children age 10 and under have heard it. In small doses, such as in emergencies, yelling is not believed to be harmful. Yet, as common as this interaction is within families, if it happens too often it can break down positive conflict-management skills and flood a family’s emotional field with negative affect.

Why Do We Yell?

The most basic reason we yell in any situation is because, on some level, we feel we are not being heard. Whether literally—the person is in another room, for example—or figuratively, not feeling heard is an incredibly frustrating experience. When we believe we have a valid point and are being intentionally ignored, misheard, or invalidated, inside our brains we are thinking, “They must not really be hearing me. I will speak louder. That should do the trick!”

Yelling also stems from a need for control. Yelling is a form of verbal aggression; it carries the message that the yeller desires to be the loudest and most dominant person in the room. If someone is yelling, it is a good bet that the yeller is feeling out of control and is feeling the need to dominate the interaction.

[fat_widget_right]

Parents often experience frustrating and even oppositional behaviors from young children. Depending on your child’s age, he or she may be focusing on developmental tasks ranging from establishing a sense of independence to experimenting with rebellion. The act of not listening to you can actually be part of your child’s necessary development.

At various times of the day or week, parents’ reserves of patience and energy can already be low. For example, a full-time parent may feel that he or she can barely make it to nap time with sanity intact. A pre-nap meltdown from their toddler hits them at their absolute lowest point of the day. A working parent’s morning can be so tightly orchestrated that just the slightest alteration in routine can cause a cascade of setbacks and tardiness. Throw in an early meeting and some traffic, and there is a perfect storm of frustration which can come lashing out toward a child. Parents can reach a saturation point at which their own coping skills are no longer carrying them through a particular interaction. At these points, parents often resort to yelling in an attempt to regain a sense of validation or control.

What’s the Case against Yelling in Families?

Yelling raises blood pressure, heart rates, and adrenaline levels. Those who yell exhibit higher levels of the stress hormone cortisol in their bloodstreams over time. These physical consequences are also seen in those who are yelled at. Like second-hand smoke, second-hand anger can take a big toll on health.

That’s a case against yelling in general, but in families with children age 10 and under, there are several other reasons that yelling isn’t healthy.

Children look to their parents to maintain the safety—physical and emotional—of the family. Babies and very young children do not yet have the ability to determine the difference between a real threat to their safety and an upsetting or frustrating circumstance. Many parents can attest to this, hurrying to the scene after having heard their toddler scream as if hurt, only to discover the source of the scream was a minor frustration such as not being able to reach a toy. The child’s cognitions in this stage are quite concrete; circumstances are either “all good” or “all bad” and there is little room for ambiguity. Children under age 5 can therefore mistake a parent’s loud tone with an alert to a true threat. This can be terrifying for a child in this developmental stage.

Fear is one of the most basic and universal emotions—every animal experiences it. Fear is centered on a primitive part of our brain called the amygdala. When fear permeates a young child’s emotional experience, such as in a household with daily episodes of yelling, the amygdala will become overly active and this will inhibit the child’s brain from working on higher-level functions such as concentration, reflection, learning, decision making, and behavior planning.

With older children who are more verbal, the words that are shouted can be even more harmful than the tone itself. Even though yelling is an attempt to gain control through aggression, the irony is that in doing so, we actually lose control of our behavior and our ability to filter and manage what we are expressing. Negative labeling, blaming, and other harsh words are especially harmful to children because children accept unconditionally that what their parents say is true. Children between approximately ages 5 and 10 have the cognitive ability to understand the words themselves, but not the adult’s emotional context. They will internalize the messages from the parent without questioning if they are accurate, and will add those messages to their budding self-concept.

[fat_widget_left]Finally, many parents who yell can relate to this scenario: “When I don’t yell, my child doesn’t listen to me. He or she only seems to respond (do what I want) when I yell.” The escalation involved in yelling can become a self-reinforcing feedback loop. Children can become desensitized over time to their parent’s escalation pattern. The child, who is interested mainly in persisting in play or attending to his or her own agenda, will naturally search for ways out of responding to a parent’s demands. We cannot fault the child for this; it is simply a piece of his or her development. The more parent-free space and time a growing child can carve out, the more he or she can explore the world around him/her and his/her own inner experience. The child learns that the parent will eventually escalate to yelling each time, and so the child learns that he or she does not need to respond until and unless yelling is used. The “pre-yelling” time becomes seen by the child as “don’t have to listen yet” time. And the parent, on the other side of this interaction, keeps needing to up the ante over time to get the same response.

How Do We Break the Yelling ‘Addiction’?

1. Set a SMART goal around yelling: a Specific, Measurable, Attainable, Relevant, and Time-bound goal that solidifies your commitment to changing this behavior. Such a goal may sound like this: “Within the next month, I will decrease my instances of yelling on weekday mornings until I’m yelling once per week or less during that time period.” Write down your goal and put it in a place you will see it every day.

2. Find ways to increase true power, so that false control is less tempting. Yelling is false control. It feels powerful in the moment, but it undermines our internal self-control and the quality of our relationships over time. Ways to gain true power include:

3. Assume responsibility for the outcome of each interaction. You are the parent. You set the stage for the relationship between you and your child. If your child escalates, this does not mean you must escalate. If the situation escalates, this does not mean you must escalate. No matter how bad the traffic, how frustrating the missing shoe, how grating the whining, or how sassy the defiance—in the end, you always have a choice.

4. Speaking of choices, realize that yelling is only one of hundreds of things you can choose to do in a frustrating moment. Instead of yelling, you could:

Some parents choose a grounding object, color, or mantra which they use to bring their attention away from their momentary anger and refocus it on their goal.

5. Return often to a developmental lens through which to view your children. At all times, children must be expected to behave as children. They cannot and do not think, process, or behave as you do. It is entirely predictable that children will lose things, drag their feet, misunderstand you, ignore you, and throw tantrums at inopportune times. The more you can remind yourself that this is developmentally normal, the less you will feel personally offended or annoyed by childish behavior.

6. When—not if—you do yell, be prepared to acknowledge and apologize for this to your children. Parents must be willing to role-model to children the process of owning up to poor choices and the effects they can have on others. If as parents we are not willing to do so, how can we expect the same from our children?

Breaking ingrained patterns of interaction like yelling is not an easy thing to do. Parents must take full responsibility for “being the change they want to see” in their families. Parents must make their tendencies and triggers conscious, face them honestly, and focus their attention on them if they wish to change. Keeping a written goal, a list of alternatives, and a developmental perspective will be of great help to the parent who wishes to reduce yelling. Over time, parents who make these efforts will be able to enjoy a great deal more peace in their family, a reduction in stressful feelings, and an increase in the amount of true power they are able to exert over their lives and actions.

Family sitting and watching televisionChances are most of what you think you know about therapy is misrepresented in the media. Why? Because pop culture’s idea of what goes on in the therapy room is largely based on fictional therapists. In short, good TV and movies depict bad therapy. The dramas—made famous by fictional therapists—that interest viewers portray the qualities that would be harmful to real-life people in therapy (and most likely would get those therapists in legal trouble).

Below are the top five lies that you may have learned about therapists on television and in movies, followed by a more realistic view of therapy:

Lie No. 1: Therapists can’t be trusted to keep your secrets or respect your privacy. Television and movie therapists are often portrayed as devious or self-serving. On Mad Men, Don Draper’s wife was seeing psychiatrist Dr. Arnold Wayne, who then reported the details of their sessions to Draper (this one tops the list).

The reality: Therapists are ethically bound to maintain confidentiality. What is said in a therapy session will never be shared with anyone else without your permission. The exception to this rule is when someone is in danger, as in the case of child abuse, for example. Legitimate therapists will explain the limitations of confidentiality at your first session.

[fat_widget_right] Lie No. 2: Therapists’ foibles, oddities, and mistakes are the norm. The media often portray therapists as incompetent, either because they are pompous or because they just aren’t effective in therapy. Sometimes they’re depicted simply as being off-the-wall. The most obvious example of an incompetent therapist is the delusional Tobias Fünke on Arrested Development—a failed psychiatrist with multiple phobias and a total blindness to the problems in his marriage and family. Mind you, Tobias is a hilarious character (and that is the point)—but there’s nothing therapist-like about him.

The reality: Therapists are highly educated, normal people. In general, therapists hold either a doctorate or a master’s degree in psychology or a subspecialty (such as marriage and family therapy), and they are required to take continuing education courses on a regular basis to keep their skills and licenses current—a license is required in most states. Therapists are bound by the ethical standards of their profession as well as by local and federal laws. While perfection might be desired by a person in therapy, therapists are human just like everyone else.

Lie No. 3: Your therapist will fix your problems. Fictional therapists on TV and in movies tell people in therapy what to do, taking for granted they “have the answer.” Even Dr. Phil (who is not fictional) primarily lectures and offers advice on his show.

The reality: A good therapist will assist you in finding your own answers. Your therapist might occasionally offer a suggestion about changing a behavior, or give you “homework” to try out between sessions (this isn’t advice, but a directive). It is much more likely that if you ask your therapist for advice, he or she will help you explore your own inner knowledge about what is best for you in a given situation. Each therapist has his or her own style. And there are different therapies that prescribe a more direct vs. indirect approach.

Lie No. 4: Your therapist will become very involved in your life as your on-call crisis manager. Many TV therapists are portrayed as being intimately involved in the day-to-day dramas of people’s lives, taking endless phone calls to help the client resolve a sticky situation. In the comedies Analyze This and What About Bob? this concept is taken to an extreme, as the therapists become overly involved and react defensively to people’s needy behaviors.

The reality: Therapists maintain therapeutic boundaries in order for therapy to be effective. The therapist will explain his/her policies at your first visit. Most likely, your interaction with your therapist will be limited to scheduled visits, which are typically just once a week, but short five- or 10-minute calls between sessions are usually not prohibited (this is an individual therapist courtesy). Therapists often do respond to crisis calls when deemed appropriate to do so. It is good practice to ask your therapist how he or she handles these issues if you are uncertain.

Lie No. 5: Your therapist might become romantically or sexually involved with you. It’s easy to think, from the examples we see on TV and in the movies, that most therapists end up in romantic entanglements with people in treatment. As an example, in the blockbuster romance The Prince of Tides, the psychiatrist played by Barbra Streisand begins therapy with her client’s brother and eventually has a sexual fling with him.

The reality: Therapists are ethically bound to avoid dual relationships or sexual contact with people in therapy. A dual relationship refers to a situation in which the therapist interacts with a person in therapy in a way that may be harmful to the person. In general, this is highly frowned upon by therapeutic ethics. No therapist should engage in a romantic or sexual relationship with you while you are in treatment with him/her.

“My therapist told me the way to achieve true inner peace is to finish what I start. So far today, I have finished two bags of M&M’s and a chocolate cake. I feel better already.”
—Dave Barry

So, how are you supposed to feel safe and keep pace with all these potential issues? First of all, it’s your therapist’s responsibility to handle sticky situations correctly and within the laws that govern them. Mental health professionals are required, ethically and legally, to explain these issues to you before the process of therapy begins. Typically, you will be asked to read and sign a detailed document (usually called an “informed consent” or “disclosure”) that describes the therapist’s way of practicing and his/her ethical and legal obligations. If you have questions, you can also contact your state licensing board, as it is set up to protect your rights.

Reference:

Squiddo (2013), Retrieved May 5, 2013, http://www.squidoo.com/psyquotes by Jaktraks.

person being stalked in parking garageBeing stalked can be paralyzingly frightening. Victims aren’t traumatized just once; they’re perpetually unsettled by attempts at contact and often begin to feel like there’s no safe place to go.

The Bureau of Justice Statistics reports that about three million people are stalked every year, most by people they know—often a former intimate partner. As many as 10% of stalking victims fear for their lives, and all victims face massive disruptions to their routines. While stalking, like domestic violence, has been around for generations, it has been only in recent years that the issue has been taken seriously, and many victims may be hesitant to seek help.

[fat_widget_right]

What Is Stalking?

At its core, stalking consists of repeated attempts to gain control over or terrorize someone. Stalking exists on a continuum. On the lower end, it might involve repeated phone calls, letters, or email contacts. In its more extreme manifestations, however, stalking might involve repeatedly going to a person’s house, making threats against a person, harming pets, stealing possessions, or interfering with a person’s relationships with friends, family, or coworkers. Stalkers may alternate between patterns of domestic violence and stalking.

Each state establishes its own legal criteria for stalking. Laws generally require multiple unwanted contacts and mandate that a victim fear for his or her safety. A coworker who comes back to see a person at his or her office daily, for example, would not be stalking, and a secret admirer who sends flowers once per week is not necessarily a stalker. Repeated contacts rise to the level of stalking when they’re designed to gain power over a person and cause emotional terror.

Why Do People Stalk?

Stalkers often emphasize that they “love” their victims and occasionally say they stalk to keep others safe. For example, an abusive ex-husband might say he stalks his ex-wife to ensure she’s properly caring for their children. Psychologically, however, stalking is a crime of control. Stalkers see their victims as possessions who are rightfully theirs, and stalking behavior is frequently activated by a breakup or an ex-partner’s new relationship.

Some mental health issues can lead to stalking. People with personality issues such as a borderline personality diagnosis may have trouble letting go of relationships and sometimes use manipulative tactics to control people. Erotomania is a delusion in which a person believes that another person—often a celebrity—is in love with him or her, and this can lead to stalking. However, not all stalkers have mental health conditions, and the overwhelming majority are men. Cultural and gender norms may contribute to stalking behavior.

What Can Victims Do to Get Help?

If you’re being stalked, don’t make excuses for the stalker or tell yourself you are overreacting. Tell a friend or family member what’s happening so you have a support person and a witness. If you are in immediate danger or are being followed, dial 911. There’s no price for overreacting, but underreacting to stalking can, in extreme cases, be fatal. Other things you can do to remain safe:

References:

  1. Help for victims. (n.d.). Stalking Resource Center. Retrieved from http://www.victimsofcrime.org/our-programs/stalking-resource-center/help-for-victims
  2. King, M. W., & Sivak, A. (n.d.). Stalking: New studies shed light on a crime that terrorizes its victims. National Crime Prevention Council. Retrieved from http://www.ncpc.org/programs/catalyst-newsletter/catalyst-newsletter-2009/volume-30-number-11/stalking-a-new-study-sheds-light-on-a-crime-that-repeatedly-terrorizes-its-victims
  3. Stalking. (n.d.). National Institute of Justice. Retrieved from http://www.nij.gov/topics/crime/stalking/
  4. Stalking. (n.d.). USDOJ: Office on Violence Against Women: Crimes of Focus: Stalking. Retrieved from http://www.ovw.usdoj.gov/aboutstalking.htm

GoodTherapy | Are You Being Manipulated? Keys to Hidden AggressionWe all engage in manipulation from time to time. When your boss asks you what you thought of his or her terrible presentation and you render lavish praise, you’re concealing your real feelings in an attempt to elicit the reaction you want from someone in power. But in close interpersonal relationships, manipulation can take on a much darker hue, leaving its targets never quite knowing where they stand.

[fat_widget_right]

The very nature of manipulation makes it challenging to know when you’re being manipulated. Manipulators attempt to conceal their motives and feelings, and their targets—who often struggle to sustain an honest, open, and manipulation-free relationship—may have to do some detective work to determine whether they’re being played.

What Is Manipulation?
Manipulation is the process of trying to change another person’s feelings, beliefs, or behaviors through indirect tactics. Rather than asking for what they want, manipulative people tend to use deception, coercion, even threats to get their needs met.

Manipulation is associated with a number of mental health conditions, including borderline personality disorder, passive-aggressive personality disorder, addiction, antisocial personality disorder, and narcissism. Not all manipulative people have mental health issues, but when manipulation becomes a primary style of interaction, it can indicate an underlying psychological issue.

Tactics Manipulators Use
If you’re concerned that you’re being manipulated, examine the tactics the other person is using. If you find yourself caught up in a web of deception and unclear motives, it could be manipulation.

Some common tactics manipulators use include lying, withholding information, denying feelings, playing the victim, blaming the victim, minimizing others’ feelings, pretending to be confused or ignorant, guilt, shame, and pretending that his or her tactics are intended to serve a higher calling such as God or a political cause. Manipulators also frequently use gaslighting—the process of provoking someone into an extreme or angry reaction, then blaming the other person for his or her reaction.

While anyone can be manipulated, expert manipulators tend to target people with and take advantage of certain personality traits. These traits include:

Why People Manipulate
For some people, manipulation may be an inadvertent strategy for dealing with a cutthroat world in which discussing feelings is often taboo. Manipulation is part of the normal range of behavioral tactics, and most people engage in manipulative strategies from time to time. People whose primary style of interaction is manipulation, however, tend to share some traits in common. These include:

How to Handle a Manipulator
Many of us are highly aware when we’re being manipulated, but are still left unsure of what to do. Because manipulators often play the victim, some victims of manipulation might excuse their behavior or insist that the manipulator doesn’t really know what he or she is doing. Manipulators thrive on hiding their motives, so it can be challenging to get them to admit their true intentions, and many people will refuse to do so even under pressure. Instead, try the following tactics:

References:

  1. Psychological harassment and psychological manipulation. (n.d.). Psychological Harassment Information Association. Retrieved from http://www.psychologicalharassment.com/psychological_manipulation.htm
  2. Simon, G. K. (n.d.). Dealing with manipulative people. RickRoss.com. Retrieved from http://www.rickross.com/reference/brainwashing/brainwashing11.html
  3. Spotting emotional manipulation. (n.d.). Cassiopaea. Retrieved from http://www.cassiopaea.com/cassiopaea/emotional_manipulation.htm

Empty waiting roomThe recent news that troubled country singer Mindy McCready took her own life has thrust the debate about the efficacy and ethics of “rehab” television shows and the people behind them, such as Dr. Drew and Dr. Phil, into the spotlight. McCready is the fifth cast member from Celebrity Rehab with Dr. Drew to die, prompting one well-known musician to take to Twitter to compare host Drew Pinsky to assisted-suicide icon Jack Kevorkian: “Same results,” Richard Marx wrote.

We wanted to know what our Topic Experts think, so we asked them the following questions: Is the criticism of Dr. Drew, Dr. Phil, and similar so-called experts-turned-media personalities warranted? Is it enough? After all, for many Americans, they are THE faces of therapy. Is that fair? Are they doing more harm than good? Is what they do simply exploitation, or is there more to it? With the popularity of reality TV on the rise, how can therapy professionals counteract any damage done by Dr. Drew, Dr. Phil, and others whose platforms extend into living rooms from coast to coast and beyond?

Here’s what they had to say:

What do you think about so-called “rehab TV”? Do you agree or disagree with our Topic Experts? Please share your thoughts in the comments section below.

Fifty-fifty with gender symbolsThe state of Washington has been working for several years to change the language in its laws to gender-neutral terms. If legislation passes as expected, no longer will there be penmanship, freshmen, and watchmen. Instead, Washington will have handwriting, first-year students, and security guards.

Several other states have followed suit, with about half making moves toward gender-neutral language. Such language is often lampooned as politically correct and excessively burdensome, but research shows that language affects perceptions. Perceptions, in turn, affect behavior, and using gender-neutral language can be a meaningful move toward gender equality.

The Pervasiveness of Gendered Language
Gendered language is so common that it’s difficult for some people to even notice it. From job postings to laws, words such as policeman, councilman, mankind, and fireman abound. This omnipresence of gendered language may be part of the problem. When people stop noticing gendered language, it’s easier to think of male as the default. People who do a double-take when they see words such as policewoman or police officer may be doing so because there’s an incongruence between what their expectation of a police officer is—a male—and the possibility of a woman filling the role. The more frequently gendered language occurs, the more likely it is that people develop male as the prototype for a particular role.

This can affect a wide range of behaviors and lead to subtle biases. A company that posts a job seeking an ombudsman, for example, may envision a male in the role because of the use of gendered language. This can give women a slight disadvantage when they seek out the job because women applicants don’t completely match the hiring manager’s vision for a future employee. The person in charge of hiring may never even be aware of this subtle bias, but this doesn’t mean it’s not there.

Effects on Women
From the time they’re children, women experience an onslaught of gendered language, and this can subtly alter their perceptions of themselves. Even women report that their prototype of police officers and firefighters is male, and this may be due in part to gendered language.

Gender conditioning can affect the choices men and women make, and when women grow up learning that they’re not the ideal image of a particular role, their options are limited.

Male as Default
The use of terms such as mankind is particularly problematic because it treats men as the default. When “man” is used to refer to “all of us,” women are completely excluded, even if the term is intended to be gender-neutral. Thus, men are established as the norm against which everything is judged, and women are treated as deviant from this norm.

Real-life examples of this can be found in the long-time medical practice of using only male research subjects—a practice that has changed over the past few years.

Setting an Example
While gender-neutral language can seem frustrating and cumbersome at first, this is primarily because it’s new, not because there’s anything particularly onerous about its use. When states establish gender-neutral language, they help this language become part of the common lexicon and set an example demonstrating that gender-neutral language is just as easy to use as gendered language.

References:

  1. Carmon, I. (n.d.). The effects of gendered language in job ads. Jezebel. Retrieved from http://jezebel.com/5803238/the-effects-of-gendered-language-in-job-ads
  2. Lacorte, R. (2013, February 3). State moves toward gender-neutral language. The Seattle Times. Retrieved from http://seattletimes.com/html/localnews/2020282616_genderneutralxml.html
  3. Leaper, C., & Bigler, R. S. (2004). Gendered Language and Sexist Thought. Monographs of the Society for Research in Child Development, 69(1), 128-142. doi: 10.1111/j.0037-976X.2004.00283.x

Woman holding young girlWhen parents view their child’s “problematic” behavior, attitudes, or troubles as a reflection of them, it can be a terrible blow to the ego. For parents with positive self-feelings, anger, hurt, and disappointment can occur when they don’t see themselves reflected in their children. (“My child should be just like me.”) For parents who do not feel very good about themselves, seeing a child as being “just like me” can feel devastating. Parents who lack self-esteem often feel like their child’s problems are their fault. Their inability to differentiate themselves from their children can also result in guilt and painful feelings of responsibility that are often overstated and inaccurate. Many parents who struggle with the idea that their child is a reflection of them (for better and worse) have not separated from their children. These parents tend to feel some responsibility for their child’s situation. Most often they believe that, either in their early behavior with their children or in their biological contribution (or both), they have profoundly affected their child’s life and character.

“Peter” came to his therapy session in a rage about “Adam,” his 25-year-old son. He had just come from his son’s apartment and was disgusted about the dirt and disarray he encountered: “What is the matter with that kid? He’s such a slob. There is stuff everywhere. It feels so chaotic! I have the same feeling when I think about how he gets drunk with his friends on the weekend. He’s a mess!”

When I asked Peter what made him so angry about this, he began to express remorse about being so enraged. Choking up, he said, “I guess I’m really hurt. I feel like Adam is being disrespectful to me. He knows I hate his messes and his drinking behavior. I feel like he’s on a terrible path of disorganization and disaster. I keep asking myself, ‘How did he turn out this way?’ ”

I asked Peter what he thought about why Adam was like this. “I don’t really know,” Peter said. “But I honestly believe it’s my fault. You know I was a terrible workaholic during Adam’s first 10 years. I neglected him when he was growing up. Then I think, if I was a workaholic, will he be an alcoholic? I know I made him this way. I’m a mess of a father.” Peter was tortured by his painful feelings and disappointment that his son hadn’t turned into the ideal adult that Peter wished he could be.

Over time, as we explored Peter’s feelings, it became apparent that he put all the responsibility for the person Adam was at age 25 on himself. He found it very difficult to see Adam as a separate individual with his own reasons for behaving the way he did. Slowly, Peter was able to consider that his influence hadn’t only been negative and that he wasn’t the only influence on Adam’s development. Adam’s mother was nurturing; Adam had many friends growing up. Peter could even recall some teachers who were influential in Adam’s life. He acknowledged, for example, that a high school teacher had encouraged Adam to stay with his music, and Peter admitted that Adam was a successful musician.

“I guess I haven’t focused enough on Adam’s successes, just on the ways I see him as a failure and blame myself,” Peter said. “Sometimes I still think that maybe Adam is punishing me when he messes up in ways he knows I hate. I guess I really have to admit that it isn’t all about me. Adam is a different person from me. It’s just hard to be OK with that. But I do want to get there. I know that would be best for our relationship.”

Peter is slowly beginning to separate from Adam and experience Adam’s successes and failures as more about Adam than him. He is also beginning to take Adam’s character and behavior less personally. Giving up the idea that “it was all my fault” makes space for Peter to see Adam as a separate individual.

“Rose,” another client, began to talk about her 10-year-old daughter, “Jessica,” in our therapy sessions.  Rose was obsessed with worry that Jessica, who had learning disabilities, would never have a successful life. She said with some sadness: “Her brain is damaged. How will she ever be OK?”

“What do you mean, ‘Her brain is damaged’?” I asked.

“You know that we had her tested and she has so much trouble focusing and organizing her thoughts,” she responded.

“Yes, I know she has some learning disabilities, but seeing her as ‘a person with a damaged brain’ seems a rather extreme way of defining your daughter,” I said.

“I sort of know what you’re saying is true,” she said. “But you know I had learning disabilities as a kid. No one identified them; no one did anything about it. I still struggle at work and in my life in general with being focused and organized. I get so depressed and anxious when I forget things or don’t get stuff done like I promise my husband or my boss. I know my brain is messed up, and Jessica is just like me. Why would I think her fate is going to be any different?”

Rose had a very strong belief that biology was determining her future as well as her daughter’s. She was reluctant to consider that her daughter’s life could take a different path from hers. She had a difficult time thinking about Jessica as a separate person with her own unique characteristics. I reminded her that she and her husband had been addressing Jessica’s learning problems and getting help for her. I also pointed out that this was very different from her own experience growing up. I emphasized that there are many influences other than biology that influence a person’s development. I also asked Rose to tell me anything she could think of about Jessica’s accomplishments. We both listened to the list Rose came up with: “Great piano player, really good artist, hula-hoop champion, kind person, good swimmer, and I guess other stuff, too.” Rose reluctantly acknowledged, “Yes, I suppose her brain works OK in some ways.”

Rose and I spent a lot of time talking not only about Jessica, but also about Rose’s negative sense of self. It was harder for her to take seriously that she has her own accomplishments. It was even more difficult to consider that Jessica was like her in some ways and not others. (Rose is a terrible artist and swimmer!) Our work has centered on Rose’s struggle to experience herself in positive ways and on seeing Jessica as a separate, differentiated individual. We have also been talking about how painful it is to see your child have areas of deficit, and even worse when you feel you are the cause. Helping Rose to talk about her impaired sense of self and its development has allowed her to make distinctions between her own experience and Jessica’s. I have tried to help Rose consider that while there could be some biology at work in regard to Jessica’s learning disabilities, so much more than being “just like me” is involved in what makes Jessica who she is.

We are familiar with parents feeling great pride in how they played a role in their children’s successes. But when parents boast incessantly about their children’s accomplishments to the extent it doesn’t feel like typical parental pleasure, we typically consider them to be narcissistic. For Peter and Rose, their great dismay in what they perceived as their children’s deficits, problems, and failures was also narcissistic.

The term narcissism comes from the Greek myth of Narcissus, in which Narcissus falls in love with his own reflection in a pool. The notion of reflection is pertinent to the experiences of Peter and Rose. Rather than experiencing narcissistic pleasure, these distraught parents experienced a narcissistic wound. They couldn’t tolerate the pain of looking into the pool (i.e., at their child who also represents the parent) and seeing something that is not “beautiful” reflected back. When they looked at their children, they saw a reflection of themselves. It was intolerable that the reflection they saw was “a mess” or had a “damaged brain.” It was not “beautiful.”

These parents are responding narcissistically, and they have not differentiated themselves from their children. One has to wonder how parents, who view their children as reflections of themselves, may have influenced their child’s separation/individuation process. As parents become more aware that their beliefs that their children are or are supposed to be “just like them” are assumptions, they will be in a better position to examine those beliefs. As a result, parents will experience less pain, and their children will be helped to develop into separate, unique individuals.

One of the reasons many children do not tell anyone about being sexually abused is because they fear that their loved ones will not believe them. Often, their abuser is a friend or family member, and although children may know that what occurred is wrong, they may be confused and worried that their caregivers will think they have misconstrued the behavior. Children who feel neglected or maltreated by caregivers may feel reluctant to disclose abuse, and many abusers threaten children, creating more reasons for nondisclosure. However, when children do reveal abuse, getting them to explain the abuse in a way sufficient to lead to prosecution can be challenging.

Various methods of interrogation are used on child-abuse victims, including open-ended questions, yes/no questions, “What happened?” questions, and “How did that make you feel?” questions. For the most part, open-ended questions and “what” questions tend to provide the least amount of detail. Children often are unable to articulate the details of their abuse. And while “how” questions that prompt children to reveal their physical reactions and feelings allow them to detail their personal experience in great detail, this is the most rarely used form of interrogation. To explore which method would provide the most accurate recollection of abuse and elicit emotional responses that could demonstrate credibility to jurors, judges, and therapists, Thomas D. Lyon of the Department of Psychology at the University of Southern California recently examined transcripts from more than 100 child-abuse cases.

Lyon discovered that when children were asked closed-ended questions such as yes/no, their responses were narrow and they exhibited little emotion. Similarly, when they were asked “What happened?” they were hesitant to reveal details and appeared emotionally undisturbed. But when children were asked how the abuse made them feel and what their physical reactions were, the responses were extremely vivid and consistent. They demonstrated emotional responses and used words such as angry, sad, afraid, confused, “sick to my stomach,” and dirty. They manifested facial and physical reactions that allowed those interviewing them to see the damage of the abuse in ways that the children could not articulate when prompted with direct questioning. “Children can be surprisingly articulate about their reactions to sexual abuse, despite their apparent lack of affect in describing the abuse itself,” Lyon said. He hopes that these findings will motivate interviewers, prosecutors, and mental health professionals to evaluate physical and emotional reactions of abuse as a means to gather details from child sexual abuse victims.

Reference:
Lyon, Thomas D., Nicholas Scurich, Karen Choi, Sally Handmaker, and Rebecca Blank. ‘How did you feel?’: Increasing child sexual abuse witnesses’ production of evaluative information. Law and Human Behavior 36.5 (2012): 448-57. Print.

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.

×

Are You a Therapist?

Grow your practice. Join our trusted directory and connect with clients who need your expertise.

Sign Up Now

Find a Therapist