Tag Archives: Psychotherapy

Looking for Love in All the Wrong Places

All throughout my practice and over the years, for both couples and individuals, I see many who find themselves in difficult if not downright abusive relationships.  That has often been an ongoing pattern in their past relationships and their current relationship may continue and mirror those problems.  Also there are many who are still looking for just the ‘right’ person but haven’t a clue as to what makes a relationship ‘right’.  Now sometimes relationships become abusive after time and it can be because two people are not right for each other so that conflict and anger become part of the dynamic.  Or sometimes stresses destroy what was once good.  But more often it is a pattern.  Someone once said to me about her friend “I can always tell which kind of guy she will gravitate to.  She always goes for the one with a certain ‘attitude’ and of course good looking.  It is those guys who are really womanizers”.

More often it is women who find themselves with angry or emotionally unavailable men who take out their frustrations on their partners, but I have also worked with men who find themselves with cold, derisive, and ‘bitchy’ women who offer little warmth or love and mistreat them.  Now relationships don’t  normally start out that way.  People usually fancy themselves ‘in love’.  But the chemistry and that mystery we call ‘attraction’ can fade pretty quickly with the reality of life’s stressors.

There are many who repeat past patterns of abuse whether it stems from original family dynamics or from past relationships.  One person I worked with had a cold, distant, alcoholic mother, and every woman he ends up with has an addiction problem of some sort.  He takes care of them and does his best to offer them the love he feels in the hopes that it will change them.  I often feel that people have a certain kind of radar that puts them in the same situation over and over again.  The key to change is understanding the behavior and the willingness to stop trying again and again to accomplish what may be impossible.  Easier said than done!

 

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“Is There Anything Worse Than Being Ordinary”

Someone said this to me recently and in a way it made my heart ache.  In my opinion, being ordinary is much underrated.  It is what most of us are and if you are your own brand of  ‘ordinary’ you are ahead of the game.  you don’t have to be famous or fabulous or extraordinary to be special and wonderful.  Trying to be the best, the smartest, the prettiest, most talented, most creative, – the ‘most’ of anything is a recipe for disappointment, self criticism, self-hatred and low self-esteem.  If you are always comparing yourself to others you will always fall short in some way.  To be the best that you can be is quite enough, even though that is a cliché.  Labeling yourself as ‘ordinary’ in a pejorative way is so very sad.  All we have to do is look around to know that fame, fortune, success, and talent does not guarantee happiness. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Addiction & Social Anxiety Disorder

Over the years I have worked with many people who suffer from addictions of all sorts –drugs, alcohol, food, sex – you name it.  Most were/are in recovery or have attempted to deal with their addictions in other ways.  But one thing I’ve noticed that they have in common is that most have Social Anxiety Disorder as an underlying problem.  That is not to say that all addicts have this.  But when you think about it, for many it makes sense.  Addictions mask emotions and help with symptomatology.   They initially make things easier – brighter if you will.  Drugs & alcohol lower inhibition and can help ease the way for social interaction.  For most, alcohol lightens the mood and lowers inhibitions and may make things more pleasant.  But social discomfort is major problem for those with Social Anxiety Disorder.  People can shake, stutter, withdraw, become mute and can’t make contact even in the seemingly most benign circumstances.  Think of Rojesh from TV’s “Big Bang Theory”.   He is a caricature for sure, but not so far from hitting the nail on the head.  The powerful underlying truth of what many with Social Anxiety Disorder deal with is that their discomfort is so great, they can’t connect.  Or they suffer greatly when trying to interact.  Drugs or alcohol can produce a major shift for them.  It is self-medicating, and many even forget what is lurking underneath – especially if they become chronic users.  But when sobriety is achieved it is there – just as it was from the beginning.  The trick is to find other ways of dealing that might bring about some real change.

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Psychotherapy: Have The Issues Changed Much in 30+ Years?

Someone asked me if the problems people come to see me about have changed much over the course of my practice.  I had to think about it, but the answer I gave is basically “no”.   The externals or presenting problems can look very different and how people approach things and what they look for in the way of solutions has changed.  We live in a high stress world but in my view the underlying issues are essentially the same.

The only real difference that I can pinpoint is that people are more open in talking about certain things.  A good example is that people are less reluctant to talk about sexual issues.  Sex in general is talked about more openly.   Sexual orientation and identity are no longer taboo topics.  Adoption and fertility issues are talked about more openly.   Addictions too are not hidden or denied as much.  As a culture I think we are more open and accepting – at least in my neck of the woods.  And so because the culture in general has changed, there is very little that is off limits.  Topics that used to be considered shameful or impossible to even mention, are talked about.  That is not to say that people don’t feel shame and pain.  They do.  But at least the world gives them permission to speak.  I consider that one of the most positive outcomes resulting from the diversity and transparency in our modern world.

Most people can talk about what was once off limits even if it is hard to open up and takes a while.  But the underlying problems regarding relationships, intimacy, self-esteem, trauma, abuse, feelings of loss of control, depression, anxieties, self- hatred –  the list can go on – those remain much the same.  We are all creatures of the human condition and so the problems we experience in our core are still the same.  It’s one of the reasons I believe in psychotherapy.  It’s a methodology that can hopefully reach us in that core.

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The Changing Face of Psychotherapy

Many years ago when I first started out in the field it was not uncommon for people to be in psychoanalysis or psychotherapy 3 – 4 times per week.  These days someone coming even 2 times per week is rare.  This change is partly because of the intrusion of insurance into medical treatment of all kinds.  Insurance controls what services are reimbursed and the frequency of visits, tests, etc.  This is especially true for mental health services, often considered by many as the stepchild of medicine.  Few can afford to see a psychotherapist more than weekly.

We can blame insurance companies & say “they’re the culprits”.  Insurance companies are offering less and reimbursing less for services they do approve, making it harder to get needed mental health services.  But this change is also because of the availability of different forms of psychological treatment, including medication, the difficulty in providing studies which can ‘prove’ the efficacy of psychotherapy, and the evolving nature of our culture at large.

The popular culture has become one of ‘quick fixes’, a ‘just do it’ mentality, and one of instant gratification.  Medication has changed the way people deal with issues. They often look first to a pill to solve their problems.  I have said before that I believe in medication.   But it’s not the magic answer and it is not right for all.   Studies have shown that medication in combination with psychotherapy is most effective.  But just as important a factor is that people are less willing to ‘go deep’.  And I don’t know if that’s all negative.  Sometimes Cognitive Behavioral Therapy – CBT makes a dent and I use it.  But there is a vast difference between knowing something intellectually & have it filter down into emotional understanding.  There are many who know the right ways they should think but can’t make the switch even with workbooks and reminders.  Then there are those who don’t make the effort because of underlying issues that stand in the way.  Our quick fix society wants to believe that these things work, but in my experience they are an aid for some but definitely not for all.  Just like medication, there is no magic.  I often say that if there was a magic pill or if I had a magic wand I would use it & find another line of work.

My friend reminds me that readers today have very short attention spans – no more than a paragraph for a blog.  I don’t know if that’s true or not but, there is definitely a trend toward shortening all aspects of communication.  I don’t know if that is good or bad or just a fact of the modern world and our busy lives.  The jury is out.  But it has certainly affected the practice of psychotherapy from the time I began working.

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Psychotherapy has an Image Problem

I saw this article in todays New York Times Op Ed section and found it interesting and informative.  See what you think.

http://www.nytimes.com/2013/09/30/opinion/psychotherapys-image-problem.html?hp&_r=0

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Observations on my work with Couples continued

Acceptance

We are all different and no one is perfect. You will never get exactly what you want, but hopefully you will get mostly what you need.  How you fold the laundry or whether you can make a perfect omelet should not be a major factor as to whether to be together.  Fairness is very important, but it’s also important to remember that what you each bring to the relationship matters in weighing both the good and the bad.

W. could not screw in a light bulb and was the most mechanically inept man R. had ever met.  He was not the macho guy she had always dreamed about.   He could never find anything in the refrigerator and would always say “where is the ….”  R. would scream “just move something and you will find it”.  This was not an uncommon occurrence but it mattered not one bit because the warmth, love, and caretaking that W. showed R. made up for it in spades.  But she could have thought “if he really cared he wouldn’t burden me so much. He would remember all of what I said/needed/wanted”.  It’s a matter of weighing the plusses & minuses and hoping that the scales balance more often than not in the positives or are mostly even.

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Observations on my work with Couples continued

Humor

Fighting & anger can be less intense if couples can laugh at themselves and see the humor in it all.  Predicaments in life have a funny side to them too.  That is not to say that we shouldn’t take things seriously, but having the ability to see humor in certain situations makes for an easier time.  Couples who have a sense of humor stand a better chance – at least in my experience.  And when I say ‘humor’ I don’t mean sarcasm & making fun of the other person.  Those things are usually not funny if you are the recipient and/or if the situation is not lighthearted.  Your partner’s sensitivities should always be taken into consideration.

The following story exemplifies how humor can be very helpful.

After a hard day working E. finally sat down to read & relax for a few minutes.  When A. came home a short time later, he looked at her & said “woman, get into the kitchen & start rattling those pots & pans”.  He was joking but it took several days for E. to get it.  It was only when she told the story to a friend who began to giggle, that she realized that it was very funny and that she over reacted.  She began laughing & laughing, and it became a seminal story in how a sense of humor can help ease conflict & misunderstanding.

More to follow.

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Observations on my work with Couples continued

Anger & the Art of Fighting

When you are together with another human being, anger, annoyance & irritation – whether expressed or unspoken, are only natural.  After all, we are not clones of each other no matter how well we mesh.  But how a couple fights is key.  Most of the couples I see don’t know how to fight in ways that resolve issues rather than exacerbate them.  Then there are others who don’t want to resolve issues but want to be ‘right’.  Some fight almost as a way of life.  They will argue about which side of the refrigerator a magnet belongs on.  Although some claim that fighting is positive because it adds spice and makes the sex better, I have not found that to be the case with those who come to me.  Rather they are hurt and exhausted, drained of the positive feelings that brought them together to begin with.  A major part of my work with couples is to help them learn how to fight better.  This and learning how to communicate are key factors in helping make a relationship work.

More to follow.

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Observations on my work with Couples continued

Deal Breakers

Some problems can be divided into what I call ‘deal breakers’ and then everything else.  And not every ‘deal breaker’ ends a relationship.  Issues regarding religion, money, children, location, and whether someone wants to be in a relationship at all, are potential ‘deal breakers’.  But often the obvious is not ever dealt with prior to getting together.  People hope that these problems will magically disappear.  They ignore the elephant in the room.   It is only human.  We are taught that “love conquers all”.  So we pretend and hope for the best.  Also, some ‘deal breakers’ are covers for other underlying feelings, and until you explore, you can never be sure.

More to follow.

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