This Blog Is About

This blog is about---You! Each and every post is about you. Use it to challenge your usual patterns, as a tool for self-discovery, to stimulate your thinking, to learn about yourself and to answer your questions about others.

Friday, March 30, 2012

Going Overboard

Sometimes an ordinary activity is engaged in with an addictive style

A perfectly innocent or ordinary activity can fit the criteria of addictive behavior if it is indulged in to excess.  We saw this a lot in recent years as the popularity of on line video gaming rose.  The term, workaholic, has become a part of the common vocabulary and is now a concept that is nothing new.  For awhile, when running or jogging was de rigeur, people talked about an exercise addiction.  The annual poker game with the guys that becomes more and more frequent and lasts longer and longer may be problematic.  Shopping to excess may be touchy in and of itself and can also lead to an additional problem of over spending on credit cards.  For some, constant access to social media seems imperative.  ("In most addictions, tolerance for the substance or behavior develops, so as time goes on increasingly greater and more frequent doses are needed for the desired effect.  Can this possibly be the case for multiple tattoos?" M.H. Gellman, PhD,Psy.D.) The list goes on.  I'm sure you can think of many examples yourself.
One of the universal assessment questions for alcoholism is, do people who are close to you ever complain about your drinking.  This is considered very telling because normal alcohol use doesn't cause problems for others.  If anyone has ever had a serious talk with you about some activity or yours, saying that it seemed a bit much, you might take a look at it.  Is it taking up too much of your time?  Do you think about it a lot, even when you're not doing it or aren't about to do it?  Whenever you get the chance to do it, do you automatically do it even if it doesn't really fit in with your plans, even if it is disruptive to your relationship?  These are some self-evaluative questions you might reflect upon.
Another test for yourself is, suppose someone close to you asks you to refrain from something---let's say, just being on the computer when the family is enjoying being with each other---and you hear that, take it in, and decide to try curbing that activity at that time.  When you catch yourself doing it and then attempt to quit, do you feel a wrenching feeling?  Is it difficult to tear yourself away?  It can be surprising to discover that in yourself.  And, yet, it may be important to curb that habit for your own sake.

I think that all people, or most, are subject to addictions.  Besides food addictions, gambling addictions, and drug addictions,---all of us can suddenly 'wake up' and find ourselves doing something compulsively.  It serves many purposes---an escape, a distraction, a time-out, a way to forget for awhile, a vacation from troubling thoughts, or a short-term form of denial of unresolved issues we may have in ourselves or in our outer lives.  
Our modern world is quite demanding.  We work more hours than is natural.  Did you know that anthropologists have determined that our ancestors, who of course worked as it came naturally, worked abut 5 hours a day?  We see ourselves as being in a technological age but really we are in the very beginning of the use of technology-right now. I think, we really don't know how to use it to help us yet; instead we are tethered to it (don't dare to not answer that cell phone call...!).

We expect ourselves  to be effective in more than one role---our job or profession, our parenting, our home maintenance tasks, our social relationships, our money management, time tracking, preparing our taxes and many other forms of business associated with just keeping things going in our personal lives.  It's a lot.  So, since unlike the Latins who build in a siesta time, or the French who know how to be in a cafe and enjoy the pairing of a bit
  of wonderful cheese and excellent wine, or the South Americans who know how to
 spend the evening enjoying a long, leisurely, relaxing dinner with family and friends, many Westerners just go from one task to another.  
I hear every day from one client or another how "stressed" they are.  One told me this week that, at her job, she takes an average of 150 phone calls per day.  Stunning to consider, isn't it.  We all know people who receive hundreds of e-mails per day.  The existence of blended families is on the rise and this means juggling a multiplicity of not-always pleasant relationships-relationships with people we didn't necessarily choose.  
It has occurred to me that the lack of opportunities to just let down, to relax, to have idle time, and the internal distress that this causes may be a factor leading to illicit affairs.  Interacting with someone not associated with duties may seem like much-needed playtime even though, in reality, it is fraught with threat.  In fact any of the recreational activities mentioned above can threaten our well-being, our health, and our important relationships.
The oft-repeated advice, moderation in all things is worth pondering. 
 Check out your own life.  How's the balance?  
Remember, by their very nature,  compulsive activities are unconscious.  So, to detect them, you have to be brutally honest with yourself.  
If you find you have to stop something or pull back a little, it may be tough at first, but better, so much better, in the long run! 

Please comment below 

Monday, March 26, 2012

Is Three A Lucky Number?

Celebrating the blog
Exactly 3 months from today, it will be the 3 year anniversary of my blog.  On June 26th, 2009, I wrote my very 1st post.   
This one makes 313 posts.     Here's to yesterday, today and tomorrow.

Sunday, March 25, 2012

The Proof Is In The Pudding

Psychiatry Grand Rounds, March 12, 2012, Herrick Hospital:  "Psychotherapy: Lives Intersecting"  Lou Breger, PhD, Prof. of Psychoanalytic Studies, C.I.T. psychotherapist

Dr Breger decided to, as the basis for a book now recently published,  contact former patients (from 50 years of practice, mind you), and poll them on what had been helpful to them in their former therapy experience with him.
First, he mentioned as the umbrella for all his results, the evidence based tenet that the relationship between the patient and the psychotherapist is paramount.  This is currently pretty well accepted as the basis for a productive therapy and is, I might mention, the almost polar opposite of what Freud designed which was the therapist sitting as an almost silent 'blank screen', taking notes while the patient was on the couch unable to see the therapist.  Suffice it to say, we have progressed from the founder's first vision.
The results that most patients of a therapy that they considered successful were, outcomes that included less depression, a decrease in anxiety and, improved relationships.  The important part of the therapeutic experience was the attention they received and the collaborative interpretations.
Here is some of the feedback he got:

  • Mistakes and Repair:  The therapist had to be able to recognize or to admit any mistakes and genuinely apologize if called for.
  • The therapist showed his humanity; he allowed his human flaws to be present and was not pompous or arrogant.
  • Humor:  This helps if it is allowed to be a part of the sessions.  I agree that humor has a place in the therapy room.  Dr. Breger told a funny story of how once, in the middle of a session, with coffee in hand, his chair broke and he went tumbling backwards into a heap of disarrayed coffee cup and ch spilled everywhere.  He and his client were able to laugh about it.
  • Insight, which most therapists think of as a signpost on the growth path, was far down on the list for the patients, but it was there.  The experience of having an insight was valued but not as highly as therapists value it.
  • The therapist assisting the client in seeing connections between events in the past and the present was valued; he gave an example of one client whose wife's car accident triggered his frightening memory of an accident he was in as a child.  My note:  Some people really resist this and want the past left alone ('let sleeping dogs lie'), but, I think that making these connections helps us to feel our life as a whole, not segmented, experience.  In other words, "It's mine, it's me.  This is my life and what happened and who I am, as a result".
  • They appreciated having their feelings being allowed instead of cut off or changed or forbidden.
  • Money:  If they honestly couldn't afford the full fee and he gave them a break, even temporarily, that meant a lot.  They felt he wanted to see them and was not just squeezing out every penny possible.
  • Self-Disclosure:  For some who had been in therapy for awhile, knowing that the therapist has problems too made the therapist less intimidating-as long as the focus didn't get turned too far for too long, in the therapist's direction.
  • Medication, exercise program design, nutritional advice, lifestyle change suggestions:  They liked a therapist who was open to other forms of treatment.  (By the way, another currently well-documented tenet is that medication and psychotherapy work well in tandem.  Medication is more effective if it is paired with therapy.)
  • Normal conversation:  They liked the feeling that they could have a genuine conversation with the therapist, that they were taken seriously, they were not just as a specimen to be analyzed.
  • Answers:  They didn't expect the therapist to have all the answers and liked it if the therapist could be comfortable in sometimes not knowing-that neither of them had to be perfect.
  • They liked it if they felt that the therapist enjoyed the patients, was warm and friendly (really opposite of Freud).  They wanted to feel that they could talk about anything and everything. 
So, there you have it, the reality of what people want and what they value when they go to therapy. How about you?  Do you agree?
  • If you want to read the book that this post summarizes, the title is in the sub-title of my post.
  • The author also wrote a book on Freud in 2000.
Please comment below

Tuesday, March 20, 2012

The Attempt and The Effort

Something good that can happen between people
 One of the subtle but lovely experiences that can be had in therapy is seeing another person trying to understand you, being with another person who is focused on you, thinking about you, and trying to empathize.  
Sometimes the therapist will 'get it', sometimes not.  But knowing that someone is paying that level of attention to you and what you are expressing can be an unequaled experience, but---you have to notice it.  That sort of activity can be somewhat quiet.

It isn't only therapists who are capable of giving this sort of attention.  You can do it.  Try giving that level of attentiveness to someone in your life when they are trying to express something.   (It also feels good to do it!)

To love is to give one's time.  We never give the impression that we care when we are in a hurry.
Paul Townier 

Please comment below

Sunday, March 18, 2012


It is my pleasure today, to introduce our new Follower, DJ
DJ (as do a number of the Followers) has her own blog, Not Over It.  There she writes compellingly and honestly about her own feelings.  I am happy, happy that she joined here.

Thursday, March 15, 2012

"You're Too Sensitive!"

What's a Person To Do?
"You're hypersensitive!"  Today two of my sessions were with individuals who see themselves as being sensitive types, as opposed to what?  As opposed to people who have "a tough skin", people who can "think on their feet," people who self-describe as being "not nice", people who "tell it like it is" and others who, to the self-described sensitive types, seem to be in control, sometimes intimidating, and almost immune to getting hurt.
The sensitive ones experience relationships as land mines.  They never know when  something disturbing is going to come their way.  When it does, as is inevitable, they pay a big price.  
What kinds of things are we talking about here?  Being teased by a friend, being criticized by the boss, being the subject of resentment or envy, or being ignored.  All of this and more, is part and parcel of interacting with others.  All of us have to deal with the slings and arrows of others if we don't want to be a hermit.  The sensitive types just feel it all much more acutely.
Not only that, they are often the least assertive types.  So, as one of my patients put it today, "informing others" of how to treat her doesn't happen much.  
Why?  She wants to please others---her boss, her friends, her relatives.  Also, for her, when a hurtful remark or action comes her way, she goes into turmoil.  Her emotional reaction is powerful and overwhelms her thinking ability, in the moment.  
She can think of plenty to say that would have reset her boundaries, or clarified her point of view, or would have just simply put a stop to whatever was bothering her,... later.
 Some people get defensive too quickly or are too aggressive for the situation.  This is not usually the problem of sensitive people.
And therein lies the rub.  The asset of the sensitive type is that often they are also more sensitive to others.  They are more careful of what they say to others, how they treat them, have more regret if they inadvertently make a mistake and step on someone else's toes.  These are the people who notice how others feel, who pick up subtle cues, who are aware if one person's comment lands badly on another.  They enter a social situation with their antennae up!  

People are often chastised and ridiculed for being "too sensitive" and, yet, I think that they are the treasures of the world.  These are the sympathizers, the helpers, the ones who try to understand, the ones who pay attention-to you and to others, the ones who care about the underdog, who listen; some of them are the volunteers, some are activists, many are careful and conscientious.
What is the problem here?  Well, they suffer maybe more than necessary.  What I came to with the second patient was, after she said, she was looking for approval and that she dreaded loss of approval, was that she needed to approve of herself.  If she gets that squared away, she may find it easier to be assertive on her own behalf.  That is what we are working on for now.
The 1st patient has been in therapy for a long time and has come up with some very helpful to her, coping mechanisms.  Today she said that what she did with a woman who is a persistent, intermittent thorn in her side, was pray that she (the person who is problematic) finds peace with herself.  Her conclusion in thinking about this woman was that she would not interact with her or others, in a hurtful way, if she were at peace with herself.  Then, she took the initiative to call her up and say, "We should meet, the two of us, so that we can plan how to work together."  She was able to do this in a genuinely friendly manner, probably because of the prayer.  It helped her to shift her attitude from hurt and irritated to creative and constructive.

If you are not the sensitive type, give those folks a break.  If you are the sensitive type, give yourself a break.  Treasure and take care of your own self the way you would a loved one.

Tuesday, March 13, 2012


In "Traveling Mercies, Anne Lamott wrote: 
"Forgiveness is giving up all hope of having had a different past."
Shared by Robert Caldwell, CPA 

Sunday, March 11, 2012

Give It A Try, Can't Hurt

Some advice I heard today that I added a bit to and am passing on to you


 Gather knowledge, read a lot, try to understand the world 

and your self.

Friday, March 9, 2012

Depression Under the Light of Evolution: Two Evolutionary Hypotheses that Make Sense of Non-Disordered Depressed Mood

Herrick Hospital-Psychiatry Grand Rounds:  Presentation by Julio Ozores, MD, UC Berkeley and The Wright Institute

A New View of How to Think About Depression
In assessing a patient who complains of depression, the biological, psychic and social components will, ideally all be considered by the treating professional.  Dr. Ozores adds another possible component, that of evolution.  There may be a reason that we have the capacity to be depressed at times; according to evolutionary theory, it is proposed that there may be times when depression is adaptive.

There is some history for this theory.  Darwin himself wrote about behavior and psychology, albeit, briefly.  Following were some offers on this subject by William James, James Baldwin, Freud and Jung.  Then came the period of reductionism when psychology was all about behaviorism.  Biology came back into the picture when it was recognized that human readiness to learn certain things exists in ways that are different from animals.  There is a Periodic Table for Psychology by Tinbergen depicting this development of the field.  Recent work has brought to light the question of why the symptom is present; when the body is injured and there is pain, behavior is organized around dealing with that.  Perhaps the same is true of depression.  Some depression may be adaptive, a way of dealing with certain situations.

Dr. Ozores did a critical evaluation of two Evolutionary Hypotheses of Depressed Mood.  Depression is prevalent.  Varying degrees of depression are universal.  The two theories are The Social Competition Hypothesis and The Social Risk Hypothesis.  The first is outlined in a book called The Maladapted Mind.  The first was explained in how all animals fight.  There is a loser who has to stop challenging, lower aspirations, and signal that the fight is over.  This generates a sense of incapacity, subordination and entrapment.  Defeat leads to depression.  Low rank=decreased serotonin.  Thus, according to Dr. Ozores' delineation of this theory, this creates social symmetry.
 In The Social Risk Hypothesis  (written about in a paper by Nicholas Allen and Paul B T Badcock), humans fight but also intensively cooperate.  We all belong to groups so social standing is crucial but, precarious; there is the threat of exclusion and ostracism.  Humans have mechanisms to monitor social standing.  Looking for signs of affiliation may lead to a shift to a risk aversive state.
He defines Non-Disordered Depressed (meaning, this can occur for periods of time as a part of the normal range of human states of mind) mood as:   Anhedonia, low motivation, loss of energy, low self-esteem, sense of incapacity, self-deprecation, negative cognitive biases, hypersensitivity, social withdrawal, sadness.

Convergence:  The study of the stress response, evolutionary psychology, ethology, and clinical psychiatry are converging on a model of clinical depression that understands it as a dysfunction of mechanisms that regulate social behavior.  The depression is causally linked to current environmental stressors in the person's life, and the stress must be specific.  It must be able to be shown how it developed to help cope with the precipitating stressors.

Consilience:  The sciences may meld, Dr. Ozores predicts, and be found to have foundations in each other.  There is an emerging consilience between psychiatry and the biology of behavior with evolutionary thinking.

Monday, March 5, 2012

Wow. And, "Whew!"

I've Been Busy

300 posts since I began the blog in 2009.
The post, Look Before You Leap/ The Imperfect Therapist Part II is the 300th post.  I am a little surprised and feel happy and proud of what I have offered here. 
 I've put up a few of pictures of me working on the blog.

Here are  links to my very first 3 posts:

The 1st one is titled, This Blog Is About, The second is, The Geography of  Your Friendships, and the third is, How's The Fit? 

After having written 50 posts, I had this to say:

One of these days, I'll have to come up with a way to be compensated for this work but, for now, it is my gift to you.  I plan to continue sharing what I have in myself, or things I come across that I think could be helpful to most people.  

Your feedback is treasured.  Please comment, check boxes, and become a Follower.  Thanks to those of you who took part in the poll.
P.S. A reader #1 'd my 300th post.  I think that's good luck!

Thursday, March 1, 2012

Look Before You Leap/The Imperfect Therapist, Part II

How Are You Supposed to Think About Your Therapist

 Therapists, with all their training, schooling, continuing education, therapy of their own, ethical standards---all of it that allows them to get to that chair and to stay in it---are still, fallible human beings.  We do make mistakes.  A lot is expected of us.  And so, most of us are very careful.   We are prone to look before we leap.  Even so, even with all of our communication skills, a therapist can say the wrong thing.  A therapist can miss the point.  A therapist can challenge the patient in a way that isn't helpful.
The intention is good.  Successful outcomes are how we build our reputations.  Satisfied clients continue to come to us and send us their friends and family members.  In addition, many of us take a personal interest in our clients and are really invested in helping them resolve whatever problem they came with.  Beyond compassion, sometimes we come to really care that a client feels well and grows in the way that they want to and develops the kind of gratification in life that they wish for.
So, most of the time, we try really hard.  We come to the office in the best condition - emotionally, physically, psychologically, spiritually, - that we can muster.  We give each and every hour our best.  There's not much room for sloughing off for therapists.  You can't really have a bad day at work and just slide through one day or take it easy.
And, yet, even with all that trying, and paying attention, and being selective, we still make mistakes.  Usually it's about making the wrong choice.

You'd be surprised how much thinking goes on in a therapist's head during any one session.  So, often there are a number of directions to possibly follow; the therapist has to make on-going choices.  It is a conscious effort to follow the client's lead while, at the same time, trying to offer options that might be helpful or more productive or provide a learning opportunity.  Inevitably, some of those choices that the therapist makes will be wrong.
Also, we forget how powerful our position is with the patient.  By that I mean that this person has trusted us with their innermost concerns and feelings; that makes them vulnerable, i.e., in a vulnerable position in relation to the therapist.  Handle with care!
 However, some people don't in fact feel that way in therapy.  I have had more than one person say, "Don't handle me with kid gloves, just give it to me straight."  And then others will be so sensitive in the situation that one wrong word from the therapist and they are devastated.  So, the therapist has to try to know which person is which Sometimes even with true good will and every intention of being helpful, a therapist will say something that is taken by the client as a criticism or a failure in sympathy.
While part of our task, as therapists, is to see beneath the surface, some people have quite a different inside from their outside.  For example, the personality presented to the world may be competent, confident, and outgoing while the inside is quiet, sensitive, and thoughtful.  It can take some time to get to know that inner part and no one, even a therapist may get it all, absolutely right.
It might be unexpected to hear that nerves are much more exposed, usually, in couples counseling than in individual therapy.  When your primary partner is there, often the most important person in the world to you, and they are there because your relationship is in trouble, you are on edge.  The dynamics in these sessions are complicated, or, can be.  Sometimes the deep disappointment in the marriage or the wrath at the partner get turned on the therapist.  It can happen in a New York minute!   So, these sessions are sometimes really loaded and tense.  Thus it is incredibly easy to step on someone's toes.

In the individual sessions, there is just a simpler scene.  Not as many surprises for the patient to handle, less fear of getting hurt, and more sense of control about topics and how the course of the session will go.  And, yet, in this case, the relationship with the therapist becomes more central.  So, an error on the beloved therapist's part can be taken really hard by the patient.

Unless, the same kinds of problems with your therapist are happening again and again, I say give her/him a little room for getting it wrong sometimes.  Bring it up.  Discuss it.  Maybe you can come to a new understanding.  Maybe the therapist has to own a mistake.  An apology may be in order.  Or, perhaps you'll find that you misunderstood.
A lot of missteps by the therapist means you got the wrong one.  But one or two, less than perfect acts or statements, should be considered within the reasonable realm of human error.  The best part is, this is one place where you should be able to say it, say how you felt or feel about it, get heard, and have a useful discussion.

The last thing I would ever want to do, so I expect other therapists feel the same, is to hurt one of my patients.  I am there to help.  I do my utmost to be attentive, supportive, kind and constructive.  Any mistakes are just that, unintended.  So, I expect that this is generally true (of all therapists).  If your therapist said something that hurt your feelings, try, at least once, to talk it over.  Here's hoping you get a happy resolution!

(To see part one of this series, click on, )

Poll Results

30% for relationship topics.  0% for posts which summarize what I learn on new theories of therapy.  30% on articles about happiness.   20% on posts about addiction.  And 20% wanted posts about therapists, so here is one today!

P.S. Other topics you'd like to see here?