Category: therapy

Help For Your Nerves: Review

Hope and Help for Your NervesHope and Help for Your Nerves by Claire Weekes
My rating: 4 of 5 stars

I help people with their thinking, emotions, relationships and beliefs every day. This little gem, written back in 1969 by an Australian physician/psychiatrist should be in the hands of every person who has ever suffered with a full-on panic/anxiety disorder. We call that general diagnosis “GAD” or Generalized Anxiety Disorder today. There are a lot of great resources out there to help. This book is quite personal, clear and wonderful. It’s not perfect; she suggests leaving the family for up to several months to recover, which is not something I would easily advise to anyone. And all the advice will probably not be enough without therapy, but it’s a helpful adjunct.

Her principles of treatment, and they are right:

1. facing fear as a normal emotion running too high in your life
2. accepting that it is doing that at the moment, and it WONT KILL YOU
3. learning to rise, or float above or behind the annoying physical sensations
4. giving your body time to heal itself from the super-tuned-in experience of fear sensation that has you knotted up

This, along with EMDR, talk therapy, exercise and a lot of self reflection can and will help most anyone recover.

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What I’ve Been Talking About This Week

I find it interesting to notice that sometimes my conversations in therapy, with vastly different people and circumstances, seem to circle around themes on occasion. This week, I’ve noticed two topics that I am repeatedly seeing in session:

1. Men who have become “awake” to their own conflicts, problem behaviors and thinking and have made radical steps to be fuller, more peaceful people. Some have partners that are whole enough people themselves who rejoice in the change, and despite years of distance, hurt and resentments, fight along with their men to restore and renew their partnership. Others have partners who are too fragile, conflicted or hurt that the reversal appears like an “act” and feel the need to flee. Whatever the result, their is great Joy in the awakening, and it’s a pleasure to keep giving these new men feedback on their personal discoveries.

2. Narcissistic Personality Disorder. If there is a personality style that kills a marriage slowly and with deep pain, this is it. Whether the partner is male or female, the chronic lack of empathy on the part of the partner leaves the hurt, bewildered and worn-out one talking to me about how empty they feel when their partner, despite all evidence to the contrary, blames the spouse for all the pain, ignores the needs of their children, and never seems to connect with them. Worse still is the adult child who begins to recognize what growing up with a narcissistic mother or father has done to their sense of self, their confidence in relationships, or their ability to trust the empathy and care of another.

(I’m looking forward to the publication of the newest edition of the DSM-V. In it is a new model of personality disorders that I think will be helpful to the therapist as they come into regular contact with these persistent personality types.)

It’s been a long winter here in MN and the snow won’t quit. Once again, we will probably go from winter to summer in 24 hours. Hope that, wherever you are, you get all 4 of the earth’s seasons.

Peace,
L

We Can’t Choose our Parents

It’s true; we can’t choose our parents.

Whatever skills or deficits they possess as people: their readiness or disinterest at caring for us, their physical and mental health, and their ability to meet basic needs for food, shelter and safety have an immediate and lasting effect on our own development. The human brain is shaped every day by the way we are cared for by those closest to us, and grows fastest during the first two years of life.

If a child is born to a parent who neglects their needs, is addicted, or who is violent, abusive or mentally ill, the effects are devastating. A human mind can be ruined if not helped and supported to develop in a healthier, more stable and flexible way.

It’s also true that in America the first time a failing family may come into contact with an institution that could help it recover is with the justice system or the public schools.

In this wonderful episode of This American Life radio show, stories are told of educational and therapeutic systems that work to re-parent our cultures disordered parent-child relationships.  If you’ve ever wondered how schools cope, or how family and in-home therapy works, take a listen. It’s great.

The American Life : Back To School, Episode 474

Willing to Risk Again

Several times this week I have found myself talking to new couple clients about their relationships, and how hurt has caused them to feel withdrawn from their partners. Sometimes this distance has lasted for years, the human need for support, connection and understanding no longer expected from their spouse. 

One of the most important aspects of relationship repair is the willingness to risk being open to a partner who has been months or years at odds with our needs and hopes. Couple therapy at its best keeps both people focused on their individual efforts, while being confident, through actions and words in the therapy room and out, that the partner is doing the same hard work. 

It can feel like being open to injury. Like you are just asking for your partner to hurt you again. Many people resist, and for every right reason! But repairing such pain means turning toward your partner and feeling what you feel, expressing your hurt and disappointment, asking for what you need again, and being willing to see if your openness can be met with a similar effort of apology, repair, and affection by your partner. That’s what a good couple therapist does every day with couples, with compassion, encouragement and patience. It’s not a free-for-all in therapy sessions. If it is, run in the other direction. 

When deciding whether to go to couples therapy, this is one question you will need to answer: am I willing to be open again to this person, this one I once loved, and see what I feel, what they have to say, what they have experienced, and work together for new, common ground? 

Pastors are a Bridge

When I first began my private mental health practice, I knew one thing was certain: I needed to meet as many area clergy as I could. Today I had the pleasure of having coffee with an another local parish pastor. Thanks, C!

So many people still experience embarrassment, resistance and fear when it comes to seeking therapy for relationships, emotions, or behaviors, they stall when it comes to getting help. They may talk to their friend or family member. They may occasionally tell their physician about how they feel. But as they get ready to reach for help, they may also talk to their pastor.

Most pastors are great at emotional triage. Trained in basic listening skills, taught how to manage themselves in emergencies, experienced at handling emotions at funerals, parish clergy are the go-to folks in many people’s lives when it comes to figuring out what to do when the going gets rough. I am honored so many people trusted their lives to me over my years in the parish. I learned early on to have a small group of trusted counselors I knew and to whom I could refer my parishioners who needed more help than I could give. I tried to think of myself as a link between suffering and help, and I kept in touch with those counselors on a regular basis.

Now, I strive to be one of those counselors that the pastors, ministers and priests around me trust. Someone they have met, looked in the eye, and gathered a personal sense of me for themselves. As I reflect on clients who have recovered well, who make the most progress in their personal goals, the ones who feel that therapy was a success: most have come to therapy via their pastors.

Thank you, Pastor, for being on the front lines in people’s personal lives. You are under appreciated in our secular culture, and over-worked inside the special world of the congregation. You may not feel it often enough, but you are loved, respected and trusted by your members, and a lot of neighbors and strangers, too. Helping people navigate the details of mental health care is a compassionate gift you give. Thank you for trusting people you care to me, and to other therapists you know and trust.

Oh, and one more thing: you are often neglectful of your own mental health. Don’t forget to reach out for help yourself. Some of us know exactly what your life is like, and can be trusted as a confidential guide to increasing YOUR emotional health.  God’s grace surround you!

The Recession and Mental Health Care

The recession has kept people who need care out of therapy.

That was the consensus of a small group of private practice therapists I met with Monday. We are a interesting and somewhat diverse group of folks: three licensed psychologists, three LMFTs and a social worker. Each of us has an individual private practice in the southwest Twin Cities, and we meet every month or so in each others’ offices for support, case consultation and resource sharing.

As our meeting was coming to a close, one of us looked around and said, “I think people are coming to therapy less often, and when they do come, they are worse.” All of us agreed. We are seeing that in our new clients: more severe symptoms of anxiety and depression; people who need medication taking themselves off and showing up in therapy; couples who might have been helped out of their patterns two years ago, making appointments like a “Hail Mary” touchdown attempt and often not even showing up to their first session.

Stereotypes of psychotherapy, widespread in the American culture, already do enough to keep people away from getting the care they need. The same kind of fear of the unknown (people avoiding their annual mammograms or other preventative exams) keeps them from seeing therapists. People fear that therapy is all about dredging up past pain, and they would rather avoid it. Or they believe that they should be able to “get over it,” whatever it is, themselves. To be fair, therapy isn’t all about the past, but it takes long looks back in order to understand the present, so the stereotype is partially accurate. What isn’t true is that it’s a waste of time, or it never works, or that its a huge money drain.

That last part, about the money, is what we’ve noticed about this recession as providers. People have lost their jobs, or are afraid they will. That anxiety alone makes us more conservative, and hunker down, and save money, and stop doing anything new. The added anxiety about what may happen to health care and insurance in the current political debate stops even more people from reaching out.

One thing I know for certain, though: nothing matters if you feel like you are losing your mind. The mind you count on to talk to others, to do your job, to care for your children, to connect with your family and friends. Actually, good overall health is dependent on mental health. If you are so afraid you can’t leave your house, or so despondent you can’t get your kids off to school in the morning, it matters little if you have low cholesterol.

Psychotherapists live with the fact that we are the lowest paid professionals in our health care system. We struggle to overcome the giant obstacles to care placed in our way by costs and stereotypes, by stigma and shame. What we wish for is for people to seek help before they are desperate, before they decide to leave their spouses, before they think often about suicide, before they start to think that they can’t get any better. Life can be so much easier with good, quality care and a compassionate professional guiding you along.

If you need help, please reach out. And if you know someone who does, ask them to help themselves. Today.

This is What I Do it For

After three years of private practice, I’m beginning to anticipate its natural rhythms.

There are some months that I have a steady schedule, and the phone rings with some regularity with requests for information and appointments. These months tend to follow the school calendar and extend into early summer. And then there are weeks that the phone stops ringing, current clients miss appointments and don’t return my phone calls, and the calendar starts to have big holes in it. These weeks coincide with major religious and national holidays, and the last weeks before Labor Day.

I now understand why therapists have traditionally taken the whole month of August off. Remember Bill Murray and Richard Dreyfuss in the 1991 comedy, “What About Bob?” (The busy New York City doctor rents a home in New Hampshire for the whole month of August only to be followed there by his newest, most eager patient, Bob.)

So while I have some unwelcome time on my hands, I have been reading. And I have been seeing some of my long term clients. And this is what I have seen: healing. While I can’t give you details, I hope it is enough to tell you that just today, I saw a client who had a difficult mental disorder that was controlling her life a year and a half ago. She told me today that she is really feeling “her normal self,” the self she remembers before the disorder took over. I smiled through her session.

The same thing happened last week, as a couple client told me that they had “completely changed” the way they moved in their relationship. Wow. We talked about what they were doing differently, and what they had learned. I remembered what it was like for them when we began. And I smiled, and congratulated them on their hard work.

That kind of healing of emotions, mind, spirit and behavior is what I have experienced in therapy as a client, and what I strive for with each new client who comes to me for help. It doesn’t always work, for a wide number of reasons. But when it does, I have to tell you: it’s joyful for me. This is what I do it for.