Enjoy the audio version of this article—perfect for listening on the go.

For many people, trauma isn’t just a singular experience—it’s something they were born into, so ingrained in their day-to-day life that they don’t recognize it for what it is.

This is the kind of trauma therapist Linda Thai would like you to know about. Thai is especially well-versed when it comes to trauma treatment, having worked with organizations like the Trauma Research Foundation, the Asian Mental Health Collective, and Fairbanks Memorial Hospital. She’s keynoted for the U.K.’s Royal Society of Medicine and the National Education Association, as well as at the Oxford Trauma Conference and the Psychotherapy Networker Symposium. As a therapist, author, educator, coach, and storyteller, Thai is candid about her journey as a survivor of the post-war Vietnamese Boat People diaspora that dropped her at the intersection of trauma, addiction, attachment wounding, and grief.

Thai found healing and recovery in yoga, which helped her process the trauma stored in her body. She studied Somatic Experiencing, Brainspotting, Internal Family Systems, Trauma-Informed Stabilization Treatment, Havening Touch, and Flash Technique. She also caught the attention of renowned trauma expert Bessel van der Kolk, with whom she’s partnered to lead workshops aimed at healing attachment trauma. And along the way, she traveled the world, bringing her expertise to thousands.

Thai’s unique approach draws from the “wisdom portal” of her ancestors. After settling on the traditional lands of the Tanana Athabascan people (modern-day Fairbanks, Alaska), she learned to live off the land with a combination of “mutuality, reciprocity, kindness, and collective responsibility.” She and her husband live in a 550-square-foot cabin they built by hand, heated by firewood they cut themselves. They pick wild berries, raise animals, fish, and hunt.

No, not everyone needs to take up woodworking to process trauma or combat the traumatic forces of sexism, racism, homophobia, and colonialism that exist in our systems and institutions. But some of the most profound healing, Thai says, comes from time-honored cultural practices, like a reverence for nature and community. She believes we must buttress our mainstream therapy approaches and techniques with an acceptance that at the heart of healing is something more innate—instinctive practices that may feel more elemental than intellectual.

Thai recently sat down with us to share how we can all cultivate more wholistic healing practices, with characteristically honest reflections on her own journey and the spiritual act of finding your way back home.

Ryan Howes: What drew you to somatic treatment for trauma?

Linda Thai: Quite simply, yoga and meditation saved my life. I was in addiction recovery, and these practices helped connect me with my body in real-time. So I started teaching them in addiction and trauma recovery settings. I also got into Bessel van der Kolk’s work, IFS, Sensorimotor Psychotherapy. I was learning all of that even before I started studying to become a therapist. I’ve also benefited a lot from studying attachment theory and applying attachment-based principles to my work.

But I’ve never felt any of it truly captures the fullness of what it means to be human: interdependent and in inter-relationship with the world. Psychotherapy hyperfocuses on dyadic relationships: between two partners, between parent and child, between therapist and client. We may see families; we may even facilitate groups—but we’re still only focusing on human relationships.

As a society, we’ve been severed from the holistic, expansive experience of our relationship to nature, to our bodies, to our ancestors, and to time itself. You could say we have an insecure, avoidant, anxious, disorganized relationship with all those things.

I immigrated to the United States as an adult. But as a toddler, I was a refugee, first in Malaysia and then Australia. Home ceased to exist long before we left it, and there was no home to go back to. I then became a refugee from a country called The Body. It put me in close proximity to all kinds of loss, including the embodied experience of secure attachment and the full experience of being human.

This is common for all refugees—religious refugees, people fleeing domestic abuse, trans youth fleeing their families, abducted and enslaved Africans, transracial and transnational adoptees. They’ve all experienced forced displacement and disrupted relationships with themselves and their sense of home. Disrupting the relationship between a people and their home is the first act of disembodiment, and once people are disembodied, they’re easier to make compliant. That’s colonialism: the trauma of colonialism is the trauma of disconnection.

This process of colonialism happens with all waves of immigrants that were othered and all indigenous people who were invisiblized. Speaking as an Asian-bodied person, my people have colluded with the model-minority myth, because it gives us more proximity to whiteness and separates us from other Black and Brown bodies. You can learn about this process as information to put it into your head, but there’s a metabolic process of grief that also takes place within the body.

RH: Much of your work focuses on intergenerational trauma and grief. How are those connected?

Thai: In graduate school, I learned that the dynamics of a dysfunctional family are “don’t talk, don’t trust, don’t feel.” Not naming your losses, not naming your sadness, not crying: those are survival strategies, especially when our rituals and ceremonies for embodied grieving have been taken from us.

As Resmaa Menakem reminds us, when trauma is decontextualized, it looks like culture. It looks like stoicism. It looks like sucking it up, or stuffing it down, or rubbing some dirt on it. And it also looks like the shaming and blaming of emotions in others and in oneself.

Parents with unresolved losses and traumas aren’t able to be there for their children in developmentally appropriate ways. And then the children learn not to cry, not to feel. You see the individual informing the family system, which informs the culture. And now we have a society that, as Francis Weller says, is replete with mechanisms for amnesia and anesthesia.

RH: Which leads to addiction for a lot of people, right?

Thai: Exactly. When I worked in addiction recovery, we’d do a timeline of our drug use alongside a timeline of our transitions, losses, and traumas. It showed how unresolved losses often become the platform for using. Some losses, like moving schools as a child and losing friends, may not have registered as a trauma, but if your parents didn’t acknowledge the losses or provide resources for support, then it most certainly was traumatic.

In the absence of an embodied way to grieve, and in a culture of patriarchy and unhealthy masculinity, the acceptable go-to emotion is anger. In my work, we often looked at fury and rage as indicators of unresolved grief and trauma. And we bring mindfulness awareness to the physical sensations of those emotions, because that’s what emotions are: physical sensations.

RH: What does healthy grieving look like for you?

Thai: Grief is a primal human need, and it’s a solitary journey that we can’t take alone. To grieve, you need to be in community, some sort of group, where the fullness of your body’s need to express grief is welcomed. It’s important we reclaim cultural rituals that make space for song, story, movement, silence, togetherness, and aloneness. You can see these elements in African American funerals, Vietnamese funerals, funerals with people who are hired to wail—professional keeners—which come out of several European traditions.

Once we expand our conceptualization of what it means to be securely tethered and have a sense of place in the world, we can then get curious about the things that were taken from us (that we may not have realized shouldn’t have been taken from us) and the things that were given to us (that we may not have realized shouldn’t have been given to us). That applies within our family systems and on a societal level. In the latter sense, collective trauma requires collective healing.

We need to come together every new moon, every full moon—something to give us a sense of rhythm. We need to be in community as a witness, as a container. And when the fruit of grief ripens in the moment, we need to know it, to carry it. Just like how we metabolize food, when we metabolize grief, we create fuel for our growth, for our humanity.

The post Embodied Healing in a Disembodied World appeared first on Psychotherapy Networker.

]]>

How do we support our clients in moving beyond limiting stories? How do we help them experience life’s rich complexity in the midst of what can feel like a never-ending barrage of emotional burdens? How do we help them focus on hard-to-face issues and make meaningful changes?

Here, some of the wisest souls in the world of psychology and psychotherapy share their answers to the biggest, most slippery questions we face—as therapists and humans.

***

TARA BRACH: How Do We End Suffering?

Clinical psychologist and renowned Buddhist teacher sheds light on the shadow sides of therapy and the spiritual path.

IRVIN YALOM: How Do We Live Our Best Life?

Psychotherapy’s most famous storyteller believes we should focus less on symptoms and more on the great, timeless issues of freedom, meaning, and mortality.

EUGENE GENDLIN: How Do We Cultivate Wonder?

The developer of the mind-body approach Focusing highlights the value of tapping into the dynamic experience of the “felt sense.”

DANIEL KAHNEMAN: How Do We Change Bad Habits?

Nobel Prize-winning cognitive research psychologist explores the role of automatic responses in human thought, and just how instinctively unwise we can be.

***

A version of this article was originally published in March/April 2013.

The post Answers to Therapy’s Big, Slippery Questions appeared first on Psychotherapy Networker.

]]>

The healthcare field needs intensive care.

Not only is it a field filled with high-stress workdays, legendarily rigorous training programs, sparse staff-to-patient ratios, and mountains of bureaucracy to navigate at every turn, but it’s also a field where exposure to physical and emotional trauma is as regular as the sound of beeping machines on an ICU unit. Nonetheless, doctors and nurses are expected to remain calm and dispassionate. Feelings aren’t simply discouraged: they’re seen as a job hazard.

And yet these health care professionals, however heroic, are also human. The work they do impacts them. They need help processing difficult experiences and coping with stress just like the rest of us—or maybe even more than the rest of us. Which begs the question: Who heals the healers? And how?

Jessi Gold, a popular psychiatrist who’s been featured in The New York Times, HuffPost, Time Magazine, and Forbes—and is also the chief wellness officer of the University of Tennessee System—started asking herself these questions during the pandemic. Gold’s recent book, How Do You Feel? One Doctor’s Search for Humanity in Medicine, chronicles her experience helping physicians, nurses, and medical students through that challenging time—along with what she discovered while seeking balance amid intense professional burnout.

Recently, she and I sat down to talk about the state of the healthcare field and how to best help our fellow providers in the medical profession.

Ryan Howes: Why is the medical profession so hard on medical professionals?

Jessi Gold: Medicine has long been one of these fields in which having feelings and being impacted by our work is seen as weakness. Vulnerability isn’t a goal doctors and nurses are supposed to strive for. Rather, it’s seen as a barrier to moving forward in your career. Having feelings is seen as selfish. For example, if I’m your doctor, and you tell me you’re dealing with something hard that strikes a chord in me, or if I see a patient die and it affects me emotionally, then it takes away from you. We learn that’s not what a good doctor does.

RH: So there’s a belief that you’re serving the patient by denying your own humanity.

Gold: The field values hard work and putting other people before oneself, which is understandable. But it often leads to healthcare professionals not feeling, not taking days off, not sleeping, not eating, and not peeing. There are things to admire about selflessness, but absolute selflessness isn’t sustainable. You can’t just give and give. After a while, there will be nothing left to give.

RH: Obviously, we don’t want brain surgeons to be immersed in their feelings in the middle of surgery. But when surgery is done, how can they switch their feelings back on?

Gold: You can detach from your feelings and reactions in the moment to do your job well. The danger arises when your job becomes your existence.

There’s a false assumption that we can detach from our feelings all the time and somehow come out okay. We start that way because we have to, and then it feels like that’s the only way to function because that’s what’s modeled all around us. We worry that if we don’t do that, we won’t be able to handle our jobs. In my book, I share about a time when I was very excited because I didn’t cry in front of a patient, and my therapist was like, “Why is that a good thing? Why are we high-fiving over this?”

I also tell a story about a patient of mine who was an ER doctor who went to an opera, and someone in the audience died. Everyone else was horrified, but she just wanted to get back to the opera. For her, it was like, “Oh, here’s death again.” We become really detached from normal human reactions to things that most people would find very disturbing.

RH: Is it true that going to therapy can have negative career repercussions for medical professionals?

Gold: It is really not true anymore, but you’ll always find someone with a story about a doctor who tried to take care of their own mental health and was somehow punished for it by having their license revoked. This may have happened a lot in the past, when medical licensing boards didn’t understand mental health conditions or how they played out in the workplace. But over time, most of them have changed their mind about the value of mental health treatment. Organizations like the Dr. Lorna Breen Heroes’ Foundation are pushing to change the wording
on some licensing applications, so it doesn’t inadvertently punish people for going to therapy. After all, it’s supposed to evaluate whether you’ll hurt a patient based on your mental health, not whether you’d benefit from therapy. In fact, I was told to go to therapy during my training as a psychiatrist.

Sure, someone can say, “You shouldn’t be practicing while you’re depressed.” But all that means is that it’s in your own best interest—and the best interest of your patients’—to notice signs of depression or burnout early and address them.

Right now, we tend to take a stop-the-bleed approach to care. Also, we tend to overwork to compensate for all kinds of other feelings, because when we overwork, we get praise. It’s the culture we live in. However, we can help people recognize that the more they take care of themselves, the better they are at their job. Taking care of themselves shouldn’t be viewed as a last resort, the way it is in the medical field.

In this culture, we’re all starting at 50 percent burnout, so chances are you can look around and say, “Jimmy looks sadder than me, and Frank isn’t sleeping either, so I think I’m good.” But your measurement scale is out of whack.

RH: How do you distinguish between regular workplace stress and burnout, particularly for healthcare workers and therapists?

Gold: Stress, in general, is a physical response that helps you get stuff done. If you have a test, the stress boosts your adrenaline, and you finish the test. The stress is temporary. Burnout, on the other hand, tends to stick around and decrease your sense of personal accomplishment. You feel ineffective, emotionally exhausted.

RH: What advice would you give a therapist who’s starting to treat a nurse, physician, or other healthcare worker?

Gold: First, I wish there was a certificate program for treating healthcare workers because we’re a weird subculture. Healthcare workers don’t like to talk about how they got to where they are, so knowing a little about their training and what they do in residency—sort of like with any cultural competency—avoids putting them in a situation where they have to educate you or re-explain stuff. What I hear a lot from healthcare workers is that the therapists they like are the ones who don’t give them suggestions that make no sense given their workplace. For example, you can’t tell them to sleep. That’s not helpful. You can say, “What’s your sleep look like?” But you can’t say, “My recommendation is you find a way to get eight hours of sleep a night.” They can’t do that. It’s more important to figure out what they can do.

Teaching quick skills is helpful—deep breathing or other relaxation tools or tips for self-compassion at work. CBT-based exercises are often quick and helpful. It also helps to recognize this population needs you to have some flexibility when scheduling sessions, because their schedule can be erratic. When I was in residency and on night float, my therapist saved me a morning time slot, and if I couldn’t make it, she understood and waived the missed session fee. Recognize that your healthcare worker clients want to come to therapy, but might need an after-hours time, or a weekend slot.

If you want to see healthcare workers, put that on your therapist profile and on your website, even though it’s not an official specialty. Also, understand that healthcare workers are coming from a field that doesn’t talk about mental health often, so it’s hard for them to even be in therapy. Be patient with them. They’re usually not comfortable with feelings, so you’ll get a lot of alexithymia, avoidance, and intellectualization. They might be uncomfortable with the process of therapy for a while. I was—and sometimes still am!

The post Medical Professionals Need Intensive Care appeared first on Psychotherapy Networker.

]]>

“Don’t put coffee up your butt” is not the kind of fatherly wisdom I thought I’d need to share with my children, but as digital natives who navigate Instagram and TikTok better than I navigate my own backyard, my kids will inevitably encounter messages about the benefits of putting coffee up their butt—along with countless other outlandish recommendations—from wellness practitioners. I take it upon myself, their parent (who happens to be a psychologist), to help them discern sound wellness advice from a scam. Shouldn’t we also do this for our clients?

According to Jonathan N. Stea, a clinical psychologist and adjunct assistant professor at the University of Calgary, the answer is: absolutely. As the author of Mind the Science: Saving Your Mental Health from the Wellness Industry, Stea advocates for therapists separating the wheat from the chaff in mental health treatments to provide the sound and effective treatments our clients need.

Beyond coffee enemas, Stea takes issue with what he says are the oversold scientific claims around acupuncture, psychedelics, Reiki, chiropractic medicine, mindfulness meditation, 12-step programs, energy therapies and even some popular therapeutic modalities. If the thought that he might be trying to slay one of your sacred cows upsets you, you’re not alone: he receives a daily barrage of hate mail messages, many directed at his infamous man-bun. On one social media post, someone commented disparagingly, “Says the guy with a man bun.” Stea quipped back, “It knotoriously annoys pseudoscience apologists.”

But he isn’t challenging popular therapeutic techniques and methods to be provocative. His mission is to help people parse pseudoscience from actual science in a culture where it can be hard to tell the difference. I recently talked with him about pseudoscience, psychotherapy, and professional ethics over a cup of coffee. That I drank. With my mouth.

Ryan Howes: You’re well known for challenging all forms of pseudoscience. So let’s say, hypothetically, I’d like to get rich and powerful by creating a pseudoscientific product. Give me a starter kit here.

Jonathan Stea: You’ll need to start with a good name and describe your treatment or product or service with science-y sounding words. Quantum is a great one because it’s so obscure. Then you need to build yourself a website that features your science-y sounding words along with anecdotal evidence and testimonials about your product or service.

The claims you tout will be completely divorced from the broader scientific literature. So, maybe you have a homeopathic product where the active ingredient is diluted out of existence, but you claim water can remember the active ingredient that was once in there—quantum physics, right? Or maybe you propose an energy healing service where you say human energy fields can be manipulated and balanced, without touch being involved. You say a practitioner can just wave their hands around another person’s body and somehow remove the energy blockages that are supposedly the “root cause” of their depression or anxiety or PTSD. If critics come at you, you reverse the burden of proof. “Why don’t you tell me why this treatment is not effective, rather than me providing evidence of its effectiveness?”

Other pseudoscience warning signs are tropes that serve to sow distrust in mainstream medicine—I outline nine in my book. One is, “Mainstream mental healthcare, like medication and psychotherapy, only masks the symptoms of your anxiety and depression: we address the root cause.” When you dig deeper into claims like this, the root cause is usually itself pseudoscientific, like a diet deficiency that you didn’t know you had. Alternative medicine tropes also like to say that their treatments are natural, safer, and have been used for thousands of years.

RH: As therapists, our answer to clients who want a quick fix for their problems is often, “We can help, but the process could be long and messy.” The kinds of products and methods you’re talking about claim, “Here’s the root cause. Here’s all you need to do to address it. It’s simple.” Given a choice between complicated or simple, most of us would choose the simple option.

Stea: That’s marketing. That’s the kind of stuff that goes viral: oversimplified, emotion-laden language as opposed to the nuanced, probabilistic, complex language of psychologists in psychotherapy or scientists in academia. Pseudoscience oversimplifies.

RH: Why are people so angry about what you have to say?

Stea: I’ve thought about this a lot. And I think tribalism plays a huge role. More and more, our political affiliations have gotten wrapped up in our scientific beliefs, and people can get very heated over that. We incorporate beliefs, including pseudoscientific ones, so deeply into our identity that any challenge to them threatens our worldview, which can bring up anxiety and cause us to lash out.

Plus, our darkest impulses come out online, where we can unleash negative reactions more easily than when we’re face-to-face with a living, breathing human being. I get about 100 hateful messages a day online, so I’ve had to get practiced at managing them, but it took a while. Now, I try to change the vitriol into humor and make an educational point out of it, if I can.

RH: It seems everyone uses the term “evidence based” for their therapeutic approach these days. Has that been oversold?

Stea: I applaud the root and spirit of that term. People do need to pay attention to science with respect to mental health, and to use evidence-based treatments. The problem is, as you’re suggesting, terms can be abused. Bad science is often published in pseudoscientific journals that focus on pseudoscientific topics or use dubious research methods.

In my book, I warn readers about the perils of randomized controlled trials because you can pretty easily have something like thought field therapy or energy healing pass a randomized trial and then lay claim to it being an evidence-based treatment. But was it the energy healing that helped, or was it the rapport building between practitioners and research subjects? That’s why in the skeptic community, there’s been a call toward science-based medicine as opposed to evidence-based medicine. Science-based medicine urges us to pay attention to scientific plausibility when conducting randomized control trials.

RH: What can we do as a profession to communicate scientific validity?

Stea: Educate ourselves. Years ago, professor and evidence-based treatment advocate Scott Lilienfeld and his colleagues estimated that there are at least 600 brands of psychotherapy out there. Most of us would be hard-pressed to name 30, or even 20 of them. The majority are untested. Maybe they work, but we just don’t know. I suspect a lot of them are based on repackaged evidence-based principles from our main cache of evidence-based treatments, like cognitive behavioral therapy and psychodynamic therapy.

RH: Psychodynamic therapy has a bad reputation among many undergraduate professors out there, but you include it among the valid treatment approaches.

Stea: Absolutely. Psychologist and researcher Jonathan Shedler has done a really great job of communicating the science behind psychodynamic therapy. When I was in grad school, it was the CBTers versus the psychodynamic folks, but when I got out into the real world, I realized that even though the language they used was different, the evidence-based principles they used were quite similar.

RH: How are mental health organizations part of the pseudoscience problem?

Stea: Personally, I’d like to see our licensing and regulatory bodies reject the use of unequivocally pseudoscientific treatments in therapy. Energy healing, past-life regression therapy—that stuff is unequivocally pseudoscientific. There’s a huge gray area though, which I acknowledge. So the responsibility to practice ethically and competently ultimately rests on individual practitioners.

If I was a psychologist who used Reiki or energy healing with clients, I’d be ethically obligated to tell them during the informed consent process, “According to the evidence, this treatment doesn’t work beyond the placebo effect, and there are other evidence-based treatments that are more likely to work.”

If I don’t want to say that to clients, then my due diligence is to stop offering that treatment and focus on the common factors of therapy like cultivating the therapeutic alliance and engaging in basic counseling skills or proven therapies like psychodynamic therapy, dialectical behavioral therapy, and acceptance and commitment therapy.

RH: If a regular clinician wants to make sure they’re minding the science, what should they do first?

Stea: It’s our ethical duty to read the scientific literature and make sure we’re practicing ethically and competently.

The post Is Therapy Slipping into Pseudoscience? appeared first on Psychotherapy Networker.

]]>

In 2012, Susan Cain became world-famous for her bestselling book Quiet: The Power of Introverts in a World That Can’t Stop Talking, arguably one of the most influential books in the therapy world that’s not actually about therapy. With her online “quiet” community that extends across 193 countries and every U.S. state, she’s showed that the introverted qualities of thoughtful, low-key people—who tend to get dismissed in our loud, extrovert-centered society—are critical to every system in existence, from families to schools to workplaces and entire global industries.

Now, what has done Quiet did for introverts, her latest book—Bittersweet: How Longing and Sorrow Make Us Whole—is doing for the wistful, sensitive, misunderstood people among us she calls “melancholics.”

In this exclusive interview, Cain talks about her own innate disposition toward melancholy, and her view of sadness and longing not as hardships to endure on the road to happiness, but as deeply spiritual states of being.

Sure, you might say, every therapist knows all emotions have something valuable to offer. But let’s be honest, how often do you celebrate a client’s sense of sadness and longing? If your favorite nostalgic poet or spiritual seeker wandered into a modern-day consulting room, what are the chances they’d be diagnosed with anxiety, depression, ADHD, or a dissociative disorder?

As therapists, we’re taught to be on the lookout for symptoms of unprocessed trauma, attachment issues, and mental illness. We’re taught to wonder if a client is dysthymic or suffering from a depressive episode. And we’re taught to be concerned. But as Cain points out, research shows that the actual correlation between melancholy and depression is mild. Just because sadness can lead to depression doesn’t mean that it will. And just because sadness can feel heavy doesn’t mean it should be seen as a burden.

So if Cain is right—and sorrow and longing are more often linked to transcendence than pathology—then perhaps spirituality shows up a lot more often in therapy than we think.

Livia Kent: How does being melancholy differ from being depressed?

Susan Cain: Melancholy and depression are two separate states. The extent to which the field of psychology makes no distinction between them drives me a little crazy. When I started researching Bittersweet, the first thing I did was type “melancholy” into PubMed, and I kept getting articles about clinical depression. Not a single one talked about melancholy as a precious state of being aware of the impermanence of everything and the great piercing joy at the beauty of life that comes with that awareness.

I teamed up with psychologist Scott Barry Kaufman and researcher David Yaden to create a scale that helps people measure where they tend to fall in terms of their state of bittersweetness. We asked questions like, Do you find joy or inspiration in a rainy day? Do you frequently experience goose bumps? Have other people described you as an “old soul?”

We found that people who score high on bittersweetness also score high on measures of creativity. They score high on Elaine Aron’s construct of being a highly sensitive person. Interestingly, they score moderately high on measures of experiencing states of awe, wonder, and transcendence. Part of why we overlook this is because of the correlation between bittersweetness and anxiety and depression. But it’s only a mild correlation, not high at all—and it’s not surprising. If you tend to feel everything intensely, you might sometimes tip into a state where that’s not helpful to you.

LK: How can therapists help clients value their melancholic states?

Cain: If somebody tends toward melancholy and vibrates intensely with everything life brings to them, we can help them understand that there are times that’s not easy. But we can also gently help them understand that they don’t have a choice about their fundamental nature. If you’re one of those people, you’re one of those people. We might help them understand how many gifts come along with that. When I’m vibrating intensely with something negative or with something I’m longing for, I can start with just understanding, This is who I am. I can hang out through it and wait for the intensity of the experience to pass. But even while I’m in the depths of it, I can understand that I have this incredible gift to feel things deeply. I can experience a sunset that much more intensely or take the things I observe and shape them into a creative act, or into an act of healing.

LK: Melancholy isn’t necessarily sadness. But sadness, too, has an important role to play in our lives. What’s the value of sadness?

Cain: If you saw Inside Out, you may remember that the two main characters are Joy and Sadness. Well, it wasn’t always that way. I gave a talk on introverted employees at Pixar and after we were done, I sat down with Pete Docter—the director of the movie—and he told me that when they first made it, the two main characters were Joy and Fear.

The production of the movie was already well underway when Docter started having a terrible feeling in his stomach, a sense that the whole movie doesn’t work because Fear has nothing to teach Joy. He went into a tailspin and began to envision his career being over. He descended into sadness—and that’s when he realized that Sadness should be the core of the movie, because it actually has a lot to teach Joy. Sadness fuels empathy and belonging. Docter knew it was going to be a huge uphill battle to convince the executives at Pixar why Sadness of all things should be a main character—because no one wants to be sad—but he was able to portray life as just that: joy and sorrow, beauty and despair.

I’m guessing many therapists wouldn’t have gone into the healing professions without the wish to help clients discover new ways of exploring the full depth of life. It’s that full-spectrum expression that can help people heal, that gives us permission to experience sadness and cry.

LK: You link melancholy with our longing for beauty. Is there a link between spirituality and melancholy?

Cain: I say this as a lifelong atheist-turned-agnostic, but I believe we come into this world in a state of longing for the more perfect and beautiful world we just left. This could be the perfect harmony we experience in our mothers’ womb, or a perfect and beautiful realm we were once a part of. You see this in all of our religions. We were once in Eden, and then we long for Eden. We were once in Zion, and then we long for Zion. The Sufis call it “the great longing for the belonging for the soul.” Then we have secular manifestations of the same great longing. In The Wizard of Oz, there’s a longing for somewhere over the rainbow. This longing is the great essence of every single human being. When we see something beautiful, what we’re seeing is a manifestation of the perfect world we want to be a part of. We experience a thrill at the majesty of it. We also recognize we’re only catching a glimpse of this world—which is why we feel sad.

LK: Therapy often focuses on helping clients get what they want. Are we too quick to discount the value of longing over having?

Cain: In our culture, we tend to think of longing as a disabling emotion, something that holds you back from being who you should really be, but I believe longing is momentum in disguise. In Old English, longing literally means “to grow longer, to extend, to be reaching.” Great acts of creativity arise from a longing to see something beautiful. Every single creative person will tell you they have a shimmering image of perfection they’re aspiring to. A writer will have the idea of the perfect manuscript they will produce, even though they know from day one they’ll never produce anything half as perfect as what they have in mind. But they still reach for it, and there’s joy in that.

LK: Clearly, there’s stuff we can all change about our lives, but we can’t change the inevitability of loss.

Cain: One of the great Japanese Buddhist haiku masters was Issa. He had a very difficult life. His first child died and then he had this baby girl, shining and perfect, and he loved her with all of his being. Then she, too, died of smallpox. And he wrote this poem: “This world of dew is a world of dew, but even so, even so.”

This poet deeply understood the Buddhist principle of impermanence, and it’s clear in these words that he still struggled to accept it at times. That’s what he’s saying in the line “but even so.” Grief, loss, and impermanence are a great gift; they might not be the gift we want, but we’re all in this mysterious mix of loss and beauty together—and that’s beautiful.

LK: What do you most want people to take away from your work?

Cain: There’s a whole realm of humanity that exists in the space that I describe as the quiet, the sensitive, the melancholic, the beauty-seeking. I’m guessing a huge percentage of therapy clients exist in this realm. I’m guessing a lot of therapists do, too. It’s so important to remember the beauty of that realm. If you really know it, you know it in a deep-down way.

There’s this centuries-old archetype of the wounded healer, which I see so acutely in the work therapists do. This comes from the Greek myth about the wounded centaur Chiron. Because he was wounded and in pain, he had the ability to heal others. There’s something in us as humans that can do this. After 9/11, we had a record number of people signing up to be firefighters. During the height of the pandemic, we had a record of number of people signing up to be doctors and nurses. A woman whose daughter was killed by a drunk driver started Mothers Against Drunk Driving. There’s something in humanity that has this impulse to take our darkest depths and turn them into something meaningful.

So maybe the pain you can’t get rid of is your creative offering, your healing offering to the world.

The post The Beauty of Longing and Melancholy appeared first on Psychotherapy Networker.

]]>

When you think of the word pilgrimage, what comes to mind? Is it a robe-clad wayfarer, trudging tirelessly across some far-off desert? A weary knight, dismounting from his horse after a long, perilous journey to kneel at some shining altar? Or perhaps a pious devotee, pressing her forehead against the warm clay of a wailing wall?

Whatever you imagine, chances are you’re not picturing someone slipping on a sweatshirt and joggers, pushing through a crowded Manhattan subway turnstile, taking the red line downtown, and walking three blocks to a therapist’s office on the outskirts of New York’s Financial District. Lawrence of Arabia this is not. But a pilgrimage? Absolutely. Just ask anyone who’s passed through the doors of the Psychotherapy and Spirituality Institute. For many, what happens there is more than just good therapy: it’s a sacred homecoming.

For Sarah McCaslin, an ordained minister, licensed clinician, and the executive director of PSI, that’s exactly the point. In her practice, the therapist’s office isn’t just a place to talk about your day-to-day troubles, but a place to explore more amorphous concepts, including your faith, your sense of spirituality, or that feeling of smallness you get when you look up at a big black sky full of stars. You might ask questions like How can I manage my anxiety? or How can I communicate better with my partner? But you might ask others, like Who am I? or Where do I belong? or Is there a higher power, and if so, do they accept me as I am?

It’s tempting to believe that PSI’s offices, which once served as living quarters for nuns, still hold some sort of lingering mystical energy that its new clinical inhabitants can call upon. After all, clients seek out PSI because they want a therapist who can examine their problems with a spiritual lens. Many have experienced spiritual trauma, like being rejected by a religious family or community, but still derive some benefit from religion they don’t want to abandon entirely. And many haven’t felt comfortable bringing up their complex feelings about religion and spirituality with other therapists.

So what makes PSI any different? “Spiritual and religious fluency,” McCaslin says. Like her, many of its therapists have two identities. “I’m a clinician,” she explains, “but I’m also clergy. Whenever I walk into a room, that’s also who I am.”

Oil and Water?

You might be inclined to think of spiritually informed therapy as a more modern form of pastoral counseling. But that’s a mischaracterization, McCaslin says. “Pastoral counseling used to be all the rage in the 60s and 70s,” she explains, “a way to give pastoral leaders the provisions to offer mental health care to congregants. But that term and model have gone out of fashion. Today, religious and nonreligious people alike trust therapists with their mental health.”

True as this might be, it begs a question: do religion and spirituality really belong in therapy? If the idea of wading into the nonsecular evokes a visceral nope from you, you’re not alone. In its original conception, psychotherapy was decidedly nonreligious. When Sigmund Freud and B.F. Skinner developed psychoanalysis and behaviorism in the late 19th and early 20th centuries, the intention was to establish psychology as a hard science. Any inclusion of religion was considered aberrant and regressive—“patently infantile” and “foreign to reality,” Freud wrote in his 1930 Civilization and Its Discontents.

Vestiges of these attitudes still exist today. According to a 2013 examination of therapists’ attitudes toward religion published in the APA Handbook of Psychology, Religion, and Spirituality, most psychologists are nonreligious. Some are even spiritually averse, often due to their own negative experiences with religion or because they see a moral or ethical need to avoid religious discussions in therapy. Less than a third of clinicians say they’ve discussed religion or spirituality with clients, and less than half say they mention it during assessment or treatment planning.

But how much potential exploration and healing is missed when therapists ignore these conversations? Not only do 70 percent of U.S. adults say religion is important in their lives, according to a 2023 Gallup poll, but most clients want the opportunity to discuss religion or spirituality with their therapist, according to a 2020 study in the journal Religions. In addition, a considerable body of research indicates that spiritual and religious beliefs are relevant to mental health, and that spiritual practices like prayer are correlated with lower levels of depression, anxiety, suicidal ideation and attempts, PTSD, and substance abuse, as well as higher levels of hope, optimism, and self-esteem.

Decades after Freud, it seems the field has slowly come around to the idea that religion and spirituality have a place in psychotherapy. The APA’s Ethics Code states that therapists should be “aware of and respect cultural, individual, and role differences, including those based on religion, and consider these factors when working with members of such groups.” Yet while 89 percent of therapists today agree that clinicians should receive training on religion or spirituality as it relates to mental health, according to a 2023 article in the journal BMC Psychology, most report receiving little to no training at all. As a result, they feel unqualified to discuss it, or worry that doing so would be unethical.

McCaslin is quick to note that what she and her team practice is ethical psychotherapy—not religious counseling, proselytizing, or evangelizing. “Some people might feel wary when god comes up in therapy,” she says. “But if we can talk about things like drugs, sex, and money, then why not God? As psychotherapists, our job is to help clients create meaning when life gets complicated. Our job is to listen well and help them tap into resources they can lean on, including their experience of what they might call transcendence or the divine.”

Identity, Belonging, and Self-Acceptance

No, therapists don’t conduct baptisms, preside over your child’s bar mitzvah, or officiate at weddings or funerals. But when it comes to that quality of shepherding—providing comfort, validation, community, and guidance in times of need—is there really all that much separating clinicians and clergy?

“I think in many ways the therapist has taken on a sort of secular priesthood,” says PSI clinician Lana Hurst. “Even though we’re becoming an increasingly secular society, people are still looking for healers and spaces to work through painful things.”

Hurst, a former pastor, says she comes from “a conservative, high-control Christian tradition,” which she began to break from around the time of her gender transition. After doing pastoral work for more progressive Chrisitan churches and finding herself increasingly attuned to how people were making meaning out of their lives, especially after painful experiences in religious spaces, she decided to enroll in a mental health counseling program. In 2022, after graduating, she began interning at PSI.

“I felt like I could combine two worlds without having to leave one behind,” Hurst notes of the career change. “Even though I came from a Christianity that says psychotherapy is demonic, that it leads people away from god, my experience has been quite the opposite. I’m not leading my clients to a Christian god, of course, but to the divinity within themselves.”

Hurst says around three-quarters of her clients are transgender or gender-nonconforming, and that many have experienced spiritual trauma. “They’re coming in with all sorts of questions,” she says. “They’re wondering what it means to embody their gender and what it means for their relationships. They’re wondering what it means for their survival in a world that tells them they don’t get to exist in this way.”

Hurst also sees cisgender clients, who find themselves wrestling with a religion that no longer serves them. “I see a lot of purity culture trauma,’” she explains. “These clients are struggling with parts of themselves, particularly around sexuality, that haven’t had any expression or acknowledgment.”

Does that word parts sounds familiar? Hurst says one of her favorite and most effective interventions for spiritual trauma is Internal Family Systems, which she says helps clients slow down, notice their wounded and protector parts, and offer compassion to all of them without trying to change them. Then, Hurst asks her clients a question: What if?

“What if you didn’t have to be so protective in this way? What if living this way wasn’t as dangerous as you think it is?” Her job, she explains, “is to help clients find a sense of harmony between those parts of themselves, to empower them to begin to imagine other possibilities.” At the end of the day, she adds, “I want them to leave therapy with a deeper sense that they’re sacred in and of themselves.”

Listening a Little Closer

What makes a therapist spiritually informed? Is it having a spiritual or religious background? Is it some innate personal quality? Or is it something that can be learned by any therapist and honed over time? Maybe, as PSI clinician Shivam Gosai claims, the key is just being a good listener.

It might seem like a no-brainer that listening well is an essential component in any effective therapy. But Gosai says it’s a certain kind of listening—which comes from developing your “Spidey Sense,” as he calls it—that takes therapy from ordinary to spiritually informed.

“Most people don’t come to therapy with spiritual questions,” he says, “but they will come up at some point. I’m very intentional about listening for spiritual elements when clients are talking.”

In 2014, Gosai spent three years living in an ashram in South India, where he studied Advaita Vedanta, a non-dual Hindu school of philosophy that believes the Self and divine consciousness are one in the same. He says the experience, which amounted to a monastic lifestyle that “opened me up to spiritual language and worlds,” helped him hone his curiosity and listening skills. After returning to the U.S., keen on studying psychotherapy with a spiritual perspective, he enrolled in a master’s program, but was surprised and disappointed to find there was virtually no mention of how to work with clients around religion and spirituality.

“I’d assumed that if we were serious about getting to know the whole person, that we’d also learn how to bring in the religious and spiritual side of people,” he says. “But we didn’t. There was just one day in class where we talked about it, and that was it.” After graduating, Gosai began looking for spiritual therapy training programs but came up empty-handed—until he found PSI. He was immediately sold, and two years ago, he joined the practice.

Gosai says some of his clients choose to work with him because of his Indian and Hindu background, like the Indian client who told him she talks to Krishna and that he talks back—something she’d never felt comfortable mentioning to other therapists. But he says that most of his clients are young adults in the throes of a “quarter-life crisis,” facing seemingly ordinary challenges with work, relationships, and family. This, Gosai says, is where his Spidey Sense usually starts tingling.

“They’re confronting existential questions about what’s next in their lives,” he says. “This feeling of I’m not happy and I want to change—that’s about identity, which has a spiritual element.” Sometimes he’ll hear something more subtle from a client, like the fact that they’re not sleeping well. “I’ll get curious about their dreams when they do manage to fall asleep, which also brings in a spiritual element,” he says. “Since I take a Jungian perspective, I might use the symbolism of their dreams to get a bigger picture of what’s happening in their life, as well as a sense of the bigger universal narrative flowing through them.”

Gosai acknowledges that wading into this territory might feel strange for most therapists. But you don’t need to spend three years in an ashram to develop your own spiritual muscles. You just need to keep an open mind, he says.

“I’m not my clients’ spiritual teacher or pastor,” Gosai explains. “But I do see the spiritual elements in psychotherapy. I see my clients’ spirituality, make space for it, and apply it toward their goals, which is something they tell me their previous therapists couldn’t or wouldn’t do.”

Spirituality Meets Social Justice

Even if you accept that religion and spirituality have a place in therapy, it’s easy enough to write them off as largely irrelevant to today’s progressive young clients, who are increasingly focused on social justice issues and cultural trauma. But according to PSI clinician Helen Park, who specializes in what she calls “anti-oppressive therapy,” religion and spirituality complement their concerns about systemic racism and oppression—and counterbalance the harm that’s come from psychotherapy’s white, Western colonial background.

Park is one of the newest members of PSI, having joined last May after stints as an artist and art educator working with young trauma survivors. “I wanted to respond to their trauma but couldn’t,” Park says, which compelled her to become a therapist. A practicing Buddhist, she took a Dharma class that happened to be taught by therapists, which solidified her conviction that spirituality had a place in the therapy room. “I loved the depth they brought to the work,” she says. After meeting McCaslin at a training program, she signed on with PSI.

Most of Park’s clients are people of color and immigrants struggling with trauma, often around family of origin experiences, immigration histories, emotional abuse, and domestic violence—problems she says are compounded when systemic racism and oppression impedes their access to inner resources.

Park calls her intervention a “psychospiritual” one: first, she simply holds space for her clients. It’s important to validate their experience when so many do not, she says. Then, she helps them develop a coherent narrative of what’s happening in their lives, often by asking them to tap into their bodies to reclaim their ancestral wisdom. “It doesn’t have to make sense in a cognitive way,” she says, “but it might make sense in your mind and body.”

Park says this kind of spiritual intervention is a breath of fresh air for her clients, who often prefer less Western styles of talk therapy. “They want to talk to someone who takes a more decolonized approach to treatment,” she explains. “Someone who says, ‘Let’s talk about your ancestral or indigenous wisdom.’ To me, that’s very spiritual. And even though spirituality has become marginalized in Western culture, it’s actually a very human experience to long for some understanding of our place in the world.”

At the end of the day, Park adds, all good therapy has a spiritual thread running through it. It’s what attracted her to the profession in the first place. “I never saw therapy as separate from spirituality,” she says. “Being in a room with multiple people every day who are sharing their deepest vulnerabilities and woundings? Walking alongside them and helping them access the wisdom inside them? That’s a deeply spiritual process.”

A Spiritual Homecoming

Every week, PSI’s therapists gather together for a morning meeting, during which they take turns leading the group in a spiritual practice of their choosing, whether a song, a poem, a meditation, or something else. Recently, one of the therapists invited her colleagues to lay down on the nearest soft surface for a breathwork session. Another time, one of the therapists played an Indigo Girls song on his ukelele.

For PSI’s therapists, what they’re doing isn’t just work—“it’s our calling,” as McCaslin likes to say. And it’s gatherings like these that not only sharpen their clinical skills, helping them attune to whatever spiritual glimmers might appear in that day’s sessions, but provide a sense of community, safety, and belonging that, in an increasingly disconnected world, has become something of a rarity.

For McCaslin, Hurst, Gosai, and Park—who’ve traveled their own circuitous, sometimes painful personal, spiritual, and professional journeys, these meetings are also a chance to receive what they offer clients every day: a spiritual refuge.

“I found this work at a time when I was questioning what I was doing in my life,” Park says. “I found my way to it through my own healing, which is still ongoing.”

“We all come from such different modalities, and I love coming together, seeing the different ways we conceptualize things,” Hurst adds. “As a trans person, I usually feel a lot of hesitancy going into spiritually oriented spaces, because I don’t always know what that means for queerness or transness. But at PSI, I feel welcomed.”

“It felt great to come to a place that was so intentional about helping clients access their spiritual parts,” Gosai says, “but also to be in company where I could be really nerdy about the spiritual elements of psychology. Landing here felt like home.”

To all therapists searching for their own sense of home, whether personally or professionally, McCaslin offers an invitation: consider how, in many ways, every good therapist already practices some kind of spiritually informed therapy. After all, at its core, spirituality is an expression of care and connection.

What would it look like if more therapists gave themselves permission to find a spiritual foothold in their own lives, to think outside the clinical box, to ask questions they might not normally ask, and to be a little braver when it comes to topics that may feel unfamiliar? What would it look like if more therapists practiced what they preach?

“We often ask our clients to think bigger, to think broader,” McCaslin says. “Why shouldn’t we do the same?”

The post The Spiritual Therapist appeared first on Psychotherapy Networker.

]]>

Since humankind first walked the earth, we’ve been struggling with how to handle the challenges of life—especially how we cope with its inevitable end. We’ve searched for meaning in death in celestial bodies, in tea leaves and fires, in prophets and oracles. Throughout history—painted on ancient sarcophaguses, etched on crumbling cave walls, inked on long-buried scrolls—navigating grief has been a spiritual endeavor.

How well can therapists leverage spirituality as a healing resource for grieving clients? Do we think of spirituality and religion as outside our scope of clinical practice? What risks should we be aware of as we attune to clients’ religious and spiritual beliefs around death?

There are few therapists better equipped to answer these questions than David Kessler, one of the world’s foremost experts on grief and loss, author of Finding Meaning: The Sixth Stage of Grief, and founder of grief.com, a comprehensive online resource for people navigating grief.

Livia Kent: From your decades of experience as a grief specialist, what role does spirituality or religion play in your healing work?

David Kessler: I’m always surprised by how much we unknowingly comfort people in spiritual terms. I notice it most often when I’m providing support to someone who’s an atheist, and I have to remember, Oh, I can’t say that. In grief work, it’s extremely important to consider a person’s religious beliefs and how they may differ from yours.

LK: Do you ask about their beliefs upfront?

Kessler: Absolutely. I ask people about their religious or spiritual background just like a doctor might ask about a medical background. It helps me know what they might find helpful. I say might because we have to remember that everyone follows their religion in their own ways.

There’s no one Catholicism, no one Judaism, no one Christianity, no one atheism. Your religion or spirituality—which are not the same but intertwined—has been shaped by your parents, your particular clergy’s view, by your community. I can’t say to a client, “Oh, gotcha, you’re a Catholic. Now I know how you’re going to respond to this loss and what to say to you.” I have to approach each client with humility, knowing I’ve never seen their exact religion before, and it’s my job to understand their beliefs so I can help them.

You might assume you already know what someone’s conception of God is, but you don’t. Do they have a watchmaker God, one that wound us up and now just lets it all play out? Or do they have a God that’s giving out rewards and punishments? There are so many different gods.

Many years ago, I was working with the Red Cross and was assigned a Muslim family to support after their loved one died in a plane crash. I thought, I’m the wrong person. I’m clueless about Muslim beliefs. I said to the family, “I’m so sorry about this devastating tragedy, but I have to say upfront, I’m not familiar with your religious beliefs and customs. What do I need to know to help you right now?” And they told me. Sometimes, all we have to do is ask.

LK: Can you give me a few examples of the kinds of questions you might ask a client to help you understand their beliefs so that you can best support them?

Kessler: Do you have spiritual and religious beliefs about the afterlife? What do you think happened to your loved one—not their body, but their soul? If you believe in an afterlife, does your loved one have an awareness of you even after death?

LK: People may say, “My loved one is watching over me and wouldn’t want me to be sad.” But expressing sadness is an important part of the grieving process, right? How do you help clients parse those beliefs without meddling with their religious or spiritual convictions?

Kessler: I’ve worked with many people who believe that if they’d just prayed enough, their loved one wouldn’t have died. Sometimes, it’s hard to remember that it’s not our place to correct or change anyone’s beliefs.

My family’s background is Judaism and evangelical Christianity. When there’s a death, the evangelical side of the family assures everyone else that the person is with Jesus, so there’s no reason to be sad. I might say, “That’s denial! Of course there’s a reason to be sad.” But I’ve come to accept that it’s not my place to dictate any right or wrong response to death.

LK: If someone deeply spiritual comes to psychotherapy to process a death, what’s the role of the psychotherapist?

Kessler: That’s a great question. In the past, I directed some of my clients’ questions to their clergy. But now, I’m much more comfortable helping my clients explore what these questions mean to them. One I hear a lot is, How did God let this happen?

It’s not my job to provide answers, or rush anyone to answer their questions too quickly. People have to find their own answers at their own pace. As therapists, we’re simply a witness to their process. Our job is to allow them to have questions, and allow them to have a human response, which is sometimes different from a spiritual response.

When my son died, two months in, a friend called to check in on me. I said, “I’m so angry. I don’t know what to do.” And she said, “Do you want the spiritual response or the human response?” I said, “I want both, but I want the human first.” And she said, “I’m surprised you’re not breaking furniture.” When I heard that, I was like, Oh, she gets it. I could break furniture with this anger.

After we talked for a while and I felt seen in my anger, she asked, “Are you ready for the spiritual response?” I said, yes. And she said, “Your son can’t die. His body died, but he can’t die.” Hearing that was comforting because I’d felt seen in my human response first. She’d witnessed my pain before jumping to the spiritual comfort.

LK: Do you feel like people who have spiritual or religious beliefs go through the grieving process more smoothly, or faster?

Kessler: I’ll just say this, I feel like my spirituality has helped me move through my own losses. But I don’t think there’s any one group of people who have an easier time than others, regardless of their beliefs. People find meaning in a lot of ways without attributing it to God. That’s the truthful answer that spiritual people may not like hearing.

LK: Is religion ever unhelpful in grief?

Kessler: Well, people might say, “Suicide is a horrible sin, and my loved one is being punished for all eternity because they died by suicide.” After I let clients go through their human experience, I’ll often say, “There are many views about that, even within your own community.” And people can usually find a priest or someone else who will give them a different view of suicide. I don’t give them a different view, but I can wonder with them if there are any other views out there.

The post God, Grief and Therapy appeared first on Psychotherapy Networker.

]]>

If you offer couples therapy, you know that amid the dramatic particulars of whatever crisis motivated a couple to work with you, there are always whispers of universal themes: one person doesn’t feel heard and respected, the other longs to feel appreciated and special, both lament the loss of passion and “the spark we had when we first met.” The urgent, incendiary details of each partner’s latest careless mistake or hurtful statement quickly obscure the bigger picture—the panoramic view of the relationship as a whole. Despite a commitment to help partners build lasting love, it’s easy to get sidetracked and lose your way.

Sara Nasserzadeh, a social psychologist, relationship coach, and author of Love by Design: 6 Ingredients to Build Lifetime of Love, has been fascinated by the question of what makes loving relationships not only survive but thrive since observing her own parents’ marriage as a child. The daughter of a social scientist and social worker who grew up in an intercultural, interfaith household in Tehran, she used to grill them on why they married each other. Her parents’ answers (“It was destiny,” “He was handsome,” “She was beautiful”) only deepened both her curiosity and skepticism about the “official” version of how love works, leaving her with more questions.

When she became a couples therapist, Nasserzadeh found herself in a position to witness hundreds of relationships and explore these questions directly. She teamed up with other researchers and did her own analysis of couples she worked with to develop what she calls The Emergent Love Model. She also created the Relationship Panoramic Inventory (RPI), an increasingly popular, comprehensive psychosocial test that’s been featured on various platforms such as the BBC and CNN.

***

Ryan Howes: How did your interest in quantifying relationships begin?

Sara Nasserzadeh: Throughout my life, I’ve lived and worked in many countries and found that in all of them, people use the term love to refer to lots of different things. They love their dog, and a beautiful autumn evening, and an intimate partner, and their friends, and their job. The word love just seems insufficient to express all its nuanced permeations. I started to ask, What does love even mean? And what is it made of?

Then, I became a therapist and saw many clients who were also confused about love. They came to me asking, “Is this all love is?” Others would say, “I love this person, but I’m not in love with them.” When I’d ask them what they meant by that, how they differentiated love from other forms of connection, many found they were grappling with a desire to experience lust, not love. Some simplified love to mean companionship: “Oh, this person doesn’t hurt me, and we get along.” In my book, I talk about the eight most common relational configurations, one of which is constitutionally bound couples. They don’t have a particularly deep connection with each other, but they’re good at delegating tasks and getting things done. Together, they maintain the marriage and the household, and they make sure the mortgage gets paid.

There’s nothing wrong with any of these models, but what we discovered in our research on love in thriving relationships is that most people are looking for the type of loving relationship that brings them “peace of heart and clarity of mind.” In other words, when you wake up in the morning, you feel fulfilled. There’s a sense of being content. You’re not chasing something more or different.

As part of the research, I went back 10 years in my session notes and focused on couples I saw for at least a year: there were 312 in all. In looking at these cases and applying grounded theory methodology, I saw that some themes kept coming up: mutual respect, shared vision, compatibility, compassion, empathy, and physical attraction. If any of these elements were lacking for a couple, it was a major pain point.

In my mind, I wondered if I’d stumbled on a practical definition for the kind of love we know most people want. But I also worried that defining something so sacred, ambiguous, big, beautiful, and complex as love would take its power away. Well, the researcher in me won out in this debate, and I sought to find out if what I saw with my 312 clients could be generalizable to all couples seeking thriving relationships.

I teamed up with scholar Pejman Azarmina, who’d developed a pyramid of self-awareness scale that encompassed thinking styles, connection styles, and personal values, which are all important in the outcome of any relationship. By combining his scale with the six elements I’d pinpointed through my qualitative research, we developed the relationship panoramic inventory (RPI) to determine what things are going to influence the outcome of a relationship for the better. In the RPI, the fundamentals of a relationship are categorized as mutual physical attraction, shared vision, moral values, connection styles, shared healthy financial attitude, positive thoughts, and emotions and abstract thinking.

We then recruited 159 couples who’d been together an average of 10 years, couples of different races, sexual and relational orientations, and education levels (a sample representative of the U.S. norm). After this diverse cohort took the RPI, we were able to validate its use as an evidence-informed assessment tool. It homed in not only on the areas where a couple needed to develop skills, but also on the areas where they were already strong.

RH: You mention two forms of love, submergent and emergent. What’s the difference?

Nasserzadeh: Our default cultural model is based on what I call the submergent love model, where relationships are characterized by a strong initial attraction, a dopamine rush, and the enmeshment of two individuals. It’s what many of us have come to associate with the ideal romantic relationship, but it’s inherently unstable because it relies on initial points of attraction and feelings that usually fade as two people face reality together and all its pressures. In the emergent love model, on the other hand, you foster an environment that’s conducive to love by cultivating six non-negotiable ingredients: reciprocal compassion, trust, shared vision, mutual loving, respect, and attraction. Although love can never be guaranteed, when these elements are present, there’s a high chance it can emerge. In this case, instant love is not the foundation but the biproduct of a thriving relationship. The RPI evolved in part from these six elements.

RH: You’re covering a lot of bases with these different categories.

Nasserzadeh: Yes, the data was even richer than this, but when we did a factor analysis, we only kept the entities that were statically significant. Many would say, “Well of course financial attitude (for example) has something to do with coupledom!” But when you have it there in black and white with the statistical analysis and the elements that make it a healthy attitude, you can show your couple that if they each increase their healthy financial attitude, even by a little bit, the positive outcome for their relationship will be significantly stronger, and it can have a positive impact on the trust, respect, and quality of loving relationship you build with one another.

The beauty of the inventory is that it highlights key areas impacting couples’ relational well-being. This way, we don’t start therapy blind-sided, waiting to figure things out by the fourth or eight session, or solely depending on the clients opinions about where they’re struggling. We can begin therapy knowing which areas are potentially contributing to the presenting issue. Everyone in the room starts the process equipped with critical information, so we’re no longer shooting in the dark.

RH: How does the RPI differ from other relationship inventories?

Nasserzadeh: There are several other solid inventories out there that collect information on relationships. However, they’re mostly focused on the problem areas and pathologies, and only offer information of the coupledom. The report that you receive from them is very much like history-taking forms. RPI has a sophisticated algorithm. It includes each individual’s attributes and how they show up in relationship to one another, and it compares that with an average couple nationally. This is important to include because it can normalize a couple’s struggles for them. If they know they’re not the only ones in that situation, they feel less alone.

RPI also includes more than 12 individually validated scales, which is not the case with other tools. It’s inclusive of various sexual and relational orientations. And it’s quick to complete, so couples are more likely to take it. Couples can also take the RPI on their own (another difference with other tools out there), and if they both consent, they can receive the report themselves.

RH: It seems like you’re providing a platform for some important and relationship-altering conversations in the therapy room. Would it make sense for clinicians to refer back to their original responses over the course of treatment?

Nasserzadeh: Absolutely. I usually ask couples to take the RPI before their first sessions with me, and then I come up with a treatment plan for them. I might say, “You had a very big fight about your family vacation that prompted you to come to me. However, based on this inventory, I see we need to work on how you’re building respect in your relationship.” This helps us get to the root of some of the tip-of-the-iceberg issues that couples present with. I think it can be helpful to refer back to the inventory regularly, or even to have a couple retake it after a few months as a point of comparison with where they started. Especially at the end of therapy, it can be gratifying for a couple to retake the RPI and see how far they’ve come.

RPI isn’t just helpful for couples. It acts as a guide for couples therapists, reducing their anxiety and helping orient them from one session to the next. They never feel stuck because they always have content to work with in one of the six areas and beyond. They can see what needs to be done to improve a relationship. It’s all right there.

RH: It does sound useful.

Nasserzadeh: Yes. I believe so. The Gottmans and other colleagues before me legitimized our field as a discipline that could be studied, and we’re hoping RPI takes that a step further to make our practices evidence-informed. In many ways, because the inventory directs people’s focus to what’s most important in creating a thriving relationship, it works preventatively, too.

New couples can get swept up in the excitement and intensity of their burgeoning relationship, and the inventory’s focus directs their energy to what will nourish them long-term. I hope the field moves away from crises-based models of couples therapy and toward preventative education, like teaching skills that help create relationship fluency for people before they have major problems.

I believe we should be thinking about couples therapy much like we do our annual medical checkups. With most couples, relationships are always changing. They’re under new forms of stress all the time. Fissures and cracks are always forming in places where we may not think to look for them.

I’ve been married for 24 years, and I know first-hand that if you don’t pay attention to the inevitable cracks that appear in your day-to-day life with a partner, they can become gaping canyons. We take RPI every year on our anniversary to regularly assess the structural integrity of the relationship’s foundation.

Ultimately, I think it’s important for us to remember that couples therapy is not just crisis management. It’s a thorough and proper science that benefits when we can draw on research and make it clear and measurable. Like with the 80/20 rule—where 80% of consequences come from 20% of causes—we can put our effort where it matters!

The post Taking the Blindfold off Couples Therapy appeared first on Psychotherapy Networker.

]]>

A therapist, a client, and a comedian walk into a bar. This might sound like the start of a hilarious joke, but for therapist David Granirer, it’s just another Saturday night. Granirer isn’t any ordinary clinician. As the founder of Stand Up for Mental Health, as well as a skilled comedian, he’s spent the last two decades helping aspiring stand-up comics—many in therapy—not only hone their craft, but alchemize their personal stories about mental health into performances that are empowering, destigmatizing, and often hilarious!

Since creating the program, Granirer has partnered with a range of mental health organizations that connect him with these comics-to-be, singlehandedly training over 700 stand-up comedians and coordinating over 500 shows in more than 50 cities across the United States, Canada, and Australia. Beyond clubs or theaters, they’ve taken their acts to workplaces, boardrooms, college campuses, and even military sites.

When I managed to pin Granirer down for an interview, he was on his way to do a gig for 900 crisis line workers at crisis con, an annual conference in Arizona. Over the next 45 minutes (Granirer promised not to bill me) we talked about his comedy origins, what training comedians and helping clients have in common, and how comedy belongs in the therapy room.

***

Chris Lyford: Blending comedy with mental health is such an interesting concept. Where did this all begin?

David Granirer: Technically, it began when I was a teenager. I’d been a guitar player, and when I developed problems in my wrists and could no longer play, I plunged into a horrific, awful depression that, combined with bipolar disorder, culminated in me attempting suicide. After getting help, I thought, I’ve got to do something constructive with my life, so I started volunteering at the crisis line where my dad and brother had volunteered after my suicide attempt. It turned out I was really good at it, and eventually they hired me as a trainer, and I continued to work there for 10 years.

Before the suicide attempt, I was known as a bit of a class clown. But my depression had caused me to lose my confidence and humor. It was only once I started getting treatment that I tried getting it back. I was in my early 30s, getting trained as a counselor, and my training center was right around the corner from a comedy club called Punchline. So after I’d finish class, I’d walk over and watch amateur hour at the comedy club. After a couple visits, I decided to try it out for myself.

CL: What was that like?

Granirer: To be honest, the first time I did stand-up, I was horrible! I did five minutes, and I completely bombed. There was dead silence afterward. It felt like the longest couple minutes of my life. I thought, I’m never going back! But then I decided to take a comedy course, and the next time I got onstage, I was prepared. I knew what I was doing. The club was packed with my friends and supporters, and it was an amazing experience. That’s when I knew I had to stick with it.

Soon, I began talking about my mental health issues in my routine. But back then, there wasn’t a lot of precedent for talking about mental health in this way, and stand-up became a process of trial and error, where I had to ask myself, Do I feel safe doing this?

I found that not only did I feel safe joking about my mental health onstage, but people would come up to me after shows and say things like, “Oh, I can totally relate to that!” or “I’ve been suicidal” or, “I feel depressed.” I was getting a lot of great feedback, and having some really wonderful conversations.

CL: That’s amazing. So how did Stand Up for Mental Health come about?

Granirer: After a couple years of doing stand-up, I was asked to teach a stand-up comedy course at one of my local community colleges. The course had nothing to do with mental health, but students would often tell me how transformative it was for them for get up and stage and talk about themselves and their problems. It was powerful for them and for the audience. So I had a good feeling that a program like Stand Up for mental Health would be transformative for people.

In 2004, I started putting out some feelers and found a handful of people who were interested in joining. Truthfully, I wasn’t sure how our first show would go, but we got a standing ovation. And so many of the comics told me how incredible they felt about succeeding in something like that. They say that public speaking is the hardest thing in the world. But stand-up comedy is a whole other ballgame. You have to get laughs every 10 or 15 seconds, and they were doing it! They’d all been told things like, “You can’t do this,” or “Be really careful about that,” and they knocked it out of the park.

CL: How do you go about training the comics? What’s that like?

Granirer: The program is a six- or 12-week virtual class, but I also do individual coaching. At the end of the training, I fly in to do a live show with the comics, usually at a theater or club. Of course, participants have to self-select, because it would be incredibly damaging if this was part of some kind of mandated treatment program. You can’t just tell someone, ”Okay, now we’re doing stand-up comedy.” So I teach people who want to do comedy all the nuts and bolts of stand-up: the formulas, tips, and techniques. My guarantee is that I’ll do whatever it takes to help them succeed. If they need time to practice outside of class, no matter how much, I’ll spend that time with them.

I don’t call the students in my course, clients or patients. I call them comics. That’s huge for people who’ve been in the system for a long time. They no longer have to think of themselves a perpetual client. Now, all of a sudden, they’re a comic, and I treat them just like I would any other comic.

I once had a student who told me about a manic episode he’d had five years earlier, where he took off all his clothes at a Walmart and ran around naked. As a counselor, I’m trained to say, “Whoa, that sounds really problematic. Let’s talk about your feelings.” But as a comic, I’m like, “Whoa, that’s hilarious! I can’t wait to see that in your act!” And suddenly, there’s a cognitive shift. All of that horrible stuff you’ve been through just becomes great material. Now, you can talk about all that stuff you’ve been hiding—and it changes the way it sits in your soul.

CL: In a way, it sounds like something you might do in therapy. You’re reframing.

Granirer: There’s something very therapeutic about it. In therapy, you get to tell your stories to another person and be witnessed. In this program, you get to tell your stories to a room full of people, and afterward they’ll applaud you and come up to you and say, “Wow, that was great!” And you begin to think, Huh, I’m not such a bad persona after all! People can really relate to me!

It’s also worth noting that these comics are great role models, and this kind of comedy is really empowering for our audience. It gives people courage and empowers them to talk about their own mental health.

CL: I’m itching to hear some of their jokes! What are some favorites you’ve heard over the years?

Granirer: One of our recent comics had this great joke. He said, “I’ve been in and out of psych wards all my life, and my dad told me, ‘In order to do great things, you have to be committed!’”

I also have some of my own that I really like. One of my favorites is this: I’ve found this great new drug for overcoming depression. It’s called winning the lottery! But seriously, I think the government should get a group of depressed people together and give them each a million dollars and see what it does for their mood. In the interest of science, I’m offering to go first. But with my luck, I’ll wind up in the placebo group!

I have another: So many people are afraid to use the word suicide. I once had a friend say to me, “But David, if I use that word, It’ll give you ideas!” And I said “Listen, man. I’ve used the words mow the lawn with my son every day for the last eight years, and it never gave him any ideas.”

One more: Sometimes my wife and I like to role-play to spice things up. One night she said, “David, who do you want me to be?” I told her, “A client who doesn’t speak!” And she said, “Nice try. I’ll be a client who doesn’t pay. But really, who do you want me to be?” So I told her, “I want you to be my psychiatrist. Ohhh, cancel my session! Up my Zoloft! I’ve been a baaaad boy, tell me I’m noncompliant!”

Lyford: I love it! What’s the audience reaction like?

Granirer: When people come to see us, they know what they’re getting. Many of our audience members have mental health issues and addictions—and they’ll often bring their families and friends, or their therapists, or their psychiatrists.

And since our audience knows what we do and wants to hear what we have to say, the reaction is incredibly positive. We get a ton of laughs. I think the best compliment I ever heard from an audience member was, “Hey, that guy with schizophrenia was hilarious!” I love that. How often do you hear schizophrenia and hilarious in the same sentence?

These kinds of reactions are an incredible confidence-booster for the comics, too. Getting applause and laughs and people coming up afterward to say how great they were—it really lessens the internal stigma they’ve had about their conditions.

Lyford: I’d imagine doing this has been transformative for you too, professionally and personally.

Granirer: I love the process of making people into stars. I love watching someone come into the class and start off really scared, thinking they’re going to fail, and then a couple weeks later getting onstage and killing it. So in a sense, I guess it’s like being a therapist! You see your clients go on to all sorts of amazing things. It’s been incredibly rewarding to watch them grow.

More personally, doing this has given me a real sense of freedom. When I started out, I had a lot of internalized stigma, too. I used to feel really embarrassed about my suicide attempt, and now I talk about it in my act.

Lyford: I’m sure a lot of clinicians will be curious about bringing humor into their therapy sessions. Can it be done?

Granirer: Definitely! It needs to be done respectfully, of course. It’s less about telling jokes and more about helping the client use their sense of humor, helping them find the comedic moments in their own life. Sometimes a client will say something like, “There’s a part of me that’s really negative,” and I’ll ask, “If that part of you was a cartoon character, what would that cartoon character look like?” At that point it starts to become absurd, and I think absurdity is the key to a lot of great humor.

***

For more information about Granirer’s work and Stand Up for Mental Health, visit standupformentalhealth.com.

The post The Funny Therapist appeared first on Psychotherapy Networker.

]]>

Clients often share ideas in session that can sound misguided, even outlandish. This has been particularly true over the past few years, with the rise of climate-change deniers, flat earthers, and conspiracists who believe Taylor Swift and the NFL are in cahoots to reelect a Democrat to the presidency.

Many therapists have been taught not to challenge these kinds of beliefs and simply view them as the client’s subjective truth. But what happens when these “truths” are so onerous to others that they result in rejection and isolation? Can espousing an unpopular or divisive idea become not just problematic for clients’ relationships, but worthy of an intervention?

Dan Ariely is a professor at Duke University, a behavioral economist, and the author of the bestselling books Predictably Irrational, The (Honest) Truth About Dishonesty, and the recently released Misbelief: What Makes Rational People Believe Irrational Things.

Recognizable by his half-beard—the result of suffering traumatic burns over 70 percent of his body when he was 18 years old—he’s the inspiration for the NBC series The Irrational, about a crime-solving behavioral scientist and burn survivor.

Ryan Howes: How can we really know when a client’s beliefs about society are harming them? And what can we do about it?

Dan Ariely: I think the key is to discern whether their beliefs separate them from society. Are their beliefs making them more isolated? Obviously, the more entrenched their beliefs, the tougher it will be to help these people, but as a social scientist interested in behavioral change, I think it’s the therapist’s obligation to try to help them avoid the funnel of misbelief—because going down the funnel of misbelief is bad for them and bad for society.

RH: How do we as therapists know if it’s a belief that’s simply different from our own, or a true misbelief?

Ariely: A misbelief has two components. It’s both a belief in something that isn’t so, and it’s a perspective on life. The perspective on life is probably more important for therapists because it becomes a lens through which your clients may view everything else.

You can say, “My client believes the earth is flat. What’s the harm in that? They’re not going to change the curvature of the earth by thinking it.” But that’s usually not all they’re thinking. Somebody who believes the earth is flat also believes that NASA and the government are lying to them, and every pilot knows the truth. Their perspective is, “There are lots of people in on this lie, and for some reason they’re hiding it from us.”

With misbelief, the lens that people adopt has the potential to worsen and expand over time, like a funnel where one belief is an entry-point that gets wider and encompasses more. If you wake up in the morning thinking someone’s out there waiting to get you, then everything you see that’s not perfect seems like it’s for that reason.

The origin of this funnel of misbelief, which can attack our entire psychology, is stress. If we have high resilience to stress, we’re able to manage more of it. But when we’re thoroughly stressed, we seek a story to explain what’s going on, and it’s even better if the story has a villain. As our resilience goes down—and society now has low resilience, since social media has substituted casual friendship for deep friendship and there’s more economic inequality—we’ll see a bigger breeding ground for misbeliefs.

RH: How does “the illusion of explanatory depth” contribute to a misbelief funnel?

Ariely: In most cases, our confidence in our knowledge of things is much higher than our real knowledge. Take the example of a flush toilet. Do you understand how one works? Most people will say yes. If I ask, “How well do you understand it on a scale from one to 10?” Most will say, “Nine and a half.” But then if I say, “Great, here are all the pieces for a perfectly new flush toilet, please build it.” Nobody can build it. How well do you understand a flush toilet now? Not so much is usually the answer.

But how do we usually try to convince people they don’t know as much as they think they do? Usually, we argue with them. Maybe you talk and the other person talks, each for half an hour. What do you do in the time that you don’t talk? You want to say that you listen, but we all counterargue in our head. At the end of an hour, we’ve talked for half an hour defending our position, and then talked in our heads for the other half-hour, still defending our position. Our record of convincing people of anything this way is just not good. Ask arguers, “How many people have you truly convinced in the last three years?” They’ll say, “Nobody.” “How many times were you convinced?” “Not once.”

What can therapists do differently? They could say, “Help me understand your perspective better. How exactly are the elections stolen? How are elections actually tallied? How would a chip fit in a needle? Help me understand your view.” Then a client might say, “You know what? I don’t really know.” The challenge, of course, is none of us likes ambiguity. But embracing it is important.

RH: Are there warning signs we should look out for? Can we predict who’ll be most susceptible to a funnel of misbelief?

Ariely: One factor is personality: narcissists in particular have a higher level of stress when they don’t get positive reinforcement, and therefore they have extra motivation to find a story with a villain in order to deal with it. The social part is interesting, too. Research shows that when people feel ostracized, everything good about humanity goes away in their eyes. And once you feel ostracized, how are you going to react? You’ll look for new people who believe what you believe. When you find them, you’ll feel connected, and maybe want to make a name for yourself, so you’ll start saying more extreme things.

Another social component we refer to comes from the Hebrew Bible, which tells the story of two warring tribes, the Gileadites and the Ephraimites. Around 1370 BC, the two tribes fought a war, and the Gileadites prevailed. As the Ephraimites fled, the Gildeadites set up checkpoints along the Jordan River. If they didn’t know which tribe someone was from, they’d ask, “Hey, what do you call this plant?” Then they’d hold up the ear of a grain plant, which the Gildeadites pronounced shi-bboleth and the Ephraimites pronounced si-bboleth. If the stranger said shibboleth, everything was fine. If not, they were slain.

Did anyone really care about the name of the plant? No. They cared about your identity. So now we use the term shibboleth to describe a discussion that looks like it’s about the facts but is really about identity. Now ask yourself how much of the political conversation is really shibboleth.

The last big component is cognitive dissonance. The moment people invest a lot in their community, in posting things, in doing their own research, it’s very hard for them to admit that they’re wrong.

RH: In therapy, if someone says, “My father abused me when I was a child,” we don’t start an investigation to figure out if that actually happened. We take them at their word. We might say, “What did this mean to you, and what can we do about it?” But now we have clients coming in saying, “The sky is green,” and we’re being put in a different predicament.

Ariely: My guess is that if people shared difficult memories from childhood, it wouldn’t separate them too much from the rest of society. But if they believe in QAnon, the odds that their friends will stop inviting them out will increase. It’s more than just a subjective experience or difference of opinion: it’s isolating.

That people don’t talk about politics at work is a real shame, because it robs us of the opportunity to see how we can still respect and interact with people who might have different opinions than us. Imagine saying, “Here’s Ryan, a smart guy who believes the opposite of me, but whom I respect. We’re working together, and I need to be understanding about the fact that he has opinions very different from mine.” That would be very healthy. The less we have the opportunity to meet people with different opinions from us, whom we also respect, the more we end up in the isolation of misbeliefs.

Today I talked to a covid denier, who thinks I’m one of the worst people in the world. She’s viewing things through her social media feed, and everybody who doesn’t believe what she does has been erased from her life. I, in contrast, wish we could find common ground.

RH: I’m sitting here thinking that if stress causes people to seek order and a villain, maybe the converse is true: a lack of stress might increase a tolerance for ambiguity. If that’s the case, maybe therapists can play a role in reducing people’s susceptibility to a funnel of misbelief, without having to delve into the details of their misbeliefs.

Ariely: I think all therapy should have a component of increasing resilience, and that means increasing friendships, and it means more loving relationships.

The post Beliefs and Misbeliefs appeared first on Psychotherapy Networker.

]]>

Making friends isn’t easy. But amid unprecedented levels of anxiety, depression, and trauma, and in the middle of what the Department of Health and Human Services recently dubbed “an epidemic of loneliness and isolation,” it’s become a whole lot harder, especially for one population—young men. According to a recent study from PBS News, 20 percent of single men say they don’t have any close friends, and more than half of all men say they feel unsatisfied with the size of their friend groups.

Luckily, many therapists are aware of the problem, and some have even turned to unusual, innovative ways of tackling it. Licensed clinical professional counselor Kevin Lanham has been working with young men for almost a decade, particularly those he says often retreat into computer and video games. A self-proclaimed gamer himself, Lanham has been using his love of gaming to find common ground with these clients, and as an entrée to exploring the quality of their friendships and how they might be improved.

I sat down with Lanham to pick his brain about the state of men’s friendships, his unique approach to working with young men, and his best piece of advice for therapists looking to connect with clients in new, fun ways.

****

Chris Lyford: Recently, there have been a number of reports claiming men are in the middle of a “friendship crisis.” Do you agree with that assessment?

Kevin Lanham: In my practice, I definitely get the sense that men are struggling to make and maintain friendships. Lots of them come to me with symptoms of a lack of meaningful bonds. This might look like dissatisfaction at work, difficulties in romantic relationships, anxiety, depression, or low self-worth. When I ask these men who they spend time with outside of work and family, many don’t have an answer. And when we delve into that, I hear their grief around having had friendships in their earlier years and losing them, or shame around having difficulty connecting with other men.

I’m concerned about this global deprioritization of friendships happening early on in boys’ lives, because I believe that the state of our friendships corresponds with how we live our lives. We tell kids that they go to school to learn, not to make friends. But what about after graduation? Do we think about whether there are going to be people around us to connect with? Most young men feel like they can’t even ask this question; so much of the focus is on getting a job or making money or finding a romantic partner, not where we can find friends.

CL: Are you noticing any generational differences in how men are thinking about friendship?

Lanham: Although most of the men I see are on the younger side, I do work with some who are 50 and older. My older clients say their friendship problems have gotten worse over time. But some have gotten used to not having friends, and I find myself educating them about the importance of friendship in later life. My younger clients, however, are watching their friends fall away in real time, during the transitions from high school to college, and from college to the working world. Many of them understand how important friendship is but struggle to deepen their connections, both in person and online.

CL: That brings me to one of your specialties: working with gamers. How’d you get interested in that?

Lanham: In college, I got really interested in group dynamics and online video gaming communities. But in graduate school, none of my classes were talking about online communities. When I told other therapists I had an interest in working with young male gamers, I kept bumping into the stereotype that young men are difficult to work with, or don’t have much to talk about, or much access to their emotions. But when I began work as a therapist, I found the opposite to be true—when I asked the right questions. When my male clients mentioned a video game they’d been playing, I didn’t just ask, “Well how long do you play, and how do we get you to stop?” I’d ask, “What do you play? Who do you play with? What do you get out of it?”

The more we explored this topic, the more I found that a lot of them were gaming for the same reasons people do any activity they enjoy: they liked gaining a sense of mastery over something. Or if they were struggling with some problem in their life, it helped them gain a sense of control over their emotions. But that wasn’t all I found: a lot of the guys I worked with also told me that games were a source of connection—but also that they were also struggling to move from an activity-based connection to a deeper level of communication, perhaps in real life. That’s where therapy comes in.

CL: So what’s your process? What sorts of questions do you ask clients to help them explore and deepen those connections?

Lanham: I start with open-ended questions like, “How do you spend your time online?” Then I’ll ask, “Who are some of the people you usually play with? Did you meet them online, or did you meet somewhere else and then start playing online?” I ask questions like, “What are you passionate about?”

These are basic questions, but they’re important ones that many therapists overlook. A couple years ago, I was working with a college student who’d supposedly been suffering from insomnia. He’d been to a bunch of sleep specialists and had been put on medication. I learned that when he was up late, he’d play video games. When I asked him what he’d been playing, he told me he’d been playing Final Fantasy XIV, which is this massive multiplayer online game that was huge in Japan. He told me he was also part of a Japanese gaming guild. See where this is going? When he was up at night, he was on Japanese time! It wasn’t that he couldn’t fall asleep; being awake meant he could play with his guild buddies. That discovery totally shifted the treatment. He didn’t need sleep medication; he needed help finding other ways of connecting that didn’t have negative consequences.

CL: It sounds like many young men, though—gamers included—do struggle to make and maintain friendships. What recommendations do you give them?

Lanham: Well, I don’t usually rush into looking for a solution. That’s something I tell the therapists I supervise: before taking a solution-focused approach, just remember how meaningful the therapeutic relationship can be. For your clients, especially those struggling to make friends, feeling a bond with you can provide the kind of experiential learning that gives them the confidence to try to connect with people outside of therapy. So I start by just being curious and trying to connect with them. I find that if you begin by recommending solutions, they don’t really stick, whereas creating a connection with the client can be healing right away.

CL: In my own life, I’ve found it difficult to make friends outside of settings like college and work. I’ve also had some important friendships fall away over the years as our paths diverged. Does that sound familiar?

Lanham: I think those are really common struggles. I was an RA in back in college, and when I left, I felt the loss of this sense of community. I kept thinking, Why aren’t there dorms for adults? It seems kind of silly, but a dorm isn’t just an apartment, it’s a place where there’s a community leader, and events, and opportunities for people to connect.

Regarding friendships falling away, I tell my clients in their 20s and 30s not to start from scratch if they don’t have to. Sometimes our relationships lapse or change, but there are ways to deepen those friendships if we want to. It takes time and effort and consistency, but it can happen. At the same time, the stakes can feel very high when you’re trying to make friends, even as an adult.

I do a lot of parts work, and I believe that inside most of us there’s a five-year-old who’s terrified that he’ll have nobody to play with. Being able to name and acknowledge this part of ourselves is important. It’s not a question of “How do I get 35-year-old me to go to the local game store?” It’s “How do I encourage a five-year-old to go back to the playground after nobody played with them yesterday?” We’re too prone to tell ourselves, “Just go. Don’t be a baby,” instead of soothing and connecting with that child part and letting them know they’re loved.

CL: What’s your best advice for therapists working with men struggling with friendship issues?

Lanham: In my experience, many men come to therapy when they’re hungry for relationships but don’t know where to begin. So just keep in mind that modeling friendship through your relationship can make all the difference. That may sound like basic knowledge, but I think it takes a mind-shift for some therapists. Really being interested in your client’s life is different from just wearing your clinical, diagnostic hat. Balancing the two is the art and science of therapy. Clients can feel when someone’s actually interested in them and what they’re talking about. Tap into that spark of interest in your client’s life, because when you do, then they’ll open up more, be more vulnerable, and you’ll have some really amazing conversations.

The post The Video Game Therapist appeared first on Psychotherapy Networker.

]]>

What happened to you? Was there abuse? Did your parents divorce? Did you experience a traumatic loss? Trauma-informed therapists routinely ask these kinds of questions when taking a client’s history. And with a deep shrug, often with an air of shame, some clients may sigh, “No, nothing happened to me.” Baffled about what reason or right they have to feel bad, they feel bad that they feel bad. They don’t realize that nothing is not nothing!

Ruth Cohn, marriage and family therapist and author of Working with the Developmental Trauma of Childhood Neglect, thinks that believing overt or incident trauma is always the cause of distressing symptoms has blinded us to another, equally devastating trauma: childhood neglect. Because nothing is the silent story of missing essential experiences, maybe more trauma-informed therapists should ask, What didn’t happen to you? Or, Who made you feel loved as a child? Who delighted in you? Who sat with you, held you when you were scared? Who talked with you and listened to you when you were lonely?

According to Cohn, neglect is the story of experiencing “too much of nothing,” starting in infancy. This deficit, many attachment researchers believe, can be even more injurious than overt trauma because it often begins early in a child’s development, when they’re most vulnerable and impressionable. Because of the unique ways neglect dysregulates the brain and body, it leaves its mark on all aspects of development and functioning.

As Cohn and I spoke, I found myself thinking about past clients who’ve had nothing much to say about their childhoods yet seemed deadened, as if existing behind a layer of bulletproof glass. How might being neglect-informed have shifted the way I approached them?

Ryan Howes: Why do you believe neglect is so often a neglected issue in therapy?

Ruth Cohn: Although my mission is to change this, as of now, most therapists are not informed or trained to recognize neglect. Since neglect is invisible—essentially, the story of nothing—clients and their therapists often don’t see it. The neglect-informed therapist has to learn to ask questions that will begin to bring to light what did not happen. We can’t wait for clients to bring up what they have no language for, only an emotional or sensory experience of.

An additional factor in this therapist blind spot is that many of us have neglect histories ourselves. Being a therapist is well-suited to the child of neglect because their shield of bulletproof glass is built into the job description. We can have a semblance or an illusion of intimacy while maintaining control and being safe from dependency. It took me quite a while to recognize myself as having been profoundly neglected, since I was much more identified with my dramatic overt-trauma story.

The survivors of neglect I work with almost always start therapy with a signature shrug and the exclamation “Nothing happened to me.” Too many uninformed therapists stop there. But many essential things were supposed to have happened that didn’t. There was too much empty space—no real attachment. This experience of being deeply disconnected gives rise to a pervasive sense of ennui. For all mammals, attachment is a survival need. Isolation is the worst form of punishment. People around the world who operate prisons know this. The neglect survivor may have achieved impressive successes in many areas of their lives, yet they don’t much care. It doesn’t mean anything because the fundamental experiences of attachment are missing. In effect, they’re lost in space, untethered, and deep down they feel like nothing matters.

Often, neglect survivors partner in life with someone who has more overt, visible trauma. The incident-trauma survivor—often the designated “problem child” or identified patient—gets all the blame and all the help while the quiet neglect survivor slips under the radar. They’re “off the hook” but also invisible and unhelped again and again. Therapists can be distracted by dramatic trauma stories or behaviors, which makes it even easier to minimize or dismiss the quiet but essential deficits of neglect. They don’t understand that neglect is a trauma in its own right. It’s not “small t” trauma. It’s serious business.

Over the years, I’ve started to say to clients, “Nothing is not nothing. Nothing is something. And nothing matters.”

Allan Schore’s 1994 Affect Regulation and the Origin of the Self was my first doorway into learning about how an infant’s brain develops in resonance with the mother’s, right hemisphere to right hemisphere. When there’s nobody there—or when the mother is erratic, withdrawn, or simply missing—this absence is not only terrifying but experienced as lethal. And because the infant lacks left-brain development and cognition, it’s unable to make sense of, or remember in any way that can cohere into a narrative, this constellation of very difficult, complicated events and feelings. There’s no language for it, no images, nothing to remember. However, a potent experience of terrifying nothing does get stored in emotional, sensory, and somatic memory, one that’s far too fragmented and difficult to access much less process alone.

Neglected infants develop brains that are hypo-aroused, meaning they’re understimulated. As they grow up, they often have trouble concentrating and getting things done, and they don’t know why. Many neglect survivors enter therapy thinking an attentional issue is “the problem.” Too often—and this is my personal beef with our field—they get slapped with an ADD or ADHD diagnosis and are quickly given an amphetamine prescription. Now we’ve got a whole generation of kids growing up on amphetamine drugs, which creates its own subset of problems.

This isn’t to minimize the reality and seriousness of attentional issues. But they can overshadow and upstage the underlying issue of neglect. Eclipsed by ADD or ADHD, attachment trauma gets missed yet again.

RH: You promote neglect-informed therapy. What are some of the signs of neglect that therapists can look for?

Cohn: There are many, but early on I observed what I’ve come to call the Three P’s of Neglect: passivity, procrastination, and paralysis. The Three P’s are a dead giveaway! These are all glaring expressions of under-arousal. It means you have clients who—in their lives, and mostly in their interpersonal relationships—have great difficulty initiating things, following through with them. Their nervous systems default to freeze or collapse, as opposed to fight or flee, which is often the default for overt trauma survivors. The freeze or collapse response replicates their experience of giving up as an infant: when they cried, nobody came, so why bother? They just collapsed. They froze. Their voice went silent, their spine dropped away into hopelessness. Therapists should look out for that too.

Another sign is the expression of profound interpersonal ambivalence, including about us therapists. They might come in letting us know that “most therapists are useless.” Even if they’ve seen a number of good therapists, humans have never been a reliable resource of help. Why would we be? They can be devaluing and rejecting. But the neglect-informed therapist will see this as a marker and have the resilience and support to receive and tolerate it.

Yet another key marker—and this might be the one that helps many therapists recognize themselves as survivors of neglect—is what I view as ferocious self-reliance, an adamant disavowal of interpersonal need because they see it as the only truly safe way to exist. Often there’s an absence of eye contact, and a distressing heavy sleepiness when sitting with them.

Because I’m rarely bored in my life, if I find myself thinking about what I’m going to make for dinner or the next blog I’m going to write for my website, that’s a sign of a profound disconnection in the therapy room. I’ve learned to see this as the client inviting me into the void or numbness of their world. Rather than feeling guilt or shame about the experience, we must earmark our countertransference as information. Part of becoming neglect-informed is learning how to work with these states.

RH: Is the therapist’s role to provide a corrective emotional experience?

Cohn: That’s our goal, but the neglect-informed therapist must be patient and discreet about this, approaching the client with humility and a willingness to be candid and authentic about what’s happening in the therapeutic relationship. We need to foster our own resilience to do this. We must be scrupulously reliable and ready to own and repair our inevitable missteps and misattunements. Many survivors of neglect were left shivering on street corners in wet bathing suits, waiting to be picked up from swim practice by a parent who “forgot” or “screwed up” somehow, again; or they were left behind at gas stations on family road trips, somehow forgotten. So, yes, we need to offer a corrective emotional experience, but without calling attention to it, because it will probably seem absurd to them, a ridiculous joke.

Progress with these clients may be painstakingly slow, taking years perhaps. As their therapists, we last as long as they let us. I think of this as a “relay event.” We go as far as we’re allowed to and then pass the baton to the next helper.

I’m convinced with all trauma—but particularly with neglect trauma—that talk therapy is necessary but not sufficient. Since the story of nothing lacks a narrative, we need more than words to elicit sensory, emotional, and somatic memories that accompany it. We need other modalities and access routes to draw out the material of a client’s deprivation. My chosen modality is neurofeedback, which may be attractive to someone who’s trying to avoid developing a relationship with their therapist and still do the work. But I make sure neurofeedback doesn’t become a therapeutic “bypass.” It’s an adjunct to the essential interpersonal work. I make it very clear to clients that I don’t do neurofeedback without psychotherapy. It’s a package deal. If you want me, you’ve got to do both.

RH: Sounds like difficult work.

Cohn: Sometimes these clients say things to us that are painful to hear. I’ve been called all sorts of names. The neglect-informed therapist must know and keep working on their own trauma, their own story to catch when they’re triggered, which can easily happen. In order to demonstrate that we’re a safe bet for the delicate experiment of a corrective experience, we must demonstrate again and again that a neglected client’s care will not be compromised or contaminated by our own “stuff.” This is an ongoing challenge for a therapist! And well worth it when we succeed, even a bit.

The post The Hidden Trauma of Childhood Neglect appeared first on Psychotherapy Networker.

]]>

As a field, we’re finally coming around to acknowledging an increasingly undeniable reality: climate change isn’t just an environmental, economic, political, and social justice issue. More and more, it’s surfacing in our clients’ lives as a relational boundary issue.

In other words, whether it’s about rinsing out a plastic bag instead of throwing it away or buying the latest electric car model, differing views on personal, environmental choices can obstruct our most important relationships, particularly when people’s passions are inflamed. How do we help clients navigate these issues?

To explore and understand this question more deeply, we spoke with Nedra Glover Tawwab, a therapist widely known for her expertise on boundaries and relationships. Not only has she written several bestselling books on boundaries, but Time magazine recently named her one of the 100 most influential people in health today. Her thoughts on how to balance advocacy with respect, clinical self-disclosure with a client focus, and being true to environmental values while respecting others’ autonomy may surprise you.

Livia Kent: Do concerns over environmental issues ever come up in your practice?

Nedra Glover Tawwab: Not with my clients, but some of my colleagues have seen it in their practice. That said, I haven’t taken on any new clients in a long time, and I think this may be a newer issue to come up in therapy.

LK: I’m wondering about your thoughts on an issue I heard about the other day. It goes something like this: a client shows up at a family reunion where Cousin Jimmy has brought a 200-pack of bottled water. This client is deeply concerned about single-use plastics; Cousin Jimmy is clearly not. What happens in terms of relational boundaries?

Glover Tawwab: Some of us are more paper-towel conscious; some of us aren’t. Some of us have electric cars; some of us don’t. I happen to compost, and that’s weird to a lot of people. People in relationships will always have differing views on things. It may cause some arguments, and usually requires some uncomfortable conversations and boundary-setting. So if you know that Cousin Jimmy is going to grab Costco’s biggest case of bottled water, you may say, “Hey, this year I’m going to bring some reusable bottles for everyone.”

You’re not trying to change Cousin Jimmy’s mind on anything, and you’re not putting the responsibility of upholding your environmental priorities on him. But you’ll be able to comfortably exist at that reunion, and so will Jimmy.

Sometimes we feel like in order to be in a relationship, we have to get the other person to adopt our perspective, which is also a boundary violation. You have to think like me to be my partner or even my friend. Cousin Jimmy may have some wonderful qualities; plastic usage is not one of them, but you can like him for the other things. When I had my first daughter, I used cloth diapers and I put that responsibility on me and not my partner because it was very important to me and not as important to my partner, who was more willing to just go buy a case of disposable diapers.

I think that’s the hard part. We try to get people to buy into our stuff and when they’re serious about their own perspective, we get upset; we get resentful. But the thing is, they also get to have their boundary. And their boundary might be, I’ll get a case of disposable diapers because I don’t want to wash poopy diapers. So how do we figure out what’s our stuff to own in these interactions as we exist in the world with other people, maybe in an office environment where everybody’s using plastic forks and cups? Do we want to say, “Hey, let’s use silverware and mugs, and wash them in the sink after lunch instead of throwing plastic away.” Therapists are probably open to those kinds of conversations, but in other environments, I can imagine certain people might be like, “I’m not washing dishes at lunch. I’m busy.” So you might have to say, “I’ll wash them because this issue is really important to me.”

LK: I can picture myself as that person, saying, “I’ll wash the dishes at lunch because it’s more important to me than anyone else.” And then I can picture myself standing at the sink, washing everyone’s mugs, seething with resentment and anger. What do I do?

Glover Tawwab: I think it’s important to remind yourself of your values—that these are your values. You’re doing this task because it’s important to you. There are certain things I really care about, and other things I really don’t care about. We can’t have 100 percent participation with every action we decide to take. We can allow ourselves to feel the resentment, but we have to be honest about the fact we can’t make other people think exactly like us. Still, being an example can be powerful. We forget how influential we can be just by being a living example of our values.

LK: A therapist writes in this magazine issue about a client who saw a bunch of Amazon packages in her waiting room and got really angry at her for supporting a company whose business and environmental practices he didn’t agree with. How would you have handled that?

Glover Tawwab: My message to all clients is: I’m here to work with you, not agitate you. So if Amazon packages are an agitation for you, now I know to be conscious of that before you come into this space. I don’t think it’s appropriate or necessary to share our personal views with clients because this space is about them, not us. They don’t need to know why I’m ordering a bunch of things from Amazon instead of buying at a local business. How does my explanation help them in their therapy? Sharing my perspective might make me feel better, but it’s not necessary for them.

I’m from Detroit, and when I moved to Charlotte, North Carolina, Barack Obama had just been elected president. I was working in a rural area, where people would come in and try to agitate me. They’d say mean things about him, and I’d just let them talk. I didn’t have to share my political preference. I understand you saw something on the news, and you feel triggered by this thing. It doesn’t matter what I think about it because this is not my space. This is your space. You can tell me all the terrible things you think about this person. I’m not Barack Obama’s cousin; I’m not going to call him. You get to complain about whatever you want. It’s your time. If you want to talk about how much you hate the color gold while I’m wearing gold earrings, it’s not going to make me like gold any less.

LK: How do you help clients—or yourself—figure out when it’s good to speak up and stand firm versus just be flexible?

Glover Tawwab: Some conversations require more attention and effort than others, so ask, Is this something that needs to be addressed in this moment, or is it something that needs to be tabled? We might feel angry or offended, but is this the time or space to talk about it? Sometimes we don’t think about a boundary as a conversational thing. We think about it as tapping someone on the nose and saying, You can’t have plastic here anymore.

I think we have to get really creative with how we have those conversations sometimes. Just having a lot of cloth towels around may discourage a person from using paper towels more than lecturing them would. So you could gift them some. I sent you a whole bundle of pink reusable towels because you love pink. Merry Christmas.

LK: I wanted to pick your brain about information burnout, or maybe we could call it empathy burnout, when it comes to news about climate-related disasters. Sometimes I find myself ignoring all the articles coming up in my feed about those kinds of things. I should read them. But it feels like too much, and I just have to get through the day. What would you tell a client in a similar situation?

Glover Tawwab: I think you have to assess where you are. Sometimes more information is good for us. We’re learning, we’re spreading the news, we’re advocating. And then there are other times when we find ourselves losing sleep or getting anxious, unable to think or talk about anything else other than the thing. At that point, you have to assess how much information is helping you and how much is harming you—and what you can manage.

LK: Do therapists have a larger civic obligation to move this issue forward in any way?

Glover Tawwab: Yes. And I think you do it by showing people what’s important in your space: plants, reusables, rain barrels, compost bins, whatever. Set up your therapy space in a way that matches your values. You don’t have to talk about it, but clients will see what’s important to you, and perhaps emulate it in some way, or at least get curious about it.

The post Personal Boundaries vs. Environmental Concerns appeared first on Psychotherapy Networker.

]]>

We’re used to hearing accusations fly about who—and what—caused the current climate crisis. It’s the oil, gas, and coal corporations; the live-stock farming and deforestation companies; the powerful, rich, selfish profiteers. The accusations land on consumers, too: if you’re buying environmentally unfriendly products and services, you’re the problem.

Psychiatrist, author, and educator Dan Siegel offers a different perspective. A therapist for over 30 years, he’s the executive director of the Mindsight Institute, founding codirector of the Mindful Awareness Research Center at UCLA, and founding editor of the Norton professional series on interpersonal neurobiology.

Without denying the need to act on environmental issues, or the problems inherent in our global economy, he asserts that our current climate crisis is a mistaken identity problem. What’s harming us isn’t “out there.” It exists in our own minds as the belief that we’re separate individuals, when in fact we’re interconnected with one another and the environment.

I talked to Siegel about how the climate crisis is a result of the human mind—and how we can harness the mind to reverse-engineer it, starting with the way we speak and use language every day to construct our sense of self. We discussed the pivotal role mental health practitioners can play in changing how we experience ourselves from separate individuals to integrated and linked relational beings.

Zach Taylor: There’s a tendency in our field to think of the climate crisis as beyond the scope of our practice as therapists. Is it?

Dan Siegel: Climate crisis is very much a mental health issue. Obviously, the effects of climate change affect mental health. But beyond that, the mind that’s created the climate crisis is unhealthy, and we need to address that. Modern culture has forgotten what Indigenous cultures have always known: prioritizing relationships between people and with nature is essential to living a wise, meaningful life. The contemplative practice of meditation has also taught us that we have to be careful about how the mind constructs the self—because the self is much more than the individual.

In the United States, which has spread its message around the world, the mind has constructed a view of the self as equal to the individual. That’s led to all sorts of problems—racism and social injustice, political polarization and misinformation, people’s addiction to screens, and the climate change problem. If I believe the self is the individual and that’s the absolute truth, then the meaning of life for me will be about getting as much stuff as I can for me and my family without regard for my environment. When you add ingroup and outgroup dynamics to this scenario, then I say, “If you’re not in my ingroup, I’m going to ignore you, or—worse—maybe even kill you.” That’s plural individualism where I believe my group is better than your group.

ZT: How has seeing the self as equal to the individual created the climate crisis?

Siegel: We’ve mistaken our own mental life as the sole source of our identity and ignored the relationality of things. Einstein said this separate self is an optical delusion of our consciousness. A hundred years ago, quantum physicists figured out that we’re more like verbs than static nouns—which was the older, Newtonian view. We’re connected in ways you can’t always see with your eyes, despite the modern mind’s noun-like perception of reality. It sees person A here, person B there, and decides persons A and B are separate.

We in the field of mental health have also been susceptible to this view. So much is about self-realization, self-discovery, self-regulation, self-compassion, self this and self that. In the child development field, I encourage people to avoid the term self-regulation and instead call it inner regulation. In the mindfulness world, rather than self-compassion, you can say inner compassion. I know it sounds dramatic, but I believe this self-equals-individual mistaken identity is the curse of modern times and is unwittingly putting the nail in our collective coffin.

ZT: How do we change this individualistic view?

Siegel: I have this funny word I use whenever I can: MWe—a combination of me and we. MWe implies we don’t have to choose between losing ourselves in other people or just being ourselves alone. MWe lets us have both. That’s the essence of integration: you don’t lose the differentiated nature of either “me” or “we.” It’s more of a fruit salad than a smoothie.

Any mental health practitioner can help clients experience this MWe. When you look at research on how self is constructed, it’s clear that language makes a big difference. If I ask, “What are you going to talk about today, Zach?” it will reinforce your sense of being a separate individual. But if I ask, “What are we discussing today?” it expands identity. It can be as simple as that. We can also use a qualifier in front of the word self, saying “my inner self” instead of just “myself.” That modifier is a reminder that there’s another, relational self.

It’s also important to experience self-expanding emotions like awe, gratitude, and compassion. Recently, when I asked Bessel van der Kolk about the key healing ingredient in a study he’d done on psychedelics, he said it was “an expanded sense of self.” We need to help our clients realize that they are their relationships—with family members, neighbors, friends, and more broadly, all of humanity. When we’re grateful for nature, it’s because we sense we’re part of something larger than our individual self. We can encourage clients to go for walks, appreciate a leaf, look up at the sky. I once asked a wildlife photographer, “What drives you?” He said, “Climate change drives me. If the next generation doesn’t fall in love with nature, they won’t try to save it.”

With every client, we have the opportunity to expand their sense of self in a way that creates an internal shift. Whether people get in touch with awareness itself during meditation, use psychedelics and do the integration work, walk in nature and experience gratitude and awe, they’re doing something similar: going beneath the delusion of separation. I’ve surveyed over 50,000 people after guiding them through a wheel of awareness practice, and one of the most common terms people arrive at when they experience pure awareness is “love.” This feeling of love is the deepest teaching in all the world’s major religions. It’s a word we’re not supposed to use in the mental health world, but how can you ignore it, even from a scientific point of view? Love links us. We need to realize that in some ways, love is the thread the universe is made of.

ZT: How can therapists help people stay connected to that thread, particularly when clients come in anxious because the environment is in a state of collapse?

Siegel: We need to help people move from a threat mind state to a challenge mind state. Climate activists who have the courage to care are burning out, and it’s because they’re seeing the lack of progress when it comes to climate as a threat to existence. But here’s the issue: if the human mind sees something as a threat, it mobilizes the threat reaction: fighting, fleeing, freezing, or fainting—collapsing into helplessness. Those reactions are a recipe for burnout. When we’re reactive, we shrink what we consider the in-group to be. We operate from an insufficiency mindset that’s the opposite of compassion and gratitude.

So instead of crying out, “Oh my God, what’s the latest threat today?” we can say, “What’s the challenge today, and how do I make it my dance partner?” I’m not suggesting we need to be a Pollyanna about this. We’re facing huge challenges. But the great news is that the human mind, because it’s causing these challenges by constructing itself as separate, can change them by experiencing itself as relational and interconnected. I’m optimistic about our ability to turn things around. The bigger question is, will we?

ZT: Not knowing the answer to that question can be discouraging for a lot of people.

Siegel: It can. But we can be part of the answer by confronting climate challenges and improving things now. And while that direction aims for a destination, we can’t get obsessed with the destination. If we do, we’re going to fret that we’re never going to get there. If you fixate on an outcome, whatever you do right now won’t be enough. You’re going to take a fatalistic view, burn out, and say, “This isn’t working.”

We have to do this work together. It’s not a solo job. And we may as well have fun doing it! I once heard somebody ask the Dalai Lama, “What’s wrong with you? You’re laughing and joyful while there’s so much suffering in the world. How can you laugh?” Without missing a beat, he responded, “It’s not in spite of suffering that I laugh and try to be joyful. It’s because of suffering—otherwise suffering will have won.” Having fun while meeting challenges isn’t disrespectful. It’s an antidote to suffering. We need to bring joy to hard moments. We have a responsibility to bring joy, love, and fun into the way we live.

ZT: What practices can help therapists do that?

Siegel: A regular loving-kindness meditation practice can help. When a person connects with an authentic intention like “May I be happy” or “May we be happy,” research shows it spreads around the brain, just like when someone improves their piano playing by imagining themselves doing scales. Humanity needs to make sure we’re shaping our intentions in an extended-self way. And that’s what loving kindness statements do.

ZT: Do you have any advice for therapists navigating this intersection between their work and climate change issues?

Siegel: I want to inspire and empower mental health practitioners. I think we’re going to be the army of people who take up leadership opportunities related to this issue and make a huge impact.

One good thing about this climate issue—if you can imagine anything being good about it—is that it might be the big wake-up call we need to get us out of this nightmare we didn’t even know we were creating. That doesn’t mean it’s easy to make changes, but I can’t think of a better profession than ours to take on these ideas, and to use the skills and methods we’ve learned to invite people to wake up from our delusion of separateness.

ILLUSTRATION © PREMIUM GRAPHICS

The post A Global Case of Mistaken Identity appeared first on Psychotherapy Networker.

]]>

These days, deciding on which approaches you want to use with clients can feel a little like selecting from an all-you-can-eat buffet. There’s more to choose from, clinically speaking, than ever before: brainspotting, havening, tapping, emotional freedom technique, polyvagal-informed techniques, and many other therapies that focus on working directly with the body to release emotional blocks and help clients shift into relaxed, receptive states. Though rarely stated openly, the implication behind these newer approaches is often what matters most for healing is present-moment experiences in the body. In fact, there’ve long been signs that as a field, we’re trending away from talk therapy as the centerpiece of our work—and in particular, away from techniques and approaches that examine the impact of lingering patterns that developed early in life with caregivers.

Which has led me to wonder: Is our field moving beyond looking back?

According to Vienna Pharaon, a marriage and family therapist and author of the bestselling book The Origins of You: How Breaking Family Patterns Can Liberate the Way We Live and Love, the only way we can truly help our clients move forward is by looking back—without, of course, getting stuck there! In her writing, social media posts, and popular podcast This Keeps Happening, Pharaon herself embodies the apparent contradictions of looking back to move forward. With nearly a million Instagram followers, she’s unmistakably hitting a nerve with millennials. She’s youthful, hip, and outspoken—not the kind of person many of us imagine when we think of a talk therapist asking about our relationship with our mother—yet she stands behind some of the basic, foundational principles that have shaped our field, especially when it comes to looking at what worked and what didn’t in our families of origin. Recently, she and I connected to discuss the life-changing power of focusing therapy on our childhoods.

Ryan Howes: How did you become interested in family-of-origin work?

Vienna Pharaon: When I started working as a marriage and family therapist, I came in with a strong narrative that my past hadn’t affected me at all, even though my parents had gone through a nine-year divorce process, the longest in the state of New Jersey at the time. I was convinced the divorce hadn’t affected me, but now I know it did. I believe all therapists, whether they know it or not, get into this line of work to resolve what’s unresolved in their lives.

Our family of origin is our first education when it comes to relationships, love, intimacy, communication, and conflict. Even though I was always known as a great listener, and people often came to me for support and advice, I didn’t have a clue what it meant to create and maintain a successful relationship because I hadn’t seen that growing up. So, while I went to grad school to help other people, a part of me was thinking, You get one chance at love, and you need to educate yourself about it.

In the end, leading a client through family-of-origin work necessitates understanding where unresolved things need tending to in your own life. I didn’t know it at the time, but I had a lot of work to do.

RH: Getting people to focus on painful things from their past isn’t an easy task. How do you approach that?

Pharaon: Healing begins with acknowledging that the most painful patterns in our adult lives are connected to the past. I see this pain as something that’s trying to grab our attention. The pain is saying, “Could you turn around and face me? We don’t have to hang out forever, but can we spend some time together so that I can be released, and I can release you?”

At this point in my career, the clients who find me know what my work is about, so I don’t have to convince them to look at the past; however, a lot of them say things like, “I want to operate differently, but every time I have the opportunity, I don’t.” Often, because clients are jumping over pain from the past, they’re unable to make the changes they want to make in the present. Looking at the past can help them make different choices.

RH: How much does grief work factor into family-of-origin work?

Pharaon: Grieving losses and having someone bear witness to that grief is so powerful in moving us forward. It’s hard to heal without witnessing. And, I often say, “When you’re stuck, grieve more.” Part of why therapy can be so effective is because a therapist bears witness to our story. Clients don’t have to go back into their pain, but they need to acknowledge it.

Viktor Frankl says, “Between stimulus and response, there is a pause.” The pause extends itself when we acknowledge and name our wounds, when we spend time witnessing what was taken or lost. In this extended pause, we can move from survival to choice, and that’s how we change patterns. Having choices is deeply healing because we often had no choice in our pain or a trauma we experienced. It just happened; we didn’t have a say in it.

The choice we have is in how we relate to things that don’t change. Clients often say, “If I write my parent or sibling a letter, if I yell at them, if I explain my perspective calmly—basically, if I try every which way to make them understand what I’m saying—maybe I can get them to change.” I help clients shift away from trying to change other people or force other people to acknowledge something they won’t, because those things create a lot of suffering. Instead, I help them ask: “How do I relate to you when I accept that the change I want isn’t going to happen?” Grief will come up around this question, but if we can move through the grief, we have a lot more choice in our relationships—in how we continue them, or not.

Another big shift occurs when we can help clients move from asking “Why won’t they change?” to seeing that people can’t change. What a client wants a parent to address might shatter something so significant within that parent that they just can’t do it. How do we accept this? Painfully.

So the work becomes getting the care, love, and nurturing we need from other places while holding space for sadness and grief. It becomes determining whether we can still have some type of relationship with family members as we accept and understand their limitations. That’s for each person to sit with and answer for themselves. Obviously, if there’s harm in those relationships, a person may have to make tough choices about whether to remain in regular contact. But if we can understand and accept someone’s limitations, we can choose a new way of relating with them.

RH: Are there situations in therapy when exploring a client’s family of origin isn’t beneficial?

Pharaon: I don’t think so, but timing is important. A therapist needs to consider when a client is prepared or ready to go to a certain place—which is part of the art of doing therapy. I’m not going to start a first session saying, “Let’s talk about your father and mother,” but I can’t imagine a situation where the way a person grew up is best left ignored over the course of treatment. Clients sometimes worry about opening Pandora’s box, or they don’t think it’s fair to discuss a family member who’s deceased and can’t respond. But we’re not saying, “Let’s see if we can find the worst thing you’ve never been able to uncover before.” We’re saying, “Let’s acknowledge your past so we can understand your historical landscape.”

RH: Many therapists today are trained in approaches that don’t focus on exploring family-of-origin experiences. What would you like them to know about this work?

Pharaon: Therapists need to find what fits them best, but I don’t know how we can avoid addressing what a person witnessed and experienced growing up. That part feels so important to me. Family-of-origin work opens up the entire landscape of a person’s life and relationships. When you understand where someone comes from, you ultimately understand them in their present day better. Early family dynamics shape us and change the entire trajectory of our lives. Once we get this, who we are today makes a heck of a lot more sense. Most of us understand intuitively that if there’s a lot of reactivity in a therapy session, there’s something historical playing out. But are we willing to explore that intentionally? Family-of-origin work gives us the foundation that the people we’re seeing were built on.

The post Vienna Pharaon on Family-of-Origin Work appeared first on Psychotherapy Networker.

]]>

Sue Johnson—developer of Emotionally Focused Therapy (EFT)—passed away at the end of April after a three-year battle with cancer. A leading force in the field, Sue was also a longtime contributor to Psychotherapy Networker. She was the 2022 recipient of the Networker Lifetime Achievement Award, a dear friend to many on our staff, and a remarkably clever writer, who could inspire deep insights and genuine laughs with her honest, down-to-earth stories.

Whether she was describing a long-suffering couple whose relationship she’d transformed, what she’d learned growing up in Britain as a pub-keeper’s daughter, or how she believed the entire field of psychotherapy needed to shift on its axis, Sue didn’t mince words or shy away from ruffling feathers. She was always uniquely Sue—a powerful presence who was also endlessly curious, constantly evolving, and beloved by many.

But her impact extended far beyond our community and the vast community of therapists she trained worldwide. Sue changed the field—radically and for the better—and in the process, created a ripple effect of healing that continues to transform countless relationships. John Gottman, describing her impact, put it this way: “Before Sue came along, couples therapy was behavioral and cognitive. She succeeded in showing that emotional interaction itself needed to be the substance of our work. Through data and research, she helped build a science of love.”

What follows is a mosaic of what we best remember about Sue through the many articles she contributed to this magazine over the years.

The Origins of EFT

Sue had a way of capturing the comedic aspects of human behavior alongside the tragic interactions that sometimes accompany romantic love. In “Are You There for Me? Understanding the Foundations of Couples Conflict” (September/October 2006), she summed up her first impression of couples work in a way most couples therapists will relate to: “People who seemed perfectly sane and reasonable often become totally unglued with their partners—enraged and aggressive or almost catatonically mute.”

Recalling the genesis of her career, when she first started seeing couples as part of her doctoral program’s clinical placement in the 1980s, she gave a particularly succinct and memorable description of couples acting out: “I remember one woman, who mostly communicated with her husband by screaming at him, sitting in my office and describing in gruesome detail all the horrible things she was going to do to his body as he lay asleep in bed that night.

As usual, he ignored her completely, except to occasionally yell back, ‘You’re absolutely crazy! You belong in a nuthouse!’ Sometimes a wife would sob to her husband, ‘I love you, I love you—you have my heart in your hands.’ Then a minute later, she’d scream, ‘You bastard! I’ll never let you touch me again!’ Partners wept, made outrageous threats, and sat sunk in depression, all the while knowing perfectly well they were destroying their relationships, but unable to help themselves.”

As a beginning couples therapist, unsure of how to help these couples with the techniques many analysts and behaviorists used at the time, she floundered. But she didn’t give up. Rather than growing discouraged, she became fascinated with “the dramatic, intricate, baffling dances” that couples enacted in her office. Where other therapists backed away from the unpredictability of couples work, Sue’s commitment deepened. Her desire to make a difference led her to study tapes of couples’ in vivo interactions, create research studies, decipher the data, and unearth previously hidden emotional truths beneath clients’ out-of-control behaviors.

As she wrote, “I realized what should have been the most obvious truth of all: marriages were primarily about the emotional responsiveness that we call love; about fundamental human attachment. These bonds reflected deep, primal survival needs for secure, intimate connection to irreplaceable others. These needs went from the cradle to the grave. How had we ever decided that adults were somehow self-sufficient?”

EFT—one of the most influential and effective couples treatments, taught in more than 40 countries—evolved out of her fascination with couples, her desire to help them, and her wish to give clinicians a way of supporting couples in forging deep, long-lasting bonds.

Dance as Metaphor

Dance was, for Sue, the quintessential metaphor for connection. Anyone who’s read her bestselling book Hold Me Tight, worked with an EFT therapist, or trained in the EFT model is familiar with phrases like the EFT Tango and the Protest Polka. As a longtime tango student herself, Sue used dance as a metaphor to capture—in a simple, relatable way—complex elements of therapy, communication, and relationships. In “The Dance of Sex” (January/February 2016), she described two different tango partners of hers—one an accomplished dancer, the other not—to illustrate nuances of true connection and attunement.

“With the accomplished partner, I had to match his fancy performance moves, which, while varied and novel, quickly became emotionally predictable. But with the second, far less skilled partner, I never knew what was going to happen next because he was picking up from me as much as I was picking up from him. Any time I started to lose my balance just a little bit, I could feel him right there with me, and we readjusted. There was one move in which I had to step around him while we shaped our bodies together. By then, we’d established our connection and were completely in sync, attuned. It was such a thrill—and this is what gives tango that erotic edge.”

Contrary to the now popular view in our field that excitement and novelty is the answer to long-term couples’ sexual disconnection, Sue insisted that “the way back into eroticism is through more intense connection.”

An Emotion Focus Beyond Couples Work

In “The Best Love Story Ever” (May/June 2019), Sue issued a call to action: “It’s time to use a different story for our own love lives, and for how we frame love for our clients through interventions. This story is called the science of attachment, and it’s a tale of how we struggle with our vulnerability, a tale of trauma and how emotional isolation is poison for a human being. It’s about how we grow into who we are and habitually engage with the world. It’s a great tale: ancient, timeless, bred in the bone, integrating inner self and social interaction. After all, the self is a process, constantly constructed in key interactions with those closest to you.”

Though EFT has always had applications within individual and family therapy, it wasn’t until 2019, when Sue published Attachment Theory in Practice: Emotionally Focused Therapy with Individuals, Couples, and Families, that she formally unveiled Emotionally Focused Individual Therapy (EFIT) as the branch of her model focused on individuals. In 2021, she coauthored A Primer for Emotionally Focused Individual Therapy, with her colleague Leanne Campbell, and the two went on to launch the first EFIT outcome study. “In the last few years, she grew just as passionate and enthralled with individual therapy as she’d been with couples therapy 30 years earlier,” Campbell shared. “Even as her health declined, her presence and intellect remained. She never stopped growing and evolving the model.”

In “An Emotionally Focused Path to Healing Trauma” (September/October 2023), Sue highlighted some of the ways her model has always been ahead of the curve when it comes to trauma, grief, and loss. “EFIT and EFT are particularly well suited to trauma work because trauma is all about emotion: emotion regulation and dysregulation. You might say trauma is an emotional disorder,” she argued. “We’re socially bonding beings, so trauma is always about relationships, and relationships are a key to its cure.”

Irreverence and Humility

Sue’s fiery convictions about the fundamental truths of human attachment were always counterbalanced by her own brand of tender, irreverent humility, which was on full display at a 2018 Symposium storytelling event, when she shared a poignant and unexpectedly funny story about her first client in a residential treatment center: 15-year-old Lee. (This story was later published as “My First Client, My Best Teacher” May/June 2018).

Lee, who was mostly mute, feared he’d die if he swallowed his own saliva, a phobia that kept him running to the bathroom during his sessions with Sue to empty his mouth. She noted, “Despite all my best efforts at empathy, insight, and problem-solving, all I could get in response to my questions and suggestions was his wide-eyed stare.” Eventually, he felt safe enough with her to swallow, but Lee had another issue: a bully people called Bruce the Bulldozer. One day, in a breakthrough moment, as Sue recounts it, Lee stood up in group and announced with gusto that he’d peed in Bruce’s favorite boots. Rather than react with judgement, Sue recognized that her work with Lee was finally paying off.

As she put it, “Defiant urination could definitely be considered the treatment of choice in Lee’s case, because he changed after that. He started to talk to me, albeit in long, stilted sentences. He made a friend in the group. We found him a foster family. That skinny boy with the big eyes taught me how to stay with a client and accept where he is. He also taught me that the magic of therapy isn’t in any flashy technique: it’s in attunement, the belonging that leads to becoming. This togetherness changes both client and therapist!”

Sue always spoke admiringly and lovingly of her father. “I hear his voice in my head,” she said in a recent interview with us. “He always saw me, a little English working-class girl—an uppity English working-class girl, as far as my other relatives were concerned—as competent and worthy and precious. If I hadn’t had that experience of absorbing my own worthiness through him, I probably would’ve been an alcoholic hairdresser in a small English town. He always told me things like, ‘You can be who you want to be,’ and ‘You can deal with things; you’re strong enough.’”

Sue Johnson lived up to—and far exceeded—those predictions. And as we mourn her passing, we hold tight to the knowledge that her vibrant spirit and enormous legacy will live on in our hearts—and in the clinical work that so many of us do every day.

The post Remembering Sue Johnson appeared first on Psychotherapy Networker.

]]>

Relationship expert Tammy Nelson joins our editor in chief for a candid conversation about the use of ketamine in couples work. Tammy goes over the risks and rewards and couples seek to take their relationship to new levels.

Also, read Tammy’s article “Supercharging Couples Work with Ketamine” and check out our May/June issue on psychedelics.

Streamed live on May 2, 2024. Some offers and promotions may not be available.

Watch senior writer and editor Alicia Muñoz and psychotherapist, supervisor, and Internal Family Systems (IFS) Therapy practitioner Carmen Jimenez-Pride, LCSW, in exploring what it means to develop a healthier, friendlier relationship with our parts.

Read Alicia’s article Inviting Your Inner Critic for Coffee.

The FDA Designates Psilocybin-Assisted Psychotherapy as Breakthrough Therapy for Treatment-Resistant Depression. MDMA for PTSD Phase III Trials Show Extraordinary Results. Almost every week, headlines promise that a treatment revolution, ushered in by psychedelics, is around the corner. Indeed, these medicines have much to offer, especially in shifting psychopharmacology from the decades-old approach of alleviating symptoms by dampening the nervous system to a more wholistic approach that enlivens us, shifts our perspective, helps us access painful feelings and memories, and even transforms our sense of self.

But is all this really so new? Or might psychedelics be another, albeit powerful, way of accessing non-ordinary states that we, as therapists, have already been tapping into for decades using other methods?

Since prehistoric times, humans have experimented with fasting, wilderness journeys, chanting, drumming, sweating, dancing, and countless other practices to alter consciousness and awaken new possibilities for healing.

A hundred years before Freud, Franz Anton Mesmer induced trances—non-ordinary states, in which people relaxed defenses and accessed inner worlds—to harness “animal magnetism” and cure conversion disorders. Freud used the same method, by then called hypnosis, and eventually free association and dream interpretation, to induce therapeutic non-ordinary states.

Ordinary states of consciousness are rooted in our individual survival needs—satisfying desires and avoiding pain. They include tendencies to escape discomfort, believe upsetting thoughts, misperceive a changing world as solid, and overidentify with our narratives about ourselves. Whatever the diagnosis or clinical issue, these evolutionarily determined propensities fuel our suffering.

Non-ordinary states can counter these tendencies by shifting our consciousness out of goal-oriented linear thought, opening us to our pain and vulnerability, and connecting us to both our inner life and the world around us—often awakening love, grief, perspective, gratitude, and awe along the way. Psychedelics can dramatically accelerate and intensify such processes, but many therapeutic pathways can lead to these non-ordinary states, including mindfulness practice, bodywork, music, art, neurofeedback, EMDR, IFS, compassion-focused meditation, and even the therapy relationship itself.

Why have we humans turned to non-ordinary states throughout our history? How exactly do these states promote healing? And even if we aren’t planning on incorporating psychedelics into our work, what do we need to know about the psychological processes they reveal?

Aversion vs. Befriending Our Demons

Sadly, we humans didn’t evolve to be happy. We evolved to survive and reproduce—which is why we’re still here, but also why we’re imbued with tendencies that can make our lives miserable. Although it may seem counterintuitive, one of our basic misery-making tendencies is the impulse to move toward pleasure and away from pain. It’s easy to see how gravitating toward food, warmth, and sex would foster survival and reproduction, as would avoiding poisonous snakes and lions. But in the realm of emotions, aversion is a recipe for disaster.

Take alcohol. Upon arriving at a party, where we might encounter people we don’t know—or perhaps worse, people we do know—starting off with a drink can seem like a good idea. But we all know what happens when we routinely rely on substances to avoid painful states. Or consider anxiety. If I get anxious before public speaking or flying on airplanes but speak and fly anyway, I probably don’t have an anxiety disorder—I’m just a nervous guy. But if I avoid public speaking or flying on airplanes to avoid feeling anxious, my life can become pretty constricted.

Even depression involves aversion—shutting down on all feelings to avoid unwanted ones. How so? Consider the difference between sadness and depression. Depression often involves hopelessness, a sense that it will never end, while sadness does not. Depression can feel deadening, as if we’re disconnected from our full inner experience and the outer world, while sadness can feel poignant, alive, connected. When we’re sad at a funeral and someone recalls a funny moment with the deceased, we can tap into joy, love, and appreciation—but not when we’re depressed, cut off from our full range of feelings.

Aversion is also a central component of PTSD. Our minds instinctively block out memories of painful events, but, as one of my clients eloquently put it, “When we bury feelings, we bury them alive.” It’s as though painful memories want to return to consciousness, bringing with them the attendant symptoms of unresolved trauma.

What’s the antidote to the many ways aversion contributes to psychological suffering? By accessing non-ordinary states, we can soften our hard-wired aversion impulse, allowing access to a fuller range of thoughts, feelings, and memories—a central element of virtually all psychological healing. Psychedelics can get us there quickly, while other treatment approaches can do it incrementally. The key is to ask ourselves, “What pain might this symptom be helping my client avoid?”

Even if the symptom itself is distressing, it’s usually functioning to ward off an experience that we imagine would be worse. Jorge, my polite, easygoing, depressed client came to see me because of chronic back pain and GI distress. He’d been a hellion as a kid but became a model citizen in adolescence. Speculating that suppressed anger was contributing to his stress and related symptoms, I asked about it.

“Oh, I never get mad anymore. I try to be a good husband and father,” he said.

“Hmm,” I responded. “So, you never get mad at your wife and kids?”

“Nope,” he replied.

I introduced him to mindfulness, not to relax, but to tune into what was actually happening in his mind and body. He soon noticed waves of tension. A few weeks later, he reported, “You know, I think I’m pissed off more often than I want to admit, but I really don’t want to screw up my adult life like I screwed up my childhood.”

“I get that,” I replied. “But I’m afraid that trying so hard to suppress the anger is now screwing up your back and stomach.”

In sessions, when I sensed aggression bubbling up, I’d ask, “What’s happening in your body right now?” He got better at noticing his anger—and eventually found constructive ways to express it. He also tuned into how ashamed he’d felt as a kid for causing so much trouble. Over time, his symptoms abated, and he realized that trying to avoid his anger was actually more painful than feeling it.

A psychedelic experience might well have thrust Jorge into recognizing his childhood shame and vulnerability around being “bad,” connected him to his fear of anger, and helped him find a way to be more authentic in his family. But in our sessions, we used non-ordinary states of mindful attention to the body and self-compassion to achieve a similar end, albeit in a gentler, more gradual way. And mindfulness practices are just one avenue for helping clients access non-ordinary states of honesty and vulnerability. Parts work, body-oriented therapy, and the intimacy of the therapeutic relationship can all do the same.

The Thinking Disease vs. Metacognitive Awareness

Aversion isn’t the only “ordinary,” survival-related propensity that non-ordinary states can help us overcome. Imagine Lucy, Australopithecus afarensis, likely our great, great, great, great, great, great, great grandmother, living 3-4 million years ago on the African savanna. She was only about a meter tall, without a thick hide. Most scary animals were faster than she was. Her hearing and sight were okay, but her sense of smell was limited—just ask a dog. How did she live long enough to reproduce? What did she do when she came face to face with a lion?

Lucy had a few things going for her. She was a social animal, so she could cooperate with her family and friends. She had a fight-or-flight response for emergencies and a prehensile thumb that would eventually allow her descendants to make tools. But her most impressive asset, the one that set her apart from other creatures, was her capacity to analyze the past to prepare for the future. Unfortunately, this capacity had a built-in negativity bias. Imagine that Lucy spied an ambiguous beige shape behind some bushes. She could think, Shit, it’s a lion!, when in fact it’s just a big beige rock. Or she could think, It’s probably just a big beige rock, when it’s really a lion. The latter thought, while more pleasant, might’ve ended her chances of passing down her DNA. So obviously our ancestors were the ones wandering around the savanna thinking, Shit, looks like a lion!

And this is the state of our thinking today—only worse because we now drink from a firehose of information, doomscrolling through every imaginable misfortune. Psychedelic journeys, concentrated meditative states, and non-ordinary states accessed through bodywork and expressive arts provide a taste of direct moment-to-moment experience outside the thought stream. Even CBT, which once focused primarily on changing our thoughts, now emphasizes developing metacognitive awareness—the realization that thoughts aren’t reality and shift based on changing moods and circumstances.

Take a second to consider something that bothers you. If it weren’t for the thought, would you be in distress at this moment? Even if you’re dealing with physical pain, it’s probably the thought that it will endure that causes the most grief. Metacognitive awareness can help us suffer less and tap into aliveness, peace, and equanimity. Non-ordinary states, especially those arising from psychedelics, can provide a sudden and powerful awareness of the reality that our narratives aren’t trustworthy, but many therapists help clients see this through other means.

People who take psychedelic journeys often return to their ordinary lives saying things like, “I can’t believe I’ve been so caught up in my stories and judgments. What really matters is love.” Tracking changing cognitions from session to session, inquiring about the origins of core beliefs, and seeing how affect follows thought and thought follows affect can also help clients identify less with rigid beliefs, opinions, and interpretations. Like most therapists, I’ve seen plenty of clients awed in session as they realize that beliefs they’ve always considered factual are just one of many possible versions of reality. “Maybe my mother didn’t actually hate me; maybe she loved me in the only way she knew how.” “I always blamed my ex for ending our relationship, but now I can see how my endless criticism helped drive her away.”

Psychedelics can blast us into metacognitive awareness and reveal new perspectives, but other resources can balance our tendency to cling to our beliefs, including meditation, yoga, the arts—anything that takes us out of our thought stream and connects us with our senses, feelings, and intuition.

Reification vs. Embracing Impermanence

Philosophers use the term reification to describe our tendency to see fluid, ever-changing phenomena as fixed or solid. It, too, is one of our brain’s highly adaptive predispositions that make us miserable. Remembering the path to the river, where fruit trees grow, and the time of day when lions saunter past our cave are examples of how the human mind can reify—meaning, see as fixed—the fluid experiences of time, space, and events occurring in our environment. Lucy’s ability to reify her world helped her identify patterns, survive, and reproduce, but in the emotional realm, reification wreaks havoc.

Although our emotional lives are extremely fluid, when we’re anxious or upset about something, we can easily imagine that we’ll never feel better. Can you recall your worry three worries ago? If we and our clients could appreciate the fluidity of consciousness, we’d all probably cope with our inevitable challenges with more grace and be a lot less upset. We’d realize things are rarely as good or as bad as they seem—because our internal emotional experiences and external circumstances are continuously shifting. This is what many people experience on psychedelics. It’s also what many non-ordinary states we evoke in therapy help illuminate, whether through mindfulness, free association, or simply reflecting on reality.

When my 68-year-old client Joelle learned that her husband, Sam, had Alzheimer’s, she spent many sessions processing the shock. “I can’t believe this is happening,” she repeated with tears, anger, and frustration. “There were so many things we wanted to do, and now I have to care for a guy who day by day is less and less like my husband.”

We focused on the pain of losing him, losing her freedom, and especially no longer being seen by him—which echoed childhood wounds. Eventually, we worked to put her grief into a larger perspective. One afternoon, I suggested, “You know, you seem to be ahead of the rest of us. Even though caring for Sam is agonizing, you’re seeing how everything that can be lost will be lost, since everything changes. We’ll all face this reality sooner or later.”

Joelle looked taken aback, and I worried that she’d experienced what I said as an empathic failure. But then she reflected, “It’s true. There’s an important lesson here if I can take it in: nothing lasts.”

Seeing impermanence more clearly can free us from the fear that our emotion of the moment will stay forever and help align our expectations with the reality of change. As a good friend of mine put it in his last year of living with cancer, “Everyone’s very nice, but the weird thing is, they all think I’m the only one who’s going to die.”

Self-Evaluation and Transpersonal Awareness

Of all the evolutionarily adaptive propensities of our brain that cause us misery, the one that has received the least attention in conventional psychotherapy is our tendency to see ourselves as separate from the rest of the world, compare ourselves to others, and feel good or bad about ourselves as a result.

Were you to visit the African savanna today with a naturalist, you’d be shown the same pattern playing out in species after species of social mammals. You’d see a dominant male, surrounded by a reproductively promising harem of females. In the next field, you’d see a group of younger males doing the species-specific equivalent of playing basketball—trying to develop the skills to become dominant themselves. Why all this emphasis on dominance? Why do birds develop pecking orders? Why do some species of crickets organize themselves into dominance hierarchies within minutes of being put in a box? Why do children, by age four, develop transitive dominance hierarchies? Statistically, dominant individuals have a higher likelihood of passing on their DNA. They have access to more resources and can provide more of these to their offspring.

Among modern humans, attempts at establishing dominance don’t necessarily involve growling, chest beating, or genital displays. Rather, they involve symbolic rank-and-class signaling and—particularly relevant to our psychological suffering—how we construct our self-esteem through comparisons with others, which inevitably leads to feelings of inadequacy or desperate attempts to stay on top. If I like to think of myself as intelligent, kind, or creative, I’m imagining that I’m more developed in these areas than others. But no matter how exceptional any of us are, we can never win at this game, for two reasons.

The first is narcissistic recalibration—the fact that we continuously change our yardsticks. Remember how good you felt when you earned your license to practice psychotherapy after years of training and test-taking? Today, did you wake up feeling great about yourself because you’re licensed? Me neither. We habituate to everything, including our accomplishments. The second reason is that what goes up must come down. Even if you’re an Olympic athlete who wins the gold medal, what are your chances of winning it in four years? In eight? Any human endeavor in which there’s a wide gulf between feeling good and bad sets the stage for addiction, so most of us become hooked on things that help us feel better about ourselves, whether our criteria are intelligence, money, creativity, physical attractiveness, athletic ability, popularity, sense of humor, kindness, generosity, or honesty. The list is long and almost always leads to misery.

An alternative is shifting from our usual self-focused preoccupation to experiencing ourselves as part of something larger—a hallmark of the psychedelic experience as well as what’s been called mystical or transpersonal experience. In fact, the Mystical Experience Questionnaire is often used in psychedelic-outcome studies. It was developed by Walter Pahnke, a Harvard psychiatrist working on his doctorate in religion. On Good Friday in 1962, he gathered a group of divinity students to measure the degree to which psilocybin facilitated a mystical experience, which he defined as a sense of internal and external unity, noetic quality (certainty that something is true), sacredness, positive mood, transcendence of time and space, and ineffability (can’t be captured in words). Stronger mystical experiences have been found to correlate with positive clinical outcomes in psychedelic-assisted psychotherapy for a variety of disorders.

Mystical or transpersonal experiences include seeing our conventional sense of separate self as a socially constructed phenomenon, which, when examined carefully, falls apart. It’s the realization that “I” am actually just a small part of a larger ecosystem and universe. This discovery can feel a bit like jumping out of an airplane without a parachute. But when we realize there’s no ground beneath us, it’s not so bad. We simply fall into the next moment of fluid, ever-changing experience, never actually “going splat.” Instead, we begin to break free from self-esteem concerns and preoccupations with our individual comfort and survival.

While psychedelics and intensive meditation practice can powerfully reveal the healing potential of transpersonal awareness, therapists have long helped clients grow in the same direction through other means. This was the case with my client Dan, a divorced accountant in his early 40s, suffering from anxiety, depression, and chronic feelings of inadequacy. He was particularly sensitive to competition with other men and feeling “less than.” After hearing of several incidents in which he was horrified that he looked “like a wuss,” I asked, “What do you feel in your body as you tell me the story right now? Does it remind you of anything?”

He soon connected with a river of memories of being bullied by his older brothers, neighborhood kids, and his father. It brought on a wash of humiliation and a fear that revealing his childhood humiliations would cause me to think less of him. After exploring these memories and feelings for a while he said, “You know, underneath all this masculine-image stuff, I think I just want to be loved.” In subsequent sessions, we talked about how we all worry about our rank in the primate troop, and we all long for love and connection. Then we explored ways he could cultivate that sense of connection outside the therapy room with his kids and girlfriend. As he worked on being more open and vulnerable in those relationships, his concerns about success and prowess diminished.

Helping clients experience connection can be a powerful antidote to preoccupation with self-evaluation. When we’re focused on making a connection, not on making an impression, our sense of inhabiting a separate self can dissolve, leaving us with a warm feeling of relational closeness.

Using IFS or similar parts models offers additional avenues to transpersonal awareness by evoking non-ordinary states where we can access our various inner parts. The more we can embrace our own plurality, the less we can identify with a fixed narrative about “me.” Rather, we can see that we’re made up of noble and not-so-noble elements, in constant flux, like everyone else. As we accept a wider range of our own experiences, we can engage in more honest, intimate connections with others.

Any form of treatment can be enhanced if we address our troublesome innate tendencies to avoid painful feelings and memories, believe in our thoughts about the past and future, cling to illusions of permanence, and get stuck in preoccupation with our stories about ourselves. Psychedelics are particularly powerful tools, but we don’t all necessarily have to get trained in psychedelic-assisted therapy. In fact, if you’re a therapist who helps clients reduce suffering, chances are you’re already accessing non-ordinary states for healing—and can use insights from the psychedelic renaissance to employ these states more effectively, enriching and enlivening your work in the process.

ILLUSTRATION © ALL YOU NEED

The post Do You Need Psychedelics to Access an Altered State? appeared first on Psychotherapy Networker.

]]>

Social change is public. It occurs in the halls of government buildings, in rallies on streets, and on ballots in voting booths. It happens when we talk to neighbors, give speeches, and write passionate social media posts about issues we believe deserve people’s attention. We move society in a new direction when we march, fundraise, and tirelessly disseminate information that will open people’s eyes to deep truths.

Right?

As a therapist, somatics teacher, and political organizer, Prentis Hemphill believes there’s another, seldom acknowledged route to social change: one that exists within a more personal space of listening, feeling, and healing. A “politicized healer”—someone who bridges individual healing work with collective political work—Hemphill believes that to create a just world, we need to do the hard, personal work of embodying the change we want, work that therapists are in a unique position to facilitate.

As a cofounder of The Embodiment Institute, Hemphill has worked with conflict resolution and leadership transitions, on individual and organizational levels, all through the lens of somatic healing. We spoke in the winter of 2023 to better understand this approach to individual and societal transformation.

Ryan Howes: How did you get into the somatics field?

Prentis Hemphill: In my previous experiences with social-change work, I noticed an unspoken undercurrent among us organizers that affected how and what we were able to do. It had to do with the fact that so many of us brought our own trauma histories to the work: our own pain and our own sense of what needed to change in our lives and in the world. Focusing on external work was really important, but not tending to how our history shaped our work and relationships meant we often hurt each other. Then I stumbled into somatics. It answered a lot of questions for me about how our individual lives connect to the broader change we’re seeking.

RH: Somatics seems so private and personal, and social change seems so grand and public. How do the two relate?

Hemphill: How do they not relate? We’re all shaped by the world we live in—the things we struggle with and the resources we have available to us—and in turn, we shape the world right back. That has political implications, if not a political root.

Maybe you have a lot of resources and feel nervous about losing them, or you don’t feel like you belong within the greater population. Either scenario shapes your relationships, your politics, and who you are on a fundamental level. That, to me, is why you can’t separate personal from social change.

Justice isn’t just a question of rights or even resources. It’s also about how we feel as individuals and who’s allowed to feel what—which is so often dictated by our history and by society. Feeling is deeply political to me. Liberating feeling is important for whatever justice project you’re working on.

RH: You’re saying that some of our social constructs limit people’s feelings, and part of therapy is to help liberate people from that?

Hemphill: Yes, I get excited about what’s possible for society if we can do that and help people be in relationship.

RH: On a practical level, how would a therapist do this?

Hemphill: Well, the body guides. The body communicates. Our bodies are constantly responding to what’s happening internally (the stories we keep retelling) and to the external world. When we work through and with the body in its own language, things can be revealed that we might not even know how to access otherwise. Complex feelings can be allowed expression through the body, and therapists can create the kind of environment the body needs for this to happen. Letting the body lead, making it safe enough for someone to feel and listen to their body, is about restoring an essential relationship. Too often we end up treating our bodies as things we have to control, rather than places where we listen. Creating a space where we can listen to the stories in our body is critical. And what we hear often has a collective resonance, historically and generationally.

Many collective experiences influence the individual body, but the individual body can influence the collective. So why can’t we encourage people to do things in their community or in the world that start to address some of the historical residue and pain they experience individually? Why not encourage them to take meaningful action within the scope of what’s possible for them, and to explore what it is to build a sense of power and agency?

RH: “What are you noticing in your body?” is a powerful question for you.

Hemphill: Yeah, because it’s almost like we’ve turned the volume all the way down on our sensations and turned the volume all the way up on everything external. When we can learn to listen to the body, it opens up a whole world of possibility.

RH: Some therapists would argue against the idea of bringing social justice work into the therapy office, saying it’s not our purview and works against therapeutic neutrality. What are your thoughts on that?

Hemphill: I wish that so-called neutrality actually existed, but I don’t think it does. Still, you don’t need to force anything on anyone. You don’t need to force people to take actions they’re not comfortable with or ready for. But if you listen closely to people, you’ll hear that what they’re sometimes trying to address in their individual lives are collective anxieties. Or you’ll hear a sense of powerlessness, frustration, or anger at the way things are being handled in the world.

If we don’t address that, we end up acclimatizing people to present conditions, or inadvertently reinforcing a sense of powerlessness in the world. I believe that part of any healing—individually and collectively—is about restoring our agency in the world, our sense that we can do things that matter, that make a difference. I think it’s a part of healing.

Inside of social-change movements, there’s been a longtime struggle over whether there’s a place for individual healing, for therapeutic work. I get that. I also get therapists’ struggle around the idea that social change can be part of individual healing.

One of the things I tell people on both sides is that it’s important for people to have power in their lives. The first place I experienced power was in my own body, in my own ability to take what’s happening inside of me seriously.

RH: You’re trying to tap into the body as a starting point to empowerment?

Hemphill: When I speak, for instance, I can transmit what I’m saying more clearly if I can be seated in my body, in my feeling, in my honesty and authenticity. That to me is the foundation of power. Once we get to that place, we can build power together as human beings. A lot more is possible that way.

If we’re really talking about power and agency, it has to be felt. It’s not a concept: it’s a feeling, and feeling in the body always has nuance to it. I’m not sure therapists are always open to seeing that nuance. Because we’re all rooted in our own centers and in our own feelings, we’re not always able to open up the breadth of feeling that can exist within our clients. I think this moment is calling on us to live a little bit more in that spaciousness and make ourselves less susceptible to reactionary narrowing, which is limiting. I want more for us.

RH: As a practitioner, do you face times when somatic work isn’t necessarily a good idea? I’ve heard people say things like, “If someone’s dealing with panic attacks, getting in touch with the body might just amplify things.” Has that been your experience?

Hemphill: I understand that caution, but the body is the center of everything for me. Even when feeling is activating, I believe the body is still the resource someone needs in that moment. It may not be their own body; they may need another body for grounding, or even to contact the body of the earth. But whether you can access deeper feeling in the moment, any change that takes place in what’s happening inside of you is a bodily, physiological change.

We have many ways to go about creating that change, but even with the best talk therapy I’ve ever done, when something shifts, I take a deep breath, I shudder, I let something go. We don’t pay attention to that necessarily. Ultimately, the most effective therapists are always operating physiologically, always helping something shift in the body. To me, that’s what it means to center the body in healing work.

The post Prentis Hemphill: Personal Healing Meets Social Change appeared first on Psychotherapy Networker.

]]>

Streamed live on April 18, 2024. Some offers and promotions may not be available.

“How far is friendship really from that special type of trust, intimacy, and closeness with clients that we call, rather dryly, the therapeutic relationship?”

Watch Networker senior writer and editor Alicia Muñoz, LPC, and Linda Carroll, LMFT, discuss the desire for closeness and friendship with clients, navigating uncertainty, and the importance of boundaries in a therapeutic relationship.

Alicia’s latest article “I Want to Be My Clients Friend: A Taboo Longing in the Therapy Room” expands on her own desires for friendship, uncertainty, saying goodbye, and more.

Watch this clip with Mark Greene, the founder of Remaking Manhood, Senior Editor for The Good Men Project, and author of The Little #MeToo Book for Men. Greene talks with Networker senior editor Chris Lyford about the state of men and the male “friendship recession,” as well as Lyford’s article in the March issue titled “In Search of the Great Male Friend: One Man’s Quest for Intimacy.” 

If someone asked you how important your voice is in your therapy sessions with clients, what would you say? Maybe you’d answer, “My presence is important, not my voice.” Or maybe you’d say, “I focus on my client and what they’re saying, not on what I’m saying or how I’m saying it.” Or maybe you’d respond, “My voice conveys my authority in the room, so in that sense, it’s important, but otherwise, it’s mostly a neutral tool I use to convey ideas and guide my client.”

Before reading the bestselling book Permission to Speak: How to Change What Power Sounds Like, Starting with You, by Samara Bay, a Los Angeles-based speech coach, I’d have said many, if not all of those things. But now, I’m looking at my voice in an entirely different way. Do I have a therapy voice? Why or why not? How does the tone of my voice convey the empathy, concern, education, or gentle authority I use in the therapy room? And what is my voice saying about me as a person, about my life experience, my values, my identity?

Although Bay works with everyone from Hollywood celebrities to high schoolers on embodying their true, authentic voice, she’s not your run-of-the-mill public speaking coach who’s solely interested in helping people go viral on YouTube, win an election, sell their ideas to a group of wealthy entrepreneurs, or land a coveted role in the next Guardians of the Galaxy movie. Her motivations are deeper and broader than that.

Bay wants us all to challenge traditional ideas about what a powerful voice sounds like. She believes our verbal power doesn’t necessarily come from emulating the deep, serious, masculine voices of many of today’s leaders. Instead, our true power arises from speaking to others from our authentic core about what matters to us. Since therapists are in the business of helping clients access authenticity, healing, and a sense of empowerment, maybe it’s time we reconsidered the importance of our voices and how we use them in the consultation room.

Ryan Howes: You often tell the story of losing your voice at age 24. Why was that so significant for you?

Samara Bay: I was in a graduate acting program, talking all day as one might expect, and over many months, it became too painful to speak. I didn’t know why. I wasn’t sick. I didn’t have any other symptoms. My voice was just gone. I’d try to push through in the mornings by communicating minimally with people, but by evening, the pain of speaking would force me into silence.

Finally, a doctor diagnosed me with vocal nodules, which are small blisters on the vocal cords. I had to go on vocal rest for a few months and seek out a speech pathologist to help me relearn how to talk. It turns out I’d picked up a habit of speaking below my body’s “optimum pitch.” This led me to consider—why? Permission to Speak came out of that inquiry. The answer took years to unpack, but the gist of it is that we all get messages from our culture about how we’re “supposed” to sound if we want to be taken seriously. One message is, “Talk low if you want to be powerful.”

RH: Some people may not feel like they have the freedom to even have a voice.

Bay: Precisely. I talk about a man who overheard me telling a cashier that I was working on a book called Permission to Speak, and he said, “Permission to speak? That’s not something I’ve ever asked for.” He had enough privilege that he never needed permission. But even that guy—who clearly isn’t approaching speaking the same way most women, people of color, somebody queer or with an immigrant story might—probably still has some drama around his voice. There’s an awareness in our bones for many of us that we don’t “talk right.” Many of us feel uncomfortable and insecure about showing up and being seen when we talk. Every human can relate to this on some level.

RH: So you’re saying I might believe I need to sound similar to powerful people around me if I want to be heard, right?

Bay: Yes, but those standards are invisible. We need to make them visible, so we can look at them. What are those standards? Where do they come from? How many thousands of years old are they? Who says that if you want to get taken seriously, you must speak in a low-pitched, unemotional voice, avoid singsong intonations, and come across as firm and confident? Maybe that’s bullshit.

If you google “How do I sound more authoritative?” you’ll find stuff like, slow down, avoid smiling, lower your voice. It’s like, ugh! This is why many of us, including men who fear that they don’t come across as alpha enough, are afraid they’re doing it wrong. The definition we have for good public speaking is too narrow. I offer many examples of people who speak differently and get taken seriously. There’s a growing body of evidence that the sound of power is changing. We need to know this so we can free ourselves from old, constraining standards.

RH: Is there any example that comes to mind?

Bay: Jane Goodall is one. I grew up in a science-focused household, and when I saw her in an old TED Talk, I was really struck by her voice and speaking style. She wasn’t presenting as a scientist with a detached, clinical demeanor—qualities often associated with credibility. I thought, There’s something brave, mischievous, delightful, and instructive about how she’s speaking. It felt like a deliberate choice. This choice is a way we can spend the currency of our power and privilege once we have it. She’s Jane Goodall, she’s on the TED stage, sure, but she’s also choosing to speak in her own voice.

What power or privilege do each of us have in our own lives right now to ask, “Am I allowed to show up more emotionally connected, with more softness, more mischievousness?” For some people, the answer will feel like, “No, my institution is too clinical,” or “No, I’m too low on the ladder,” or “No, I literally don’t feel safe showing up as me.”

Our voices reflect the life we’ve lived and whatever has influenced us. Those influences include where we grew up and how our parents sounded, but also whatever criticisms we absorbed. We sound like the choices we’ve made, and the ones made for us. Getting curious about our voice is the first step. What speech habits did you pick up to get by that helped you hide or maybe sound intimidating? Linguists will say, every vocal habit we’ve picked up, we’ve picked up for a reason. It worked at some point. So in exploring our answers, let’s love on the ways that we’ve been resilient, rather than shame ourselves for the habits we picked up that don’t serve us anymore.

RH: Therapists often talk about how shame impacts a client’s tone of voice, making it sound like they’re trying to hide while speaking. Your message seems to be about trying to bust some of that shame.

Bay: It is. That’s literally the whole thing. We can talk about voices all day long, but I don’t actually care about the sound coming out of your mouth, I care about your relationship to it.

You might wonder, How do I come across in a room? How am I perceived? Do I feel like I deserve to be in that room? If I tell myself, “I’m going to talk wrong,” my relationship to my voice will be evident in things like how often I say um and uh, lose my words, come across as inarticulate, hold my breath, sound too high-pitched, or too aggressive. Too this, too that. We know from the nervous system that the human body can either connect or protect. It can’t really do both at the same time. So how do we move out of protection mode and into connection mode when we talk about what matters to us in front of a lot of people? Or even in front of one client?

RH: When I hear my own recorded voice, I wonder, Am really that nasally?!

Bay: Almost everyone has to face the anatomical reality that they sound different to themselves on the inside than they do on the outside. What’s important is that we then ask, “Okay, yes, I sound different, but is the story of me that’s coming across to people different than I think it is?” Here’s where we tend to tell ourselves, “God, I sound stupid.” We foist cultural standards we’ve absorbed from other people—otherwise known as biases—onto ourselves. We have voice biases like “I prefer a low-pitched, masculine, standard American voice.” If that’s our bias, we conclude, “I don’t sound right,” and dismiss ourselves before anyone else can.

It helps to question our biases. Are they true? Are we trying to sound like someone else? It can be helpful to collect for ourselves a list of people we notice, like Jane Goodall, who make us think, Oh, I like how she shows up. They offer us a new narrative. It’s not, Okay, well, now I want to show up like Jane. It’s Oh, there’s a new possibility here, a new way to be in public, to pitch my idea, to be more human, to focus on connecting and what I care about. This is what I call caring out loud, rather than hiding the fact that we care, or pretending we care when we actually don’t.

Caring out loud inspires a sense of trustworthiness in your listener or your audience. Are you showing your humanity? The thing that’s so cool about our voices is that they simply reveal how willing we are to show up as a person. Or they reveal that we’re not willing to show up.

RH: In the therapy world, people sometimes develop a “therapist voice” in graduate school as they’re learning the craft because they think, understandably, I need to talk how my supervisor talks. We talk about this voice in a bit of a derisive way because it can come across as insincere. “Ooh, mmm, ahh. Tell me more about that.” It’s not just the words, it’s also the intonation.

Bay: Almost every industry has a vocal norm. We know how pilots are supposed to talk to us when the plane hits turbulence. We know how a newscaster is supposed to vocally signal, “I’m a professional in the news world.” Do those standards serve our culture at large in terms of the diversity of background and expression we hope for? I don’t think so, but it’s hard to change industry standards. A useful approach in your profession might be to ask, Is the norm helping? Does it feel good? Do I have the leeway to explore other ways of showing up?

Humans are beautifully complicated. Sometimes, a “therapist voice” might help the therapist have a boundary to avoid connecting with their client like a friend. That’s valuable. But that’s protection, not connection. That’s signaling, “I care about you, but in my role as a therapist we don’t have the kind of relationship where you share your shit and then I share mine.” So you’ve set up a guardrail: “I’m going to talk to you like I’m not quite a person.”

The juicy question is, “When does that not work?”

RH: As a therapist, if you’re working with a client who has experienced marginalization, what steps do you take to help them speak with power in their own way?

Bay: I think it’s irresponsible as a coach to say, “Talk this way. This is the standard. If you want to get taken seriously, you must do this,” but I think it’s equally irresponsible to say, “Just be yourself. You’ve got this. Bye.” We need to help clients ask questions like, “In what ways have I negotiated myself away?” “What aspect of myself could I bring back?” “What if I started to tell people stories or joke more or spend less time worrying about my accent?” “What if I started to bring the version of me that shows up around my favorite people into this other space?”

When we’re exploring how we talk about things that are dear to our hearts we have an almost spiritual opportunity to show up for ourselves and for our ideas. That’s when this conversation is so vital, especially with people who’ve been marginalized.

If they’re going to talk in front of people on this day and at this time, the pressure in on. We can help them recalibrate toward what feels good in their body. What would it feel like if they honored their idea, the people they’re talking to, and the people they’re presenting their idea on behalf of? When the focus is on these kinds of things, it makes the question of, “How do I sound” much less distracting. Ultimately, your outward focus when you speak can help you talk in a way that’s more human, that sounds more like you in front of your favorite people. It’s a more love-based approach to public speaking.

RH: Focusing on the message and on the people you’re talking to sounds like it would reduce self-consciousness.

Bay: The final chapter of my book is on how to make it about your audience, because shifting your focus to what really matters (and away from the “should” of how to sound) works wonders. It’ll accomplish much more than working on your pitch or avoiding ums. It gets at the heart of what speaking is all about, which is connection.

Samara Bay joined us for a Networker Live interview. Watch here.

The post What Story Does Your Voice Tell? appeared first on Psychotherapy Networker.

]]>

Will people really turn to a human if a “humanly enough” chatbot is available? What if human-to-human therapy becomes accessible only to a privileged few? All valid reasons that AI could be bad for psychotherapy, but what benefits can it provide you and your clients? Join Heather Hessel alongside editor in chief Livia Kent to discuss Hessel’s recent article on the beneficial role that AI can play for therapists.

Read the article here.

When you start to list all of Dr. Frank Anderson’s accolades, it’s easy to get lost. Author, therapist, clinical instructor and trainer, Hollywood consultant, advisor, trauma expert, psychiatrist… Even he has trouble keeping up.

“I’m a weird combination,” says Frank Anderson. “I’m a psychiatrist. But sometimes even I forget that I’m a psychiatrist. Because I don’t do typical psychiatry stuff anymore.”

Coming from someone with such a strong reputation in trauma, Anderson’s comment is intriguing. Many people in the psychotherapeutic field shift their emphasis and focus over time, but he has taken his skills to a whole new area.

“It’s really work that I feel passionate about,” he says.” And all the things I do—teaching and writing and speaking—are all aligned with that.”

A Different Perspective

It takes courage to look at the long-studied field of trauma research and treatment and suggest there’s a better way. That’s just what Anderson does.

“I think psychotherapy is important, but it’s not one-size-fits-all, and I think there are limitations to psychotherapy. As the world evolves, accessibility is important. For example, there’s a way for people to access through social media in a way that they could never access or afford in psychotherapy.”

When it comes to accessibility, Anderson sees the value of social media. He demonstrates this with his own psycho-educational presence on apps like TikTok, Facebook, and YouTube. With nearly 30,000 followers on Instagram, Anderson is clearly a leading voice online in the field.

“I like moving us forward in these ways that are challenging for the field,” he adds. “I don’t think people are going to go to therapy in the same way. I think they’re going to do therapy on their phone.”

Though that version isn’t without its pitfalls. Anderson notes that although social media users can put their problems into a chat bot or search for them on social media, that’s not always helpful. He explains, “I have this value for coaches and people who are not therapists who are bringing [accessible change]. I think there’s some limitations when people are not trained—especially when you’re talking about severe trauma.”

Personal Experience of Trauma

As a gay man, Anderson knows about transcending trauma—he’s done it himself. When he was six, he was sent to a site for testing because he played with dolls. “I spent five years in conversion therapy of sorts,” he shares. “Back then it was considered a disorder. They didn’t send me away to a camp, but they sent me to therapy. I was being programmed. I have very little memory of the whole experience because I dissociated through most of it, but the message was very clear. I was wrong, and I had to be made right.”

In addition to this, years later when Anderson was in college, his younger sister suffered a psychotic break during her first year of high school. The event devastated him, and he desperately wanted to save her. He was in school to be a pharmacist like his father, but the situation changed his trajectory.

Anderson trained as a psychiatrist at Harvard Medical School and subsequently worked with Bessel van der Kolk in the early days at The Trauma Center in Boston. He was at the right place at a very important time: it’s where he immersed himself in treating and teaching about trauma.

Finding Purpose and Healing Through Storytelling

“After the release of my second book, I feel like I got my purpose,” he says. “I remember the moment I went for a run after that book got released, and I said, Okay, world, it’s yours. It was kind of the culmination of my professional life for sure.”

Writing books brought Frank into his proper field: healing through storytelling. He makes the trauma of pain and life understandable; his voice isn’t overintellectual or intimidating, and he somehow makes trauma simple and easy to understand.

More specifically, through his books and content, Frank brings trauma healing to the world with his own voice and sharing through the lens of Internal Family Systems, transcending trauma to get to a better place inside. “I went from being a button-up Harvard professor to being an influencer,” he notes.

Such reach means more people might be able to process their trauma, people who, for example, can’t necessarily afford therapy. “I just kept getting this message: You’re here to bring trauma healing to the world. You’re here to bring love, compassion, and unity. I didn’t even know what it meant at the time. It feels larger than me. I’m moving out of the realm of psychotherapy into the general public as I’m bringing trauma healing to the world—moving and translating this message out of the therapy room.”

Expertise and Experience

Anderson’s style, warmth, and informality make him approachable. Others who have attained his level of professional expertise have a tendency to sound condescending at times; Anderson is different. He speaks a language that makes the complexity of trauma work understandable, that breaks it down simply.

Scaling what he does wasn’t just about his vibrant warmth and personality—it also involves finding a new language with which to present it. “There’s an aversion to the word trauma, but people can relate to overwhelming life experience,” he says. “I’m translating our therapy-speak into everyday language.”

Which may be exactly where it belongs.