Choosing To Begin Psychotherapy

Seeking out psychotherapy is a major decision.  Most people will make attempts to handle difficulties in their lives by speaking with a close a friend or family member.  Others will turn to self-help books or on-line resources that offer advice for coping with stress or challenging relationships. Sometimes friends or acquaintances will speak with me and ask me if they need to see a psychotherapist.  Of course, I think psychotherapy can benefit most people which is why I do the work.

Since I have a bias, I returned to the work of James F. T. Bugental for clarification about when it is time to begin psychotherapy.  In his 1978 book, Psychotherapy and Process: The Fundamentals of an Existential-Humanistic Approach,  Dr. Bugental had some helpful and clear insights about what leads a person start psychotherapy.

"A person comes to psychotherapy out of a sense of possibility, a feeling that there is the potential for life to be different than it has been.  This difference may -for a given person at a given time- be a hope that there will be less pain or anxiety, a seeking for greater realization of inner possibilities,  a quest for improved relations with others, or a belief that there are richer possibilities for life than one has known thus far."

The key piece from this brief passage is the understanding that a person begins psychotherapy with hope that is mixed in with some apprehensiveness.  This might seem unexpected.  We commonly think that a person who seeks a therapist is overwhelmed and experiencing a sense of despair rather than hopefulness.

Psychotherapy is actually an optimistic undertaking.  The new client needs to recognize that the current life situation is unsatisfactory and a change is needed.  This client has summoned the courage to seek out focused, therapeutic support and is hopeful that taking a risk to create change in one's life will be beneficial.  The client will allow himself/herself to be open to the idea that improvement is possible.  Allowing oneself to be vulnerable and to let go of the familiar life that is being led, with its struggles and inadequacies, is nothing if not courageous and optimistic.

In this way, we can see that seeking psychotherapy is not an act of desperation.  It is truly a step forward grounded in confidence.  It requires valuing oneself enough to work at moving from frustration to comfort.

The quote above is taken from Psychotherapy and Process: The Fundamentals of an Existential-Humanistic Approach p.47 by James F. T. Bugental; 1978 by Random House.

Youngsters Coping With Trauma

     Last week I was able to attend the Charleston Child Trauma Conference in South Carolina. The sessions focused on supporting children and teens who have been victimized by different forms of neglect or abuse. Although this is a difficult topic to consider, the mental health profession is recognizing the immediate and long-term risks faced by young people who have been mistreated. 
     We cannot erase the overwhelming situations that impact a portion of youth in our society. We can recognize the impact of mistreatment and work to help them cope with the stressors they face.  
     Dr. Karen Horney wrote about children adjusting to significant stress in their lives in her 1945 book, Our Inner Conflicts.

"...the child gropes for ways to keep going, ways to cope with this menacing world. Despite his own weakness and fears he unconsiously shapes his tactics to meet the particular forces operating in his environment. In doing so, he develops not only ad hoc strategies but lasting character trends which become part of his personality...At first a rather chaotic picture may present itself, but out of it in time three main lines crystallize: a child can move toward people, against them, or away from them...In each of these three attitudes, one of the elements involved in basic anxiety is overemphasized: helplessness in the first, hostility in the second, and isolation in the third." 

      

    Dr. Horney recognized that children tend to develop a strategy to deal with their sense of being alone and overwhelmed in a dangerous world. This is most pronounced for children who have been victimized. She went on to explain that children who present as helpless try to make connections to gain support and move toward people. Children who are hostile move against people because they lack trust in others and look to fight so that they can feel stronger and protect themselves. Children who isolate themselves move away from connections with others because they feel misunderstood and do not make the effort to connect or fight.       We have all encountered children and teens who predominantly behave with one of these three attitudes that were described over 70 years ago by Dr. Horney. We are sometimes quick to think these children are simply misbehaving. We can describe them as needy and clingy; oppositional and rebellious; or aloof and conceited.
     It is rare that we will know the personal histories (especially the traumatic histories) of the young people who we coach, teach, supervise or otherwise encounter in our daily lives. We should take the time to consider that the youngsters we find challenging might be doing the best they can to cope with stressors many of us could never imagine. Youngsters often need our kindness and understanding more than they need our criticism.

The quote above is from Our Inner Conflict: A Constructive Theory of Neurosis pp.42-43 by Karen Horney; 1945 by W.W. Norton & Company, Inc.

It Wasn't Supposed To Happen Like That

Most of us spend more time than we would like worrying. And in most cases, we worry about what might happen. We sometimes think about past events too, but the worry is usually focused on what might take place because of what we already said or did. This sense of anxiety we experience has a future orientation. We want to know what is going to happen next so that we can be prepared for it. If the next thing that comes at us is going to be bad, we want to prevent it.

It is impossible to know exactly what will happen next. Sure we can set goals and make plans and prepare ourselves so that our lives move in a general direction. But then suddenly a hurricane moves up the east coast and it moves slower than expected and rains a lot more, and the damage is from inland floods, instead of winds and surf on the coastline.  Many of the situations we struggle with in our lives are events that we could not have planned for or events that did not follow the script we had put in place. In fact, some of our most challenging struggles come from situations we never thought of worrying about; while those situations that fueled our anxiety, interrupted our sleep, and ruined our appetite, like our car breaking down on the way to a job interview, never materialized.
Carl Jung wrote about how the unpredictability in day to day life leads to anxiety (he called it neurosis back then) in his 1917 essay, On The Psychology of the Unconscious.

"Much indeed can be attained by the will, but, in view of the fate of certain markedly strong-willed personalities, it is a fundamental error to try to subject our own fate at all costs to our will...But has it ever been shown, or will it ever be, that life and fate are in accord with reason, that they too are rational? We have on the contrary good grounds for supposing that they (life & fate) are irrational, or rather that in the last resort they are grounded beyond human reason. The irrationality of events is shown in what we call chance, which we are obviously compelled to deny because we cannot in principle think of any process that is not causal and necessary...In practice, however, chance reigns everywhere...The plentitude of life is governed by law and yet not governed by law, rational and yet irrational."

Here Jung is wondering if it is reasonable to worry. He questions whether it makes sense to be anxious about future events. Many of us would say that we should absolutely be anxious simply by pointing to how badly events turn out for people. Jung points out that all the energy we put into our worries and all the time spent being anxious will not allow us to make sure our plans are followed perfectly. Chance events cannot be prevented by better planning or by spending more sleepless nights with our minds racing.

Ninety-nine years ago Jung wrote about the fact that we need to expect some unexpected events to occur. We all hope and try to convince ourselves that certain actions on our part will always lead to the best anticipated outcomes. We also know that this is impossible, which leads us to worry and become anxious and we even end up missing out on the pleasures that life can offer us.

We would be better off if we accepted that we cannot always control the outcomes of events and that when situations do not go the way we would like it does not always mean that we were unprepared, or naive, or foolish for setting high expectations. It simply means that life happened and nature followed a different path which we could never have predicted. We can still enjoy life anyway if we give ourselves permission to reduce the worry and the anxiety about events that are beyond our control.

The quote above from Carl Jung was originally published in 1917. I quoted a 1953 publication of Two Essays on Analytical Psychology (p.49) by C.G. Jung, which was published by Bolligen Foundation, Inc. in New York, NY.

Anxiety Is Common To Everyone

People worry about things. It is normal to think about all the items on our to-do lists, or the health of loved ones, or those projects at work. When the worry becomes more intense we may even become fearful. Generally, we are afraid of what might go wrong. A certain amount of stress about these worrisome or frightening situations helps us to focus our energy and take action. We complete a task, offer support to a sick friend, or plan a strategy to meet the deadline for that project. Our worries and fears are situational and temporary. When we take steps to confront them, they don't linger. They may be replaced by another stressful situation, which also leads to action, and then that worry fades. This is a typical cycle for most of us in our fast-paced culture.

Anxiety is a different condition which confronts people from childhood through the retirement years. Rollo May wrote about the contrast between anxiety and fear in his 1983 book titled, The Discovery of Being.

"The understanding of anxiety as ontological illuminates the difference between anxiety and fear. The distinction is not one of degree nor of the intensity of the experience. The anxiety a person feels when someone he respects passes him on the street without speaking, for example, is not as intense as the fear he experiences when the dentist seizes the drill to attack a sensitive tooth. But the gnawing threat of the slight on the street may hound him all day long and torment his dreams at night, whereas the feeling of fear, though it was quantitatively greater, is gone for the time being as soon as he steps out of the dentist's chair. The difference is that the anxiety strikes at the central core of his self-esteem and his sense of value as a self, which is the most important aspect of his experience of himself as a being."

When Dr. May writes about anxiety being ontological he means that it is a state of being or an indication of who we are. By contrast, fear is a temporary emotion that we have and it is not what we are. May and the other existential psychotherapists of the mid to late 20th century recognized that being anxious was part of being human.

Everyone experiences a certain amount of anxiety in her or his life. It is an unavoidable condition. There is variation in how effectively we can live and cope with our own unique sense of anxiety. The next blog posts will focus on where anxiety comes from and how we can manage the experience.

The quote in the post above was taken from page 108 of The Discovery of Being by Rollo May; published in 1983 by W.W. Norton & Company, Inc.

Be Your Own Authority

We all have skills and talents. Sometimes it is hard for us to acknowledge those things that we do well. We don't like to brag. We know it is impolite to appear conceited. On the other hand, people have a need to be productive and to use their skills. Doing what we are good at allows us to be helpful to others and it helps us to gain confidence.

If this is the case, why do we find ourselves in those frustrating situations where we don't have permission to display our talents. These circumstances lead us to feel all alone and tear at our sense of confidence. We can even feel trapped in these situations. Those who have a position of stated or implied power try to maintain control by creating situations where we feel threatened when we attempt to use our skills for the good of others and ourselves.

Erich Fromm

Erich Fromm wrote about this situation in his 1947 book, Man for Himself: An Inquiry Into the Psychology of Ethics.

"The goal of humanistic conscience is productiveness and, therefore, happiness, since happiness is the necessary concomitant of productive living. To cripple oneself by becoming a tool of others, no matter how dignified they are made to appear, to be "selfless," unhappy, resigned, discouraged, is in opposition to one's conscience; any violation of the integrity and proper functioning of our personality, with regard to thinking as well as acting...is acting against one's conscience."

Here Fromm describes what he refers to as one's conscience. We usually think of conscience as that little voice in our head that reminds us to follow the rules and to tell the difference between "right" and "wrong." But who made the rules? And who decided what is "right?" What Fromm was telling us nearly 70 years ago applies today. We don't need to rely on an authority in the persona of a boss, guru, or elder to determine what is right for us.  Fromm's concept of humanistic conscience is what we determine to be our true selves and our true morals. The right action for each of us is to take those actions that allow us to be productive and reach our full potential.  What is right for me, can be different than what is right for you.

Fromm made it clear that we do not have to serve another authority figure. Being selfless in service to others is not necessarily the right thing to do. The path to feeling complete and experiencing happiness only comes from using our skills and expressing our talents, whatever they may be. Anything else brings about a sense of discouragement, frustration, and sadness.

We will find ourselves in situations where others try to control us by limiting us. They will even do their best to make us feel guilty or selfish for wanting to grow. Fromm made it clear that we must have a clear conscience when we make the right choice to become our true selves by using our skills for the betterment of ourselves and others.

Quote is from Erich Fromm's 1947 book, Man For Himself: An Inquiry into the Psychology of Ethics (Location 2112 in the Kindle edition)

The Struggle To Become Unique

Children depend on the guidance of their parents, caregivers and teachers from a very young age. At the same time they seek out opportunities for independence. This dance, led by the youngsters, can be taxing on the adults. This has been the case since the earliest human cultures. Over time the thing that has changed is how well, or how poorly, the adults cope with children and teens who need security and reassurance while also wanting autonomy. Each generation of adults who care about children experience the stress of navigating this unavoidable internal conflict of young people as they work to become the individuals they hope to be. The current norms and pressures of a society frequently dominate how adults manage this push and pull with young people.
Gordon Allport was a prominent psychologist in the first half of the 20th century who had clear insights about a child's struggle between security and independence. He wrote about this problem in his 1955 book Becoming: Basic Considerations for a Psychology of Personality.

"Thus there seem to be two contrary forces at work. The one makes for a closed tribal being. It takes its start in the dependence of the child upon those who care for him. His gratifications and his security come from the outside; so too do all the first lessons he learns: the times of day when he may have meals, the activities for which he is punished and those that bring reward. He is coerced and cajoled into conformity but not, we note, with complete success. He shows a capacity even from birth to resist the impact of maternal and tribal demands. While to a certain degree his group shapes his course, at the same time it seems to antagonize him, as if he realized its threat to his integrity. If the demand for autonomy were not a major force we could not explain the prominence of negativistic behavior in childhood....All his life long this being will be attempting to reconcile these two modes of becoming, the tribal and the personal: the one that makes him into a mirror, the other that lights the lamp of individuality within."

Dr. Allport clearly described what the experience is like for children who struggle with the conflict of meeting the social norms of the community so that they can be accepted and provided with care. At the same time, children do not want to be carbon copies of their caregivers. They develop a view of who they can become based on their experiences and view of the world, and they realize their own internal striving to be unique individuals.

Adults who care about the children in their lives need to set boundaries and offer guidance while being careful to not limit independence. Adults must realize that children need limits that do not serve as punishments or harsh restrictions. Children can understand that limits, when presented with kindness and support, demonstrate that the adult is offering support and security. A world without limits would be chaotic and threatening to a child. Harsh or unreasonable limits lead children to lose confidence in themselves or to develop an attitude of needing to protect themselves from being devalued.

The safety and security kindly offered by the adults in a community (family, school or neighborhood) allow children to have confidence needed to explore, test limits, push the rules or even break the rules. Them they wait to see if the adults will demonstrate authentic caring by consistently enforcing limits in a way which teaches that the world is not chaotic or punishing. At the same time the children help the adults learn. Adults realize, with some reluctance, that children can move into the world (which adults paradoxically perceive to be chaotic) beyond the security provided by current boundaries, and become independent. Children can take the risks to become individuals who will survive and thrive.

Young people will be able to struggle with challenges, impose limits on themselves, and then move beyond their own limits. They will grow and continue to lead their own lives rather than simply reflecting the norms of the community members who raised them.

The quote in the post above was taken from page 35 of Becoming: Basic Considerations for a Psychology of Personality by Gordon W. Allport; published in 1955 by Yale University Press, Inc.

Happiness Part 2 - Relaxing

The last blog post here discussed one route for experiencing happiness in our lives as described by psychologist, Eric Fromm. That route was focused on putting in effort to challenge ourselves with tasks, or hobbies that add value to our lives. Fromm noted his idea for another contrasting pathway to happiness in, Man For Himself: An Inquiry into the Psychology of Ethics.

"The other type of pleasure which is left for discussion is not based on effort but on its opposite, on relaxation; it accompanies effortless but pleasant activities. The important biological function of relaxation is that of regulating the rhythm of the organism which cannot be always active. The word "pleasure," without qualification, seems to be most appropriate to denote the kind of good feeling that results from relaxation."

Nearly 70 years ago shortly after the end of World War II, Dr. Fromm was telling people that it was OK to relax once in a while. He was a proponent of taking it easy. It seems he realized our parents and grandparents who were part of the greatest generation that struggled to win the war needed permission to slow down. 

Today many of us lead over-scheduled lives filled with exertion. We all find many demands placed on us. Technology not only keeps us tethered to our colleagues and bosses when at home, but also to our family and friends when at work. Job, family and social demands easily pull at us if we try to relax. 
I have also noticed a creeping feeling of guilt experienced by people when they do slow down. They are worried that they will be seen as lazy, or that they are letting someone down, or that someone else is getting ahead of them at school or at work. This is the experience of adolescents and adults in our culture today. We have a situation developing in our society where taking it easy brings on agitation or even a sense of stress. 

We may be at a moment in time when we need permission to relax; and not only to relax, but to actually enjoy the experience of relaxation and take pleasure in it. We need to allow ourselves to be happy when we are doing nothing that requires focused effort for a sustained length of time. This does not mean taking a nap. It means enjoying an activity that requires minimal effort which is not focused on a goal; like going for a walk without monitoring the miles or your heart rate. Or reading a novel without worrying what your book club members will think about your insights at next week's meeting. 

It is healthy to set goals and work toward them. It is equally healthy to take time to slow down, relax, and enjoy the pleasure of recharging ourselves. Resting is not being lazy. Resting is necessary to have balance in our lives and to find pleasure is simply being ourselves and enjoying the experience.

Quote is from Ethan Fromm's 1947 book, Man For Himself: An Inquiry into the Psychology of Ethics (Location 2508 in the Kindle edition) https://www.amazon.com/Man-Himself-Inquiry-Psychology-Ethics-ebook/dp/B00BPJOD8K/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=1472839933&sr=8-8#nav-subnav