tired mother with childIf you are a mother, you have probably experienced at least one day (if not many) when you wondered if you were cut out for the job of parenting. Mothering is hard work. Even on our best days parenting our kids, there are difficult moments. Many days, it is the occasional joyful moment that makes it all worthwhile. Other times, it may not feel like the good justifies the bad.

You can find some blogs these days that describe parenthood more authentically and accurately than in the past, including the good, the bad, and the ugly. Moms are increasingly owning up to the fact being a mom is tough and sometimes thankless. But almost universally, these stories end with a phrase such as “It’s all worth it,” “I still wouldn’t trade being a mother for anything,” or even, “Being a mother is the best job in the world.”

But what if your experience of motherhood doesn’t include that last sentence? What if your true feeling is that, while you love your child/children, motherhood itself is not what you thought it would be and you just don’t enjoy it much?

For some mothers, these feelings arise out of depression, and once the depression lifts, joy enters into the parenting experience and all regrets about becoming a mom dissipate. But for others, even after recovery from depression, and despite loving their child and enjoying many moments with them, the bottom line is that motherhood is not a job they enjoy overall or would choose again.

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If it were any other job, it would be acceptable to acknowledge that it’s hard and maybe you’re not totally suited to it, but when you’re talking about motherhood, admitting you don’t love it is a huge taboo.

A recent study published in the journal Demography found that, on average, happiness decreased more in the two years following becoming a parent than following a job loss, divorce, or even the death of a spouse. Clearly, not every mother is happy with her new life, and yet those feelings are typically buried, not talked about, and the women who feel that way often experience shame and guilt.

So few mothers admit to having these feelings, but that doesn’t make them go away. Parenting is difficult, and of course it makes sense that not everyone is equally suited to it temperamentally. But the stigma of admitting that one doesn’t really enjoy being a parent is enormous, and the necessity of hiding those feelings can be a huge burden—which in itself is a contributor to depression and anxiety.

Acknowledging our ambivalence—the fact not every moment, nor even every stage, of motherhood is fun—allows mothers to accept themselves for who they are and what they feel, and be freer to find ways to make motherhood more authentically enjoyable.

There are those who would point out that enabling women to acknowledge their negative feelings about motherhood might adversely impact our children. How can our children feel loved and wanted if they knew the way Mom really feels about her job? But I would argue the opposite: By stuffing those negative feelings, by shaming mothers for their normal responses, normal emotions are more likely to be acted out in negative ways.

Acknowledging our ambivalence—the fact not every moment, nor even every stage, of motherhood is fun—allows mothers to accept themselves for who they are and what they feel, and be freer to find ways to make motherhood more authentically enjoyable. Being honest within ourselves and accepting all our feelings gives us permission to do motherhood differently—and perhaps allow more acceptance in our children of their own inevitable negative feelings as well.

Don’t look to social media for validation of your motherhood experience. Don’t compare your insides to other people’s outsides. If you don’t feel heard, understood, and validated by your partner, friends, or family, therapy can be an outlet to explore and accept your complicated and ever-changing emotions regarding parenthood and life.

Reference:

Myrskyla, M., & Margolis, R. (2014). Happiness: Before and after the kids. Demography, 1843-1866.

parent and childBeing a good parent can be difficult. We are never really taught how to raise children effectively, and generally tend to repeat behaviors we have learned from our own parents. If we grew up in a dysfunctional environment, this can lead to our replicating the same mistakes we witnessed and experienced as children when our turn to become parents comes around.

Many parents who come to see me ask how they can learn better parenting skills. They often feel ineffectual when trying to discipline their children, but do not know what they can do differently. The following are some effective tools to use in order to bring about a little more order in your household:

1. Praise Your Children

Any time you catch your child being good, make sure you let him or her know how appreciative you are of his or her good behavior. Everyone responds in positive ways to praise, children included, so this will encourage your child to behave in desirable ways.

2. Use Behavioral Incentives

In order to inspire your kids to do their chores, put a chart or calendar up on the wall listing, day by day, the tasks you want them to complete. This could include things such as taking out the trash or setting the table for dinner, but you can also include behaviors such as doing their homework, brushing their teeth, or being nice to siblings.

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When the child performs the desired behaviors, he or she gets to put a sticker on the chart for the day. As your child accumulates a certain number of stickers, he or she can earn special incentives that are known ahead of time. These could be anything from choosing a favorite dinner, going on a special outing, watching a movie that your child has been looking forward to, or anything else he or she would enjoy.

For very young children, it can be helpful to break down the day into shorter periods in order to reward desired behaviors more quickly. You may want to have them be able to earn three stickers a day, for example—for the morning, afternoon, and evening. Even if they are not successful for the entire day, they can at least be rewarded for shorter time periods and will gradually want to earn more and more stickers and rewards.

3. Use Consistent Discipline Techniques

When your children misbehave, they need to understand the specific behaviors you do not want them to do. Let them know what they are doing wrong, then provide a warning. Your explanations should be very clear and simple, so that they understand exactly which were the problem behaviors.

When your children misbehave, they need to understand the specific behaviors you do not want them to do.

If a child continues to misbehave, put him or her in a designated area away from the rest of the family that has been chosen for time-outs. Make sure that the child remains in the designated spot for the entire time-out period. The time-out should not last more than several minutes, but the child should not be allowed to talk or play during this time.

At the end of the time-out period, reiterate to your child the reason that he or she was put in time-out and ask for an apology. Consistency is very important when it comes to teaching children appropriate behavior, so the time-out strategy should be used every time your child misbehaves after having been given an initial, unheeded warning.

4. Communicate with Your Child

If your child is acting uncharacteristically poorly, attempt to find out what may be going on. Children have a tendency to act out when they are being picked on at school or sense tension within the family. Try talking with them to find out if they are upset about something you are unaware of so you can address any potential problems.

5. Maintain a Structured Routine

Children respond well to structure, so try to have meals and bedtime at the same time every day. When kids become overly tired, they may be more prone to acting out, so make sure they are getting enough rest.

Using the techniques above can help to make for a more peaceful home environment. If you are still having problems managing your child’s behavior or your child has recently become more fearful, angry, or aggressive, meeting with a psychotherapist may be helpful in order to explore the underlying reasons for the behaviors and to get your child back on track.

How upsetting to make such a discovery! It is unusual, developmentally, for an 8-year-old to smear feces on the wall, though I would hesitate to jump to the conclusion of mental health issues or other concerns without having more information.

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It doesn’t sound as if there has been a lot of open communication between your families historically. If that is the case, I can understand your hesitation. It sounds as if you are trying to be sensitive to their feelings, which is admirable. If, however, there are some developmental or behavioral concerns, it is important that her parents are fully informed so that they can take appropriate steps to get her the support she needs.

My recommendation would be to share the information in as nonjudgmental a way as possible. You can mention what you found, express that it puzzled you, and that you just wanted them to be aware.

My recommendation would be to share the information in as nonjudgmental a way as possible. You can mention what you found, express that it puzzled you, and that you just wanted them to be aware. Be sure to avoid jumping to conclusions or making accusations about intent. Sticking to the facts can make it easier to present difficult information. You said she “seems like a nice girl otherwise”—she likely IS a nice girl, and while it may be difficult to fathom what led to her actions, the simplest way to find out what happened is to ask.

It might be an awkward conversation. The parents might react defensively or with embarrassment. They may also appreciate knowing. What does your husband think? It is his sister and her family, after all. Does he have suggestions on what approach might work best? Would it be easier if the information came from him?

You also may want to consider what you would want if the roles were reversed. If it were your child, would you rather find out right away, thus allowing you the opportunity to respond to your child’s needs? Think about what it might be like the next time they visit. Would you feel comfortable putting her in the guest room again? Chances are, this incident would come up, and then the embarrassment and awkwardness could be coupled with frustration at not having heard about it before.

Best of luck,
Erika

“GoodTherapy | The Power Differential and Why It Matters So Much in TherapyI’m trying to imagine ethics without an awareness of power. That would be like trying not to step on anyone’s toes, without an awareness of one’s feet.” —Susan Mikesic

The power differential is the inherently greater power and influence that helping professionals have as compared to the people they help. Understanding both the value and the many impacts of the power differential is the core of ethical awareness. Written codes for ethical behavior are based on the strong positive and negative impacts of this power differential.

People seeking help are in a position in which they must trust in the knowledge and guidance of their caregiver. This results in a greater-than-ordinary vulnerability. Consequently, people are unusually susceptible to harm and confusion through misuses (either under- or overuse) of power and influence.

Examples of Power Inequality

“The impact of the role, control, and power difference between client and therapist is very strong and also very subtle, and thus demands a strong ethical stance. In brief, your role as the therapist [or any helping professional] is to create a safe space, empower your client, protect your client’s spirit, and to see a wider perspective.” —Hakomi Institute Code of Ethics preface

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Stated another way, there is a power inequality whenever you take on a role that gives you authority over another or creates the perception that you have authority. Power differential roles include: supervisor, clergy, body worker, healer, lawyer, coach, group leader, therapist, counselor, doctor/nurse, mediator, teacher, social worker, massage therapist, guide, and social worker.

Personal Power and Role Power

In talking about the power differential, it is necessary to clearly describe and distinguish between two kinds of power. This distinction is important because it makes clear that the increased power that accompanies a position of authority is role-based and not the same as personal power.

I like to show the difference between these two powers with scarves. When I am a therapist, I have my personal power, of course, but I wear my added-on role power as if it were a scarf. When I leave my office, I take my role-power scarf off. My personal power stays with me. It’s like my scarf has access to and stores information related to the enhanced power that belongs to my role. With my scarf on, I can remember multiple details about my clients’ processes. When I take my scarf off, I can and need to leave those details and responsibilities behind.

This is not a purely black-and-white thing. Of course I continue to have concern about the people I work with in therapy, and I am known as a therapist or teacher even when I am not in these roles. But many misuses of power are a result of the person in the up-power role over-identifying with his or her role power, forgetting that this is a role-based add-on power.

My friend Nancy’s husband, Daniel, is a commercial airline pilot. Until they understood this dynamic, their marital relationship was quite compromised each time Daniel came home and acted as if he were still the airline pilot—a commanding position. Things changed when Daniel ritually took off his hat with the symbolic words, “I’m hanging the pilot on the hook now.”

Up-Power and Down-Power

I refer to those in positions of increased role power as having “up-power” and those in corresponding positions of lesser power as having “down-power.” These are simple and directional terms not intended to indicate disrespect, disempowerment, exploitation, manipulation, better, worse, power over, or power under. Instead, these terms are intended to denote role differences in responsibility and vulnerability.

Up-power and down-power positions have cognitive, emotional, and somatic differences. As an exercise, I ask my students to walk around the room imagining walking with someone up-power to them. My students notice a variety of things—feeling smaller, more cautious, protective, turned inward (or, for some, feeling relaxed, eager, relieved). Then, when imagining walking with someone they are up-power with, they notice feeling more spacious, focused on the other, taller, kind, caring, and alert. It is very clear to them that the two roles are experienced differently. For most, this is a surprise. A student described the difference in this way: “When I’m a practitioner, my personal needs and ‘stuff’ are behind me resting against my shoulders, and when I’m a client, my personal needs and ‘stuff’ are sitting right there in a huge ball on my lap, visible and available.”

We move back and forth daily between being in up-power positions and down-power positions.

We move back and forth daily between being in up-power positions and down-power positions. (Like putting on a scarf or robe when in a role and taking it off when leaving the role, we move from up-power therapists to a down-power supervisee, or up-power doctor to down-power patient, for example.) We are usually unaware of the shift. This unconscious shifting of roles makes it more difficult to clearly understand the dynamics and impacts.

Some up-power roles carry a stronger differential—and, therefore, a stronger risk of harm—than others. For example, the president or a police officer or a therapist has a greater power difference than the chair of a committee or a clerk in a store. But all up-power roles have impacts and dynamics.

Value of the Power Differential

In the helping professions, the power differential has great value. Used wisely and appropriately, it creates a safe, well-boundaried, professional context for growth and healing. More specifically, when used ethically and effectively, the power differential offers people in therapy, students, supervisees, and patients some important assurances:

These values can be reduced to six categories:

  1. Safety, kindness, and boundaries
  2. Larger frame
  3. Expertise
  4. Assigned responsibilities
  5. Accountability
  6. Assessment and productivity

Think about it. When you go to a therapist, doctor, or teacher, you want to be in an environment where you can get what you need. You want the environment to be different than just talking to a friend. When you get on a plane, for example, you want and need the pilot to look and act competent. Wearing jeans and a T-shirt just won’t do. You need him or her to be skilled, to embrace his or her role, and treat you with respect.

Understanding and Owning Your Power and Influence

Because the power differential is role-dependent, it is easy to over-identify with (or get inflated by) this increased or enhanced power. However, it is just as easy to misuse this increased power by under-identifying with it. The central idea here is the necessity to understand and own your role power so that you can be conscious and informed.

Here are several misunderstandings that illustrate the multiplicity of the impact of the power differential for both helping professionals and people who seek help:

The power difference between therapist and person in therapy, or other similar pairs, is the dynamic that creates down-power vulnerability. Down-power vulnerability, based in a role, is what creates the need for ethical guidelines to protect people from harm.

Woman with hands covering facePeople I work with in psychotherapy often tell me how they manage bothersome thoughts or worries: “I just try not to think about it.” This process of mental avoidance—trying not to think about specific thoughts or feelings—can actually trigger unwanted thoughts. For example, if I instruct you not to picture an elephant, what happens? Do you not think of an elephant?

Our ability as humans to distract and compartmentalize our problems and emotional experiences is part of an evolutionary and complex mental system. Avoidance is not inherently good or bad as a widely applied coping skill. However, the way one avoids stress may affect his or her level of engagement with others. Mentally speaking, avoidance is a typical response to stressful thoughts and events. Crossing the street so as to not pass by someone walking in your direction is an example of physical avoidance. The paradoxical effect of anxiety and mental avoidance leads us to a new therapeutic model.

Acceptance-based behavioral therapy (ABBT) is from the third wave of cognitive behavioral therapy (CBT) approaches. This new flood of therapies incorporates mindfulness practices. ABBT, for its part, focuses on the management of cognitive avoidance. It addresses the omnipresent suffering that encompasses the mind’s ability to project into the future and dwell or ruminate on the past. Our thinking in this department is more complex than for any other mammal on the planet, but to a fault.

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The worry that we create through habitual patterns of thinking serves as a form of avoidance from the present moment experience. The avoidance becomes automatic or habitual over time, so we tend not to be aware that we are avoiding things. We might not realize that the worrying or our perception of an association in the future distracts us from other emotional topics.

This is especially resonant in American culture. Westernized values center on productivity and success as determinants of self-worth. This egocentric position ingrains our fixation on what the future will bring. It is eloquently framed the “intolerance of uncertainty.”

Worrying or attempting to not fixate on an idea or memory is viewed by ABBT as a “natural response” rather than inherent pathology. The worrying takes place as a way to reduce physiological arousal around something aversive or feared, but allows us to avoid more distressing issues. One of the ways this directional thinking or grasping (i.e., future or past) causes us so much stress is that the observation becomes self-identification. An inability to tolerate the ambiguity of an uncertain future creates a tendency to respond in a negative way. Negative prediction or judgments of the future lead us to further worry, which we then try to manipulate as the cycle perpetuates.

Take an invitation to public speaking as an example. If you are asked to give a presentation in front of a group of coworkers tomorrow, you might start thinking about material to reference or what the room looks like that you will present in. Then you ponder how many people will be in attendance. You consider what type of attire you should wear and how people will be staring at you. What if you make a mistake? The thinking and worrying narrows your focus toward potential social threats (the coworkers watching, the bosses evaluating, etc.).

The associations can begin to entangle the person and they become hooked by their own mental processes around the potential experience. The cognitive aspect pairs with physical reactivity such as increased heart rate or a sinking feeling in one’s stomach to condition the anxiety. Rather than noting this experience as anxiety, people often self-define as saying or thinking, “I’m really anxious!” The idea of being anxious is fused with the person. The person views himself or herself negatively and further worries about how he/she will respond in this perceived state of mind. A conclusion often stems from personal judgments around the anxious state and can come in the form of a belief: I am weak.

If your way of operating includes attaching to these beliefs, certain states of mind (fear, sadness, anxiousness) become framed as personal deficits or flaws. Put more simply, the idea that there is “something wrong with you” is cemented. When a person believes there is something wrong with him or her, often the thought is that if I could just fix [insert a perceived deficit], then my life would be better. The self-criticism and judgmental thinking—not the perception of stress or deficit—tends to be the issue needing addressing. Awareness of your state of mind throws a wrench in this way of thinking and changes the operating system.

Acceptance-based behavioral therapy facilitates a system of operation with an emphasis on active awareness of one’s mind. Thoughts and feelings are not being replaced or altered. You recognize or observe what is occurring in the present moment.

Acceptance-based behavioral therapy facilitates a system of operation with an emphasis on active awareness of one’s mind. Thoughts and feelings are not being replaced or altered. You recognize or observe what is occurring in the present moment. Initial worry manifests as a thought and not who you are. However, beginning to worry about the worry and the avoidance strategies that accompany that way of operating is the process ABBT is directed toward. It also arranges a structured framework for therapists to work with the reactions of people in therapy (i.e., the behavioral component to the CBT coin).

The ABBT approach presents as a new way of operating for some people. Think about the functional change that occurs in the transition from desktop computers to mobile devices for using the Internet. The first major step of ABBT is being connected. It is like finding a Wi-Fi network to link with. The connection enables you to cultivate an expanded awareness or Wi-Fi signal as opposed to the narrow Ethernet cord-to-wall technology of the desktop computer. One must carry this signal of awareness and not be tangled up or fused with internal experiences (i.e., thoughts, rumination, etc.). The second step is a willingness to read or face the news of your experience (i.e., feeling states). The analogy here is once you are connected to a signal, you can open up a single web browser like Google or Internet Explorer. Engaging with the browser (don’t be tempted by random advertisements, Facebook or Twitter) offers the third metaphorical piece to ABBT: mindfully participating in personally meaningful behaviors.

As humans, we all benefit from increased awareness and empathic responses to environmental changes. Cultivating this practice of momentary acceptance while observing one’s own internal states will intrinsically create meaning within the activities one engages in. Put simply, if you are open and willing to put out a clear signal and connect with the world, your options for engagement are boundless.

Reference:

Roemer, L., & Orsillo, S. M. (2014). An Acceptance-Based Behavioral Therapy for Generalized Anxiety Disorder. In: D.H. Barlow (ed.) Clinical Handbook of Psychological Disorders. Fifth Edition. New York: The Guildford Press, pp. 206-236.

Thank you for your letter. I am sure that it hurt your feelings, to say the least, when your husband laughed at your request to remove the woman from his Facebook friends list. I also think that, while your feelings are very understandable, this woman is in some ways a red herring for both of you. My sense is that something is missing from the marriage and your feeling undervalued might be there with or without the online classmate. Somehow, his flirtation only exacerbated a feeling of disrespect and devaluing—a big “ouch” for anyone.

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First of all, “extremely flirtatious” sounds concerning. From what you saw, did it stray into the sexually explicit? Did they toy with the idea of taking things a step further—“Hey, at the next class reunion, you and I will have our own private stroll down memory lane,” or something along those lines? It is hard to make a judgment about this secondhand, though again the important thing is your hurt feelings and the sense of being in second place (yikes). We all want to feel we’re “the one” with our partner. I also, though, wonder if his leaving it open for you to read was an unconscious communication of a kind, a signal to you that he wants these kinds of conversations with you and not her. An indirect distress call of sorts, or maybe even a protest bordering on the passive-aggressive. If this is truly a “secretive” relationship, he’s not being very secretive about it.

As for marital drift, I can’t tell you how common an issue this is for long-term marriages. Routine and day-to-day security is a double-edged sword: it is comforting, but it can dull our appreciation of who we’re with. We feel secure in knowing what to expect, that our partner is there for us, day in and day out … and may also begin to wish for something a little more vivid and emotionally satisfying, since our partner is always there day in and day out. Routines both soothe and lull us into complacency. Plus, if someone is “always there,” there may be little urgency regarding sex. Sex and physical intimacy (touching, cuddling) can wait until later, or the next day, tomorrow, maybe this weekend, next week … etc. Perhaps, then, this incident is an opportunity to rekindle something. Your husband obviously means a great deal to you, and I have the feeling a little freshness in the romance department could liven things up.

I’m thinking of at least two things to possibly try, depending on the state of affairs. First, more superficially, you could try something spontaneous that you both find a turn-on, something outside the usual routine—a weekend getaway somewhere you both like, some lingerie or a sexy movie you can watch together (and no, we’re never too old), back rubs, an old role-playing game you haven’t tried in a while. These are just some of the first things that come to mind. Laughter, too, can be sexy. Perhaps you both need a night out at the comedy club, or dance lessons (my wife’s favorite), followed by a nice dinner while sharing memories. There’s also massage: a foot rub with massage lotion can do wonders, taking a bath together with candles, and so on. Again, these are more surface things, but sometimes a little spark is all that’s needed.

I would emphasize avoiding concrete solutions at first—i.e., to “unfriend” her or not—until after you have shared feelings and listened and tried to understand how the other feels. Jumping into concrete details will dilute the more essential task of understanding each other’s perspectives and hopes, fears, desires, etc., at play in the marriage as of today.

Or it could be that what’s needed is way of addressing the depths of your feelings and the concern over a strained connection; you may want to sit him down, at a time that works for both of you, and spell out as calmly and non-accusingly as you can what it is you feel and would like to see happen, to make sure he really understands your concerns and how this episode has hurt. I recommend approaching this as partners who are seeking to strengthen the bonds of “the team.” (Rather than “you’re my problem here,” it’s “distance is our problem here.”) Try to keep the focus on you as much as you can, rather than that online woman. He is married to you, not her, but you’re not feeling it lately. You miss him as the man you love, and want to feel him as your chosen partner, not (I’m just guessing) your roommate. You can also mention that when he laughs and dismisses the idea, it feels minimizing and perhaps even abandoning.

I would emphasize avoiding concrete solutions at first—i.e., to “unfriend” her or not—until after you have shared feelings and listened and tried to understand how the other feels. Jumping into concrete details will dilute the more essential task of understanding each other’s perspectives and hopes, fears, desires, etc., at play in the marriage as of today.

Try asking him for his perspective, and—here’s the hard part—try and listen as openly as you can. Imagine, for a moment, you are a friend and not his wife. Is there something bugging him about the relationship? What does he think may be going on here? What was it he found with this friend and not you that can, hopefully, be sparked in the marriage? Does he understand how hurtful it was to stumble upon this online “chat”? I hope that such a dialogue would strengthen your bond, since hurt feelings can also be a catalyst for a couple’s coming closer together with deeper understanding.

It is often a turn-on to feel one’s partner understands how they feel, what they desire, and what hurts. Then we have not just a partner but an ally, someone in our corner who knows our heart, warts and all, and loves and accepts us for who we are. I hope you and your husband are able to find some of this … and there’s no shame in seeking out some couples counseling if the two of you need a little assistance sharing and hearing each other. Sometimes, even just a handful of sessions, with a focus on empathic and reflective listening, can help.

Best of luck to you, and thanks for bravely writing!
Darren

Couple in Adult Learning ClassCan an old dog learn new tricks? Can we change in adulthood? Many of us struggle with this question as we make New Year’s resolutions that we fail to meet: eating healthier, exercising, overcoming behavioral habits that keep us from living up to our personal and relational goals.

Sometimes we blame our genetics—it’s our DNA that is keeping us stuck! Or we blame our childhoods—if only we had better parenting, we could reach for the stars! There is no question that we are each born with a temperament, and that genes play a role in our abilities and limitations. And early childhood experience does shape our brains. In fact, neuroscientists these days look at the interplay between genes and environment, or G x E. But does that mean once we have survived childhood we are fixed, set in our ways, determined by our nature and early nurture?

Neuroplasticity in Adulthood

Until a decade or so ago, many scientists thought that while children’s brains are malleable or plastic, neuroplasticity stops after age 25, at which point the brain is fully wired and mature; you lose neurons as you age, and basically it’s all downhill after your mid-twenties. Fortunately, this rather grim view of the aging brain has been upended by more recent research. We now know that the human brain is capable of change throughout life. It’s true that a typical child’s brain is more plastic, more capable of change and new learning than a typical adult brain. And we do lose neurons as we age. But it’s not all downhill; the adult brain can create new neuronal connections and even new neurons born from neuronal stem cells. In addition to these gray matter (neuronal) changes, there can be change in our white matter, the pathways between neurons and the myelin that allows neurons to communicate efficiently.

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What Promotes Neuroplasticity?

We are not guaranteed vibrant, flexible brains as we age, however. A lot depends on how we live our lives. The adult brain needs oxygen and stimulation to stay sharp and capable of change.

Researchers have identified the following three habits as facilitating neuroplasticity as we age: physical exercise (which increases blood flow to the brain, delivering much-needed oxygen), paying attention, and learning new things. Once I learned about the impact of physical movement on neuroplasticity, I increased my exercise to daily from twice a week. And I see the difference in both body and mind! While an aerobic workout is great, even walking briskly for half an hour will increase blood flow and feed oxygen to hungry neurons.

The second factor that increases neuroplasticity, paying attention, is the opposite of acting on automatic pilot. Most of the time we do function on automatic, which is easier and less tiring than thinking through and being aware of our every move. This automaticity can be to our advantage, as we easily ride our bike or whip up our favorite recipe. But living on automatic can mean that we miss precious moments, forget to smell the roses, or take for granted a majestic mountain vista. Waking up to our experience allows us to be present. It also allows the brain to be more active and flexible. One of the best ways to pay attention is to engage in mindfulness practices, whether through a formal practice of meditation or in more informal ways.

The third stimulus to brain plasticity in adulthood is learning new things. This comes naturally to a young child, for whom everything is new. By contrast, adults tend to be less open. We get comfortable with the familiar; we like to kick back, relax, and do the same old, same old. This may feel good, but it does not contribute to neural flexibility. And if we combine same old, same old with not exercising—being a couch potato, television, potato chips and all—we are depriving the brain of the nutrients of neuroplasticity.

Mind-Sets about Change

Some of us are more open to change than others. Carol Dweck’s research offers a fascinating glimpse into our mind-sets about change. Some people, she says, have a fixed mind-set; they are not interested in changing, or assume they are incapable of change as adults. This is epitomized in Popeye’s famous statement, “I yam what I yam.” By contrast, people with a growth mind-set assume they are capable of change and growth in their lives.

Change in Couples

Some folks come eagerly to therapy, looking forward to the possibilities of learning and transformation. Others are hesitant, defending their right to be as they are. It’s not uncommon in a couple that one partner takes the “let’s change and grow” position, while the other comes to therapy reluctantly.

Old habits have quite a hold on us and are hard to change. To wire in a new set of behaviors, we have to repeat them over and over again. Eventually, these new behaviors become the new normal.

For hypothetical example, Tina, feeling increasingly disconnected in her marriage and frustrated that Joe doesn’t share her enthusiasm for deep, emotional conversations, drags him to therapy to improve their relationship. Joe comes to couples therapy because he loves his wife and doesn’t want to lose her. But he is resentful. He says, “I’m the same man you married—the strong and silent type. You’re the one who has changed!” For Joe, Tina’s evolving needs and her pushing him to change are the problem. Joe has a fixed mind-set, and he defends his right to stay the same. Tina has a growth mind-set; for her, transformation and growth are vital nutrients. Their “meeting of the mind-sets” is the first challenge we will face as we work together. I will help Joe see the positive payoffs of change, and I will help Tina back off from her campaign to reform Joe.

Most of us don’t want to “be changed” by someone else. We want to author our own change. Tina sees change as a transitive verb with a direct object: “Tina changes Joe.” But Joe doesn’t want to be the direct object of Tina’s change agenda. He wants some autonomy to choose his change. Family therapists have long observed that the only person you can change is yourself. Both Joe and Tina may decide to change in order to revitalize their relationship—but this needs to be a choice for each of them. Authoring your own change can be empowering; having change foisted on you can breed resentment.

Making Change Last

Let’s come back to those New Year’s resolutions. We have great intentions, and do engage in healthier habits for a while—only to find a few weeks in that we are backsliding. It’s too cold to go to the gym. There’s no time. We are great at coming up with excuses. Why is it so hard to live up to our goals and make new changes last?

Once again, neuroscience points to the answer. Habits become wired into the brain; once established through constant repetition, circuits of neurons keep our habits in place. Old habits have quite a hold on us and are hard to change. To wire in a new set of behaviors, we have to repeat them over and over again. Eventually, these new behaviors become the new normal.

When I started swimming as an adult, every trip to the pool was an effort as I worked to coordinate my breathing with my strokes. My brain and body were not accustomed to an aquatic life. Now, after years of regular visits to the pool, I crave my morning swim; I feel so natural in the water, I wonder if I was a fish in a former life.

Embracing a Growth Mind-Set

Whether we like it or not, things change. Our brains and bodies are evolving all the time—getting stronger as we exercise mentally and physically, getting weaker as we age or become couch potatoes. We can’t stop the process of time and aging, but we do have some choices over how we deal with our lives and relationships.

We can opt to live in a way that nurtures neuroplasticity—or we can close our hearts and minds to the new. We can exercise body and mind, or we can let our physical and mental faculties slide. Our mind-sets and our habits affect the brain, for better or worse. Choosing change, a growth mind-set, allows us to nurture neuroplasticity in our brains and promotes flexibility in our personal and relational lives.

Which mind-set will you choose?

References:

  1. Doidge, N. (2007). The brain that changes itself. NY: Viking.
  2. Dweck, C. (2006). Mindset: The new psychology of success. NY: Ballantine.
  3. Fishbane, M.D. (2013). Loving with the brain in mind: Neurobiology & couple therapy. NY: WW Norton.
  4. Ratey, J.J. (2008). Spark: The revolutionary new science of exercise and the brain. NY: Little, Brown & Co.

person crouching, hidingA seizure is a sudden and unexpected loss of control accompanied by abnormal body movements or convulsions, a loss of consciousness, or both. Though epileptic seizures are caused by sudden, rapid, and chaotic electrical discharges in the brain, not all seizures are epileptic.

Psychogenic nonepileptic seizures (PNES) are not caused by abnormal discharge of electrical brain signals, but instead are emotional in nature and usually triggered by stress or anxiety. Although these seizures are rarely discussed, they are not rare. PNES have a prevalence similar to that of multiple sclerosis.

Statistically, one in five people sent to epilepsy centers experience PNES rather than epilepsy. In fact, a team of physicians and psychologists at Johns Hopkins Hospital reported that more than one third of patients admitted to the inpatient epilepsy monitoring unit were experiencing stress-triggered seizures rather than true epileptic seizures.

Diagnosing Psychogenic Nonepileptic Seizures

Because PNES can mimic epileptic attacks, they are often misdiagnosed. At least 80% of patients experiencing PNES are treated with antiepileptic drugs for several years before a correct diagnosis is made.

[fat_widget_right]The source of this dilemma is multifaceted. Most physicians do not have access to electroencephalogram (EEG) video monitoring, and even those who do can easily misread an abnormal EEG without video if they have not been specifically trained in epileptology. A 2005 study of 46 patients published in the Neurology journal revealed that 54% of EEG readouts were misinterpreted as epilepsy.

Epileptic seizures tend to be more serious than PNES. If there is any doubt, a neurologist will usually treat the more serious condition. If medication fails to treat seizures, a patient is then referred to an epileptic center, and it is often there that the diagnosis of PNES is made.

With proper equipment and specialized knowledge, an epileptologist can easily distinguish between epilepsy and PNES. An EEG-video monitoring system monitors a patient for several hours and sometimes days until a seizure occurs, though there are techniques that can be used to trigger a seizure to speed up the monitoring process if necessary or desired. By analyzing the video of the seizure, a diagnosis of PNES can be made with 100% certainty.

Causes and Risk Factors

PNES is a somatoform illness, meaning that emotional stress creates physical illness in the body. These seizures are emotional in nature—induced by stress—and often result from traumatic experiences, some of which may have been repressed or forgotten. Such traumas may include divorce, physical or sexual abuse, death of a loved one, incest, or any other great loss or sudden upheaval in one’s life.

Individuals without developed coping skills may be more susceptible to PNES than those with a high level of resiliency to stress. A team of neuropsychologists and neurologists at Johns Hopkins University School of Medicine found that people with PNES don’t necessarily have a higher frequency of stress and/or trauma than others, but they seem to lack effective coping mechanisms to deal with stress and are thus more affected by it.

Coping with Diagnosis and Stigma

Psychosomatic illnesses like PNES are often misunderstood by family members and even by physicians and other health care professionals. A person may be reluctant to accept the diagnosis and become upset when told the seizures are psychological. Some people completely refuse to accept the diagnosis and continue to take antiepileptic drugs even as symptoms continue. This places responsibility on the physician to stop administering the drugs.

A lack of public knowledge and awareness of PNES only increases the misconceptions, misdiagnoses, and stigmatization of the illness. Somatoform illnesses like PNES are real—resulting from real stressors and traumas—and should be treated as such.

Treatment and Outcomes of PNES

Overall, PNES can be treated if properly diagnosed. The earlier the diagnosis, the better the outcome may be. About 70% of people who receive adequate treatment for PNES eventually experience a complete disappearance in seizures. The recovery time will vary from patient to patient depending on the severity of the traumas and stressors involved, as well as the person’s established coping mechanisms and resiliency to stress.

While a neurologist typically treats epileptic seizures, PNES tends to be treated by a psychologist or other mental health professional. Someone who has been newly diagnosed and has been taking antiepileptic drugs will need to work with a neurologist to gradually come off the drugs rather than stopping use abruptly.

About 70% of people who receive adequate treatment for PNES eventually experience a complete disappearance in seizures.Treatment for PNES typically involves various types of psychotherapy. Cognitive behavioral therapy (CBT) may be used to help people develop adequate coping skills to deal with life stressors. Relaxation techniques and biofeedback are also used to help manage and cope with stress.

For those whose seizures are a manifestation of past trauma, PNES is typically treated as posttraumatic stress. In this case a physical seizure may be the body’s way of expressing what the mind cannot. Some physicians have also found eye movement desensitization and reprocessing (EMDR) to be an effective treatment for PNES.

EMDR is a synthesis of many different therapeutic approaches including CBT, psychodynamic, interpersonal, body-centered, and experiential therapies. This information-processing therapy occurs in eight phases—attending to past traumas that contribute to the pathology being treated; the current situations, beliefs, and sensations that are triggering the dysfunctional emotions; and the positive experiences needed to improve mental health and well-being in the future.

The costs of being treated for misdiagnosed epilepsy are high and should not be ignored. As the incidence of misdiagnosed PNES continues, it is important for neurologists, psychiatrists, and psychologists to work in collaboration to raise public awareness, remove the stigma, and provide proper diagnosis, treatment, and support.

References:

  1. Benbadis, S.R. and Heriaud, L. Psychogenic (Non-Epileptic) Seizures: A Guide for Patients and Families. (n.d.). Comprehensive Epilepsy Program: Tampa General Hospital & University of South Florida College of Medicine. Retrieved from: http://hsc.usf.edu/COM/epilepsy/PNESbrochure.pdf
  2. Desmon, S. (2012, April 10). Symptoms that Mimic Epilepsy Linked to Stress, Poor Coping Skills: Patients with “Pseudo-Seizures” Often Misdiagnosed. Johns Hopkins Medicine. Retrieved from: http://www.hopkinsmedicine.org/news/media/releases/symptoms_that_mimic_epilepsy_linked_to_stress_poor_coping_skills
  3. The Truth about Psychogenic NonEpileptic Seizures. (n.d.). Epilepsy Foundation. Retrieved from: http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures
  4. What is the actual EMDR session like? – EMDR International Association. (n.d.). Retrieved from http://www.emdria.org/?120

Calm and confidentHis name was Zack. Zack was a 150-pound, 2-year-old Newfoundland dog—my buddy. Wild at heart—at best only ever semi-domesticated—he loved nothing more than to escape from our three-quarters-of-an-acre fenced yard and head toward the hundreds of acres of forest and trails that lay just up the road from our house.

I came home from work late one afternoon and discovered Zack was gone. I parked my car, got out, and then heard the screech of brakes, a loud, dull thud, and one heart-breaking yelp. I ran up the road to the crest of the hill and saw that my worst fears had come true. Lying in the road— illuminated by the car’s headlights—was Zack, tongue hanging out from the side of his open and bleeding mouth, his bear-like chest still. He was dead, killed by a car traveling over the crest of the hill, by a driver who could not see him until it was too late. I felt devastated.

For the next several weeks, as I traveled this same road, each time I came over the crest of the hill where this tragedy had occurred, the image of Zack’s lifeless body, lying in the road, involuntarily came to mind accompanied by all the associated feelings of grief. The sight of the crest of the hill had become a trigger for activating painful memories.

A couple of months later, I attended a weekend workshop focused on something called neuro-linguistic programming, or NLP for short. NLP is the study of how thought and language impact and influence personal experience.

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During the NLP training, the two facilitators—Rick and Ricky—asked that we each find a partner to complete an exercise. In this exercise, one person was to act as the “client” and the other as the “therapist.” The client was directed to pick a memory that was still bothering him or her. The therapist was directed to guide the client through the steps of an NLP procedure called the “swish pattern.”

We were told that when using the swish pattern, it was not necessary for the client to reveal the contents of his or her memory to the therapist. This meant the entire process could be completed without the therapist even knowing the client’s issue.

For this exercise, I opted to play the role of client. As the “client,” here are the instructions I received and followed:

  1. Select a specific “unpleasant memory” you want to change.
  2. Close your eyes and mentally re-create that unpleasant memory to the best of your ability. Imagine it in detail as if it was happening to you now. Be in the experience and see, hear, and feel what you would if it were happening now. (Note: for this exercise I recalled coming to the crest of the hill, finding Zack dead, and feeling devastated.) This original unpleasant memory will soon become the cue for triggering a new “pleasant substitute memory.”
  3. Next, create an alternative mental image of what you would prefer to recall—a pleasant substitute for the original, unpleasant memory. (In my case, I wanted the crest of the hill to automatically trigger a pleasant image of a time spent with Zack instead of triggering the unpleasant memory of his lifeless body lying in the road. The pleasant memory I selected was an image of Zack standing on his hind legs, front paws hanging over the fence, black tail wagging, and happy to see me.) Imagine this new alternative “pleasant memory” as if it was happening to you now. Be in the experience and see, hear, and feel what you would if it were happening now. This is now your new substitute pleasant memory.
  4. Now, once again, imagine a big, bright picture of the unpleasant memory you wish to change (your original cue image). In the bottom right-hand corner of this mental picture, construct a small dark picture of your new “pleasant memory” that you would prefer to experience instead.
  5. Now, quickly and smoothly expand the small, dark image of the pleasant memory so that it grows to become a big, bright image right in front of you—completely replacing the unpleasant memory. This quick exchange of images (from unpleasant to pleasant) takes about a second. Swap the images in the time it takes you to say, “swish.” The key point is to make the exchange sudden and very fast.
  6. Repeat steps four and five 10 to 12 times.

I listened attentively and followed all of the therapist’s instructions. This was my first experience with the “swish pattern.” Was it effective? Last week, I drove to the old house. As I passed over the crest of the hill, sure enough, the first memory that came to my mind was the happy image of Zack standing on his hind legs, front paws hanging over the fence, black tail wagging and happy to see me—just like we programmed my mind to do in this exercise first completed a quarter of a century earlier.

Is the swish pattern magic? No. Does it always produce such impressive results? Probably not. But when you have a troubling memory, is it worth giving it a try? Absolutely!

Thank you for your message and for having the courage to reach out. I’m sorry to hear that your marriage has run into some challenging times. I hope this message will prove useful and will help you find some solutions.

When partners seem to lose interest, it is natural for the other party to feel as though perhaps it has something to do with them. While that may be the case in some situations, it is not always that way. Often, it may have absolutely nothing to do with the partner.

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There are many reasons people might lose interest in sexual activity—work stress, financial trouble, and physical issues are just a few possible reasons. Before assuming that your husband is no longer sexually interested in you, consider that there may be something else going on.

The first question that comes up for me is whether your husband might be experiencing some erectile dysfunction issues that may be getting in the way of his sexual interest/willingness. If that is the case, he may be embarrassed and masking it with anger. For some men, the loss of the ability (or decreased ability) to function sexually is a significant blow to their masculinity. Of course, I have no idea if this is the case, but it is worth considering. There may be any number of other causes. Sometimes, people lose interest in sexual contact with their partner if the partner changes his or her physical appearance, hurts them deeply, or if they feel somehow unsafe in the marriage. As you can see, the possibilities for why your husband may not be interested in sexual contact right now are many, and until you do some exploration, you may not have the answer you’re seeking.

My suggestion to you is that you step into a place of compassion and understanding, and with gentle curiosity ask your husband if he can set aside the anger and talk to you about what is going on.

My suggestion to you is that you step into a place of compassion and understanding, and with gentle curiosity ask your husband if he can set aside the anger and talk to you about what is going on. Let him know that you love him and want to meet him where he is but you must know what’s happening with him. Let him know that you are not judging him, not taking it personally, and simply want to understand so you can know how to proceed.

If he remains unwilling to talk, you may want to consider seeking out a therapist who can help you decide what steps to take next.

When you approach your husband, be sure to do it at a neutral time. Whatever you do, don’t approach him right after he refuses sex, because that is a high-tension time. I suggest you set a time with him, a few days or even a week in advance, when you can talk. If you both work and have stressful weeks, maybe choose a weekend time. When the time comes, sit down in a quiet place, free of distractions, and begin the discussion. If things get heated or tense, it’s always OK to take a brief “timeout” to cool down and come back to it. With a difficult topic like this one, it may take a few tries to discuss it fully, but a peaceful and satisfying resolution will be worth the effort.

However, you know your situation better than I do. The shouting you mention is concerning. If you ever feel unsafe with your husband or have any indication he could be physically violent, consider calling the National Domestic Violence Hotline at 1-800-799-7233 and/or finding a safe place to stay, at least until things calm down.

Good luck,
Lisa

Two Young Women Friends Sitting Together on SofaRelationship issues and communication problems are frequent reasons many individuals and couples come to see me for therapy. One aspect of the work is to explore feelings and conflicts in relationships and empower people to engage with their partners with the aim of understanding and being understood. To do this, we look at what interferes with the ability to be empathic to the other’s experience. It would seem that understanding where the other person is coming from and seeing their point of view would not create difficult problems in relationships. However, it turns out not to be so simple. The loss of one’s sense of self in the process of engaging another’s feelings must be addressed.

The Risk of Empathy

As I engage with these people in therapy, I often discover that there is a limitation in the ability to be empathic in relationships, especially in situations where there is disagreement. Some believe that acknowledging empathy when there is conflict puts them at risk because the other will mistake their understanding for agreement. If that should occur, the empathic person can feel like their thoughts and feelings have been dismissed and negated. They fear that their expression of empathy will be seen as acknowledging the rightness of the other and they will be the loser. The feeling is not just of losing the argument, but a loss of some piece of the self.

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Glen and I were working on his feelings of helplessness with his partner, Alan. They had been a couple for six years, but to Glen’s disappointment, he could not get Alan to agree to move in together. Each time Glen suggested they give it a try, Alan got angry and told Glen to stop nagging him. He would say he loved Glen, but had no interest in living together. Glen would feel hurt and pushed away.

“He is so mean to me,” Glen said. “I don’t know why I stay with him when he repeatedly rejects me. Can I really believe that he loves me when he treats me this way? You know how scary it is for me to speak up for myself in my life. You and I have been working on that and now that I’m doing better and asking for more, what good does it do me? When I ask Alan for what I want, he still mistreats me.”

I asked Glen: “What do you understand about why Alan, who has stayed with you for six years, won’t move in with you?”

Glen replied: “He says that in his last relationship, living together was a disaster and he and his partner fought constantly. But just because it makes him anxious that our relationship will become like that is no reason to keep denying me what I know will be perfectly fine. I just think he wants to control me. He is talking about his history and absolutely refuses to see us as different. I get so hurt and angry. He can get really sad and even cries sometimes when he tells me how painful that relationship was. But he needs to get over it.”

Glen could see only his own point of view. It was very difficult for him to be empathic—to get him to consider what it would be like if he put himself in Alan’s shoes. He became very irritated with me.

“I don’t get it,” Glen said. “You have helped me to learn more about who I am and what I want, and now you want me to abandon my own thoughts and feelings and wear Alan’s shoes. I need to stay in my own shoes. Alan’s shoes don’t fit me. Maybe he should try my shoes on for size.”

I asked Glen to tell me more about what he thinks the downside would be if he could empathize with Alan. He had no trouble replying.

“If I let myself feel what it’s like to be Alan and recognize his worries and anxieties, it will legitimize his point of view. What I want will lose all meaning. I know I’m right about this. We have had this fight for almost six years and now he would win. I don’t want to be a loser. You know, for the most part we have a good relationship. We spend a lot of time together; we love each other; we have fun. But every time I bring up that if we don’t live together it isn’t a real relationship, we get into a huge fight. Then it feels like we are enemies and neither one of us will give in. I’m afraid that if I stop fighting for this, I will become helpless and powerless in the relationship and disappear. Sometimes I even think Alan would leave me if I gave in because he would think I’m a wimp with no sense of who I am or what I want.”

Glen mistakes allowing himself to understand how Alan feels about moving in together for agreement with Alan. He is stuck on the idea that he will be a “loser” if he is empathic. But his biggest fear is that being empathic means he will betray his own wishes and lose a part of himself.

Identification, Not Empathy

In contrast to Glen, Katy is concerned that she has too much empathy. She came to see me because she was feeling overwhelmed with feelings of having to care for her aging father and, at the same time, attend to her daughter who had just left for college and was having a difficult time adjusting. She described her emotional situation as follows:

“I am so filled with feelings I can’t breathe. My father is very sick with cancer. He’s scared and very demanding. I feel so much empathy for him. I’m frightened, too. We’re so close. What’s going to happen to me when he dies? I’m also on call for my daughter. She can’t seem to settle in at college. She calls me every day. I spend hours trying to soothe and reassure her. I know just how she feels. I remember when I went away to school and my parents would try to help me. She is such a mess. I’m such a mess. My father needs the same kind of soothing she does. I guess I do, too. My husband tries to help, but he thinks I’m over-involved. I don’t know how I could feel any other way. My father and daughter are both in pain, and I can’t help but share their feelings.”

Katy saw herself as a loving and responsible daughter and mother. She believed her response to her family members was the “right” way to feel. While she acknowledged feeling burdened by the demands made on her, she thought that “it’s my duty to give my all and do my best to make them feel better.” She recognized that for months she had given up much of her own life to devote herself to her family. Not only was she exhausted, but it was creating conflict with her husband: “He told me that I’m always anxious and preoccupied and that I’ve disappeared from our relationship. He says it’s OK to worry and help, but he accused me of being consumed with my father and our daughter. He keeps saying, ‘Where are you? I want you back.’ ”

Katy describes herself as feeling empathy for her father and daughter. These intense feelings, however, are not empathy. Empathic feelings occur when one can emotionally imagine what it is like to be in another person’s feeling state. Someone with empathy strongly feels what the other person is feeling but maintains a sense of being separate. In contrast, Katy is identifying with her father and daughter. She can’t maintain her separate self. The feelings she experiences are the same as the feelings her father and daughter suffer. She is identifying with them and taking on their feeling states. She cannot have her own separate, empathic feelings. Her sense of self is lost.

Loss of One’s Sense of Self

The therapeutic work with Glen and Katy could easily focus on the concrete problems each of them brings to their sessions. Glen and I could work on his becoming comfortable with Alan’s refusal to move in together. Or we could look at what makes Glen feel so mistreated and rejected when this occurs. And we do explore those issues. Katy and I could work on her anxiety and guilt about her conflicts and limitations in helping her family members. And we do work on these issues as well as on her relationship with her husband.

Empathic feelings occur when one can emotionally imagine what it is like to be in another person’s feeling state. Someone with empathy strongly feels what the other person is feeling but maintains a sense of being separate.

But the therapy with both these individuals has been most productive when we address the feelings of loss of self. For Glen, conflict in the relationship is exacerbated when he refuses to empathize out of fear of losing himself. For Katy, there is no room for herself when she identifies with the other and becomes overwhelmed and infused with everyone else’s feelings.

As we dig deep into the dynamics of these two relationships, we are left with the necessity of having to explore: What happens to me when I am faced with the other person’s feelings? Glen struggles with considering that he can try on Alan’s shoes and appreciate how they fit Alan, even if they are not his style. He is beginning to recognize that he can like the look for Alan, but know that he doesn’t have to change the style that is right for him. Katy looks at how she responds to her father’s and daughter’s feelings and is learning that she is not the same person as her family members. She is starting to recognize that she can set boundaries and still be a good and loving family member. It is not easy, however, to separate and feel for them, rather than become them.

As Glen and Katy come to understand what has interfered with their being empathic, they are in a better position to relate to their significant others in loving ways while retaining their sense of self.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

young asian woman hiker sit mountain rockPsychotherapy can be about more than treating symptoms; it can be a path to living a more fulfilling life.

People often begin therapy to alleviate symptoms—a worthy goal, to be sure. But perhaps even more compelling is the ability of psychotherapy to help us counter our tendencies to stay in our comfort zones, and to challenge us to open ourselves to the aliveness and dynamism of the ever-evolving now. It can help us tap into our potential and live happier, more meaningful lives.

Yet it’s not uncommon to hear people say that therapy is like using a crutch, or that therapy makes people dependent on their therapists. In some cases, such claims may indeed be true. However, good therapy is meant to empower us, to help us mature, to stand on our two feet and face whatever comes our way.

Furthermore, therapy is not an easy process. If your therapist is doing his or her job, you will feel uncomfortable at times as you examine uncomfortable feelings and the reasons they exist. Whoever thinks that therapy is a crutch or an easy process clearly has not gone to therapy.

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Therapy Takes Courage

Engaging in the process of therapy is a courageous endeavor that is not for the faint of heart. Successful therapy demands that you see what you do not want to see within yourself. We all have parts that we don’t want to see, parts that scare us and that we have carefully hidden deep inside.

Good therapy is meant to help us uncover those parts. Even in the safety of a strong therapeutic relationship, that is no walk in the park. It requires commitment, emotional stamina, capacity to tolerate difficult emotions, capacity to shift attention to different aspects of ourselves at the right moments, and compassion—lots and lots of compassion. It requires dedication and a willingness to be in (inner) places that we haven’t been before, a willingness to be vulnerable.

Vulnerability Is True Strength

Allowing ourselves to be touched and open to experience in a non-defensive way is a very vulnerable thing to do. The idea that this is a weakness is a delusion; nothing takes more courage than to meet the parts of us that are scared and hidden. As long as we try to force our way into seeing our depths, we will not have access; the way in is through vulnerability and allowing our experience be exactly what is.

Allowing ourselves to be touched and open to experience in a non-defensive way is a very vulnerable thing to do. The idea that this is a weakness is a delusion; nothing takes more courage than to meet the parts of us that are scared and hidden.

This is no easy task. Our culture advances a belief that we need to “pull ourselves up by our own bootstraps,” but that belief is based in unconscious fear that dominates our experience—in fact, it is an act of violence toward ourselves.

If instead of beating ourselves into action we learned to invite the shaky, scared parts of us to show up, and we hold them with openness and let ourselves directly feel all of their uncomfortable sensations, we are being as courageous as we can possibly be. We are willing to meet ourselves without hesitation.

If we allow ourselves to feel the sense of deficiency (or whatever we are resisting), without defending against it, in time we can begin to experience a palpable sense of strength, courage, and determination that is not based on ideas of what should be, but are actual, felt experiences. Good therapy can help us with this.

Real Therapy Has Results Beyond the Reduction of Symptoms

There are real, tangible benefits to engaging in this process, including an increased sense of freedom. By understanding and unwinding the inner structures we have hidden inside, we are also recovering a great deal of previously frozen aliveness. By learning to see through our emotional and mental defenses, we also gain openness, awareness, and responsiveness. We become more finely attuned to what we need and to what is needed at any given moment.

A simple way to measure psychological well-being is by how responsive we are to the immediate environment without our old filters getting in the way as much. Neither reactive nor passive, we become able to appropriately act in a way that supports our continuous development.

This is not a mental exercise; it includes all of our being. It includes awareness of our mental, emotional, and somatic (physical) states. It requires uncovering our past beliefs and ideas about reality. It also requires getting to know our limitations and our capacities. And it requires us to not be defended—or at least not extremely defended. In a way, therapy can be an adventure into our inner landscapes, a process in which we are willing to be transformed by self-discovery.

By becoming aware of the parts of us that we didn’t know existed, we can begin to know ourselves in a more intimate way. In turn, our satisfaction in life increases, because our actions, emotions, and thoughts come into greater alignment. Furthermore, by understanding our unconscious inner conflicts and relational patterning, we begin to lessen their impact on our well-being and our capacity to respond appropriately to life.

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.