Children with social, emotional, and behavioral difficulties (SEBD) often exhibit speech, language, and communication needs (SLCN) as well. Clinicians and educators who work with these children have the challenge of identifying which type of treatments will best serve the needs of these special children. SEBD has been shown to be linked to communication deficits, but this relationship has not been fully explored. Gender, social conditions, intelligence, and relationship styles are factors that contribute to both SLCN and SEBD. Most children with these problems are not identified until they enter school, making the correlation between them more convoluted. For instance, executive function deficits may not be discovered until children enter school and exhibit symptoms of attention deficit hyperactivity disorder (ADHD). Other children may live with negative psychological and physical conditions such as abuse or neglect that can cause the children to stifle their communication, resulting in communication problems later on.

The most common type of treatment for SEBD is cognitive behavioral therapy (CBT). In a recent analysis of existing research, James Law of the Institute of Health and Society at Newcastle University in the UK looked to see whether CBT was ever combined with communication therapy for children. He also studied the research on CBT outcomes in children with Asperger’s, autism, and anxiety to determine whether the therapy had any positive impact on communication skills. For his research, Law examined 19 separate studies that included data from 148 children with SEBD and SLCN.

Although Law did not isolate one particular CBT approach that would be most beneficial for these children, he did discover that variation in communication enhancement techniques had a positive impact. Specifically, more formal techniques appeared to help the children with autism spectrum issues the most, and naturalistic and educational approaches were identified as effective methods for children with mild communication and behavior problems. In conclusion, Law added, “The potential overlap between SLCN and SEBD needs to be widely recognized by practitioners, and the implications for practice of this overlap explored more fully.”

Reference:
Law, J., Plunkett, C. C., Stringer, H. (2012). Communication interventions and their impact on behaviour in the young child: A systematic review. Child Language Teaching and Therapy, 28.1, 7-23.

Cognitive fusion is a process that involves attaching a thought to an experience. Cognitive fusion is beneficial in many ways. Through the process of cognitive fusion, people can become interested in story lines in movies and books because they attach their emotions to the events. Hobbies that elicit positive feelings can be enhanced as a result of cognitive fusion as well. Even feelings of love can be influenced by cognitive fusion. But this process can also impair behavior in individuals with certain psychological issues. People who struggle with anxiety and depression experience negative thoughts that can prevent them from taking positive actions. For instance, when someone with depression focuses on feelings of worthlessness because they have been unable to overcome their depression, they may continue to avoid seeking help because of the perceived outcome. Individuals who suffer with anxiety also find themselves trapped by cognitive fusion when for instance, they believe they will panic if they are exposed to stressful situations, and therefore avoid all situations that could induce stress, even if they are necessary for recovery.

Understanding how cognitive fusion affects mental health is a relatively new area of research. Acceptance and commitment therapy (ACT) is a mindfulness-based therapeutic approach that teaches clients how to accept negative feelings independently of perceived outcome. Therefore, ACT and other mindfulness techniques aim to teach cognitive de-fusion. Because there is little evidence exploring this, Kristen N. Herzberg of the Department of Psychology at the University at Albany of the State University of New York, recently conducted a study that employed a new tool to measure the effectiveness of ACT on cognitive fusion.

Herzberg and her colleagues developed the Believability of Anxious Feelings and Thoughts Questionnaire (BAFT) and administered it to over 900 individuals, half of whom struggle with extreme anxiety, undergoing 12 weeks of internet ACT treatment. She found that BAFT was quite accurate at identifying levels of cognitive fusion. Specifically, the BAFT was able to measure anxiety sensitivity, avoidance, and cognitive de-fusion in the participants. The results also showed that the anxious participants saw significant reductions in avoidant behaviors after completing the cognitive fusion–targeted ACT program. Herzberg added, “Taken together, these findings suggest the BAFT to be a reliable, valid, and useful measure of cognitive fusion.”

Reference:
Herzberg, K. N., Sheppard, S. C., Forsyth, J. P., Credé, M., Earleywine, M., Eifert, G. H. (2012). The Believability of Anxious Feelings and Thoughts Questionnaire (BAFT): A psychometric evaluation of cognitive fusion in a nonclinical and highly anxious community sample. Psychological Assessment. Advance online publication. doi: 10.1037/a0027782

 

GoodTherapy | Breathing Lessons for Coping with Grief

We breathe all the time, right? So, what’s the big deal?

Most of us are not breathing properly throughout our days for optimum health and well-being. Most of us have poor posture, we sit at our desks for long periods of time, slump in our seats, stare at screens, move very little… This is a problem for much of the population.

If grief is added on top of those bad habits, our situation becomes even more difficult. Grieving on its own makes us feel like we want to be slumped down, curled into a ball. It makes us want to protect our hearts. The chaotic yet static state sometimes even stops our breath entirely. If you are grieving, you may notice that your breathing is very shallow, or that you are holding your breath without even realizing it. You may suddenly find yourself gasping for a breath, as if you’ve been under water, reaching for the surface. This is not abnormal in grieving. Grief affects every part of us, including our breathing. Here is your chance to learn to breathe through grief.

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Finding a quiet time at any point in your day to simply breathe can be a wonderfully healing tool. Anytime you notice that you are feeling anxious, particularly tired, or that you are holding your breath, take a moment—right then and there—to breathe.

Stoplights make good cues to practice your breathing as well. In addition to helping you notice your breath and serving as reminders to practice your breathing exercises, breathing at stoplights can help to counteract the stress we experience when we are confronted with the stress of the rest of the world—other drivers, traffic jams, errands that must be run—while we are in the midst of our grief. Inside your car, you can create a space of calm and peace simply with your breath. Practicing your breathing, and any other coping techniques, when you are calm, helps you be able to put them to use when you need them, such in the midst of anxiety or a panic attack (also not uncommon in grief).

Additionally, noticing your breath and increasing your use of breathing practices can also help you to become more mindful of your own thoughts and feelings, giving you a sense of control and stability in an otherwise incredibly chaotic time of life. The more you notice how you feel, what your thought patterns are, how your body is affected by your responses to the world around you, your grief experience, your thoughts and feelings, the less out of control you can begin to feel. A greater sense of calm and control can help you along your healing process.

Many people are told, “Take a deep breath.” But in my practice, I have found that when I ask people to show me how they take a deep breath, they often suck in their stomachs and fill up their chests. This is actually the opposite of deep breathing. Breathing this way restricts our lungs’ ability to take in oxygen and to release carbon dioxide. The result is an excess of CO2 in our bodies. Not inhaling enough oxygen and failing to exhale enough CO2 can create fatigue, mental fog, and decreased tissue function. For a grieving person, this can intensify many of the normal grief reactions that we go through as part of the grief experience. Breathing deeply and fully can be a helpful tool to decrease stress, increase clarity of thought and help to counteract fatigue. Not only that, but chest breathing stimulates our sympathetic nervous system—our fight or flight stress response. Think about it: When we are startled, what do we do? We open our mouths with a sharp intake of a chest breath. This alerts our brains that there is a danger. Breathing into our chests stimulates the very response we are trying to counteract. Learning to take deep belly breaths is essential to decreasing anxiety and getting more oxygen to the brain.

Read on to learn some simple but truly effective breathing exercises to decrease anxiety, clear your mind, and counteract some of the natural symptoms of grief.

Breathing Exercise: Just Breathe

This is an exercise in simply noticing your breath, helping you to become more aware and mindful of your own breath as it moves in and out of your body.

Breathing Exercise: Simple Deep Breathing

For this breathing practice, sit in a comfortable position with your hands relaxed, either in your lap or resting on your thighs or knees. Then begin.

Breathing Exercise: The Three-Part Breath

The three-part breath is a specific breathing technique used in many yoga practices and can be very useful in times of stress or whenever you need to relax. This type of breathing triggers your parasympathetic nervous system or the “relaxation response” (the opposite of the fight/flight stress response) and allows your body and mind to more easily release stress and tension. It is physiologically impossible for your body to be in a stress mode when you practice the deep three-part breath.

Obviously, you can’t breathe this way all the time, but when you do, it can help you think more clearly and decide on another coping skill or something else you can do to move away from the anxiety you may currently be feeling. Or you may decide to use the breath to sit with the pain of grief. This is okay too. Calmness in the midst of pain can help us know that we can survive the next moment, and then the next.

If you feel dizzy or lightheaded while practicing the three-part breath, or any other breathing exercise, stop the practice immediately and allow your breathing to go back to normal. Sometimes if we are not used to a great deal of oxygen, the change can cause lightheadedness or dizziness. Know your own body and be mindful of the changes you notice.

I hope that these breathing lessons may help you through your grief journey and beyond. Just breathe.

Cognitive behavioral therapy (CBT) is a widely used approach to treat symptoms of general anxiety disorder (GAD). The goal of CBT is to help an individual be more tolerant of their worrying behaviors, thus decreasing the negative psychological and physical symptoms of GAD. Applied relaxation (AR) is an alternative approach that is used for various mental health problems, including GAD. It focuses on the somatic symptoms of tension and physical discomfort associated with anxiety, with the goal of reducing worry. Both CBT and AR have been shown to be effective at diminishing the symptoms of GAD in individuals who struggle with emotional and somatic symptoms. However, few studies have compared the dynamics that cause the symptom reduction in each of these treatment approaches.

Eleanor Donegan of the Department of Psychology at Concordia University in Montreal sought to identify the mechanisms by which AR and CBT worked and also to determine if one was more effective than the other at maintaining long-term symptom reduction. For her study, Donegan evaluated 57 individuals who underwent either AR or CBT over a period of 12 weeks. She found that for both groups, the amount of time they spent worrying each day decreased from approximately 36% of the time to 20%. Additionally, both AR and CBT reduced the amount of daily anxiety by nearly 50%.

Donegan noted that even though the participants were much less anxious as a result of their treatment, they still had significantly higher levels of worry and anxiety than non–clinically anxious individuals. When Donegan looked at how the effects were achieved, she found similarities and differences. Specifically, even though both AR and CBT decreased somatic anxiety, the effect on worry was more significant in the individuals who underwent CBT. However, Donegan believes that both of these techniques could be useful to address GAD. She added, “Change in worry occurs in part because of change in somatic anxiety, and vice versa, in both CBT and AR.”

Reference:
Donegan, E., Dugas, M. J. (2012). Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028132

Woman rubbing neckMost women have experienced some symptom of premenstrual discomfort at one point or another—whether it be bloating, aches and pains, breast tenderness, fatigue, tension, headaches, or sleep, eating, and/or mood disturbances. By some estimates, up to 80% of women experience at least one symptom with some regularity. For approximately 5% of women, however, symptoms are severe enough to meet criteria for premenstrual dysphoric disorder, or PMDD.

PMDD can lead to impaired functioning and quality of life during the last week of the menstrual cycle and until about 4 days after menstruation has begun. Significant anxiety, depression, and irritability are commonly reported features of PMDD. Women with either premenstrual syndrome (PMS) or PMDD frequently seek relief in one or a combination of over-the-counter medications, a prescription, or natural remedies, but too often relief is elusive.

What Causes PMS and PMDD?

Although at present there is no definitive understanding of why some develop these syndromes and others do not, a woman’s body undergoes a number of hormonal changes throughout her cycle. It is thought that disruptions in these processes may lead to the above symptoms. Specifically, disruptions in the hormone progesterone as well as in neurotransmitters (chemicals in the brain), such as serotonin and gamma-aminobutyric acid (GABA), and the stress hormone cortisol, may be responsible for PMS or PMDD.

There has also been research examining the roles of calcium and magnesium in these conditions because both minerals vary with the menstrual cycle; however, it is not entirely clear whether imbalances in calcium and magnesium directly cause PMS/PMDD. Although there is not enough data to establish a causal relationship, being sedentary, consuming large amounts of caffeine, sugar, and alcohol, and being very stressed are among the factors associated with having PMS.

Mental, Physical, or Both?

Many women with PMDD also meet criteria for major depressive disorder or seasonal affective disorder, and some have panic or other symptoms of anxiety that are quite severe. It is important to note that although PMDD is included in the Diagnostic and Statistical Manual of Mental Disorders, it is a condition that has a physiologic basis, even though it may include psychiatric symptoms or coexist with other psychiatric disorders.

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There are a number of natural remedies that are commonly used for PMS or PMDD symptoms, including chasteberry (also known as Vitex or Monk’s Pepper), evening primrose oil, saffron, St. John’s wort, soy, B6, calcium, and magnesium. Only a few of these remedies have sufficient evidence to support their use at this time, however. These include:

Discuss any herbal or vitamin supplements you take with your doctor to make sure these are appropriate for you and that they will not interfere with other supplements or medications you may be taking.

In addition to the above, the following lifestyle changes are recommended:

It goes without saying that if you have premenstrual symptoms that make it hard to do the things you want and need to do, see your gynecologist for an accurate diagnosis. He/she can help rule out other physical or psychological syndromes that may appear similar to PMS or PMDD. If your mood symptoms are severe (e.g., you experience panic or disabling anxiety, feelings of hopelessness, or suicidal thoughts), seek professional help immediately.

For more information, consult the following:

References

  1. Pearlstein, T., & Steiner, M. (2008). Premenstrual dysphoric disorder: burden of illness and treatment update. Journal of Psychiatry & Neuroscience, 33(4): 291–301.
  2. Whelan, A. M., Jurgens, T. M., & Naylor, H. (2009). Herbs, vitamins, and minerals in the treatment of premenstrual syndrome: a systematic review. Canadian Journal of Clinical Pharmacology, 16(3), e430-e431.

Japanese bridgeTherapy as a sacred ritual might sound a bit pompous to some. After all, therapy is often considered something of a “have to,” not a “want to.” I would like to consider that therapy is something other than a way out of struggle, depression, and pain. My clients teach me each week that something beautiful is explored, born, or manifested in our weekly get-togethers. As they make their weekly voyage to therapy, they pledge to themselves the opportunity to discover the full range of their experience.

Like a good cup of coffee in the morning, therapy is like a morning jog-so-you-can-get-going kind of ritual. Whether writing morning pages in our journals to scribe our thoughts, or pulling the garden vegetables from the earth for tonight’s dinner, therapy has its place in our lives. It is like sacred nourishment for our soul. It is a commitment to understanding ourselves more intimately, completely, and thoroughly, by doing our weekly sit-in with our therapist.

As my clients cross the threshold of becoming, I see the meaning therapy has become to them and the rituals that they encounter.

Setting the Stage
Upon making the first appointment, it has begun. The ritual begins with a friendly, “Hi, how are you.” The client’s “call” embarks on finding a therapist who will see, feel, and hear them most authentically. They seek to connect their experience with someone who will honor and embrace them. Testing the waters, they may begin with a brief explanation of their story in a “give and take” sort of fashion until a connection is made. Upon feeling a spark, the conversation deepens, which consummates an appointment. This reciprocal dance begins the sacred ritual of setting the stage of meeting, time, and place.

Entering Sacred Space
After arriving, entering the room, closing the door, and with sacred agreements signed, both the client and I begin entering into the depth of what will be shared and discovered. While sitting in front of me and releasing the tension, the client intimately begins the next ritual. The sacred opportunity to be fully seen, heard, and felt has begun. Time and space become a blessed opportunity away from tiring commitments, chores, and obligations. There is sacredness in saying the unsaid and feeling the unfelt before me as their therapist. A trust begins to unfurl as the holy journey to revealing and expanding is explored. Highs and lows, struggles and gains, celebrations and sorrows are all fruit for the harvesting. As my clients explore the depths of their experience, I enter my role of providing safety, empathy, and challenge. Each week, building on the last session, the client and I meet with a greeting and enter into sacred space.

Bridging the Gap
Often clients enter therapy with some blockage to unravel, relationship to untangle, or goal to achieve. As we work through the existing sludge to get to the other side of their desire, I notice that my role vacillates among many. The roles of mentor, educator, and guide work many vantage points to include inner-child work, adult development, and familial understanding. The gap of our work together contracts and expands as we discern emotional terrain, physical symptoms, and insight. Weekly, as we deepen, each of these becomes a sacred practice. Commitment to healing, commitment to knowing, and commitment to discovery become not only tasks, but a revered journey. Our deepening relationship begins to transform, soften, and deepen. There is a sacredness in the reciprocity and trust which now gather their place at the altar of unfolding.

Packing Up
As the merger of relationship between the client and therapist expands and deepens within the context of an hour, there must be time to choose the “take with” nuggets of insight and knowledge gained. Much like camping in the park, we sort through, pack up, and continue our journey back to the familiar. Reflecting, we ponder the sacred meaning of this particular hour. The client and I ask ourselves, “What did we learn?” We take a look back and gather threads of awareness and pieces of clarity as we seek to create meaning of this experience. Moments are given to encapsulate the importance of the discovery by way of closing statements, new visions, and take-home assignments. As the hour quickly ends, the door opens and we say our goodbyes. The sacred journey ends and begins with hope and uncertainty as we look forward to unfolding, yet again, what is to become of our meeting together.

Related articles:
Healing Through Expressive Arts Therapy
Therapy for Self Growth

Making a diagnosis of generalized anxiety is sometime a tricky proposition. Anxiety has many manifestations as well as many underlying causes. Anxiety may be chronic and always at the edge of a person’s consciousness or the condition may flare up in acute episodes called panic attacks. Appropriate treatment is essential and typically involves a mix of cognitive-behavioral therapy, pharmaceuticals, and careful follow-up by the treating physician. Xanax (alprazolam) is currently one of the preferred medications for dealing with many anxiety-related psychological illnesses. Anxiety should not be ignored, as the effects of nervous tension and fear include a decrease in quality of life, along with possible secondary effects such as high blood pressure.

Researchers in the Netherlands recently tested a model for understanding the nature of anxiety in humans. At the same time, the experiment highlighted the effectiveness of certain medications at reducing some aspects of anxiety. Specifically, these researchers used the startling effects of white noise and electric shocks to induce surprise or fear in the subjects. In addition to Xanax, subjects were given Lyrica (pregabalin), diphenhydramine (a common sedative ingredient in over-the-counter cold remedies), or placebo. Individual anxiety levels were measured through subjective reporting and a number of objective tests, including eye movements, pupil dilation, and skin conductance. The design of the experiment included random shocks and noises, both with and without prior warning.

As expected, shocking events preceded by a warning produced less anxiety than those that came by surprise. Both Xanax and diphenhydramine reduced overall levels of anxiety but for very different reasons. Whereas Xanax works by altering certain neurotransmitter levels, diphenhydramine has a more general, systemic effect. Surprisingly, subjects given Lyrica showed very little modulation of their anxiety levels. Researchers surmised that because Lyrica takes longer (up to 6 hours) to reach peak effectiveness, the experiment wasn’t capturing an accurate picture of events.

This experiment confirmed that Xanax is effective at reducing one manifestation of anxiety: the so-called “fear-potentiated startle response.” However, the results were less informative about anxiety in general than the researchers had hoped. The sample size was too small to uncover any new revelations about the nature of human anxiety. Ideally, research will one day make the work of quickly and accurately diagnosing anxiety disorders much easier and more straightforward.

References
Baas, J., Mol, N., Kenemans, J. L., Prinssen, E. P., Niklson, I., Xia-Chen, C., et al. (2009). Validating a human model for anxiety using startle potentiated by cue and context: the effects of alprazolam, pregabalin and diphenhydramine. Psychopharmacology, 205, 73-84.

Abstract artGrief arises as a product of a loss that we have experienced. It is associated with losses that may include a person’s health, job, relationship, pet, or loved one. We may not be able to describe the roller coaster of emotions, yet we do know that we are not ourselves. When we feel out of sorts, sensations surface such as low self-esteem, illness, depression, and confusion, which can manifest into thoughts that our feelings are out of our control. As a result, this full-body experience may be difficult to process or verbalize. To mend this sorrow, the expressive arts can create a doorway to the unspeakable by opening all channels to the grieving body.

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Opening Up to Grief

Expressive arts therapy encourages movement of the imagination that we may struggle with during our grieving process. Our art influences how we look at, unblock, wrestle with, and shed light on the need to distance and detach from our pain. When we dodge grief to avoid, deny, or block the inevitable pain, the arts invite the imagination of these stuck places to come to the surface in images, movement, color, and sound. Our art process releases the tension of grief, allowing it to expand and contract, while providing a safe container in which this process can take place. When we create, we give ourselves permission to examine all that is happening within our grieving bodies.

“Art shows how the difficulty can contain its cure if channeled into life-affirming expression.”
-Shaun NcNiff

Understanding the Experience of Grief

There are five to seven stages often associated with the grieving process. They may be experienced as denial, pain, anger, bargaining, depression, upward turn, reconstruction, and acceptance. The experience can feel like a roller coaster ride of ups and downs, mood swings, and erratic behavior. When we drop in to our art-making, the grief is given containment—a place to be held. This containment permits the pain to speak and encourages our healing. Making sense of what is happening comes to light. We may notice this in a color that strikes a mood, or a picture that recalls a memory, or an emotion to be felt. It is an opportunity for the most vulnerable parts of a grieving body to speak, feel safe, be heard, and be externalized. Once the art is created, we can then dialogue with it further and support our need to metabolize all that is going on within us.

 

“The reward for attention is always healing.”
-Julia Cameron

Facing Grief and Piecing Life Together

Fragments of memories, like bits of broken glass, can be difficult to hold emotionally around anniversary dates, picture books, and mementos. They can feel like a jab to the heart, invite an unwanted memory, or open a floodgate of emotion. These fragments seek meaning and solace, yet can wander in and out, tugging and vying for attention at awkward moments. As we seek to piece our lives together after a loss, the expressive arts can heal us by giving these bits and pieces the attention they deserve and need. For a moment, we can sink into ourselves and allow our memories, thoughts, and feelings—those we desperately struggle with—an opportunity to speak, to be heard, and to be felt. Each time that we engage the process using the arts, we give ourselves a break, a breath, and a reprieve from the pain that seeks expression beyond talk therapy.

References:

  1. Cameron, J. (1992). The Artist’s Way. New York: Tarcher/Putnam Publishing.
  2. McNiff, S. (2004). Art Heals. Boston, MA: Shambhala Publications.

Silhouette of woman sitting at sunset“This is a healing. I haven’t allowed myself to heal. I didn’t understand it. I mean I heard what people said when they said this, but I didn’t understand it – until now.”
– Independent filmmaker

At significant moments in sessions, we pay attention to the nuances of our client’s experiential process as it is conveyed through their verbal and nonverbal communication; and we rely on our own experiential process for our vital clinical intuition. We listen through these levels to grasp what our client is experiencing. It is inconceivable to consider the practice of psychotherapy without paying careful attention to experiential process.

But what is meant by experiential process? Are there different levels of experiential process? What does it mean when we say that someone is “too much in their head” or, for that matter, too much in their feelings? What makes one type of psychotherapy really experiential and another less so? Does experiential process have its own natural properties? If such properties exist, how can we know them? These are philosophical and theoretical questions of great value to clinicians.

This article is the first of a series introducing you to Eugene Gendlin’s philosophy of experiencing, its theoretical principles, and its clinical applications. As a philosopher and phenomenologist, Gendlin makes a rare contribution to our work because he addresses ontological questions about the nature of experiencing itself. While a growing number of clinicians, from different schools of psychotherapy, know the clinical value of his experiential focusing method, the philosophy itself is less well known. Ahead of its time, it can now be seen as providing an intellectual holding environment for some of the latest developments in intersubjectivity theory, self-psychology, trauma work, and what is now called the philosophy of the implicit.

My plan in this introduction is to give a brief background to Gendlin’s thought and then to show you how his conceptualization of the natural “laws” of experiential process have direct application to our work with clients.

Gendlin is a philosopher who collaborated with Carl Rogers when they met in 1952 at the University of Chicago. Gendlin’s first major work, Experiencing and the Creation of Meaning (1962), introduced the experiential dimension, and he went on to say that, based on his research (see below, re: The Experiencing Scale), client-centered therapy was not enough. Rogers acknowledged this, citing Gendlin’s contributions to his own article called “On a process conception of psychotherapy” (Rogers, 1958, p. 142). Gendlin went beyond the person-centered approach to describe his view of experiencing in what now is called the implicit dimension of meaning and “implicit knowing.”

Gendlin and his collaborators discovered that clients who showed no progress in therapy didn’t seem to have a capacity to “refer inward” in a particular way. Gendlin designed a way to capture and teach this natural process to anyone interested in working with their inner experiencing.  In order to test the validity of the focusing method, Gendlin and Hendricks developed The Experiencing Scale, a statistically reliable method of measuring levels of experiencing. In the last 20 years, experiential focusing has been cited as an excellent example of a microunit of naturally occurring human change process (Patterns of Change), that can be worked with across most approaches to psychotherapy.

Consider this: You have within you—“beneath” your everyday practical use of language—another dimension, an inner language, that is an imagistic dialogue between you and your immediate experiencing. It is you speaking to yourself (and listening to yourself) in your own code. Gendlin calls it the “zigzag” between the everyday use of language and the way we may actually hold our experiencing in a “bodily felt” way.

We start the process when some situation in our lives—something we “find ourselves in”—feels stuck or painful. The problem beckons to us in a bodily way. We want to move into the place where meanings can reconstellate. To touch into this realm, we sit quietly, eyes lowered, with attention inside. We let form how exactly the situation touches us, how it is meaningful to us, but in an implicit way, not in words. You might say that It finds a way to let itself develop explicitly.

By staying still yet alert, our inner sensing seems to order itself; bodily felt senses (to be defined in the next article) carry within them a palpable sense of significance. As we let them come to us (we cannot in fact go after them!) they prioritize themselves. In a way, they tell us what we need to be attending to. As we hold them in our awareness, we let our words speak directly from our immediate sense of them. And, as this happens, something starts to happen, however subtle. Something starts to dawn on us. Our usual way of holding a situation starts to open—but it’s not only the situation. It is the way we “hold” the situation. We notice a palpable change. This was a good moment in a good therapy session.

If the above description seems familiar to you, that is probably because you have access to your own creative process; you refer to it without needing to know how it might work. The process has its own palpable efficacy. If you are taken by the process, Gendlin’s philosophy in action, you might over time find yourself “living the practice.”

Gendlin’s worldview has helped me to sit with the pauses, stuck places, and moments of uncertainty that are intrinsic to life, including to my life’s work as a psychotherapist. His view of the human universe lends a beauty to the process of meaning making, helping our clients and ourselves stay alive to the creative process that makes good therapy.

This first attempt to describe the microprocess of experiencing will be refined in further articles. In my next article, I will use clinical examples to demonstrate Gendlin’s principles so that you can see them in action.

References:
1. Depestle, F. (2007). The Primary bibliography of Eugene T. Gendlin.  Retrieved March 3, 2012, from http://www.focusing.org/gendlin/gol_primary_bibliography.htm
2. Gendlin, E. T. (1962).  Experiencing and the creation of meaning:  A philosophical and psychological approach to the subjective. New York: Free Press of Glencoe. Second Edition, Evanston IL: Northwestern University, 1997.
3. Rice, L. N., & Greenberg, L. S. (1984). Patterns of change, intensive analysis of psychotherapy process. New York: Guilford Press, 213-248.
4. Rogers, C. R. (1958). A process conception of psychotherapy. The American Psychologist, 13, 142-149. Also in: Rogers, C. R. (1961). On  Becoming a person: A psychotherapist’s view of psychotherapy. Boston: Houghton-Mifflin, 125-159.

Chalk scribbles and hand holding chalkA perception of artists as eccentric, different, and living on the social periphery seems to precede this group outside of therapy and, likely, within the context of treatment as well. There seems to be an unspoken premise that ingenuity is motivated by pain or pathology, or at least some might argue there is a sort of affiliation. Some might assume that this relationship is causal: that trauma causes creativity and thus most artists are contending with some type of affliction. An alternative possibility may be that art is not necessarily motivated by pain; rather the capacity for creative inspiration is something that is brought into the recovery process by those who have such inclinations. In other words, some survivors who are able to express through art may have access to a recovery tool that others do not.

The explanation for eccentricity may serve those outside of the life of the creative in the collective search for continuity versus holding a truth for the individual. Cultural positions regarding gender, race, and other demographic variables have been acknowledged as significant in how therapy plays out as well as having a significant impact on people as they attempt to navigate their lives and define themselves. To postulate art as a product of illness likely has implications within the therapeutic context and thus may be worthy of evaluation. Regarding creative inspiration as a resiliency factor in the same way as personality traits, support systems, and solid attachment histories could be relevant in our approach with this population. The focus here will be in identifying the ways in which creativity can respond to trauma and mitigate its effects while simultaneously acting as a supportive tool.

Traumatic symptoms place significant demand on individuals’ emotional lives; the persistence and intensity of flashbacks, nightmares, hypervigilance, and other challenges can be unrelenting. Repeated images of disturbing aspects of events, difficulty relating to others, and emotional flooding are clearly something to be contended with for survivors. Distortions in reality such as feeling generally distrustful of others, feeling generally unsafe, or even varying degrees of psychosis are also indicators that integration of painful material has not occurred. Digestion and piecing together the historical puzzle are necessary components of feeling better. Access to creativity may assist in regulating affect while working towards making sense of trauma.

The drive to write or perform music or dance, act, paint, or draw seems to exist or not exist in someone. Perhaps to some extent it can be cultivated; however it appears we all come to the table with our own idiosyncratic gifts. Creative motivation is often described as an illusive and illogical propellant that tends not to yield financial and social gain. The reward seems to be internal and is related not only to the product (i.e. a painting, story, piece of music) but to the process. Engagement in developing something creative (much like I am attempting to do now) can have a dissociative feel; there is a disconnect from reality and a hyperfocus that is quite distinctive (I refer to this as the creative stupor). There is an openness in the process, a permission to explore the unspoken, to be childlike, and to express with depth and abandonment.

The intersection of painful events and the creative process either in the context of therapy or outside of it can be salubrious in that both the art and the person benefit. [fat_widget_left]Barriers in discussing dark, shameful, or disturbing information can be softened with creativity; in fact it seems to be a conduit for undigested material. The juxtaposition of style and history may influence the artistic product, but the experience of engaging with art is most relevant to this topic. It appears to facilitate a connection to the extreme, which is what characterizes traumatic injury. The disengagement from reality while simultaneously connecting to experience may offer a unique means of working through unprocessed material. Additionally, themes presented in the artistic product may provide insight to both therapist and client as to where the focus of the work belongs or where the individual is stuck.

Explanations for phenomena logically influence our response to them. Defining the creative process or artistic product as a function of pathology likely effects the cultural response to art as well as the therapeutic context. The identification of those within this demographic as having a unique tool to inform us as their clinician as well as to aid in their process could foster a dynamic shift in the work we do. Conceptually, eccentricities in people, whether it be through art, a mathematical gift, or idiosyncratic ways of thinking could all be potential resiliency factors. This doesn’t imply that we assume our clients should use their gift therapeutically, rather that we maintain curiosity and openness to it while allowing it to inform our work.

Related articles:
Healing Through Expressive Arts Therapy
Shadow Work: Transforming Emotional Suffering into Freedom
Reasons why Trauma Treatment & Recovery might Be a Bad Idea

MichaelPicucci Love resizedAfter 5 years of sobriety, in 1985, I began to notice a pattern in my sexual relationships: Even if I really liked someone, I couldn’t go more than 3 months before my attraction to them fizzled. I would then find some reason to end the relationship, although I never really understood why, and it made me feel bad. Thankfully, while I was leading a weekend retreat on Spirituality in Recovery, one participant pressed for bringing the subject of sex into the process.

Although I was unprepared, it gave me the opportunity to address the issue, and I shared my struggles with the group. When I asked if anyone else identified with the issue, all hands went up. I immediately felt a sense of relief, having previously thought I was uniquely flawed. And then I felt angry that no one had told me about this before, which launched my enthusiasm to shift the primary focus of my work. I began to create healing techniques for underlying trauma and sexual challenges.

The sexual-spiritual split, a deep psychic schism within almost everyone, prohibits loving relationships from forming and enduring. The chasm between sex and love, caused by generational, cultural, religious, and early programming, planted seeds in our unconscious that makes merging with another virtually impossible without the specific healing that new perspectives and experiences can offer.

In the previous article (Part One), I describe the subtle powers of Source Energy, our innate intelligence, to direct us forward. I have chosen sexual healing as the next pathway for expanding our access to Source Energy, although there is no particular linear course. Sexual energy, primal and fundamental to our nature, fully awakens our sensorial nature that always knows our best next step in life. A shift in perspective in our relationship toward the life force in sex can expand our Source Energy.

Like most of us who grew up in the Western world, I internalized sex and all references to it as shunned experiences to keep secret. Many of us received discordant messages in our formative years: love, family, and good deeds provide a happy, acceptable life. Conversely, anything having to do with sex, or even our bodies, was cloaked in a wall of shame and secrecy. While experiences vary, our collective consciousness suffers from this split, locking us out of our own rich, informative, multidimensional sensuality.

There are five key elements to dissolving the sexual/spiritual split:

Shifting Concepts: S.E.X.

Our erotic energy pathways have suffered trauma and distortion. To heal those wounds by utilizing expansive Source Energy, we must gently put our old concepts about sex aside. Most of us never developed a healthy, conscious context for having erotic pleasure. We clumsily fall into sex, gradually shaping ideas about it from what we have observed, and from our own, perhaps awkward, experiences.

When barriers dissolve, we are more likely to have more of what could be called “sacred” or “transcendent sex” and an openness to meaning and purpose for all types of lovemaking, including with ourselves. In paying attention to old sexual identities, we can rediscover, or in some cases reinvent, a new meaning of sex. Our willingness to detach from outdated conditioned thinking is the foundation for transforming sexuality to the sacred.

To help us step out of the cultural box, my partner and I created the abbreviation, S.E.X., for Soul Energy eXchange. It suggests we can choose to enlighten our sexual experiences by focusing on energy that comes from our souls, not just our bodies, and thereby designing a new outlook on pleasure. For those who are willing, it does take a bit of work. It’s rare that I’ve met anyone with an ongoing rich and fulfilling sexual life who did not have to go back in their history to create new contexts for their erotic experiences. But the payoff is huge.

S.E.X. Primary Energies

There are four primary forces in Erotic Ritual’s Soul Energy eXchange (S.E.X.): love, pleasure, lingam, and yoni, which are Hindu Sanskrit terms for penis and vagina. Though lingam energy is typically male identified as drive, pursuance, initiation, and aggression, it’s an energy shared in both genders. Yoni energy, feminine, receptive, creative, and artistic, is also found in both sexes. Love is an energy transmitted from the heart. It can be felt through hands of a lover or from a father or mother to a child. It is gender-neutral. Love means losing ourselves in the beloved. Pleasure takes many forms, but erotic pleasure can be defined as stimulation of the pleasure centers of the brain through visual and tactile stimulation. While some have a low threshold for erotic pleasure, others may find everything erotically pleasurable.

The kind of love we are exploring is the love that moves us to listen and intuit what our lover wants, to care about the other person’s needs. It is best to have the constant energy of love as the foundation for everything in life. The energy of love can be triggered by the energy of pleasure, but it is at its greatest when love is present first.

We have all experienced limiting conditioning in the expression of our lingam and/or yoni energies. Most of us experienced some sort of trauma that blocks our love and pleasure energies as well. Unlocking trauma and toxicity of shame and melting frozen erotic energies are pathways to the sacred. Judgment- free experimentation, using all four of these soulful forces, leads us on a path to the divine, to earth energy, and to a greater connection with the universe.

Perhaps more than in other rituals, through Erotic Ritual we learn that we are all expressions of a much larger source of communal energy. It melts barriers and we feel less isolated. Notice when you are having an erotic experience there is always giving and receiving of energy. Sometimes it’s reciprocated or sometimes one is consistently giving or receiving, and either is fine. Allow yourself to be really present in any prolonged erotic exchange and you will find yourself in a circle of energy. (The yoni expression fully experiences the lingam expression, and vice versa.)

Sexual Concerns

The very private issues that people have shared with me about sex have ranged from not feeling that they are desirable, to experiencing a sexual apathy, erectile and/or orgasmic dysfunction, or feeling detached from a loving partner. Sometimes it’s an obsession with body parts that they just don’t like or think something is wrong with.

Many people carry much the same type of burden, sometimes silently. The principles of Source Energy can have a very beneficial impact in renegotiating and resolving these hardships. With the right resources, including therapy in some cases, the barriers to erotic fulfillment will dissolve, creating possibilities for a blissful engagement with one’s self and with another.

When the sex in a monogamous relationship is unsatisfying, a substantial foundation is at risk. If the condition lingers, with sex becoming almost nonexistent, then the relationship is compromised. Often couples aren’t equipped with the tools to communicate sensitive issues. Their avoidance, sometimes lasting years, continues the downward spiral. Addressing these problems with the assistance of Source Energy can enhance those very skills.

Happily, mine is a loving, growing, and sexually fulfilling relationship, lasting many years. All of our efforts have paid off. Creating sacred time and using it for shame-free sex while opening our hearts, along with taking responsibility and respecting ourselves, have all been key. Sexual loving intensifies consciousness and pure love. In that vast, nurturing ocean there is no ego, nothing to defend, only a sense of just being and connection.

Communication in these sensitive areas can at first feel like hard work. With practice, it eventually becomes quite natural. When my partner and I explored having a committed relationship those many years ago, my primary request was that our sexual relations be the first priority in our union. Even in a number of long-term relationships I’d been in there was the sex-spirit split, along with undeveloped communication skills, causing sex and sensuality to wither. They were left with a sense of deadness in a potentially thriving relationship.

Instead, having made the commitment, we began a life of focalized conscious S.E.X. Expansiveness and sexual gratification became a planned, sacrosanct part of our time together. While it might seem to defy spontaneity, let me suggest that there is a significant payoff. Respecting existing realities—being tired, stressed, too busy, or distracted—doesn’t mean spontaneity is stifled. Rather, without earnest communication of our needs and desires, or without planning, we cannot build rich, enduring erotic lives.

Sexuality, Higher Consciousness, and Fantasy

Although it could feel clumsy, it is crucial to learn to express what we need and desire, as well as what we fantasize about. I like to call it reclaiming adolescent awkwardness, to allow people to go where it might be difficult, in order to heal the sexual-spiritual split, a requirement in forming intimate relationships that are authentic.

In sexual counseling, many are curious about where their fantasies come from, often feeling shame for having them. I tell my clients good fantasies are like rainbows, mysterious and beautiful, sometimes fleeting, and they are to be respected. Their origins may vary from abuses early in life to Freudian, or they may relate to recollections of pleasure from our past. Sometimes they mysteriously come from no conscious recollection whatsoever. Focalizing Source Energy filters the shame out of our fantasies and allow us to fall more deeply in love with ourselves. Self-love is essential to grow in sacred sexuality. Having fantasies doesn’t mean we’re bad or that something is wrong with us, as we don’t have to act on them. Only shame is Godless. Removing the shame from our fantasies transforms them, and that contributes to keeping a long-term relationship sexually alive.

Natural Resistance to S.E.X.

With all our knowledge we still encounter resistance to a loving fusion of our sexual and spiritual energies. The delicate nature of exploring repressed sexual history is likely to trigger that very resistance. When we appreciate the essence of our resistance to removing shame, our fantasies can be an entryway to joyous energetic harmony, where we can experience full-body orgasm along with deeply felt spirituality. Full-body orgasm refers to a burst of the four energies in S.E.X. that can take over every dimension of our physical and subtle energy being. When this happens, we can experience expansiveness and sometimes formlessness that is sublime. It is a full-body encounter that is uniquely restorative when we feel depleted and deeply relaxing when we are tense.

If we can consent to the reality that energy and its many vibrations and frequencies make up our physical reality, we can learn new skills to heal, with an efficient pathway to our inner wisdom. When we energetically experience resolution in our bodies from sexual barriers, we land in the divine center of Source Energy. As we tap into it, the more it begins to lovingly lead our lives.

Related articles:
Part I: Source Energy Optimizes Life – Finding Source Energy
What Do Your Sexual Fantasies Mean?
Fanning the Spark of Sexual Passion

Family portrait of family sitting on couchFamilies need to be together. After all, the family as a group exists to provide support, nurturance, food, shelter, resources, and a stable future to each member. While most families have their ups and downs, even stressed, impoverished, chaotic families want to live with one another. When is it in the family’s best interest for members to separate from one another? Can leaving the family home for a short while ever bring healing to the relationships in the long run?

Family separations occur in American culture in formal and informal ways. Formally, families can legally be ordered to separate by the courts because of domestic violence, child sexual, emotional, or physical abuse or neglect, chronic drug or alcohol abuse, and/or failure to educate and when there is a threat to the life, health, and well-being of one or more family members. Typically, less-intrusive assistance has been attempted at many levels before a court order occurs, including weeks or months of child-centered school counseling, family therapy, marriage counseling, social work support, addiction treatment, spiritual community support, or elder advocacy.

All of these actions occur at local, county, and state levels because we as a society believe that we have a stake in supporting and sustaining healthy families. State laws vary but generally have been written with family reunification as the end goal of this intervention process, wherever possible. Violent fathers, neglectful or addicted mothers, and abusive siblings can and often do change and grow into healthier, happier parents, spouses, siblings, and grandparents. We want families to get along well and have what they need to contribute to the world. No one benefits when families are so chaotic and dysfunctional that it takes dozens of people and thousands of hours and dollars to try to help.

[fat_widget_right]More informal separations occur every day, particularly among highly distressed married couples. Unable to live in the same home without physical or emotional pain, one member of the couple leaves the home temporarily and lives elsewhere. Unlike a formal, legal intervention of family separation, this kind of separation is less likely to change the marital interactions at all. What it usually does is create less fighting and conflict in the home, while increasing the stress of the separating spouse and any children in the family. The only person who may feel any relief is the remaining spouse, and this relief is generally temporary. The focus is shifted to the dozens of life details that, once shared, have to be renegotiated, from grocery shopping and bill paying to getting a child to baseball practice.

Unless a separated couple gets professional support and assistance immediately, the family begins to reshape around the absence of the separated parent. Children feel neglected and forgotten, no matter how diligent the separated parent is in spending time with the children. There is just no adequate substitute for living together, and the children’s behavior often suffers. The couples will simply shift their conflict away from one another in the short term and have no real plan of action for getting everyone back together. Because separation only tones down conflict and doesn’t solve it, I almost always suggest that separated couples who want to remain married work at getting back together as soon as possible, and always with professional family or marital therapy. If this is not the chosen path, statistics predict this couple will end up divorcing.

Separation is often a necessary choice when family behaviors become violent, abusive, or dangerous. But in nearly all cases, families should be helped to heal and reunify as soon as possible. Separation is not the best course of action unless it is the only course left for health, safety, or stability’s sake. Every one of us needs to feel like we belong and to be part of a group of people who know, appreciate, sacrifice for, and value us most of all. At our best, these are our families. It’s worth the effort to make them as healthy, whole, and loving as possible.

Related articles:
Three Truths Every Couple Needs to Know About Marriage
Want Family Therapy? These 4 Problems Should Be Treated First
Harness the Power of the Marriage Bond

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