Romantic love can be all consuming. In the beginning stages of a relationship, one or both partners may be overwhelmed with feelings of affection for the other partner. Couples may want to spend all of their waking hours together and actually crave each other’s presence when apart. These feelings are not uncommon in many budding romances. However, when they persist and lead to unhealthy behaviors, this type of love can become destructive. Much like an addiction to drugs or alcohol, people who experience love addiction pursue their drug at the expense of their friendships, careers, family members, and even self-respect.

In a recent article, Dr. David Sack, a psychiatrist and addiction specialist, explains what love addiction is. He says that people who are in addictive relationships experience limerence, a term introduced by psychologist and author Dorothy Tennov to describe love obsession and dependence. Limerence mimics new romantic love, but unlike true love that constructively develops into reciprocal, mutual affection, limerence is usually destructive. When one partner exhibits limerent behaviors, they may begin to cross emotional and physical boundaries in order to secure the attention and affection they need. Even when the feelings are not returned, the limerent partner may continue to chase after the other partner. Sack says, “Behaviors may become dangerous, such as stalking or unwanted contact, and require outpatient or residential love addiction treatment, professional counseling, and/or 12-step work.”

Limerent relationships are not all bad. Although most end with one partner being rejected and hurt, some actually grow into healthy and mutually loving unions. Individuals who display limerent behavior in one relationship may continue to do so in future relationships, creating a pattern of destruction and disappointment. Sack suggests that individuals who believe they are involved in a limerent relationship, either by their own actions or those of their partner, work with a professional to identify the negative behaviors. Understanding the cause of the limerent patterns will help an individual become aware of why they behave the way they do and give them an opportunity to transform negative patterns into more positive and promising ones.

Source:
Sack, D. (2012, June 28). Limerence and the biochemical roots of love addiction. From the Huffington Post. Retrieved from http://www.huffingtonpost.com/david-sack-md/limerence_b_1627089.html

Related articles:
What to Look for in an Addiction Therapist, Part 1
(Don’t) Keep Coming Back

People battling cancer often experience fatigue and low energy levels, despite getting adequate rest. Fatigue is one of the largest negative impacts on a cancer patient’s quality of life. In fact, in some surveys, patients identify fatigue as a more bothersome effect of cancer than pain. Treating the secondary effects of advanced disease, including fatigue, is one of the main goals of modern cancer research. Lifestyle interventions, such as physical exercise or group therapy, have yet to demonstrate significant improvement in terms of patient fatigue levels. Pharmaceutical approaches may be most effective in reducing cancer-related fatigue.

Ritalin (methylphenidate) is generally prescribed for attention deficit disorder in children and narcolepsy in children and adults, and it’s available in both immediate and sustained release formulations. There is conflicting evidence as to whether Ritalin might be useful in reducing cancer-related fatigue. While some studies have shown significant improvement in cancer patients’ quality of life after taking this medication, others have produced negative or insignificant results.

With cancer, researchers sometimes have difficulty separating the effects of an experimental treatment from a patient’s routine treatment. The most recent study of Ritalin and cancer fatigue, conducted in part by the Mayo Clinic, showed no significant improvement for all but the most serious cases of tiredness. Participants were placed into drug or placebo groups and administered identical tablets for three weeks. Fatigue and quality of life surveys were conducted at regular intervals. As with all drug research, however, primary effect is not the only consideration; adverse effects must be considered and carefully weighed against the desired outcome.

In the Mayo Clinic study, participants receiving daily sustained-release Ritalin reported nervousness and loss of appetite at a rate far greater than the placebo group. Patients with Stage III or IV cancer and severe fatigue showed the most significant improvement, but they also experienced the most adverse events. Whether or not the potential benefits outweigh risks must be decided on a case-by-case basis. Researchers acknowledged that perhaps immediate release Ritalin could offer greater benefit, and future investigations may take up this line of reasoning. As for now, a non-pharmaceutical approach to managing cancer-related fatigue may still be the safest alternative in most instances.

Fatigue, sleepiness, and even depression often linger for months or years after cancer has gone into remission. In many cases, the effects of cancer treatments are so damaging to healthy cells that full recovery is an uphill struggle. Currently, there is no overwhelmingly effective approach to reducing fatigue in cancer patients and survivors. Ritalin might be useful in advanced stages of the disease, but more study is needed to be certain.

References

1. Methylphenidate – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved April 16, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000606/
2. Moraska, A.R., Sood, A., Dakhil, S.R., Sloan, J.A., Barton, D., Atherton, P.J., Suh, J.J. et al. (2010). Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Long-Acting Methylphenidate for Cancer-Related Fatigue: North Central Cancer Treatment Group NCCTG-N05C7 Trial. Journal of Clinical Oncology, 28, (23), 3673-3679.

I first met Albert Ellis, the founder of Rational Emotive Behavior Therapy (REBT), about 35 years ago. Soon after I became an Associate Fellow and a Supervisor with the Albert Ellis Institute in New York City, and was a died-in-the-wool devotee for decades.

Al was open to all of us adding or subtracting a variety of techniques, whether meditation, homeopathy, yoga philosophy, or anything else, as he had already incorporated disparate ideas from areas as diverse as Buddhism and behaviorism. He wanted each therapist to put his or her own stamp on their ways of working, although I believe he assumed we would all keep the REBT skeleton beneath whatever robes we draped it in.

Rigid, dogmatic thinking was not the coin of his realm. In fact, he loved to engage in lively discussions of all therapeutic techniques and was happy to incorporate anything he believed would help shift a client to becoming more unconditionally self-accepting.

Of course, like any parent, he was proud and delighted when his baby, REBT (the precursor of cognitive behavioral therapy [CBT]), would be “proven” to be effective in alleviating depression, anxiety, anger issues, or anything else, as it was with 40-plus years’ worth of studies.

This plethora of evidence-based practice studies that have lauded the effects of REBT and CBT is what led to the Swedish government’s decision to invest heavily in training clinicians to provide CBT to people with depression and anxiety and spend no money on training or treatment in other modalities. Naturally, the Swedish government was a bit shocked when a recent study showed that training therapists in and treating clients with CBT had little or no effect.

In response to these findings, Scott D. Miller, Ph.D. wrote: “The widespread adoption of the method has had no effect whatsoever on the outcome of people disabled by depression and anxiety.  Moreover, a significant number of people who were not disabled at the time they were treated with CBT became disabled.”

Apparently, this has not deterred the American Psychological Association from resurrecting its plan to draft and promulgate a series of guidelines pushing specific treatments for different mental health issues.

Dr. Miller and his colleagues at the International Center for Clinical Excellence have analyzed many studies showing little difference between treatment approaches in terms of outcome. They argue that all approaches work almost as well, and efforts to target specific treatments for each psychiatric diagnosis are not an effective use of time and money.

Dr. Miller recently talked about what works in behavioral health and recommended shifting the focus to designing client-tailored services rather than spending so much energy on examining specific treatment models and techniques. Meanwhile, Sweden has decided to end the exclusive use of CBT for the treatment of anxiety and depression, realizing that people need to have therapy choices.

As a holistic psychotherapist for almost 40 years, I think it is obvious when treatment is working: people self-report feeling better. They engage in life more fully, sleep better, take better care of themselves, and have more satisfying relationships and more meaningful life experiences.

As much as it can be wonderfully useful to study psychological modalities, theories, and philosophies, at the end of the day it all boils down to whether the person has been helped or not. Using evidence-based practice studies as a Procrustean bed will only cause pain and prolong suffering, just as the original one tried to stretch or shrink people to fit its specifications.

Source:
Miller, S. D. (May 13, 2012). Revolution in Swedish mental health practice: The cognitive behavioral therapy monopoly gives way. Retrieved from http://www.scottdmiller.com/?q=node%2F160&goback=%2Egde_53475_member_125725759

Related articles:
What is CBT?
Deep Breathing and Guided Imagery
When Someone Really Listens, We Heal

Play is an important part of a child’s development. It enables them to engage creativity and learn necessary social skills. Children are often introduced to concepts like sharing, taking turns, and working together when they participate in group play. This critical time of development allows children to learn how to practice patience, empathy, and other necessary social skills. Although the research on play has demonstrated the many benefits, such as creativity and emotional maturity, few studies have looked at how creativity exhibited through play affects storytelling and divergent thinking, two aspects that further emotional regulation and enhance psychological development.

To address this, Jessica Hoffman and Sandra Russ of the Department of Psychology at Case Western Reserve University conducted a study involving 61 young girls in kindergarten through fourth grade. The team used the Affect in Play Scale to assess the girls’ mood processes and cognitive behaviors as they construed narratives. The researchers also relied on parent reports to measure emotional regulation and evaluated the girls for divergent thinking abilities throughout the task. They found the pretend play allowed the girls to express creativity that directly increased their divergent thinking abilities. The creative play enhanced storytelling skills of the participants and allowed them to express high levels of emotional regulation. The team also explored how executive functioning was affected by creative play but found no relationship.

Hoffman noted that the participants in this study were typically performing young girls and believes that additional research on clinical and nonclinical participants would further add to the limited literature on the many positive influences of pretend play. She said, “Overall, results of this study are promising with regards to the associations between pretend play and other important life skills for children.” With play therapy and other creative approaches receiving more attention in recent years, understanding the forces behind these often successful treatment methods is vital for clinicians interested in using these techniques.

Reference:
Hoffan, J., Russ, S. (2012). Pretend play, creativity, and emotion regulation in children. Psychology of Aesthetics, Creativity and the Arts 6.2, 175-184.

According to a recent article, being completely honest with your mate about infidelity might not always be the best strategy. Clinical Psychologist Bruce Stevens explained that understanding the need to be honest about the affair can help guide the decision whether to do so or not. Stevens has worked with couples for more than two decades and said that his experience has shown him that only about half of marriages survive after an affair has been revealed. He says, “After an affair is found out, it’s like a bomb has been dropped on the relationship and you cannot predict how it will go.”

When someone confesses to having an affair, it can create a sense of chaos unlike any other the relationship has ever experienced. Stevens knows that couples who put in the effort to work through the many issues that arise after the affair have a good chance of salvaging their relationship and usually have a stronger, better, healthier relationship because of it. Stevens says that many people admit to their affair in order to assuage their own guilt. He believes that this reason should not be the motivating factor for full disclosure. Stevens says there is no guarantee that both partners will be able to overcome the damage caused by the truth and thinks it’s almost like playing Russian roulette.

The good news is that Stevens also thinks that there is significant hope for couples who can be realistic after they go through the pain of discovering an affair. If both partners are willing to accept responsibility and recognize that they are both human beings, flawed and imperfect, they have a very good chance of moving forward in their life together. Regardless of whether partners choose to come clean about their infidelity or not, Stevens reminds us that affairs are like fairytales. They are illusions that allow us to temporarily escape reality. The difference is, affairs rarely end “happily ever after.”

Related articles:
Reasons for the Affair
When Is the Marriage Really Over?
The 5 Truths Every Married Person Needs to Know About Affairs

One of the primary goals of successful therapy is the formation of a meaningful and strong therapeutic alliance. This bond between the therapist and client is essential for creating an environment of openness, acceptance, and trust. Therapists are largely responsible for developing this foundation, but clients contribute significantly to the bond as well, even if they are unaware they are doing so. Many clients bring past experiences into therapy. Negative and judgmental encounters with previous therapists can cause clients to be distrusting and fearful in treatment, creating barriers to constructive working alliances. Understanding how clients’ past experiences influence the therapeutic bond, and how therapists can overcome these challenges, was the focus of a recent study conducted by Christian Moltu of the Division of Psychiatry at the District General Hospital of Forde in Norway.

Moltu interviewed a dozen therapists and asked them to describe how they overcame hurdles they experienced with hesitant and resistant clients. The therapists were trained in a range of approaches and yet each described similar methods for interacting with difficult clients. Each therapist stated that he or she achieved a productive working alliance, despite their clients’ reservations, by doing one of three things. The therapists said that successful alliances occurred when clients asked the therapists to help them with the relational challenges they faced. Additionally, therapists noted that bonds were built when they acknowledged the clients’ willingness and courage to overcome existing challenges. Lastly, when clients were unable to move past victimization and suffering, therapists found a way to build a bond with them by recognizing this deficit in their clients and explaining that the goal of therapy was to move from challenging situations to positive outcomes. Moltu added, “We found that participants experienced the client as contributing relationally and that this influences how the therapists respond and are present in the interaction.” By being attentive to the past experiences a client brings to therapy, a therapist can work with the client to overcome these limitations and ultimately develop a strong and cooperative therapeutic relationship.

Reference:
Moltu, C., Binder, P.-E., Stige, B. (2012). Collaborating with the client: Skilled psychotherapists’ experiences of the client’s agency as a premise for their own contribution in difficult therapies ending well. Journal of Psychotherapy Integration. Advance online publication. doi: 10.1037/a0028010

Religion has been shown to be a stabilizing factor for mental well-being. Research has demonstrated that people who have religious beliefs tend to have better mental health, physical health, and more satisfying relationships than those who do not have any religious beliefs. Religious individuals who seek therapy may look specifically for a therapist who is of their religious affiliation; however, many choose to work with secular therapists in order to receive an unbiased assessment of their psychological state. Because of this, it is important to understand how religious clients view the treatment they receive from secular therapists. Carrie L. Cragun of the Department of Educational and Counseling Psychology at the University of Albany in New York was curious to find out if religious individuals held negative or positive opinions of secular therapists and the treatment they provided.

Cragun recently reviewed assessments from 11 Christian individuals who had received therapy from secular therapists. She evaluated whether the clients reported their experiences as positive or negative and how religion influenced their reports. Cragun found that the majority of the clients reported positive experiences from the secular therapists. This was most often the result of working with a therapist who was open and willing to discuss religious beliefs. The therapists who were judgmental and less inclusive with respect to faith were seen as providing a negative therapeutic experience. However, when therapists explained that they were unqualified to discuss their client’s religion, the clients respected that response and still rated the overall experience as positive.

Religious beliefs play a significant role in the lives of many clients. This study demonstrates that many individuals do not feel comfortable initiating discussions about this important topic to therapists. “Results suggest that creating safety for clients to discuss their religious identity and beliefs could begin on intake,” Cragun said. “Therapists could ask about clients’ coping methods or specifically about religion and spirituality.” Providing an environment in which a client feels fully accepted regardless of religious devotion or ambiguity will set the stage for full disclosure in other areas. Cragun believes that the best place for this to start is when students are studying to become therapists. Learning about the importance of multicultural issues and how to integrate these issues into therapy will allow therapists to be more inclusive of clients from every ethnic and religious background.

Reference:
Cragun, C. L., Friedlander, M. L. (2012). Experiences of Christian clients in secular psychotherapy: A mixed-methods investigation. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0028283

The novel Fifty Shades of Gray has attracted enormous attention since its recent publication. The popularity could be attributed to the characters’ scandalous sexual trysts laid out in vivid detail. Or it could be due to the fact that women really do want more sexual pleasure in their relationships. In a recent article, clinical psychologist and sex therapist Dr. Stella Resnick explains why she believes the public has such a voracious appetite for this type of literature. Resnick practices Gestalt therapy, which integrates body and mind presence and awareness. Her experience has taught her that every form of physical contact, including touch, kissing, and even eye contact, increases overall sexual pleasure. She believes that intimate play is an integral part of a healthy sexual relationship.

Resnick has been working in her field for more than two decades and says that contrary to popular belief, men seem to lose interest in sex more quickly than women. This could be a result of the pressures men feel to provide financially and their sense of responsibility as the head of the family. The natural progression a partner makes from lover to family member can actually undermine sexual attraction and excitement for men and women alike. In fact, Resnick says that these feelings of “love” for each other can create barriers to healthy sexual fun. Resnick says that maintaining a sense of playful sexual activity is important for many reasons. “New brain research has shown that what’s essential for enhancing new learning is to keep the brain engaged and attentive and that playfulness is one of the best ways to do that,” she says. Learning about each other’s wants in and out of the bedroom helps broaden the bond between partners both physically and emotionally. Resnick suggests couples engage in conversations about sexual desires and act on them. Taking time to relax and enjoy a sexual encounter, including play, can create a sexual experience that will satisfy both partners and keep both brain and body engaged.

Related articles:
Fanning the Spark of Sexual Passion
7 Steps for Talking Your Way to a Better Sex Life
Different Shades of Sexuality: The Psychological Aspects of BDSM

In counseling, many of the ways to address anger can also be used as tools to address anxiety. Deep breathing is one such tool. Getting that full, deep breath of oxygen will indeed help both our mind and body. Sadly, we may not stop to focus on our breathing or take in enough of that good oxygen. Furthermore, in times of distress, rapid breathing is more likely and will not help the thinking process or our ability to calmly make decisions.

When I sit in session and show clients that taking that breath is a bit more than a second or two process, they seem confused. Yet nearly everyone reports feeling remarkably calmer after trying it. Personally, I like to close my eyes so I am not focused on what is around me. Imagine as you take in that full breath through your nose that you are soaking in positive energy. Hold it a second or two, and then slowly breathe it out through your mouth. This is not a race. In fact, try to expel it slowly. Slowing down your breathing will mean you are slowing down your mind and body.

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Now, in the process of this deep breathing, let’s add some guided imagery. For this, think of a calm place. I would like this to be somewhere you feel relaxed and positive. For me, it is the beach. I want you to see yourself there without having to focus on where else you may need to be or other things you may need to be doing.

Experience as many of the senses as possible. For example, sitting on the sand, I can feel it between my toes. I can feel the warmth of the sun on my arms. I can smell the cool beach air and the scent of suntan lotion, and I can hear the gentle crashing of the waves and even children playing off in the background. I can also see the beauty of the area, as I watch the birds in the distance over the water. The beach is a calming place for me, so as I take in my deep breaths, I imagine soaking in the warmth and wonder of it, even as I am in my car, home, or wherever I am practicing.

The more senses you can envision, the easier it is to remain focused in the moment. Some people choose amusement parks or other loud venues. That’s okay as long you can focus and keep to your steady breathing pattern. The goal here is to consciously and intentionally slow our minds down while adding these positive and relaxing components. When asked if you should practice this when anxiety is creeping up, I say to try and practice these tools at least a few times a day. I don’t want you to have to wait until the anxiety is noticeable. Rather, if we are practicing relaxation, we will not only be in a better position to deal with it in those moments, but hopefully even fend some of it off in the first place via a calmer, more relaxed you.

Your mind is indeed a powerful tool. We hear about sharpening it with memory exercises and such to enhance our cognitive skills, but what about teaching it to relax? We live in a fast-paced society where expectations can be massive and relaxation is not taught in school. Rather, we learn how to be better students and thus more successful human beings. You need to teach your mind and body to calm down and be okay with relaxing once in awhile.

We all have dreams and goals in life starting at a young age. Some of us want to sing for a living, others want to become teachers, and some want to become veterinarians. We have the desire to be liked and known by many, to have families and luxuries. But is there more to life than these hopes?

Understanding the concept of self-actualization could help you come to a better realization of what you’re doing with your life, and where you want to be.

A recent Huffington Post article by Russell Bishop visited the concept of self-actualizing in comparison to self-conceptualizing: “Self-actualization represents the process of becoming more of who you already are, while self-concept is more about your self-talk, about trying to become something or someone you may hope you are but fear you are not,” Bishop said. “While your self-talk represents an amalgam of beliefs, hopes and fears that you have accepted about who you are, your soul-talk emanates from the depth of who [you] truly are, encouraging you to grow, to blossom, and to expand.”

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The Four Aspects of Self-Actualization

From The Inspired Life: Unleashing Your Mind’s Capacity for Joy, by Susyn Reeve:

• Being all you can be
• Living to your full potential
• Honoring and valuing your gifts, talents, and skills, and generously sharing them in service of the highest good for all: a more peaceful, loving, and compassionate world
• Living a life of passion and purpose

Six Tips Toward Self-Actualization

From The Inspired Life: Unleashing Your Mind’s Capacity for Joy, by Susyn Reeve:

• Nurture and cultivate a loving relationship with yourself—vibrant self-esteem is a powerful foundation of self-actualization.
• Acknowledge and value your specific and unique gifts.
• Have the courage to follow your calling from within.
• Answer this question: If I wasn’t afraid and I knew I could not fail, who would I be and what would I be doing? This defines your self-actualized vision. Then the question becomes: To live into this vision, what are the thoughts I think, the words I speak and the actions I take?
• Use breakdowns, blocks in the road, challenges, and stepping stones to support your vision.
• Understand the creative process, how the brain works, and have a community of support—your vision keepers.

Obstacles to Self-Actualization

Susyn Reeve, a self-esteem expert and the author of The Inspired Life: Unleashing Your Mind’s Capacity for Joy,  says that unfortunately, many people haven’t even started on the road to self-actualization.

“They don’t understand how the brain works, the creative process, and that everything that exists begins inside and then is brought to form outside,” she says. “Most people suffer from low self-esteem and do not believe in themselves—they feel unworthy, unloved, and are ashamed of these feelings. Their fears, worries, and anxieties stop them in their tracks. They give more credence to the opinions of others and fail to honor their inner knowing.”

Valery Satterwhite, an inner wealth consultant, has additional advice for people who want to become self-actualized. “It is essential to first reconnect with who you really are and what you value most,” Satterwhite said. “Too many people live life through the prism and the prison of a false personality where the real self is buried under layers of expectations—who a person ‘should be’ and what he or she ‘must do.’ As children we tend to condition ourselves—we shape-shift our identities—in order to stay connected, loved, and belong in our environment. The more we strip away these false layers, the more we are able to expand our sense of self and our place in the world.”

She said everyone is capable of self-actualization, and most people want this for themselves, but many people don’t completely become self-actualized. “Whether or not they achieve it depends upon how willing they are to step beyond the comfort zone of conditioning to explore new perspectives, new learning, and new insights,” Satterwhite said.

“Those who live in fear will not travel very far in their journey of self-actualization,” she added. “Fear is restrictive—it cuts off expansion and actualization whether it be within an individual, society, or government. Those who value themselves and the gift that is this life enough reach a point where the pain of staying inauthentic overrides their fear. Those who step into their fears know the joy that comes with the learning and the growth that comes with the courage to step into the unknown. Often what we fear the most is what our heart is calling us to become. It scares us because it matters that much.”

Five Stages to Self-Actualization

Sarah Lendt, a nationally certified counselor, references the humanist psychologist Abraham Maslow‘s definitions of the stages that people must master before they can reach the final tier of self-actualization. The five stages are:

1. Physical needs, like food and water
2. Safety and survival, including physical and emotional safety and shelter
3. Love and a sense of belonging
4. Esteem and self-esteem
5. Self-actualization

It can be challenging, of course, to move past all of these steps to get to self-actualization.

Lendt said, “In our lifetime we strive to meet these various needs,” according to Maslow’s concept of self-actualization and his hierarchy of needs. “Circumstances may cause us to go back to a particular stage and need to fulfill it again; once a need is fulfilled, we can work toward achieving the next need. Sometimes unmet needs can cause a person to become fixated or stuck at a particular level.”

Self-actualization is “looking outside ourselves to do good for others, and receiving satisfaction in life for such behaviors,” Lendt said. “It is a point where we are being the best we can be—self-fulfilled and helping others … I think most people certainly can achieve it, but there is so much pressure, so many expectations in our world that people hold of themselves and others, that it is hard to get beyond the esteem level—feeling good and confident about yourself so much that you can look outside yourself in your actions.”

Nine Characteristics of Self-Actualized People

From Kendra Cherry:

• They engage in self-acceptance and accept other people for who they are, as well as treat others equally with respect.
• They are realistic and able to look at the world in a logical and rational way while still remaining positive.
• They have a strong sense of responsibility and work on solving problems.
• They have “peak experiences” in life that help shape who they are.
• They follow their own path, are autonomous, and do not give into what others want from them.
• They enjoy spending time alone and are comfortable with solitude, while still enjoying the presence of others. They use this time to discover themselves.
• They have a good sense of humor that doesn’t harm others.
• They are spontaneous, and although they follow general rules and guidelines, they are not bound by these.
• They enjoy the journey of life, as well as reaching the final goals.

Depression can be challenging. If you have experienced it, then you know that the most basic tasks can become excruciating and leave you feeling apathetic and drained of your willpower. Simple tasks like getting out of bed, doing the laundry, and playing with your children may be daunting. While talk therapy and medications may be helpful, they are not the only solutions to relieving symptoms. This is where art therapy comes in. Art therapy has become an effective treatment in supporting, releasing, and integrating the symptoms of depression by supporting you in exploring depression via the senses. Although art might seem less conventional, it can be just as effective as talk therapy because it utilizes the whole body experience and not just the intellect.

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When Words Do Not Speak

It can be difficult to open up to a complete stranger about your deepest and darkest emotions. Sometimes, we are taught to suppress our emotions and put on a blank face, even when experiencing inner turmoil. In art therapy, words are not always necessary. A mere lump of clay or a blank canvas can be far less threatening than giving voice to painful feelings, words, or images. The simple act of a scribble on paper can likely bring light to darkness, ignite conversation, or be a release for a depressing thought. Because something cannot be heard by the human ear does not mean that nothing is being said or revealed. Art therapy supports our process when words are not enough.

The Capacity to Feel Again

In addition to creating a communication bridge between you and your therapist, art therapy can also help you come to terms with what you are actually feeling. Perhaps you have felt numb or distanced and “incapable” of feeling when depressed. Creating art is at the heart of expression and emotion, supporting your capacity to feel again. Once you have created and externalized a part of yourself as something concrete and tangible, it is easier to acknowledge that such an emotion existed in the first place. By creating, you give yourself permission and voice to that which is difficult to speak. You might feel a sense of relief or a movement of your depression once you have transferred it onto your canvas.

Creating One’s Own Happiness

Research shows that when we observe something that we believe to be beautiful, the neurotransmitter dopamine—located in one of our pleasure centers in the brain—is released. Interestingly, the brain activity observed when we look at art is actually comparable to the brain activity representing love! It’s nice to know that in addition to having created your own art, positive feelings increase.

Research proves art therapy is a beneficial method of treating depression across a wide spectrum of personalities. Many even discover a newfound passion for art and are surprised at the talent that emerges once their emotions are channeled into their artwork. Only in this unique field are therapists performing what is considered by traditional psychoanalysts to be the hardest of tasks: getting those with depression to proactively express, manage, and overcome their symptoms … with the end result being something truly beautiful.

References:

1. Study shows art may help with depression. (2012, June 6). Retrieved from http://www.arttherapyblog.com/mental-health/study-shows-art-may-help-with-depression/#.T9dlRdUth30
2. Bar-Sela, G. (2007, Nov. 16). Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17351987
3. Holm, M. (2011, Aug. 11). Art therapy for depression. Retrieved from http://www.naturaltherapypages.com.au/article/art_therapy_for_depression
4. Riley, S. (2001, July). Art therapy with adolescents. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071468
5. Vann, M. (2012, April 4). 8 Unconventional ways to ease depression. Retrieved from http://www.everydayhealth.com/depression-pictures/unconventional-ways-to-ease-depression.aspx#/slide-3

“Shy is the most terrible feeling that you can get.”

“Shyness is a habit that began when someone was afraid to talk and didn’t know what to do. Sometimes shyness can make us seem boring.”

“If I say the wrong thing, I shy to say something again.”

“I am shy because I’m afraid that people will laugh at me. If someone laughs at me, I will feel afraid, shy and I think I did something wrong.” (Other fears are “teasing and whispering.)

“I hope I can get rid of shy, but it’s really hard.”

“I want to be less shy because I don’t want always to be a shy girl, and I want to be a good, smart, and brave girl.”

These words come from the students in my sixth grade English-as-a-second-language classroom in Central Kalimantan, Indonesia. We were talking about “shy” because all of them worry about being laughed at or being wrong or not good enough. One student covers his mouth when he can’t think of what to say or is too shy to say it. Another student speaks so softly that I we have to read her lips to understand. Over the semester the things that seem to help the most are: “Would you like us to come back to you?” “Would you like a little help?” “Maybe you could write it for me,” saying in a playful, singsong voice, “Just a little bit louder and a little bit slower.” Sometimes I say, “Did you understand?” If the others shake their heads, I ask, “Would you like to?” When they nod yes, I say, “So could you say it again, please?”

Still, after some months their shyness was still interfering with speaking and learning. I knew that what they were thinking and feeling was so much greater than what they could say aloud. As the above sentences show, their writing was more revealing than their words. However, one of our major class goals is to increase confidence and fluency in speaking English.

One day, the other sixth grade teacher unexpectedly had to leave, so class expanded to 12 students. We began with the “yes, and” game in which one person begins a story and then turns to the student next to him who says, “yes, and” and then continues the story. When a student was shy and couldn’t think what to say, the other students laughed. It seemed like “release of anxiety laugh” rather than a mean laugh, but it was laughter—just what these students are most afraid of. We finished the first round of the story.

“So, some of you felt shy.” (Heads nod.) “In class Six A, we have talked about when you are shy you are most afraid of being laughed at, right?” (Heads nod again.) “So how many of you felt shy?” (Most hands go up.) “How many of you are afraid of being laughed at?” (Most hands.) “How many of you laughed?” (Most hands.) “What kind of laughter was it?” “Just teasing, not mean,” answered one student as the others nodded. “So, let’s try an experiment. In the next story, let’s make an agreement that no one will laugh. Okay?” To my amazement, during the next round of a new story, some of the students were slow, but all spoke, we heard all of them, and no one laughed. (Two students did begin to laugh out of habit but caught themselves and stopped.) “So, what did you notice?” “We didn’t laugh.” “Right.” “What else did you notice?” “We hear everyone.” “Yes. So, it seems that when you are not afraid of being laughed at, you don’t feel and act so shy.” They nod.

In our next class, we talked some more. “What are you imagining that the others are thinking when they are laughing at you?” “You’re not good enough. You’re a fool. You’re bad.” “No wonder you don’t want to talk,” I said. “How scary. So, when you’re laughing, what are you thinking?” “Not mean things, Bu.” One brave student said, “I’m laughing because I’m glad it’s not me.” Another said, “I’m laughing to be friendly because the silence feels bad.” Another brave student: “Sometimes I am thinking they are not smart, but even if I’m thinking that, I don’t have to laugh.”

“So, let’s make a picture of this. Action 1: You are feeling shy and are having a hard time speaking. Step 2: Others laugh. Step 3: You think they are thinking one of these things:

(Here we listed all their thoughts and then rated them in this order. ‘I’m not good enough.’ (All the students named this one.) ‘I’m bad. I’m a fool. They hate me. I’m wrong.’ Step 4: You feel even more shy. Step 5: Others laugh . . . . So, it just goes on and on, maybe even getting worse. Does that seem right?” (Heads nod.)

Interestingly, in Indonesian, the word shy (malu) is also a word for shame. And, indeed, shy and shame feel like cousins to me. Cousins with a big difference. Shy is a normal feeling and results in behavior that can be changed. Shame is an intense and irreparable feeling of core inadequacy, badness, or unworthiness; one is forever doomed. The impact of shame is secrecy, disconnection, and an inability to assess reality. Shame: I AM not good enough. I AM unlikeable. I AM a fool. I AM a mistake. Shy: I don’t feel good enough. I feel disliked. I feel like a fool. I made a mistake.

I explained this difference to the students and we talked about how most of the time they are making up what the others are thinking and it is not at all true. “Oh, I understand. Yes, I’m making it up.” We translated the shame ideas to shy ideas. I AM not a good enough person became I’m feeling not good enough right now. I AM bad became I’m feeling bad right now. I AM a fool became I’m feeling foolish. They hate me became sometimes I don’t feel like people like me. I AM wrong became I made a mistake. They tried out feeling what the difference was between the sentences on each side of the big sheet of paper. Then I whispered in each student’s ear: “You’re good enough even when you feel shy.” Each one shyly smiled.

Back to writing. “Please write about shy again.”

“I’m not shy when I really know about the other person.”

“If I get shy or say the wrong thing, I want my friends are not laughing at me, but they can help me.”

“Stop caring too much about what the other people thinks about you.”

“The best way to not be shy is to be brave and try to do that thing even if you are shy.”

“I’m not shy when someone make me confident.”

“When I’m not shy, I feel like a hero because I’m brave.”

This was a heroic topic for this group of students to explore. During the next week, we tried a few things that I found on the internet to help with shyness. For example, appreciating yourself, breathing from your belly, moving your body, imagining yourself as confident and happy, getting more comfortable with making mistakes, remembering that everyone feels shy sometimes, noticing and writing down your successes.

Now, at the end of the semester, all the students except one, by their own assessment, feel more fluent and confident speaking in English. All of them still are slow to speak in English sometimes. They’re still afraid of not doing well enough sometimes. But they know the difference between, “I don’t feel good enough right now and I’M NOT GOOD ENOUGH and the difference between, “I made a mistake, and I AM A MISTAKE.”

Shame, the cousin of shyness, is a right use of power issue because the feeling is so intense and feels so irreparable that it disconnects people from relationships, disempowers them, and removes their ability to assess reality. When activated by shame, people are out of relationship with others. When out of relationship with others, and unable to assess reality, people misuse their personal and positional power in ways that harm themselves or those around them or in their care. Understanding the dynamic of shame and helping yourself and others disengage from it are high priorities for using power wisely and well.

Related articles:
Shame as an Ethics Issue – Part III
Don’t Underestimate Me: Ethical Use of Power for and With Children
Excessive Impression Management and Interference With Identity