Young woman lying on the grass at summer sunsetLet’s stop making mindfulness something other than what it is. Let’s stop making mindfulness the great cure-all. Let’s stop making mindfulness another gimmick to improve ourselves. Because it’s not.

If we look clearly at the definition of mindfulness, we see that it is an inherent capacity in all of us—one that doesn’t need to be made into an object. It is our birthright. Simply put, mindfulness is a way of being aware of our ongoing present-moment experience with an attitude of nonjudgmental acceptance. It is the opposite of being distracted, yet you can be mindful of being distracted. It is the opposite of being on autopilot, yet after enough practice it becomes automatic.

Meditation practice supports mindfulness, but meditation is not mindfulness; meditation merely helps train the mind to be in a mindful state. Mindfulness doesn’t belong to anyone or any one tradition, although many meditative and contemplative traditions (particularly Buddhism) make it explicit in their practices.

Mindfulness is an ever-deepening way of being that can be understood only by living it.

[fat_widget_right]

What Is It, Really, to ‘Live in the Moment’?

As you become increasingly, continuously aware of yourself—with an attitude of wanting to know your experience deeply—your perceptions can change dramatically. What a gift to live life in such a way! If we can begin to rest in the mystery of not knowing what is going to happen next, we open to the possibility of living an exciting life of ongoing discovery and freshness. Even the most mundane activities can become rich, full of texture and volume, and we can experience them anew each time we encounter them.

It’s very easy to fall back into dullness and numbness, though, especially when our environment doesn’t support our aliveness. Also, depending on our current capacity to trust, our ability to open or stay open may be challenged. If we grew up in an abusive environment, we may have much more difficulty resting in the aliveness of not knowing, and we may experience this excitement as dread and anxiety.

The good news is trust can be developed. By repeatedly encountering our open, spacious, and restful nature through mindfulness, our organism begins to trust more and more in the process. Every time we experience true openness and get past the anxiety of not knowing, our nervous systems relax—and that relaxation is deeply nourishing for the parts of us that remain young and afraid.

If we are able to truly take in the relaxation, something deep in us transforms. This is not a one-time thing, but a continually deepening process.

Practicing Without a Goal

Mindfulness is not about becoming a better businessperson, a more focused worker, a more efficient human being, or even an enlightened person. Mindfulness is about becoming more intimate with yourself, more aware of your direct experience in a more alive way.

If you’re practicing mindfulness to increase your capacity to achieve something, it may indeed work. However, the real gift of mindfulness is deep intimacy with ourselves. When we are truly intimate with ourselves, our understanding of who we are can radically transform in ways we couldn’t imagine beforehand, and we can experience a sense of “me” that is not shaped by our history.

Some say it doesn’t matter what our initial motivation for practicing is; what matters is that one begins practicing. In my experience, this seems to be true. I’ll admit when I began practicing, my motivation was narcissistic in nature. I had all these ideas in my head of being some kind of “master of the mind,” becoming a better person, or getting to some marvelous state of mind. I didn’t realize back then that with that attitude, I was rejecting myself. By wanting to become someone other than who I was, I was rejecting who I was at that given moment.

No Two Paths Are the Same

We are each moving along our own path, and all the circumstances that have brought us to this moment are uniquely ours—which means that whatever supports our journey is also uniquely ours. Part of our path requires us to find for ourselves what it is we need to keep opening to it. Mindfulness helps us develop that sensitivity, in learning little by little how to truly live in the moment.

After many years of practice in conjunction with other forms of inner work, I can say that, for me, mindfulness boils down to simple, conscious acceptance of the immediacy of my experience—and that, in and of itself, is the reward of the practice.

When we first start practicing, we have no way of differentiating what is motivating us to do what we do. The more we become in touch with ourselves (in mind, heart, and body), the more we are able to tease apart our various motives and make decisions that are congruent with our deepest longings.

Paradoxically, however, we can’t do this alone; we need others on our journey. We need to feel our connections and rub against others to know ourselves. We also need the guidance of others who are further along the path.

After many years of practice in conjunction with other forms of inner work, I can say that, for me, mindfulness boils down to simple, conscious acceptance of the immediacy of my experience—and that, in and of itself, is the reward of the practice. Other benefits pale in comparison to savoring each changing moment of aliveness with its infinite subtleties and flavors.

Mindfulness doesn’t take away the anguish of being alive. The truth is that life has moments of pain for everyone, and what mindfulness does is give us the capacity, or container, to stay open in the midst of such pain. Even if we need to shut down because the pain is so intolerable, our mindfulness allows the process to go more smoothly.

We cannot expect to want to feel the goodness in our lives without also experiencing the pain. However, we can learn how to breathe through it, and with mindfulness and attunement to our own, unique needs, we can find what will support us in the process.

Senior in nursing home visits with family memberPutting a family member in a nursing home may be one of the toughest decisions families have to make, and unfortunately, the decision for many doesn’t tend to feel “good.” Many hope for a long life of independence, and becoming immobile, senile, or dependent on others is a thought people simply like to avoid. As a psychotherapist who works in a nursing home, I often encounter family members racked with guilt, which has led me to analyze the experience.

Help Them Through the Adaptation Phase

Many of the nursing home residents I speak with openly express their discomfort at being in a nursing home, and some manifest symptoms of depression as a result. In my experience, it is typical for a new resident to struggle with this new environment. After a (sometimes long) transition period, many will begin to adjust. According to an article published in Nursing Research and Practice, this is called the “adaptation phase,” with the typical period of adjustment being cited as three to six months (2013).

[fat_widget_right]During the adaptation phase, a new resident may be struggling to respond to new rules and expectations of the nursing home staff, as well as learning to live with a new group of people. The adjustment period can be really tough, and unfortunately, some seniors may never fully adjust to a nursing home environment.

Help Them Avoid a ‘Loss of Control’

There are a number of ways family members, friends, therapists, and staff can help improve the quality of life of nursing home residents. I am focusing on family members in this article, but if you are looking at this problem from a different perspective, please utilize this advice to help a nursing home resident you care about.

Many nursing home residents I’ve spoken with express feelings of a “loss of control” when they don’t have any say in the facility where they end up living. With that said, one of the first ways to help a senior make the transition to a nursing home is to give the person a chance to evaluate options and make decisions regarding the new residence. Finances may be a huge barrier when looking for care, but giving a family member the right to shop around and choose a residence can help foster a sense of independence and control from the beginning of the transition (2013).

A window can make a big difference in a person’s living space within a nursing home. An article in the Journal of Aging Research says that a window view doesn’t even need to overlook plush greenery to be beneficial. It can simply offer something to look at, such as pedestrians, wildlife, or any landscape (2015). If the resident’s individual room does not offer a window, access to a private space with a window and a view may offer similar benefits. Adding plants to the resident’s room can also create a more personal environment and take away from the medical feel of the room.

Personal items from the resident’s previous home can also create a sense of familiarity and mastery over the experience. This may include pictures, furniture, or comfort items such as blankets. Allowing the resident to personally pick out items to bring to the nursing home can also contribute to the sense of control that can be so important to a healthy adjustment to nursing home living.

Help Them Stay Social

Initially, it can be intimidating to join the other residents in activities, but engaging in social activities and continuing ones enjoyed before the transition can positively affect a resident’s sense of happiness. If you’re a family member, go over the schedule of activities with your loved one and help pick out some that appeal to him or her.

Life in a nursing home is different, but it’s not the end. A person can continue to feel loved and cared for, and offer their love and care in return.One of the best ways to help your family members ease into a nursing home is simply to listen to them. Often, seniors at the nursing home I work in tell me they don’t tell their children or family members about their feelings of depression because they don’t want to burden them. Others say they attempt to tell their family members, but their feelings are dismissed. Many new nursing home residents will experience depressive symptoms and feelings of hopelessness as part of the adjustment phase. Allow your family member to talk about this experience so he or she doesn’t feel further isolated. This may evoke your own guilt or a desire to fix the situation, but remind yourself that your loved one has limited people to talk to, especially about emotions. Your ability to sit and listen will help demonstrate that you care and are available for support.

Lastly, and perhaps most important, provide a sense of hope for your family members. Consider what might increase comfort in the home and offer some options. Listen to their struggles without defending them. Offer them your time and company, share pictures of the family, bring food from home, and remember to tell them how important they are to you. Life in a nursing home is different, but it’s not the end. A person can continue to feel loved and cared for, and offer their love and care in return.

References:

  1. Degenholtz, H.B., Resnick, A.L., Bulger, N., & Chia, L. (2014). Improving quality of life in nursing homes: The structured resident interview approach. Journal of Aging Research, 2014, doi: http://dx.doi.org/10.1155/2014/892679
  2. Riedl, M., Mantovan, F., & Them, C. (2013). Being a nursing home resident: A challenge to one’s identity. Nursing Research and Practice, doi: http://dx.doi.org/10.1155/2013/932381
  3. Van Hoof J., Verhagen, M.M., Wouters, E.J.M., Marston, H.R., Rijnaard, M.D., & Janssen, B.M. (2015). Picture your nursing home: Exploring the sense of home of older residents through photography. Journal of Aging Research, doi: http://dx.doi.org/10.1155/2015/312931

Businesswoman presenting to colleagues at a meetingWhile there are many benefits to having high intelligence, many managers, supervisors, and other workers—particularly those who work in businesses in which interpersonal relationships are key—have become keenly aware that workplace success may depend on their ability to use another invaluable personality trait: emotional intelligence.

What Is Emotional Intelligence?

The concept of emotional intelligence (EQ) was introduced by psychologists Peter Salovey and John Mayer in a landmark article in 1990. The idea was popularized in 1995 by psychologist and author Daniel Goleman after the release of his book, Emotional Intelligence: Why It Can Matter More than IQ.

Emotional intelligence refers to the capacity to identify, evaluate, and manage emotions in one’s self as well as in other people. While some researchers believe this ability may be trained and developed, other experts suggest emotional intelligence is a trait a person must be born with.

Principles of Emotional Intelligence

[fat_widget_right]A number of theories have emerged to explain the concept of emotional intelligence. Salovey and Mayer developed the ability model, which emphasizes a person’s capacity to understand and use emotional information in social contexts. Konstantin Vasily Petrides developed the trait model, which focuses on how people view their own emotional abilities, and Goleman developed the mixed model, which uses principles from both the ability and trait models.

Though each model has its distinguishing features, the underlying principles of the models are similar. According to Goleman, the key principles of emotional intelligence include:

Emotional Intelligence in the Workplace

Many mental health experts believe emotional intelligence is a valuable asset in the workplace. In certain environments, employees with high levels of emotional intelligence may be better able to cooperate with others, manage work-related stress, solve conflicts within workplace relationships, and learn from previous interpersonal mistakes.

This may not mean high emotional intelligence is beneficial or necessary for all jobs. Studies show that while jobs that require large amounts of interpersonal interaction—for example, sales or real estate jobs—may benefit from workers who possess high emotional intelligence, the opposite is true for occupations that are generally more individualistic, such as a research scientist or an accountant.

In settings where people tend to work alone, people who possess high emotional intelligence may actually perform at a lower level than the average worker because they may be overly concerned about the emotions of other people.

Emotional Intelligence and Leadership

In certain environments, employees with high emotional intelligence may be better able to cooperate with others, manage work-related stress, solve conflicts that may arise within workplace relationships, and learn from previous interpersonal mistakes.Though emotional intelligence may not be necessary for every type of job, it can be a vital trait for most people in leadership positions. To be effective leaders in the workplace, managers, supervisors, and other authority figures must be able to function productively with people under their charge. A good leader is able to create the type of work environment where each person feels relevant and motivated to succeed.

Leaders with high emotional intelligence are able to use their social skills to foster rapport and trust with their employees. They tend to view their team members as individuals with unique abilities, backgrounds, and personalities, rather than as a uniform collective. Effective leaders seek to understand and connect emotionally with their staff—genuinely sharing in their joys as well as their concerns. The ability to build mutual trust and respect can become especially important if an unpopular decision is made within the business setting, but the managers need to keep their teams working efficiently.

Like all other types of relationships, work relationships may experience problems sooner or later. When conflict arises, leaders with high emotional intelligence may be better able to control their own impulses, view the situation from all perspectives, and seek mutually beneficial solutions. Effective leaders are transparent and are not afraid to admit when they are wrong. They are also more likely to try to improve work relationships.

Telltale Signs of Leaders with Low Emotional Intelligence

While leaders with high EQ are more likely to maximize the efforts and output of their employees, leaders with low EQ are more likely to have a negative impact on the productivity of their teams. Leaders with low EQ may display attitudes and behaviors such as:

Despite these issues, however, some experts believe emotional intelligence may be trained and developed.

The Potential Downsides of Emotional Intelligence

Though emotional intelligence is usually painted in a positive light and is often considered to be a valuable personality trait, a balanced view of the concept can be important. Emotional intelligence, like any other skill or talent, may be used positively or negatively depending on the intentions of the person wielding the ability.

As people with high EQ are better able to manage their own emotions and evaluate the emotions of others, they have the capacity to be more deceptive and manipulative than other people. Business leaders with high EQ and self-serving motives may toy with the emotions of their employees, using them to climb the corporate ladder with little regard for their workers’ long-term welfare.

Such leaders may also pretend to offer friendship and support, while secretly seeking to undermine the ambitions of team members who could become potential rivals. They may even expose their workers to public embarrassment, shame, or guilt in an effort to reach their own personal goals.

Those seeking to become effective leaders may do well to reflect on the importance of emotional intelligence. Leaders who are eager to hone specific aspects of their emotional intelligence may utilize self-help publications or seek the support of a qualified counselor, therapist, or coach.

References:

  1. Craemer, M. (n.d.). Emotional intelligence is vital to workplace success. Retrieved from https://www.washington.edu/admin/hr/pod/leaders/orgdev/alliance/articles/EQ_Craemer.pdf
  2. Deleon, M. (2015, May 8). The importance of emotional intelligence at work. Retrieved from http://www.entrepreneur.com/article/245755
  3. Grant, A. (2014, January 2). The dark side of emotional intelligence. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2014/01/the-dark-side-of-emotional-intelligence/282720/
  4. Llopis, G. (2012, September 24). 5 ways to lead with emotional intelligence—and boost productivity. Retrieved from http://www.forbes.com/sites/glennllopis/2012/09/24/5-ways-to-lead-with-emotional-intelligence-and-boost-productivity/
  5. Salovey, P. & Mayer, J. D. (1990). Emotional intelligence. Retrieved from http://www.unh.edu/emotional_intelligence/EIAssets/EmotionalIntelligenceProper/EI1990%20Emotional%20Intelligence.pdf

fuzzy heart pillow on couch

How important is the therapeutic relationship—the relationship between a person in therapy and his or her therapist—to the change process? Is the relationship itself the primary source of healing or are techniques the mechanisms for positive outcomes? And where does “love” fit in to all of this?

Out with the Old

My career in social work began with a full-time psychotherapy position in a rural town at a small mental health clinic. I was convinced my recent academic instruction had taught me everything under the sun, but also that I was clinically inept to practice as a therapist. Fortunately, the thoughtful, compassionate, and experienced supervisors at the clinic reined in my earnest energy.

I met with a clinical social worker on a weekly basis for supervision. She was a former nun with a wicked proclivity for curse words and an extreme disdain for computers. The topics that arose in the supervision hour varied. We talked about my personal issues, people who got under my skin in the therapy setting, and even her recollection of the days when people in therapy—as well as therapists—smoked cigarettes throughout sessions. What I remember most from our time together was her insistence that the beginning and end-all goal of psychotherapy was the same: you want the people you help in therapy to love you.

[fat_widget_right]

She did not mean love in the romantic sense, nor was she veering from any ethical boundaries. This was not a trick or gimmick. She believed that the person in therapy improved based on the degree of emotional connection, including shared trust and belief in the therapeutic relationship. I immediately dismissed the idea. My graduate school never talked about love, and I didn’t know of any research to back what my supervisor was saying.

I was trained to understand psychology as a series of universal principles. These principles are translated cross-culturally. I was clinically oriented and meticulously uniform with many of the therapeutic modalities I applied. The rigid stance I took on this disallowed vulnerable feelings from surfacing within the therapeutic relationship. It was easier for me to sit back and diagnostically judge than to truly join with people in therapy.

The Role of Therapeutic Alliance

My supervisor at the time was describing (and to some degree going beyond) the concept of the therapeutic alliance. Simon Goldberg of the University of Wisconsin-Madison has conducted research on this concept. It is an emotional bond between the therapist and the person in therapy, which includes a shared agreement regarding the goals to work on as well as the form of psychological intervention used (Goldberg et al., 2013).

Goldberg brought up a related construct—the real relationship (Gelso & Carter, 1994)—which involves the “actual, non-transferential relationship between a client and a therapist” which he feels most accurately reflects what we might call love in therapy. The real relationship is theorized to operate in tandem with the therapeutic alliance, combining the emotional bond of therapist and person in therapy with agreement on the tasks and the goals of where the therapy work is headed. “Love has something major to do with effective therapy,” he adds.

Part of the therapeutic alliance includes a positive attachment contracted around the mutually defined treatment plan for therapy. The role of the therapeutic alliance is central to psychotherapy, and the effect is independent of the type of therapy used. The quality of the therapeutic alliance accounts for approximately 30% of the clinical outcome, while the guiding theory or model used accounts for 15% (Walsh, 2013).

In other words, therapists are all different, but the methods or theories they use are far less important in terms of a person feeling better (Germer et al., 2005). This means that the alphabet soup of therapy acronyms (e.g., EMDR, CBT, DBT, ACT, etc.) are relatively minor ingredients to what really fills the therapeutic bowl: a person’s individual characteristics (participation, motivation, problems, background) and the therapeutic alliance (Walsh, 2013).

However, many therapists swear by their affiliated or credentialed techniques. So, what accounts for the change that occurs in therapy?

Phases of the Therapeutic Alliance

Goldberg states that the theory and technique offer a “rationale on some ritual that the client and therapist engage in.” This collaborative partnership with mutual agreements as to the problem and solution is the predominant factor for change in psychotherapy.

For alliance to build, the therapist needs to be flexible and not hold tightly to an agenda. Priority is placed on collaborating with the person in therapy to establish and maintain the therapeutic relationship.

Past research looked at this alliance as developing from two phases. Phase one sees the person in therapy believing in the therapist as the desirable source of assistance. With warm regard and support from the therapist, the caring relationship commences. Therapy begins on this foundational level. In phase two, the alliance involves the person in therapy buying into the process of therapy via commitment to the procedure (i.e., shared understanding of the problem, value of the examination of the problem) as well as each person’s responsibility for the process (Horvath et al., 2011).

For alliance to build, the therapist needs to be flexible and not hold tightly to an agenda. Priority is placed on collaborating with the person in therapy to establish and maintain the therapeutic relationship (Horvath et al., 2011). The quality of the relationship can be assessed based on the “level of mutual and collaborative commitment to the ‘business of therapy’ by therapist and client” (Horvath et al., 2011; p. 15). This is the “collaborative enterprise” of psychotherapy. Essentially, the question and answer comes down to how well the person in therapy and the therapist work together in sessions.

Collusion Versus Confrontation

Specific variables and behaviors can be assessed for each role of the enterprise. The therapist’s non-reactivity to comments or overall antagonism of the person in therapy is reflected in the therapeutic alliance. My work centers on the conceptual space between collusion and confrontation. It is essential for the therapist to hear—not ignore—criticisms, but this must be done by threading the needle between colluding with the person in therapy or confronting his or her ideas. This perspective requires a dance between total agreement or affirmation and a scared-straight challenge or proverbial wrestling match.

For example, a person might say, “Am I a bad patient?” The therapist’s collusion with this statement might come across as, “Let’s talk about something else,” or, “You can be difficult at times.” The other end of the spectrum is confrontation. A therapist says, “No, no, no. You are not a ‘bad patient.’ ” Or the therapist could say, “Where did you get that idea?” in direct opposition to the statement. A middle-ground response finds the therapist replying, “What would it mean to you to be a ‘bad patient’?” This is the essence of non-defensive but attuned responsiveness.

The therapist does not personalize or absorb any statements, but also does not ignore or avoid emotional comments (Horvath et al., 2011). This is the narrow window or divide between collusion and confrontation that fosters alliance. This is an attuned, appropriate, and nonjudgmental response. Isn’t that love?

References:

  1. Gelso, C. J., & Carter, J. A. (1994). Components of the psychotherapy relationship: Their interaction and unfolding during treatment. Journal of Counseling Psychology, 41, 296–306.
  2. Germer, C. K., Siegel, R. D., & Fulton, P. R. (2005). Mindfulness and psychotherapy. New York: Guilford Press.
  3. Goldberg, S. Personal communication, December 5, 2015.
  4. Goldberg, S.B., Davis, J.M., & Hoyt, W.T. (2013). The role of therapeutic alliance in mindfulness interventions: Therapeutic alliance in mindfulness training for smokers. Journal of Clinical Psychology, Vol. 69(9), 936–950.
  5. Horvath, A. O., Del Re., A. C., Fluckiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16.
  6. Walsh, J. (2013). Theories for direct social work practice (2nd). Belmont, CA: Thompson Brooks/Cole.

Woman sits on edge of bed with head in handsHave you ever been in a relationship that felt as though it sapped all of your energy? If so, you may have been in a codependent relationship. Codependency is generally defined as a type of relationship in which one person supports the other in an unhealthy behavior of some kind. This could be enabling someone to maintain an addiction, to not take responsibility for his or her actions, or to become overly reliant on you.

Codependency is often learned in a dysfunctional family environment. There are generally underlying issues that have been ignored or minimized, such as an addiction, physical or sexual abuse, or a family member struggling with a chronic mental health condition. Frequently, the person in the caretaking role disregards personal needs and focuses on providing for the other financially, emotionally, and/or physically. The person being taken care of comes to depend on the caretaker’s help in order to enable him or her to maintain life choices. Feelings in this type of family or relationship are generally repressed, and problems tend to go unacknowledged.

Some of the signs that indicate you might be in a codependent relationship include:

[fat_widget_right]

  1. Recognizing the harmful behaviors that your partner or loved one is engaging in, but providing for that person in such a way that he/she is not having to suffer consequences.
  2. Remaining in an unhealthy relationship despite the emotional and psychological toll to your own health.
  3. Feeling unappreciated, angry, and resentful, but also afraid of retaliation if you stop “rescuing” or taking care of the other individual.
  4. Difficulties with setting appropriate limits or boundaries in the relationship.
  5. Putting the needs of others before your own.
  6. Being overly protective and taking on all responsibility for your partner or loved one.
  7. Minimizing or denying the problem.
  8. Having poor communication skills, especially regarding the problem and/or your emotions.

Although the caretaker in the codependent relationship usually has good intentions and generally acts out of a sincere desire to help a partner or loved one, the situation typically ends up backfiring. Over time, the caretaker an start to feel unacknowledged and taken for granted. By constantly protecting the loved one from the consequences of his or her actions, the relied-upon partner actually helps to foster even more of the destructive behaviors. This, in turn, prevents the loved one from experiencing important life lessons and learning to take responsibility.

So how can you stop the unhealthy dynamics of a codependent relationship? A few methods include:

Although codependent relationships can be extremely challenging, change is possible by following some or all of the methods listed above. A great deal of pain and suffering can be alleviated by learning to set healthier boundaries in order to stop any destructive behaviors and support the growth of the partners or family members involved.

Moving couple holds stacks of boxesNot all couples plan for a trip down the aisle. Even couples who have been in a relationship for years may choose to forgo tradition and not get married.

Statistics from the Centers for Disease Control and Prevention (CDC) indicate that over the last decade, adult Americans appeared to be steadily falling out of love with marriage. According to the report, the year 2012 saw an average of 6.8 marriages per 1,000 people, a consistent decrease from 7.5 marriages per 1,000 people in 2006 and 8.2 marriages per 1,000 people in 2000.

A 2011 analysis of United States census data conducted by the Pew Research Center found only about 51% of American adults are currently married—a record low. Compare these statistics to the 72% of American adults who were married in 1960, and some social trends may begin to emerge.

A Shift in Public Attitude About Marriage

With numerous studies suggesting healthy marriages promote physical well-being, boost mental health, and protect children from social and educational problems, the following questions may arise: Why do some couples choose not to get married? And what living arrangements are replacing marriages in 21st century America?

[fat_widget_relationships_right]Data from the Pew Research Center analysis suggests age and public attitudes may play significant roles in the current trend to remain unmarried. Of all Americans ages 18-29, only 20% are currently married, compared with 59% in 1960. Whether young adults are completely abandoning marriage or temporarily delaying it is not yet clear. However, evidence suggests young adults today may be focusing on furthering their education or seeking to establish a social foundation before considering marriage. The analysis reveals an increase in the number of college graduates who decide to marry later in life.

Public attitudes toward marriage are also changing. While marriage may have been expected in the past, the current perception is somewhat mixed, with a growing number of people viewing marriage as unnecessary, said Lori Hollander, LCSW-C, BCD, an expert in relationships and marriage. A 2010 Pew Research survey reports almost 40% of Americans believe marriage is becoming obsolete.

“Marriage is no longer looked up to, and being single is no longer looked down upon,” Lori Hollander said.

What factors have contributed to this public shift in perception? The increasingly sophisticated desires of modern-day adults, coupled with the drive to fulfill these desires with as much freedom as possible, may be influential. Bob Hollander, husband of Lori and a relationship therapist for more than 25 years, suggests people simply want more out of life and love.

“Happiness is no longer just about having a full-time job and keeping the bills paid,” Bob Hollander said. “We now see people who are looking beyond mere survival, and the needs that are being met are simply more sophisticated.”

People in the past may have viewed marriage as an effective way to start a family, build financial stability, or gain happiness, but many modern-day adults are able to meet those needs without a marriage license.

In recent years, single-parent households, single-person households, and cohabitation have all become more popular. Whether the intention to marry is present or not, couples are now moving in together before marriage more than ever before. This trend may be attributed to multiple factors, including:

Tools for a Successful Relationship

According to data from the Pew Research Center, marriage may still be a goal for many Americans, even if it is not among their top priorities. Thirty-six percent of adults report a successful marriage as being one of their most important goals in life, while 48% of Americans say a successful marriage is not most important. A larger portion of adults (53%) view being a good parent as one of their most important goals.

People in the past may have viewed marriage as an effective way to start a family, build financial stability, or gain happiness, but many modern-day adults are able to meet those needs without a marriage license.More than half of Americans surveyed believe marriage does not make a difference in having a fulfilling sex life, being financially secure, feeling happy, reaching a desired social status, or getting ahead in a chosen career.

Stuart B. Fensterheim, LCSW, a specialist in emotionally focused therapy, relationships, and marriage, explains the changing nature of beliefs about healthy relationships.

“For years, people have lived with the idea that relationships are one big guessing game,” Fensterheim said. “On top of that, so many folks now fear that they will have to give up something that they love in order to sustain a marriage. Healthy partnerships are just not that way.”

Married or not, there are many resources available that may help build a healthy, happy, and lasting relationship. Couples counseling can help take the guesswork out of relationships, set realistic expectations, and teach the skills needed to enable love to grow. Individual partners may also seek the assistance of a qualified therapist if they are experiencing specific personal challenges.

References:

  1. Centers for Disease Control and Prevention. (2015). National marriage and divorce rate trends. Retrieved from http://www.cdc.gov/nchs/nvss/marriage_divorce_tables.htm
  2. Cohn, D. (2013). Love and marriage. Retrieved from http://www.pewsocialtrends.org/2013/02/13/love-and-marriage/
  3. Cohn, D., Passel, J. S., Wang, W. & Livingston, G. (2011). Barely half of U.S. adults are married—a record low. Retrieved from http://www.pewsocialtrends.org/2011/12/14/barely-half-of-u-s-adults-are-married-a-record-low/
  4. Copen, C. E., Daniels, K. & Mosher, W. D. (2013). First premarital cohabitation in the United States: 2006-2010 national survey of family growth. Retrieved from http://www.cdc.gov/nchs/data/nhsr/nhsr064.pdf
  5. Copen, C. E., Daniels, K., Vespa, J. & Mosher, W. D. (2012). First marriages in the United States: Data from the 2006-2010 national survey of family growth. Retrieved from http://www.cdc.gov/nchs/data/nhsr/nhsr049.pdf
  6. Rosenblum, C. (2013, September 13). Living apart together. The New York Times. Retrieved from http://www.nytimes.com/2013/09/15/realestate/living-apart-together.html?pagewanted=all&_r=1

A young girl whispers to her motherEffective and meaningful communication is vital to human growth and function. However, the 21st century’s emphasis on speed has often produced quick results at the expense of quality and durability. These days we want our food faster and our coffee in an instant. Communication, like many other facets of human life, has been affected by our need for speed. The push for instant gratification has seen the rise of instant messaging. While getting the word out quickly does have its benefits, too often we focus solely on what we say rather than what we hear.

Why Listening Well Is So Important

A poll of 100 mental health professionals revealed communication problems is the most often cited contributing factor for divorce (65%). When considering divorce, 56% of women said their husband’s lack of listening was among their top communication complaints.

[fat_widget_right]Good listening skills can foster good communication and minimize misunderstandings. While other common relationship concerns—such as lack of emotional support, inability to resolve conflict, financial stress, and unfulfilled expectations—are serious issues within their own right, the application of good listening skills often means that many interpersonal conflicts may either be resolved more easily or avoided completely.

There are occasions when some conflicts become explosive and the situation may progress far more quickly than expected. In these circumstances, it may be important to slow down and listen. Listening well allows you to accurately gauge the situation from the other party’s perspective, discover the other party’s true concerns or needs, and respond in a manner that may quell the emotionally heated exchange. Poor listening skills, however, often contribute to poor communication.

Types of Listening Skills

In an effort to become a better communicator, learning and practicing different types of listening skills may be necessary. In many cases, we listen in order to learn facts, uncover emotions, or analyze a particular issue. Of course, the type of listening skill you choose to employ at a particular time will depend greatly on the setting, the audience, and your communication goals. After considering your circumstances closely, you may decide to use one of these types of listening:

Active listening – This skill encourages the listener to focus his or her full attention on the speaker. It involves repeating what the listener believes the speaker said, but in the listener’s own words. The listener may also express his or her understanding of the speaker’s psychological response to the situation. For example, an active listener may say “I understand you are upset that I borrowed your notes without asking.” The speaker may then confirm or clarify the listener’s understanding.

When listening, you may sometimes become distracted by your own thoughts. Perhaps you may be overly concerned about what you are going to say in response, or you may believe you already know what the speaker is about to say. However, active listening involves setting aside judgment during the listening process and using nonverbal communication—such as facial expressions, gestures, and other forms of body language—to show the speaker that complete attention is being paid to his or her message.

Reflective listening – This strategy is often confused with active listening as it too involves giving the speaker undivided attention, using nonverbal cues, and asking questions in order to confirm ideas or provide further clarification. However, while active listening encourages the listener to express what he or she thinks the speaker says or feels, reflective listening encourages the listener to reflect or mirror the speaker’s psychology and emotions so the speaker feels as if he or she is being listened to.

The goal of reflective listening is to provide support while trying to understand the speaker’s perspective. This approach can be crucial to maintaining romantic, business, and social ties as it demonstrates sensitivity to the speaker’s emotions.

Key points to remember during reflective listening include:

Critical listening – This listening strategy is often used when the aim of the listener is to evaluate and analyze what is being said. Critical listening is often employed in situations that involve decision-making or problem-solving. Unlike active listening and reflective listening, which are both non-judgmental listening skills, critical listening involves the use of personal judgment.

Critical listening can be an excellent tool in academic or business contexts in which the primary goal of communication is to garner accurate information, compare it to what is already known, and apply it to situations in which it may be beneficial. A critical listener will ask questions about whether the information being transmitted is credible, logical, or being used for manipulation. As critical listening is usually results-oriented, it may be best used when neither the speaker nor the listener is overly concerned about his or her emotions during communication.

Ways to Apply Listening Skills

While it can be important for good communicators to learn good listening skills, it may be equally important to learn how to apply these skills effectively. To facilitate meaningful communication, it is recommended that the listener face the speaker and maintain eye contact. Not only can this approach minimize possible distractions, it can give the speaker the impression that his or her message is being taken seriously.

Listening well allows you to accurately gauge the situation from the other party’s perspective, discover the other party’s true concerns or needs, and respond in a manner that may quell the emotionally heated exchange. Poor listening skills, however, often contribute to poor communication.A good communicator should also be relaxed during conversation. Though an effective listener may be mindful of interrupting the speaker and only ask clarifying questions when the speaker pauses, he or she may send nonverbal cues to the speaker that can significantly affect the flow of communication.

Good communicators are also encouraged to keep an open mind, picture what the speaker is saying, and give appropriate feedback at appropriate times. This practice may put the speaker at ease—particularly if he or she is relating a difficult issue—and may prompt the speaker to provide more information than expected.

As social beings our quality of life is often dependent on meaningful communication with others, and the application of effective listening skills can be a big part of that effort. When properly used, these techniques can help enhance our marriages, families, careers, and more.

If your goal is to become a better communicator as you carry out your role as parent, partner, teacher, supervisor, or friend, try applying these strategies to your life. You may discover improvements in your personal relationships in the process. Being a good speaker is commendable, but if you want to be a good communicator, you may want to stop talking for a moment and listen up!

References:

  1. American Psychological Association. (2004). Marital education programs help keep couples together. Retrieved from http://www.apa.org/research/action/marital.aspx
  2. Bernstein, E. (2015, January 12). How active listening makes both participants in a conversation feel better. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/how-active-listening-makes-both-sides-of-a-conversation-feel-better-1421082684
  3. Conflict Research Consortium, University of Colorado. (n.d.). Active listening. Retrieved from http://www.colorado.edu/conflict/peace/treatment/activel.htm
  4. Deutschendorf, H. (2014, September 3). 5 ways to improve your listening skills. Retrieved from http://www.fastcompany.com/3036026/how-to-be-a-success-at-everything/5-ways-to-improve-your-listening-skills
  5. Doherty, W. H. (n.d.). How common is divorce and what are the reasons? Retrieved from http://www.divorce.usu.edu/files/uploads/lesson3.pdf
  6. Kilpatrick, J. (2015, May 31). Types of listening skills. Retrieved from http://www.livestrong.com/article/82419-kinds-listening-skills/
  7. Poor Communication is the #1 Reason Couples Split Up: Survey. (2013, November 20). Huffington Post: Divorce. Retrieved from http://www.huffingtonpost.com/2013/11/20/divorce-causes-_n_4304466.html
  8. Scott, K. (2015, September 8). How to connect with your kid using reflective listening skills. Retrieved from https://www.goodtherapy.org/blog/how-to-connect-with-your-kid-using-reflective-listening-skills-0908154
  9. Schilling, D. (2012, November 9). 10 steps to effective listening. Retrieved from http://www.forbes.com/sites/womensmedia/2012/11/09/10-steps-to-effective-listening/
  10. Taft College. (n.d.). Active listening skills. Retrieved from http://www.taftcollege.edu/lrc/class/assignments/actlisten.html

Social worker interviews mature womanClinically trained social workers are the nation’s largest group of mental health service providers. Social work is considered one of the five core mental health professions by federal law and National Institutes of Health. With more than 200,000 in the field, there are more clinical social workers than psychologists, psychiatrists, and psychiatric nurses combined.

Who Are Social Workers?

Social workers are highly trained professionals working to improve the quality of life and well-being of others through direct practice, crisis intervention, research, community organizing, policy change, advocacy, and educational programs. Social workers are dedicated to the pursuit of social justice and strive to help those affected by poverty, disabilities, illnesses, divorce, unemployment, and other personal problems and social disadvantages.

Being a social worker requires extensive knowledge of human behavior and development, as well as social, cultural, and economic institutions and the ways in which they interact. Most social workers will hold at least a bachelor’s degree in social work or related field, though many (especially clinicians) will hold a master’s degree and valid license to practice.

A good social worker will often possess a high degree of compassion and empathy, a passion for helping others, strong interpersonal and problem-solving skills, and good listening and organizational skills.

What Do Social Workers Do?

Social workers fight for social justice, equality, and the overall well-being of people in need. Social workers are responsible for many of the liberties we have today. These include:

[fat_widget_right]In addition to advocacy work, social workers also help people solve problems in their daily lives. They may assist those who are adopting a child, fighting an illness, or facing an addiction. They help protect abused or neglected children, deal with behavioral problems in schools, and help hospice patients adjust.

Clinical social workers diagnose and treat mental health conditions as well. They provide individual, family, and couples therapy, and they assist with depression, anxiety, family problems, and other mental health or behavioral issues. They may work in private practice or at a mental health or therapeutic facility. Social workers host support groups, create treatment plans, and facilitate interventions when necessary.

Some common duties of a social worker include:

Where Do Social Workers Work?

There are several common areas of focus in the social work industry:

A good social worker will often possess a high degree of compassion and empathy, a passion for helping others, strong interpersonal and problem-solving skills, as well as good listening and organizational skills.Social work is unique in the way it can be found in most aspects of community life. Social workers are employed in schools, hospitals, rehabilitation facilities, hospices and nursing homes, private practices, government institutions, correctional facilities, law offices, military organizations, public welfare agencies, nonprofit organizations, and some private businesses and corporations.

Even when social workers are employed in office, they may spend time traveling to visit with people in need. School social workers may also travel from school to school or hospital social workers from hospital to hospital.

Why Social Work Is in Demand

According to the United States Bureau of Labor and Statistics, overall employment of social workers is expected to grow at a rate of 19% between 2012 and 2022. The demand for health care social workers is expected to grow by as much as 27% during this same time period—a rate much higher than the average growth rate for all occupations. One reason for the increase in demand is due to the aging of the baby boomers, who will soon need long-term care and assistance.

Social workers in the mental health and substance abuse fields will also be in high demand, with a 23% increase in employment expected by 2022. More people are expected to seek mental health treatment, and people who have a substance addiction are increasingly sent to treatment programs rather than jails or prisons.

How to Become a Social Worker

Those interested in entering the social work profession should first prepare for admission to the program of their choice by gaining valuable volunteer experience and obtaining professional references in the field.

A bachelor’s degree is the minimum requirement for an entry-level social work position, but most employers prefer a graduate degree. A master’s level education in social work is a requirement for clinical licensure in most states.

An undergraduate degree in social work is not necessary to gain admittance to a master’s program; virtually any bachelor’s degrees will suffice. Upon graduation, a few years of supervised work is necessary to gain licensure.

When to Reach Out to a Social Worker

References:

  1. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2014-15 Edition, Social Workers. Retrieved from http://www.bls.gov/ooh/community-and-social-service/social-workers.htm
  2. National Association of Social Workers. (NASW). Social Work Profession. Retrieved from https://www.socialworkers.org/pressroom/features/general/profession.asp
  3. National Association of Social Workers (NASW). Social Work History. Retrieved from http://socialworkers.org/pressroom/features/general/history.asp
  4. National Association of Social Workers (NASW). Who are Social Workers? We Help. Retrieved from http://www.naswdc.org/pressroom/2011/HSH-FactSheet2011.pdf

Cup and blanket on windowsillAs the holidays and end of the year approach, many experience the recurrence of grief as they remember happy times with a deceased loved one. Loss and grief are among the most powerful emotions we can experience. When grief recurs, particularly in relation to the pain of holidays, it can be confusing and overwhelming.

During the holiday season, symptoms of grief that have previously relented might suddenly return, and it can seem as though one is actively grieving again. This experience is known as an “anniversary reaction” or “anniversary grief.”

[fat_widget_grief_right]The first year following a loss is considered the most challenging as a griever faces many new experiences for the first time without the loved one. Psychologist Dr. Therese Rando (1993) describes six processes necessary for healthy grieving. Among these processes is the need for readjustment into the world without the lost loved one. This is, perhaps, the biggest challenge faced during the first year after a death.

It’s common for waves of grief to overwhelm and disrupt the process of adjustment, as described by Rando. Although anniversary reactions can occur for many years following a loved one’s death, they are usually felt most keenly during this first year as milestones are confronted. Holiday milestones can be particularly difficult as anticipation builds.

The deeper truth of loss is that we are never truly finished with grieving when someone significant to us dies. However, there are many ways to live with the loss without suffering from it.Symptoms can include anxiety, anger, and difficulty sleeping, including waking up early or falling asleep. Sadness, crying, fatigue, difficulty concentrating and focusing, and loss of interest in social activities can also be common. Additionally, symptoms may be more than emotional changes. Often, intrusive memories of the loss and memories of past celebrations return.

The deeper truth of loss is that we are never truly finished with grieving when someone significant to us dies. However, there are many ways to live with the loss without suffering from it. It is important to know the return of grief is a normal part of the healing process.

Here are some suggestions to manage the reactions to anniversary grief during the holidays:

References:

  1. Corr, C. A., Nabe, C. M. and & Corr, D. M. (1997). Death and Dying, Life and Living, Pacific Grove, CA: Brooks/Cole Publishing Company.
  2. Rando, T. A. (1993). Treatment of Complicated Mourning. Champaign, IL: Research Press.

Standing woman looks out windowIt has been more than 30 years since Dr. Patrick Carnes published his book, Out of the Shadows: Understanding Sexual Addiction, which introduced the concept of sexual addiction. One working definition of sexual addiction is a pathological attachment to a mood-altering experience of sex.

At that time, the focus was almost entirely on males who were addicted to sex. But new ground was already being broken. When I first met Jennifer Schneider—an Arizona psychiatrist—in the early 90s, she and a colleague had recently completed a book about couples recovering from sexual addiction.

Schneider and her colleague obtained detailed information about married females who were addicted to sex. Twenty-four women and 17 husbands were interviewed by telephone; 7 of the male spouses declined to take part in the survey. The findings were provocative back then, but they are confirmed by my own clinical observations over the years.

Gender Differences in Sex Addiction

Unlike the majority of men with sex addiction, most women are aware of their codependency when they initially begin therapy with me—either alone or with a partner. Codependency can be briefly described as looking outside oneself to other people in order to define self-worth.

[fat_widget_sex_right]This makes the early stages of recovery particularly difficult for women who are sexually compulsive. Initially, a period of abstinence is important in order to learn to maintain sexual boundaries. But that requires being able to say no without it affecting self-worth. As one woman in therapy put it, “I don’t want to deprive him or drive him to look elsewhere for sex!”

I find that is rarely a problem for a man choosing a period of abstinence. Unfortunately, this culturally learned gender difference makes it much more difficult to rebuild marriages in which the wife is sexually compulsive. Females with sex addiction often feel alone and unsupported as they work toward recovery.

Steps for Women in Recovery

In order to appreciate the complicated nature of sex addiction for women, it’s important to recognize how terrifying psychological isolation can be. One woman told me, “I feel ashamed that I feel lonely even in my marriage, like something in me is broken and defective.”

Consequently, women in recovery benefit most from a combination of supportive individual therapy and group experience, both 12-step and therapist-led. In 12-step meetings such as Sex and Love Addicts Anonymous (SLAA), participants share experiences, strength, and hope. In her book, Ready to Heal: Women Facing Love, Sex, and Relationship Addiction, author Kelly McDaniel lists some of the numerous benefits:

You may not be able to heal your brain alone, and the brain usually doesn’t function at its best capacity when you are isolated. Therapy can provide a trusting relationship and a healthy context for healing.Healing relationships requires healing the mind and the lifelong patterns that have shaped responses to the people closest to you. When your mind is fearful, you may have problems trusting or acting outside of your truest morals and values. Women with sex addiction may have difficulty being their best selves, and many of their sexual behaviors may have fallen outside their value system.

Healing your life also means healing your brain, and this may require professional support. Sexual addiction thrives in isolation. You may not be able to heal your brain alone, and the brain usually doesn’t function at its best capacity when you are isolated. Therapy can provide a trusting relationship and a healthy context for healing. McDaniel makes these suggestions for being a careful consumer when you’re ready to find a therapist:

Women experiencing sex addiction today have a much greater chance of finding a caring and well-trained professional than their mothers may have had. You owe it to yourself to find the best help possible.

References:

  1. Carnes, P. (2001). Out of the shadows: Understanding sexual addiction (3rd ed.). Center City, MN: Hazelden.
  2. McDaniel, K. (2008). Ready to heal: Women facing love, sex, and relationship addiction (2nd ed.). Carefree AZ: Gentle Path Press.
  3. Schneider, J., & Schneider, B. (1989). Rebuilding trust: For couples committed to recovery. Center City, MN: Hazelden.

therapist comforting a person in therapyConfidentiality in therapy is vital to the therapeutic process. Confidentiality also means outside observers cannot weigh in on the quality of therapy. In search of a reliable way to evaluate therapy quality, a study published this month in PLOS One proposes one potential model: a computer that can evaluate therapists’ empathy.

Evaluating Empathy with a Computer

Researchers from University of Southern California, University of Washington, and University of Utah say methods for evaluating therapy that require an outside observer can potentially alter the therapeutic process and undermine confidentiality. As an alternative, they developed a program that listens to therapy sessions, then rates the therapist as either “high empathy” or “low empathy” based on a speech analysis.

Using therapist training sessions, the team taught the program to detect empathy cues in language. Phrases that signal the highest amounts of empathy include “it sounds like,” “do you think,” and “what I’m hearing.”

Kathy Hardie-Williams, MEd, MS, NCC, LPC, LMFT, said such phrases measure the extent to which a therapist hears and mirrors the emotions of people in therapy.

[fat_widget_right]“Not to be confused with sympathy, empathy is a person’s ability to recognize and share the emotions of another while seeing the situation from the other person’s perspective,” Hardie-Williams said. “Sympathy is a feeling of care or concern for another, but does not have the component of a shared perspective or shared emotions.”

The University of Southern California’s Signal Analysis and Interpretation Lab continues to improve upon the model. Researchers are now working to help the program analyze tone of voice, diction, and the extent to which a therapist mirrors the speech patterns of people in therapy.

The Role of Empathy in Therapy

Empathy is just one component of quality therapy, but Hardie-Williams said it is vital to people’s willingness to openly share with their therapists.

“I believe genuine empathy is important in therapy because in order to maintain the therapeutic alliance, [people] need to be able to perceive that the therapist can share [their] emotions and experiences,” Hardie-Williams said. “[People] who come in for therapy often have a deep shame core that gets in their way, and in order to process it, they need to share their shame with someone they feel emotionally safe with.”

Choosing a Therapist

Everyone may seek something different from a therapist, but in general it can be important to recognize some guidelines for effective therapy. People seeking a therapist should also be attuned to warning signs of bad or ineffective therapy.

Reference:

Blumenthal, A. (2015, December 2). Can you tell if your therapist has empathy? Retrieved from https://news.usc.edu/89274/can-you-tell-if-your-therapist-has-empathy/

Storm clouds gathering over waterIn the face of our depressed moods, friends, loved ones, and even our therapists may say things like, “Stop doing that to yourself!” or “Get over it!” We may even say to ourselves, “Why can’t I just get over it?” These forms of “psychotherapy” usually come from a loving place but often turn out to be ineffective. But why? Why is it that we can stop ourselves from doing certain things (touching a hot stove, for instance), but when it comes to the low energy, hopelessness, helplessness, and self-attacking thoughts of depression, we can’t “just get over it”?

When ‘Get Over It’ Does Work

Believe it or not, as a therapist I spend a fair chunk of my day using a form of “Stop It!” therapy, often with success. When a person is (1) in conscious control of a behavior, (2) no longer wants to do it, and (3) wants my help to stop, challenge (Abbass, 2015) or response-prevention interventions can be quite effective.

“Get over it!” is a form of challenge or response prevention—it says, “Stop doing the thing that hurts you!” When you look at it that way, you can see the loving core of the comment. When someone asks me for help with a pattern they know is self-defeating, such as stubbornness or detachment, but they intentionally continue to do it, challenging them with a “don’t” intervention is one of the most compassionate, helpful things I can do.

When ‘Get Over It’ Doesn’t Work

When someone has conscious control over a behavior, “get over it”-type interventions can help, but my clinical work looks much different when the self-defeating pattern is unintended or unconscious, habitual, or automatic. Decades of clinical research in intensive short-term dynamic psychotherapy (e.g., Abbass, 2015) have shown that a portion of those experiencing depression have symptoms driven by an unconscious emotional process—a process that, at least at the start of therapy, occurs automatically and is entirely beyond their control.

[fat_widget_depression_right]

In ISTDP, we call this process “repression” or “instant repression”—the process by which mixed emotions toward another person are instantaneously and unintentionally shunted back against the self, either in the form of depression or somatic symptoms (this is a slightly different definition of repression than in psychoanalysis).

Often, people who experience repression-driven problems never recognize they were mad at someone else; instead, they are instantly overcome by a process of self-blame and self-torture that leaves them feeling fatigued and hopeless. At no point did they decide to do this. Before therapy, this is just how their brains are wired; they automatically say, “When I feel anger toward someone I love, I protect them by pointing it back at myself.” Considering the people we love most are the most likely to irritate us, this is a potentially dangerous state of affairs.

Saying ‘Get Over It’ to Someone with Repression

So what happens when we say “get over it” to someone with depression that is driven by unconscious repression? Here, the “get over it” confronts the depressed mind with an impossible task: (1) gain conscious control of an unconscious process that is currently operating out of your awareness, or (2) do a thing you simply can’t do (yet).

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self. Instead of lovingly reducing the person’s symptom burden, then, the “get over it” would actually make symptoms worse by activating anger that will be sucked back in via repression.

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self.

‘Get Over It’ and Psychotherapies for Depression

Some therapies encourage us to challenge, question, or detach from our depressive thoughts and moods. Other therapies encourage us to get up and do something even when we have no energy. Sometimes, for some people, these approaches produce positive benefits.

My concern, however, is that for folks who have depression caused by unconscious repression processes, questioning their thoughts implies, “Don’t think that,” and encouraging different behaviors implies, “Don’t be like that.” These both sound a lot like saying “get over it” to someone who is not in conscious, intentional control of the symptom; asking them to do something different when they literally cannot. This could trigger anger toward the therapist that will get shunted into repression and lead to worsened therapy outcomes. No one wants that.

How ISTDP Can Be Useful

ISTDP is an ideal therapy for building the capacity to become consciously aware and tolerant of the mixed emotions that usually get deflected back on the self in repression-driven depression and somatization. When working with people with depression in ISTDP, the therapist is in a largely supportive mode, helping people self-reflect on and feel the feelings that were previously getting automatically and unintentionally converted into depression or somatic symptoms. This builds affect tolerance—the ability to feel feelings while still being able to think clearly and channel them in a satisfying way.

This process helps people with repression because, rather than telling them what not to do or what they should do, it gives them another option—it helps them become more comfortable with their emotional reactions so they can then decide how to channel their emotions. In ISTDP, what people wind up “getting over” is the destructive way their mind would unconsciously bury mixed emotions. Once they can think clearly while being in touch with their emotions, rather than being unconsciously overwhelmed by those emotions, they can then make wise, authentic decisions about what to do.

Reference:

Abbass, A. (2015). Reaching through resistance: Advanced psychotherapy techniques. Kansas City, MO: Seven Leaves Press.

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.