Therapists Related Quotes

ABUSIVE MEN COME in every personality type, arise from good childhoods and bad ones, are macho men or gentle, “liberated” men. No psychological test can distinguish an abusive man from a respectful one. Abusiveness is not a product of a man’s emotional injuries or of deficits in his skills. In reality, abuse springs from a man’s early cultural training, his key male role models, and his peer influences. In other words, abuse is a problem of values, not of psychology. When someone challenges an abuser’s attitudes and beliefs, he tends to reveal the contemptuous and insulting personality that normally stays hidden, reserved for private attacks on his partner. An abuser tries to keep everybody—his partner, his therapist, his friends and relatives—focused on how he feels, so that they won’t focus on how he thinks, perhaps because on some level he is aware that if you grasp the true nature of his problem, you will begin to escape his domination.

Fear and anxiety affect decision making in the direction of more caution and risk aversion... Traumatized individuals pay more attention to cues of threat than other experiences, and they interpret ambiguous stimuli and situations as threatening (Eyesenck, 1992), leading to more fear-driven decisions. In people with a dissociative disorder, certain parts are compelled to focus on the perception of danger. Living in trauma-time, these dissociative parts immediately perceive the present as being "just like" the past and "emergency" emotions such as fear, rage, or terror are immediately evoked, which compel impulsive decisions to engage in defensive behaviors (freeze, flight, fight, or collapse). When parts of you are triggered, more rational and grounded parts may be overwhelmed and unable to make effective decisions.

Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel.

Changes in Relationship with others: It is especially hard to trust other people if you have been repeatedly abused, abandoned or betrayed as a child. Mistrust makes it very difficult to make friends, and to be able to distinguish between good and bad intentions in other people. Some parts do not seem to trust anyone, while other parts may be so vulnerable and needy that they do not pay attention to clues that perhaps a person is not trustworthy. Some parts like to be close to others or feel a desperate need to be close and taken care of, while other parts fear being close or actively dislike people. Some parts are afraid of being in relationships while others are afraid of being rejected or criticized. This naturally sets up major internal as well as relational conflicts.

It seems to me that anything that can be taught to another is relatively inconsequential, and has little or no significant influence on behavior.

The most traumatic aspects of all disasters involve the shattering of human connections. And this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss. As a result, recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love. Of course, medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible—even with the best medications and therapy in the world—without lasting, caring connections to others.

Complex PTSD consists of of six symptom clusters, which also have been described in terms of dissociation of personality. Of course, people who receive this diagnosis often also suffer from other problems as well, and as noted earlier, diagnostic categories may overlap significantly. The symptom clusters are as follows: Alterations in Regulation of Affect ( Emotion ) and Impulses Changes in Relationship with others Somatic Symptoms Changes in Meaning Changes in the perception of Self Changes in Attention and Consciousness

complaining about the way a relative would try to make me feel guilty, my father quipped, “Just because she sends you guilt doesn’t mean you have to accept delivery.

Changes in Meaning: Finally, chronically traumatized people lose faith that good things can happen and people can be kind and trustworthy. They feel hopeless, often believing that the future will be as bad as the past, or that they will not live long enough to experience a good future. People who have a dissociative disorder may have different meanings in various dissociative parts. Some parts may be relatively balanced in their worldview, others may be despairing, believing the world to be a completely negative, dangerous place, while other parts might maintain an unrealistic optimistic outlook on life

Parts of you are phobic of anger and generally terrified and ashamed of angry dissociative parts. There is often tremendous conflict between anger-avoidant and anger-fixated parts of an individual. Thus, an internal and perpetual cycle of rage-shame-fear creates inner chaos and pain.

Relationships in life don’t really end, even if you never see the person again. Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

While the primary function of formal Buddhist meditation is to create the possibility of the experience of "being," my work as a therapist has shown me that the demands of intimate life can be just as useful as meditation in moving people toward this capacity. Just as in formal meditation, intimate relationships teach us that the more we relate to each other as objects, the greater our disappointment. The trick, as in meditation, is to use this disappointment to change the way we relate.

Alterations in regulation of affect (emotion) and impulse: Almost all people who are seriously traumatized have problems in tolerating and regulating their emotions and surges or impulses. However, those with complex PTSD and dissociative disorders tend to have more difficulties than those with PTSD because disruptions in early development have inhibited their ability to regulate themselves. The fact that you have a dissociative organization of your personality makes you highly vulnerable to rapid and unexpected changes in emotions and sudden impulses. Various parts of the personality intrude on each other either through passive influence or switching when your under stress, resulting in dysregulation. Merely having an emotion, such as anger, may evoke other parts of you to feel fear or shame, and to engage in impulsive behaviors to stop avoid the feelings.

Dissociative parts of the personality are not actually separate identities or personalities in one body, but rather parts of a single individual that are not yet functioning together in a smooth, coordinated, flexible way. P14

Changes in the Perception of Self: People who have been traumatized in childhood are often troubled by guilt, shame, and negative feelings about themselves, such as the belief they are unlikable, unlovable, stupid, inept, dirty, worthless, lazy, and so forth. In Complex Dissociative disorders there are typically particular parts that contain these negative feelings about the self while other parts may evaluate themselves quite differently. Alterations among parts thus may result in rather rapid and distinct changes in self perception.

Assume that most times when you feel anxious, depressed, or angry you are not only strongly desiring but also commanding that something go well and that you get what you want. Cherchez le should, cherchez le must! Look for your should, look for your must! Don’t give up until you find it. If you have trouble finding it, seek the help of a friend, relative, or REBT therapist who will help you find it. Persist!

The things most people need to learn in therapy are related to attachment, abandonment, love, and fear. We are trying to access basic emotional processes that are organized in primitive and early-developing parts of the brain. The language of these emotions is also very basic; it is the language of childhood. The more complex the language and ideas you bring into therapy, the more likely you are to stimulate your clients’ intellectualizing defenses.

Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem from which you need medical help.

A diagnosis limits vision; it diminishes ability to relate to the other as a person.

You as a whole person are thus unable to reconcile conflicts about anger and learn to tolerate and express anger in healthy ways. Inner turmoil and dissociation are maintained.

Specific parts of you personality may be angry and are usually easily evoked. because these parts are dissociated, anger remains an emotion that is not integrated for you as a whole person. Even though individuals with dissociative disorder are responsible for their behavior, just like everyone else, regardless of which part may be acting, they may feel little control of these raging parts of themselves. Some dissociative parts may avoid or even be phobic of anger. They may influence you as a whole person to avoid conflict with others at any cost or to avoid setting healthy boundaries out of fear of someone else’s anger; or they may urge you to withdraw from others almost completely.

People with Complex PTSD suffer from more severe and frequent dissociation symptoms, as well as memory and attention problems, than those with simple PTSD. In addition to amnesia due to the activity of various parts of the self, people may experience difficulties with concentration, attention, other memory problems and general spaciness. These symptoms often accompany dissociation of the personality, but they are also common in people who do not have dissociative disorders. For example everyone can be spacey, absorbed in an activity, or miss an exit on the highway. When various parts of the personality are active, by definition, a person experiences some kind of abrupt change in attention and consciousness.

As Beck and other cognitive therapists have emphasized, much of what constitutes a depression is centered around responding to one awful thing and overgeneralizing from it—cognitively distorting how the world works.

Most dissociative parts influence your experience from the inside rather than exert complete control, that is, through passive influence. * In fact, many parts never take complete control of a person, but are only experienced internally. * Frequent switching may be a sign of severe stress and inner conflict in most individuals.

Some people (like singularly unhelpful and clearly underqualified physical therapists, unsympathetic GPs, and that supremely irritating second cousin who ate all the stuffing at Christmas) assumed that a lack of feeling in certain body parts shouldn’t affect sleep at all. Her insomnia in such situations, they said, was something she could easily overcome. Chloe liked to remind those people that the human brain tended to keep track of all body parts, and was prone to panic when one of those parts went offline. Actually, what Chloe liked to do was imagine hitting those people with a brick.

if I am to facilitate the personal growth of others in relation to me, then I must grow, and while this is often painful it is also enriching.

Happiness comes from making good choices. Integrity, energy, perseverance, and courage all contribute. In short, happiness is related to character structure, work, health and relationships.

In therapy we discover that we heal through relating, for the wounds that occurred in relationships must be healed in a relationship, a relationship where the therapist doesn’t talk at us but with us.

An openness to being changed by the client is required of the person-centred therapist. A person-centred therapist who is closed off from being changed implicitly denies the full humanity of the client.

Some dissociative parts of the personality, living in trauma time, may experience the same emotion no matter the situation, such as fear, rage, shame, sadness, yearning and even some positive ones just as joy.

There’s another related concept that I share with John: impermanence. Sometimes in their pain, people believe that the agony will last forever. But feelings are actually more like weather systems—they blow in and they blow out. Just because you feel sad this minute or this hour or this day doesn’t mean you’ll feel that way in ten minutes or this afternoon or next week. Everything you feel—anxiety, elation, anguish—blows in and out again.

To summarize, the rationale for using the here-and-now is that human problems are largely relational and that an individual’s interpersonal problems will ultimately be manifested in the here-and-now of the therapy encounter

Cognitive therapists, like Aaron Beck of the University of Pennsylvania, even consider depression to be primarily a disorder of thought, rather than emotion, in that sufferers tend to see the world in a distorted, negative way.

Some dissociative parts of the personality, living in trauma time, may experience the same emotion no matter the situation, such as fear, rage, shame, sadness, yearning and even some positive ones just as joy. * Other parts have a broader range of feeling. Because emotions are often held in certain parts of the personality, different parts can have highly contradictory perceptions, emotions, and reactions to the same situation.” * This explains many feelings, emotions, and doubts about the unknown haunting us at times. * Awareness and discovering the inner world may help, tremendously.

There seems every reason to suppose that the therapeutic relationship is only one instance of interpersonal relations, and that the same lawfulness governs all such relationships. Thus it seems reasonable to hypothesize that if the parent creates with his child a psychological climate such as we have described, then the child will become more self-directing, socialized, and mature.

There are secret rooms inside us,” I had said to my therapist. “A relatively benign construct,” he said, and so I did not bother with the rest of it. That in my house we never left them, that in my house my mother and father preferred them to everywhere else.

While there is no solution to existential isolation, therapists must discourage false solutions. One’s efforts to escape isolation can sabotage one’s relationships with other people. Many a friendship or marriage has failed because, instead of relating to, and caring for, one another, one person uses another as a shield against isolation.

Ginny could see me more realistically, she could begin to de-idealize me and relate to me on a more human basis.

Resolving the past comes after you learn to cope in the present both with your external and with your inner world.

We become well by relating to what is here; we become ill by relating to our fantasies. The therapist stops us from running away from ourselves so we can rest in r

I always say toward the end of the hour: “Let’s take a minute to look at how you and I are doing today.” Or, “Any feelings about the way we are working and relating?” Or, “Before we stop, shall we take a look at what’s going on in this space between us?” Or if I perceive difficulties, I might say something like: “Before we stop, let’s check into our relationship today. You’ve talked

perhaps it is less important that a teacher cover the allotted amount of the curriculum, or use the most approved audio-visual devices, than that he be congruent, real, in his relation to his students.

For example, in order to identify these schemas or clarify faulty relational expectations, therapists working from an object relations, attachment, or cognitive behavioral framework often ask themselves (and their clients) questions like these: 1. What does the client tend to want from me or others? (For example, clients who repeatedly were ignored, dismissed, or even rejected might wish to be responded to emotionally, reached out to when they have a problem, or to be taken seriously when they express a concern.) 2. What does the client usually expect from others? (Different clients might expect others to diminish or compete with them, to take advantage and try to exploit them, or to admire and idealize them as special.) 3. What is the client’s experience of self in relationship to others? (For example, they might think of themselves as being unimportant or unwanted, burdensome to others, or responsible for handling everything.) 4. What are the emotional reactions that keep recurring? (In relationships, the client may repeatedly find himself feeling insecure or worried, self-conscious or ashamed, or—for those who have enjoyed better developmental experiences—perhaps confident and appreciated.) 5. As a result of these core beliefs, what are the client’s interpersonal strategies for coping with his relational problems? (Common strategies include seeking approval or trying to please others, complying and going along with what others want them to do, emotionally disengaging or physically withdrawing from others, or trying to dominate others through intimidation or control others via criticism and disapproval.) 6. Finally, what kind of reactions do these interpersonal styles tend to elicit from the therapist and others? (For example, when interacting together, others often may feel boredom, disinterest, or irritation; a press to rescue or take care of them in some way; or a helpless feeling that no matter how hard we try, whatever we do to help disappoints them and fails to meet their need.)

Following Strupp (1980), clients change when they live through emotionally painful and long-ingrained relational experiences with the therapist, and the therapeutic relationship gives rise to new and better outcomes that are different from those anticipated and feared. That is, when the client re-experiences important aspects of her primary problem with the therapist, and the therapist’s response does not fit the old schemas or expectations, the client has the real-life experience that relationships can be another way. When clients experience this new or reparative response, a response that differs from previous relationships and that does not fit the client’s negative expectations or cognitive schemas, it is a powerful type of experiential re-learning that readily can be generalized to other relationships (Bandura, 1997).

Speed is about time, but it’s also closely related to endurance and effort. The faster the speed, the thinking goes, the less endurance or effort required. Patience, on the other hand, requires endurance and effort. It’s defined as “the bearing of provocation, annoyance, misfortune, or pain without complaint, loss of temper, irritation, or the like.” Of course, much of life is made up of provocation, annoyance, misfortune, and pain; in psychology, patience might be thought of as the bearing of these difficulties for long enough to work through them. Feeling your sadness or anxiety can also give you essential information about yourself and your world.

One of the obvious implications is that a person will have to face the fact that she cannot meet other people’s expectations. This signals the end of what might be called the “camel” phase of human development. I believe it was Nietschze who suggested that for the first part of life, we are camels, trudging through the desert, accepting on our backs everybody’s “shoulds” and “don’ts.” Camels only know how to spit; they don’t think for themselves or talk back. As the camel dies, a lion is born in its place. Lions discover both their roar and the art of preening. The lion may be a little shaky at first, so support and encouragement are vital. But once the camel begins to die (e.g., signaled by depression), there is no turning back. Symptoms occupy the space between the death of the camel and the birth of the lion. A therapist can be a good midwife during this liminal phase.

Fear of the Dark I’ve always been prone to worry and anxiety, but after I became a mother, negotiating joy, gratitude, and scarcity felt like a full-time job. For years, my fear of something terrible happening to my children actually prevented me from fully embracing joy and gratitude. Every time I came too close to softening into sheer joyfulness about my children and how much I love them, I’d picture something terrible happening; I’d picture losing everything in a flash. At first I thought I was crazy. Was I the only person in the world who did this? As my therapist and I started working on it, I realized that “my too good to be true” was totally related to fear, scarcity, and vulnerability. Knowing that those are pretty universal emotions, I gathered up the courage to talk about my experiences with a group of five hundred parents who had come to one of my parenting lectures. I gave an example of standing over my daughter watching her sleep, feeling totally engulfed in gratitude, then being ripped out of that joy and gratitude by images of something bad happening to her. You could have heard a pin drop. I thought, Oh, God. I’m crazy and now they’re all sitting there like, “She’s a nut. How do we get out of here?” Then all of the sudden I heard the sound of a woman toward the back starting to cry. Not sniffle cry, but sob cry. That sound was followed by someone from the front shouting out, “Oh my God! Why do we do that? What does it mean?” The auditorium erupted in some kind of crazy parent revival. As I had suspected, I was not alone.

... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and other negative responses. Because it is not unusual that relational and other forms of traumatization began when the client was preverbal, he or she may not have words. The lack of access to emotions or to words to describe them is known as alexithymia and is a common response to trauma. What the client is likely to have instead is somatosensory, behavioral, dissociative, and relational manifestations that therapists must seek to understand and translate into words, a process that involves hard work and intense focus.

first started therapy, I found it very hard to cry. I feared I’d be carried away by the flood, overwhelmed. Perhaps that’s what it feels like for you. That’s why it’s important to take your time to feel safe, and trust that you won’t be alone in this flood – that I’m treading water here with you.’ Silence. ‘I think of myself as a relational therapist,’ I said. ‘Do you know what that means?’ Silence. ‘It means I think Freud was wrong about a couple of things. I don’t believe a therapist can ever really be a blank slate, as he intended. We leak all kinds of information about ourselves unintentionally – by the colour of my socks, or how I sit or the way I talk – just by sitting here with you, I reveal a great deal about myself. Despite my best efforts at invisibility, I’m showing you who I am.’ Alicia looked up. She stared at me, her chin slightly tilted – was there a challenge in that look? At last I had her attention. I shifted in my seat. ‘The point is, what can we do about this? We can ignore it, and deny it, and pretend this therapy is all about you. Or we can acknowledge that this is a two-way street, and work with that. And then we can really start to get somewhere.’ I held up my hand. I nodded at my wedding ring. ‘This ring tells you something, doesn’t it?’ Alicia’s eyes ever-so-slowly moved in the direction of the ring. ‘It tells you I’m a married man. It tells you I have a

Existential isolation, a third given, refers to the unbridgeable gap between self and others, a gap that exists even in the presence of deeply gratifying interpersonal relationships. One is isolated not only from other beings but, to the extent that one constitutes one’s world, from world as well. Such isolation is to be distinguished from two other types of isolation: interpersonal and intrapersonal isolation. One experiences interpersonal isolation, or loneliness, if one lacks the social skills or personality style that permit intimate social interactions. Intrapersonal isolation occurs when parts of the self are split off, as when one splits off emotion from the memory of an event. The most extreme, and dramatic, form of splitting, the multiple personality, is relatively rare (though growing more widely recognized); when it does occur, the therapist may be faced (...) with the bewildering dilemma of which personality to cherish.

And now here I am, making a stupid joke with Wendell and smiling dumbly. He asks if I’m having a reaction to his beard. “I’m just not used to it,” I say. “But it looks good on you. You should keep it.” Or maybe you shouldn’t, I think. Maybe I’ll be too attrac . . . I mean, distracted. He raises his right eyebrow, and I notice that his eyes look different today. Brighter? And did he always have that dimple? What’s going on? “I’m asking because how you respond to me is related to how you respond to men—

The more someone is hurt and bullied in his life, the more he is not heard or seen, the more he is criticised and belittled - the less likely he is to experience human relations with a lens other than that of his own needs and the pain of those needs not being met.

Frosh (2002) has suggested that therapeutic spaces provide children and adults with the rare opportunity to articulate experiences that are otherwise excluded from the dominant symbolic order. However, since the 1990s, post-modern and post-structural theory has often been deployed in ways that attempt to ‘manage’ from; afar the perturbing disclosures of abuse and trauma that arise in therapeutic spaces (Frosh 2002). Nowhere is this clearer than in relation to organised abuse, where the testimony of girls and women has been deconstructed as symptoms of cultural hysteria (Showalter 1997) and the colonisation of women’s minds by therapeutic discourse (Hacking 1995). However, behind words and discourse, ‘a real world and real lives do exist, howsoever we interpret, construct and recycle accounts of these by a variety of symbolic means’ (Stanley 1993: 214). Summit (1994: 5) once described organised abuse as a ‘subject of smoke and mirrors’, observing the ways in which it has persistently defied conceptualisation or explanation. Explanations for serious or sadistic child sex offending have typically rested on psychiatric concepts of ‘paedophilia’ or particular psychological categories that have limited utility for the study of the cultures of sexual abuse that emerge in the families or institutions in which organised abuse takes pace. For those clinicians and researchers who take organised abuse seriously, their reliance upon individualistic rather than sociological explanations for child sexual abuse has left them unable to explain the emergence of coordinated, and often sadistic, multi—perpetrator sexual abuse in a range of contexts around the world.

Some readers may find it a curious or even unscientific endeavour to craft a criminological model of organised abuse based on the testimony of survivors. One of the standard objections to qualitative research is that participants may lie or fantasise in interview, it has been suggested that adults who report severe child sexual abuse are particularly prone to such confabulation. Whilst all forms of research, whether qualitative or quantitative, may be impacted upon by memory error or false reporting. there is no evidence that qualitative research is particularly vulnerable to this, nor is there any evidence that a fantasy— or lie—prone individual would be particularly likely to volunteer for research into child sexual abuse. Research has consistently found that child abuse histories, including severe and sadistic abuse, are accurate and can be corroborated (Ross 2009, Otnow et al. 1997, Chu et al. 1999). Survivors of child abuse may struggle with amnesia and other forms of memory disturbance but the notion that they are particularly prone to suggestion and confabulation has yet to find a scientific basis. It is interesting to note that questions about the veracity of eyewitness evidence appear to be asked far more frequently in relation to sexual abuse and rape than in relation to other crimes. The research on which this book is based has been conducted with an ethical commitment to taking the lives and voices of survivors of organised abuse seriously.

Our inner experience is that which we think, feel, remember, perceive, sense, decide, plan and predict. These experiences are actually mental actions, or mental activity (Van der Hart et al., 2006). Mental activity, in which we engage all the time, may or may not be accompanied by behavioral actions. It is essential that you become aware of, learn to tolerate and regulate, and even change major mental actions that affect your current life, such as negative beliefs, and feelings or reactions to the past the interfere with the present. However, it is impossible to change inner experiences if you are avoiding them because you are afraid, ashamed or disgusted by them. Serious avoidance of you inner experiences is called experiential avoidance (Hayes, Wilson, Gifford, & Follettte, 1996), or the phobia of inner experience (Steele, Van der Hart, & Nijenhuis, 2005; Van der Hart et al., 2006).

Managers usually have extensive knowledge of events and of the system. They are often available to explain to the therapist the internal systemic dilemmas that are not otherwise evident. Generally, they are fairly empty of affect. Another term for managers has been internal self-helpers (Putnam, 1989).

Yet the paradoxical aspect of my experience is that the more I am simply willing to be myself, in all this complexity of life and the more I am willing to understand and accept the realities in myself and in the other person, the more change seems to be stirred up. It is a very paradoxical thing—that to the degree that each one of us is willing to be himself, then he finds not only himself changing; but he finds that other people to whom he relates are also changing. At least this is a very vivid part of my experience, and one of the deepest things I think I have learned in my personal and professional life.

Trust of others is in short supply for many adult survivors, as complex trauma generally involves major relational betrayal. It is, therefore, expectable (although paradoxical) that clients with these histories are predisposed to be mistrustful at the outset of therapy, precisely because of (and in proportion to) the actual trustworthiness of the therapist. When past experiences have thought hard lessons, namely, that one can least afford to trust the people who should be most trustworthy, it stands to reason that confusion about trust results. The therapist must understand and not take offense either personally or professionally and not react judgmentally or defensively. Practically speaking, this involves the therapist being prepared to patiently and empathically respond to active or passive tests or challenges to trustworthiness as legitimate and meaningful communication that deserves a respectful reply in action as well as in words.

It fades relatively quickly, just a flash and gone. All these years, you’d think I’d finally get over the PTSD. But it doesn’t seem to work like that. My therapist says I spent so much time drinking and drugging away my trauma that it’s just going to take a long time to work through it all. And even she knows only the tip of the iceberg.

The redirection of orientation and attention can be as simple as asking clients to become aware of a "good" or "safe" feeling in the body instead of focusing on their physical pain or elevated heart rate. Or the therapist can ask clients to experiment with focusing attention away from the traumatic activation in their body and toward thoughts or images related to their positive experiences and competencies, such as success in their job. This shift is often difficult for clients who have habituated to feeling pulled back repetitively into the most negative somatic reminders of their traumatic experiences. However, if the therapist guides them to practice deeply immersing themselves in a positive somatic experience (i.e., noting the changes in posture, breath, and muscular tone that emerge as they remember their competence), clients will gain the ability to reorient toward their competencies. They experience their ability to choose to what they pay attention and discover that it really is possible to resist the somatic claims of the past.

Though diagnosis is unquestionably critical in treatment considerations for many severe conditions with a biological substrate (for example, schizophrenia, bipolar disorders, major affective disorders, temporal lobe epilepsy, drug toxicity, organic or brain disease from toxins, degenerative causes, or infectious agents), diagnosis is often counterproductive in the everyday psychotherapy of less severely impaired patients. Why? For one thing, psychotherapy consists of a gradual unfolding process wherein the therapist attempts to know the patient as fully as possible. A diagnosis limits vision; it diminishes ability to relate to the other as a person. Once we make a diagnosis, we tend to selectively inattend to aspects of the patient that do not fit into that particular diagnosis, and correspondingly overattend to subtle features that appear to confirm an initial diagnosis. What’s more, a diagnosis may act as a self-fulfilling prophecy. Relating to a patient as a “borderline” or a “hysteric” may serve to stimulate and perpetuate those very traits. Indeed, there is a long history of iatrogenic influence on the shape of clinical entities, including the current controversy about multiple-personality disorder and repressed memories of sexual abuse. And keep in mind, too, the low reliability of the DSM personality disorder category (the very patients often engaging in longer-term psychotherapy).

In fact, the same intervention or response may even have the opposite effect on two different clients with contrasting developmental histories and cultural contexts. For example, if a client’s parent was distant or aloof, the therapist’s judicious self-disclosure may be helpful for the client. In contrast, the same type of self-disclosure is likely to be anxiety-arousing for a client who grew up serving as the confidant or emotional caregiver of a depressed parent. Greater sharing with the therapist may help the first client learn that, contrary to her deeply held beliefs, she does matter and can be of interest to other people. In contrast, for the second client, the same type of self-disclosure may inadvertently impose the unwanted needs of others and set this client back in treatment as, in her mind, she experiences herself back in her old caretaking role again—this time with the therapist. This unwanted reenactment occurs because the therapeutic relationship is now paralleling the same problematic relational theme that this client struggled with while growing up.

and spiritual salvation, known in English as Man’s Search for Meaning. In it, he shares his theory of logotherapy as it relates not just to the horrors of concentration camps but also to more mundane struggles. He wrote, “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances.

All things being equal, you should be able to trust most of your feelings. But if they derive from dissociative parts of yourself that live in trauma-time, that is, are not oriented to the present or are hyperfocused only on specific aspects of an experience to the exclusion of others, these thoughts are more likely to be inaccurate and not fit with current, external reality.

There are two types of personalities, Type A and Type B. Whereas Type B’s are laid-back and non-competitive, Type A’s are characterized by ambition, aggression, and a need for control. (This is a broad generalization and many people lie somewhere between A and B.) Type A’s are champing at the bit, and that drive can translate to stress; indeed, these traits are often associated with stress-related ailments.

Today, acknowledgement of the prevalence and harms of child sexual abuse is counterbalanced with cautionary tales about children and women who, under pressure from social workers and therapists, produce false allegations of ‘paedophile rings’, ‘cult abuse’ and ‘ritual abuse’. Child protection investigations or legal cases involving allegations of organised child sexual abuse are regularly invoked to illustrate the dangers of ‘false memories’, ‘moral panic’ and ‘community hysteria’. These cautionary tales effectively delimit the bounds of acceptable knowledge in relation to sexual abuse. They are circulated by those who locate themselves firmly within those bounds, characterising those beyond as ideologues and conspiracy theorists. However firmly these boundaries have been drawn, they have been persistently transgressed by substantiated disclosures of organised abuse that have led to child protection interventions and prosecutions. Throughout the 1990s, in a sustained effort to redraw these boundaries, investigations and prosecutions for organised abuse were widely labelled ‘miscarriages of justice’ and workers and therapists confronted with incidents of organised abuse were accused of fabricating or exaggerating the available evidence. These accusations have faded over time as evidence of organised abuse has accumulated, while investigatory procedures have become more standardised and less vulnerable to discrediting attacks. However, as the opening quotes to this introduction illustrate, the contemporary situation in relation to organised abuse is one of considerable ambiguity in which journalists and academics claim that organised abuse is a discredited ‘moral panic’ even as cases are being investigated and prosecuted.

Some people hope that therapy will help them find a way to be heard by whoever they feel wronged them, at which point those lovers or relatives will see the light and become the people they’d wished for all along. But it rarely happens like that. At some point, being a fulfilled adult means taking responsibility for the course of your own life and accepting the fact that now you’re in charge of your choices. You have to move to the front seat and be the mommy dog driving the car.

Breakups tend to fall into the category of silent losses, less tangible to other people. You have a miscarriage, but you didn't lose a baby. You have a breakup, but you didn't lose a spouse. So friends assume that you'll move on relatively quickly, and things like these concert tickets become an almost welcome external acknowledgment of your loss - not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

The patient brings with him into therapy all the failures and suspicions and losses he has experienced through his life. The defensive forms of insecure attachment - avoidance, ambivalence, disorganisation - will be brought into play in relation to the therapist. There will be a struggle between these habitual patterns and the skill of the therapist in providing a secure base - the capacity to be responsive and attuned to the patient's feelings, to receive projections and to transmute them in such a way that the patient can face their hitherto unmanageable feelings. To the extent that this happens, the patient will gradually relinquish their attachment to the therapist while, simultaneously, an internal secure base is built up inside. As a result, as therapy draws to a close, the patient is better able to form less anxious attachment relationships in the external world and feels more secure in himself. As concrete attachment to the therapist lessens, so the qualities of self-responsiveness and self-attunement are more firmly established in the inner world.

Anxiety (loneliness or “abandonment anxiety” being its most painful form) overcomes the person to the extent that he loses orientation in the objective world. To lose the world is to lose one's self, and vice versa; self and world are correlates. The function of anxiety is to destroy the self-world relationship, i.e., to disorient the victim in space and time and, so long as this disorientation lasts, the person remains in the state of anxiety. Anxiety overwhelms the person precisely because of the preservation of this disorientation. Now if the person can reorient himself—as happens, one hopes, in psychotherapy—and again relate himself to the world directly, experientially, with his senses alive, he overcomes the anxiety. My slightly anthropomorphic terminology comes out of my work as a therapist and is not out of place here. Though the patient and I are entirely aware of the symbolic nature of this (anxiety doesn’t do anything, just as libido or sex drives don’t), it is often helpful for the patient to see himself as struggling against an “adversary.” For then, instead of waiting forever for the therapy to analyze away the anxiety, he can help in his own treatment by taking practical steps when he experiences anxiety such as stopping and asking just what it was that occurred in reality or in his fantasies that preceded the disorientation which cued off the anxiety. He is not only opening the doors of his closet where the ghosts hide, but he often can also then take steps to reorient himself in his practical life by making new human relationships and finding new work which interests him.

The overarching principle of a therapeutic relationship is that therapists should be ever mindful of a variant of the Hippocratic oath and, to the degree possible, strive to "do no more harm" (Courtois, 2010). Complex trauma clients have already experienced considerable harm, much of it at the hands of other human beings. As a result of the ubiquitous processes of transference, attachment styles, and IWM [Internal working models], these clients often view the therapist's behavior and their relationship through the lens of their trauma-related negative interpersonal expectancies and unhealed emotional wounds and injuries. Therapists should not be surprised to be "guilty until proven innocent", not because clients with complex trauma histories are "unfair" or "unreasonable" but precisely the opposite - because the most realistic self-protective stance for them (given the fact that betrayal and harm have been more the rule than the exception) is to "distrust first and verify" (or to be hypervigilant) rather than to start with an expectation of safety and trustworthiness.

I looked up to see the sun struggling behind a gray mass of snow clouds. I could relate. And then a beam of sunlight found a way through. A sign? Maybe. But what was this? I gasped. The bakery esters had refracted into visible bands of flavor. Red raspberry, orange, and the yellow of lemon and butter. Pistachio, lime, and mint green. The deepest indigo of a fresh blueberry The violet that blooms when crushed blackberries blend into buttercream. The Roy G. Biv that a baker loves. And then the darkness: chocolate, spice, coffee, and burnt-sugar caramel.

Ten New Rules for Parent–Adult Child Relations RULE #1: Your adult child has more power than you to set the terms of your relationship because they’re more willing to walk away. Basic game theory: she who cares less has more power. RULE # 2: Your relationship with your adult child needs to occur in an environment of creating happiness and personal growth, not an environment of obligation, emotional debt, or duty. RULE # 3: You are not the only authority on how well you performed as a parent. Your adult child gets to have their own narrative and opinions about the past. RULE #4: Use of guilt trips or criticism will never get you what you want from your adult child, especially if you’re estranged. RULE #5: Learning to communicate in a way that is egalitarian, psychological, and self-aware is essential to a good relationship with your adult child. RULE #6: You were the parent when you were raising your child and you’re the parent until they die. You brought your child into this world. That means that if your child is unable to take the high road, you still have to if reconciliation is your goal. RULE #7: A large financial and emotional investment in your child does not entitle you to more contact or affection than that which is wanted by them, however unjust that may seem. RULE #8: Criticizing your child’s spouse, romantic partner, or therapist greatly increases your risk of estrangement. RULE #9: Criticizing your child’s sexuality or gender identity greatly increases your risk of estrangement. RULE #10: Just because you had a bad childhood and did a better job than your parents doesn’t mean that your adult child has to accept all of the ways that they felt hurt by you.

Humans never outgrow their need to connect with others, nor should they, but mature, truly individual people are not controlled by these needs. Becoming such a separate being takes the whole of a childhood, which in our times stretches to at least the end of the teenage years and perhaps beyond. We need to release a child from preoccupation with attachment so he can pursue the natural agenda of independent maturation. The secret to doing so is to make sure that the child does not need to work to get his needs met for contact and closeness, to find his bearings, to orient. Children need to have their attachment needs satiated; only then can a shift of energy occur toward individuation, the process of becoming a truly individual person. Only then is the child freed to venture forward, to grow emotionally. Attachment hunger is very much like physical hunger. The need for food never goes away, just as the child's need for attachment never ends. As parents we free the child from the pursuit of physical nurturance. We assume responsibility for feeding the child as well as providing a sense of security about the provision. No matter how much food a child has at the moment, if there is no sense of confidence in the supply, getting food will continue to be the top priority. A child is not free to proceed with his learning and his life until the food issues are taken care of, and we parents do that as a matter of course. Our duty ought to be equally transparent to us in satisfying the child's attachment hunger. In his book On Becoming a Person, the psychotherapist Carl Rogers describes a warm, caring attitude for which he adopted the phrase unconditional positive regard because, he said, “It has no conditions of worth attached to it.” This is a caring, wrote Rogers, “which is not possessive, which demands no personal gratification. It is an atmosphere which simply demonstrates I care; not I care for you if you behave thus and so.” Rogers was summing up the qualities of a good therapist in relation to her/his clients. Substitute parent for therapist and child for client, and we have an eloquent description of what is needed in a parent-child relationship. Unconditional parental love is the indispensable nutrient for the child's healthy emotional growth. The first task is to create space in the child's heart for the certainty that she is precisely the person the parents want and love. She does not have to do anything or be any different to earn that love — in fact, she cannot do anything, since that love cannot be won or lost. It is not conditional. It is just there, regardless of which side the child is acting from — “good” or “bad.” The child can be ornery, unpleasant, whiny, uncooperative, and plain rude, and the parent still lets her feel loved. Ways have to be found to convey the unacceptability of certain behaviors without making the child herself feel unaccepted. She has to be able to bring her unrest, her least likable characteristics to the parent and still receive the parent's absolutely satisfying, security-inducing unconditional love. A child needs to experience enough security, enough unconditional love, for the required shift of energy to occur. It's as if the brain says, “Thank you very much, that is what we needed, and now we can get on with the real task of development, with becoming a separate being. I don't have to keep hunting for fuel; my tank has been refilled, so now I can get on the road again.” Nothing could be more important in the developmental scheme of things.

... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent result of the social stigma they carry and the widespread (but not entirely accurate) belief among professionals and insurers that those with Cluster B personality disorders (especially borderline personality disorder[BPD]) cannot be treated successfully, cannot recover, and are a headache to practitioners. For example, the BPD diagnosis continues to be applied predominantly to women often, but not always, in a negative way, usually signifying that they are irrational and beyond help. Describing posttraumatic symptoms as a personality disorder not only can be demoralizing for the client due to its connotation that something is defective with his or her core self (i.e., personality) but also may misdirect the therapist by implying that the patient's core personality should be the focus of treatment rather than trauma-related adaptations that affect but are distinct from the core self. In this way, both therapists and their clients may overlook personality strengths and capacities that are healthy and sources of resilience that can be a basis for building on and enhancing (rather than "fixing" or remaking) the patient's core self and personality.

One of the fundamental directions taken by the process of therapy is the free experiencing of the actual sensory and visceral reactions of the organism without too much of an attempt to relate these experiences to the self. This is usually accompanied by the conviction that this material does not belong to, and cannot be organized into, the self. The end point of this process is that the client discovers that he can be his experience, with all of its variety and surface contradiction; that he can formulate himself out of his experience, instead of trying to impose a formulation of self upon his experience, denying to awareness those elements which do not fit.

In her book claiming that allegations of ritualistic abuse are mostly confabulations, La Fontaine’s (1998) comparison of social workers to ‘nazis’ shows the depth of feeling evident amongst many sceptics. However, this raises an important question: Why did academics and journalists feel so strongly about allegations of ritualistic abuse, to the point of pervasively misrepresenting the available evidence and treating women disclosing ritualistic abuse, and those workers who support them, with barely concealed contempt? It is of course true that there are fringe practitioners in the field of organised abuse, just as there are fringe practitioners in many other health-related fields. However, the contrast between the measured tone of the majority of therapists and social workers writing on ritualistic abuse, and the over-blown sensationalism of their critics, could not be starker. Indeed, Scott (2001) notes with irony that the writings of those who claimed that ‘satanic ritual abuse’ is a ‘moral panic’ had many of the features of a moral panic: scapegoating therapists, social workers and sexual abuse victims whilst warning of an impending social catastrophe brought on by an epidemic of false allegations of sexual abuse. It is perhaps unsurprising that social movements for people accused of sexual abuse would engage in such hyperbole, but why did this rhetoric find so many champions in academia and the media?

When the individual has, in his process of change, reached the seventh stage, we find ourselves involved in a new dimension. The client has now incorporated the quality of motion, of flow, of changingness, into every aspect of his psychological life, and this becomes its outstanding characteristic. He lives in his feelings, knowingly and with basic trust in them and acceptance of them. The ways in which he construes experience are continually changing as his personal constructs are modified by each new living event. His experiencing is process in nature, feeling the new in each situation and interpreting it anew, interpreting in terms of the past only to the extent that the now is identical with the past. He experiences with a quality of immediacy, knowing at the same time that he experiences. He values exactness in differentiation of his feelings and of the personal meanings of his experience. His internal communication between various aspects of himself is free and unblocked. He communicates himself freely in relationships with others, and these relationships are not stereotyped, but person to person. He is aware of himself, but not as an object. Rather it is a reflexive awareness, a subjective living in himself in motion. He perceives himself as responsibly related to his problems. Indeed, he feels a fully responsible relationship to his life in all its fluid aspects. He lives fully in himself as a constantly changing flow of process.

As I talked, I found that no matter how distressing the details I related, I could feel nothing. I was disconnected from my emotions, like a hand severed from a wrist. I talked about painful memories and suicidal impulses—but couldn’t feel them. I would, however, occasionally look up at Ruth’s face. To my surprise, tears would be collecting in her eyes as she listened. This may seem hard to grasp, but those tears were not hers. They were mine. At the time I didn’t understand. But that’s how therapy works. A patient delegates his unacceptable feelings to his therapist; and she holds everything he is afraid to feel, and she feels it for him. Then, ever so slowly, she feeds his feelings back to him. As Ruth fed mine back to me.

But feeling ashamed and not telling anyone about it has NEVER HELPED. My hope is that by telling people about all this stuff, maybe others will relate. And then I won’t feel alone? And yes, of course, I’ll call my psychiatric nurse, Matt. Though he just changed insurances and I need to find somebody else. And Scott will call his therapist and his psychiatrist. And yes, we will call Deda and Jim from our Recovering Couples Anonymous meeting we’ve been attending and they will laugh. Deda will say, “Are you trying to scare each other?” Yes, yes we are! We thought it might help! And yes, twelve-steppers, we are “WORKING THE STEPS of the program,” you sanctimonious church basement carps! We are on step four, if you must know. I’d like to blame the above morning episode on myself or my poor diet or the city of Los Angeles or something about how and who I am that might be solved, but let’s just call it a Thursday.

The therapist Terry Real described our well-worn behaviors as “our internalized family of origin. It’s our repertoire of relational themes.” People don’t have to tell you their stories with words because they always act them out for you. Often they project negative expectations onto the therapist, but if the therapist doesn’t meet those negative expectations, this “corrective emotional experience” with a reliable and benevolent person changes the patients; the world, they learn, turns out not to be their family of origin. If Charlotte works through her complicated feelings toward her parents with me, she’ll find herself increasingly attracted to a different type, one that might give her the unfamiliar experience she’s seeking with a compassionate, reliable, and mature partner. Until then, every time she meets an available guy who might love her back, her unconscious rejects his stability as “not interesting.” She still equates feeling loved not with peace or joy but with anxiety.

Some addictions are clear. The homeless woman with the fresh track marks over years of scars. The man who loses his home and car to gambling debts and now is hiding from dangerous creditors. Some addictions are softer, easier to engage in and still get up and function every day. Those of us who take out a bag of chips or tray of muffins after a tough day. Or go shoe shopping for our 8th pair of black sandals that we are never going to wear. There are addictions that excuse us from society altogether, those that keep us barely afloat within it, and those that become a barrier between us and the rest of the world. It’s only a matter of degree, in the end. How do we define when we cross over into addiction territory? As a relationally-trained therapist, my answer is a simple one. When our addiction becomes our primary relationship. Maybe not in our hearts and heads. But in our behaviors, definitely. When we don’t have control over our addictions, we are spending time, resources, and energy on the addiction instead of the people we love. And instead of, let’s face it…ourselves.

Ten Questions People Ask About Difficult Conversations 1. It sounds like you’re saying everything is relative. Aren’t some things just true, and can’t someone simply be wrong?   2. What if the other person really does have bad intentions – lying, bullying, or intentionally derailing the conversation to get what they want?   3. What if the other person is genuinely difficult, perhaps even mentally ill?   4. How does this work with someone who has all the power – like my boss?   5. If I’m the boss/parent, why can’t I just tell my subordinates/ children what to do?   6. Isn’t this a very American approach? How does it work in other cultures?   7. What about conversations that aren’t face-to-face? What should I do differently if I’m on the phone or e-mail?   8. Why do you advise people to “bring feelings into the workplace”? I’m not a therapist, and shouldn’t business decisions be made on the merits?   9. Who has time for all this in the real world? 10. My identity conversation keeps getting stuck in either-or: I’m perfect or I’m horrible. I can’t seem to get past that. What can I do?

I want to end here with the most common and least understood sexual problem. So ordinary is this problem, so likely are you to suffer from it, that it usually goes unnoticed. It doesn't even have a name. The writer Robertson Davies dubs it acedia. “Acedia” used to be reckoned a sin, one of the seven deadly sins, in fact. Medieval theologians translated it as “sloth,” but it is not physical torpor that makes acedia so deadly. It is the torpor of the soul, the indifference that creeps up on us as we age and grow accustomed to those we love, that poisons so much of adult life. As we fight our way out of the problems of adolescence and early adulthood, we often notice that the defeats and setbacks that troubled us in our youth are no longer as agonizing. This comes as welcome relief, but it has a cost. Whatever buffers us from the turmoil and pain of loss also buffers us from feeling joy. It is easy to mistake the indifference that creeps over us with age and experience for the growth of wisdom. Indifference is not wisdom. It is acedia. The symptom of this condition that concerns me is the waning of sexual attraction that so commonly comes between lovers once they settle down with each other. The sad fact is that the passionate attraction that so consumed them when they first courted dies down as they get to know each other well. In time, it becomes an ember; often, an ash. Within a few years, the sexual passion goes out of most marriages, and many partners start to look elsewhere to rekindle this joyous side of life. This is easy to do with a new lover, but acedia will not be denied, and the whole cycle happens again. This is the stuff of much of modern divorce, and this is the sexual disorder you are most likely to experience call it a disorder because it meets the defining criterion of a disorder: like transsexuality or S-M or impotence, it grossly impairs sexual, affectionate relations between two people who used to have them. Researchers and therapists have not seen fit to mount an attack on acedia. You will find it in no one’s nosology, on no foundation's priority list of problems to solve, in no government mental health budget. It is consigned to the innards of women's magazines and to trashy “how to keep your man” paperbacks. Acedia is looked upon with acceptance and indifference by those who might actually discover how it works and how to cure it. It is acedia I wish to single out as the most painful, the most costly, the most mysterious, and the least understood of the sexual disorders. And therefore the most urgent.

If ... we hear ourselves speaking words that convey attunement to the process unfolding in this moment--a felt sense of receiving, cultivating, believing, supporting and trusting--we are more apt to be attending from the right with support from the left. This way of experiencing may also be coupled with attention to felt sense, comfort with being rather than pressure to do, and a respect for the undulating rise and fall of healing that unfolds naturally in the space between. When we are in this mode, we have a tendency to speak more tentatively and to check in with our relational partner about how he or she is receiving what we are offering. This past part is particularly important because it reflects our growing felt-sense awareness that the system of the person we are helping knows more about what needs to happen next than we do. In addition to the humility and respect this engenders, we may also notice that instead of wanting to get rid of some state, we are more apt to acknowledge its meaningfulness and be present to it just as it is. Listening in this way, the so-called negative state may reveal itself as telling an important truth and become an opening toward healing. We may also be aware of the limitation and incompleteness of words, leading us to honor silence as well.

With regard to complex trauma survivors, self-determination and autonomy require that the therapist treat each client as the "authority" in determining the meaning and interpretation of his or her personal life history, including (but not limited to) traumatic experiences (Harvey, 1996). Therapists can inadvertently misappropriate the client's authority over the meaning and significance of her or his memories (and associated symptoms, such as intrusive reexperiencing or dissociative flashbacks) by suggesting specific "expert" interpretations of the memories or symptoms. Clients who feel profoundly abandoned by key caregivers may appear deeply grateful for such interpretations and pronouncements by their therapists, because they can fulfill a deep longing for a substitute parent who makes sense of the world or takes care of them. However, this delegation of authority to the therapist can backfire if the client cannot, or does not, take ownership of her or his own memories or life story by determining their personal meaning.Moreover, the client can be trapped in a stance of avoidance because trauma memories are never experienced, processed, and put to rest. Helping a client to develop a core sense of relational security and the capacity to regulate (and recover from) extreme hyper- or hypoarousal is essential if the client is to achieve a self-determined and autonomous approach to defining the meaning and impact of trauma memories, a crucial goal of posttraumatic therapy.

I want to, first of all, remove a very major error that exists in the study of Rumi today not only in America but also among a lot of Persians, Turks and others who consider Rumi only as a kind of nationalistic emblem. Rumi was a Muslim, he was a Muslim poet. He never missed his prayers. He said, (عَقل قربان کُن بہ پیش مصطفیٰ) “Sacrifice your intellect at the feet of the Prophet.” Masnavi is a commentary to the Qur’an. He knew the Qur’an extremely well. At the beginning of the Masvani, he says this remarkable sentence, (این کتاب اصول اصول اصول دین) “The book is the principle of the principle of the principle of religion [in respect of its unveiling the mysteries of attainment to the Truth and of certainty].” So it is very very clear that this book is dealing with the heart of the religion. There is no secular Rumi which is authentic. Rumi cannot be secularized … In order to understand Rumi you have to understand that he was not a New Age Poet. He was not born in California. He does not represent what [some of us] are looking for; a kind of bland, sentimental, universality in which you do not do anything for God, you don’t have to reform yourself, you just get together and be happy. He is not that kind of a poet, you must understand that. The relation of Rumi with Islam once severed will make Rumi irrelevant as a spiritual therapist … Anyway, it is very very important to realize that all the message of Rumi, everything he wrote is just in order for us to remember God. – “Rumi and the Renewal Of Life

The development of a working alliance is crucial because it addresses a psychic phobia associated with relationships that is common in complex trauma clients. As we discussed, when primary relationships are sources of profound disillusionment, betrayal, and emotional pain, any subsequent relationship with an authority figure who offers an emotional bond or other assistance might be met with a range of emotions, such as fear, suspicion, anger, or hopelessness on the negative end of the continuum and idealization, hope, overdependence, and entitlement on the positive. Therapy offers a compensatory relationship, albeit within a professional framework, that has differences from and restrictions not found in other relationships. On the one hand, the therapist works within professional and ethical boundaries and limitations in a role of higher status and education and is therefore somewhat unattainable for the client. On the other, the therapist's ethical and professional mandate is the welfare of the client, creating a perception of an obligation to meet the client's needs and solve his or her problems. Furthermore, the therapist is expected to both respect the client's privacy and accept emotional and behavioral difficulties without judgment, while simultaneously being entitled to ask the client about his or her most personal and distressing feelings, thoughts and experiences. Developing a sense of trust in the therapist, therefore, is both expected and fraught with inherent difficulties that are amplified by each client's unique history of betrayal trauma, loss, and relational distress.

The first thing I want to say about Boyfriend is that he’s an extraordinarily decent human being. He’s kind and generous, funny and smart, and when he’s not making you laugh, he’ll drive to the drugstore at two a.m. to get you that antibiotic you just can’t wait until morning for. If he happens to be at Costco, he’ll text to ask if you need anything, and when you reply that you just need some laundry detergent, he’ll bring home your favorite meatballs and twenty jugs of maple syrup for the waffles he makes you from scratch. He’ll carry those twenty jugs from the garage to your kitchen, pack nineteen of them neatly into the tall cabinet you can’t reach, and place one on the counter, accessible for the morning. He’ll also leave love notes on your desk, hold your hand and open doors, and never complain about being dragged to family events because he genuinely enjoys hanging out with your relatives, even the nosy or elderly ones. For no reason at all, he’ll send you Amazon packages full of books (books being the equivalent of flowers to you), and at night you’ll both curl up and read passages from them aloud to each other, pausing only to make out. While you’re binge-watching Netflix, he’ll rub that spot on your back where you have mild scoliosis, and when he stops, and you nudge him, he’ll continue rubbing for exactly sixty more delicious seconds before he tries to weasel out without your noticing (you’ll pretend not to notice). He’ll let you finish his sandwiches and sentences and sunscreen and listen so attentively to the details of your day that, like your personal biographer, he’ll remember more about your life than you will. If this portrait sounds skewed, it is.

Type II trauma also often occurs within a closed context - such as a family, a religious group, a workplace, a chain of command, or a battle group - usually perpetrated by someone related or known to the victim. As such, it often involves fundamental betrayal of the relationship between the victim and the perpetrator and within the community (Freyd, 1994). It may also involve the betrayal of a particular role and the responsibility associated with the relationship (i.e., parent-child, family member-child, therapist-client, teacher-student, clergy-child/adult congregant, supervisor-employee, military officer-enlisted man or woman). Relational dynamics of this sort have the effect of further complicating the victim's survival adaptations, especially when a superficially caring, loving or seductive relationship is cultivated with the victim (e.g., by an adult mentor such as a priest, coach, or teacher; by an adult who offers a child special favors for compliance; by a superior who acts as a protector or who can offer special favors and career advancement). In a process labelled "selection and grooming", potential abusers seek out as potential victims those who appear insecure, are needy and without resources, and are isolated from others or are obviously neglected by caregivers or those who are in crisis or distress for which they are seeking assistance. This status is then used against the victim to seduce, coerce, and exploit. Such a scenario can lead to trauma bonding between victim and perpetrator (i.e., the development of an attachment bond based on the traumatic relationship and the physical and social contact), creating additional distress and confusion for the victim who takes on the responsibility and guilt for what transpired, often with the encouragement or insinuation of the perpetrator(s) to do so.

Many of those who have experienced trauma in early childhood grow up to become adults with dysfunctional lives and dysfunctional relationships, never being able to solve such issues within themselves, not even with the help of the best therapists in the world, because the root cause of it has been removed by the institutions in control of mental health training programs, mainstream media and public opinion. And the root cause of all evil, including self-inflicted evil, lays on the capacity to differentiate good from evil, which has helped us survive as a society and as individuals throughout the entirety of human history and up to this day. Once you remove this natural ability from anyone's awareness, no theory, despite the amount of logic and common sense in it, will ever work. As a matter of fact, not many people know what serves their best interest, because they don't even know what is good or evil. They relativize their ignorance to justify their stupidity. And this constitutes a thicker layer on top of their innate capacity to perceive reality. Many problems, including those related to self-esteem, could easily be solved, if one was able of properly differentiating what promotes survival from what leads to death. Whenever a large group of people lacks such capacity, they are promoting a dysfunctional society by default, and in doing so, replicating the same traumas that made them themselves dysfunctional as humans. And that’s how an overall mindset rooted on victimization and justification promotes the power of those in control. One cannot ever be free unless he rebels against his own status quo and towards a higher level of individualization, risking that which he depends the most upon — the respect and acceptance of friends and family. The battle of ego and social validation against ethics, has made many souls captive to a world created to weaken them and blind them. Indeed, it is interesting to see how humanity replicates the tortures of medieval times with more sophisticated weapons, and how wars developed towards a higher degree of abstraction, in order to nullify any resistance, or the mere level of awareness justifying it.

Wake up every day, expecting not to know what's going to happen, and look for the events to unfold with curiosity. Instead of stressing and managing, just be present at anything that pops up with the intention of approaching it with your best efforts. Whatever happens in the process of spiritual awakening is going to be unpredictable and moving forward, if you're just the one who notices it, not fighting or making a big project out there. •       You may have emotional swings, energetic swings, psychic openings, and other unwanted shifts that, as you knew, feel unfamiliar to your personality. Be the beholder. Don't feel like you have something to fix or alter. They're going to pass. •       If you have severe trauma in your history and have never had therapy, it might be very useful to release the pains of memories that arise around the events. Therapy teaches you how to express, bear witness, release, and move forward. Your therapist needn't know much about kundalini as long as he or she doesn't discount that part of your process. What you want to focus on is the release of trauma-related issues, and you want an experienced and compassionate therapist who sees your spiritual orientation as a motivation and support for the healing process. •       This process represents your chance to wake up to your true nature. Some people wake up first, and then experience the emergence of a kundalini; others have the kundalini process going through as a preparation for the emergence. The appearance happens to do the job of wiping out, so is part of either pattern. Waking up means realizing that whoever looks through your eyes, lives through your senses, listens to your thoughts, and is present at every moment of your experience, whether good or bad, is recognized or remembered. This is a bright, conscious, detached and unconditionally loving presence that is universal and eternal and is totally free from all the conditions and memories you associate with as a personal identity. But as long as you believe in all of your personal conditions and stories, emotions, and thoughts, you have to experience life filtered by them. This programmed mind is what makes the game of life to be varied and suspense-filled but it also causes suffering and fear of death. When we are in Samadhi and Satori encounters, we glimpse the Truth about the vast, limitless space that is the foundation for our being. It is called gnosis (knowledge) or the One by the early Gnostics. Some spiritual teachings like Advaita Vedanta and Zen go straight for realization, while others see it as a gradual path through years of spiritual practices. Anyway, the ending is the same. As Shakespeare said, when you know who you are, the world becomes a stage and you the player, and life is more light and thoughts less intrusive, and the kundalini process settles down into a mellow pleasantness. •       Give up places to go and to be with people that cause you discomfort.

Treating Abuse Today (Tat), 3(4), pp. 26-33 Freyd: You were also looking for some operational criteria for false memory syndrome: what a clinician could look for or test for, and so on. I spoke with several of our scientific advisory board members and I have some information for you that isn't really in writing at this point but I think it's a direction you want us to go in. So if I can read some of these notes . . . TAT: Please do. Freyd: One would look for false memory syndrome: 1. If a patient reports having been sexually abused by a parent, relative or someone in very early childhood, but then claims that she or he had complete amnesia about it for a decade or more; 2. If the patient attributes his or her current reason for being in therapy to delayed-memories. And this is where one would want to look for evidence suggesting that the abuse did not occur as demonstrated by a list of things, including firm, confident denials by the alleged perpetrators; 3. If there is denial by the entire family; 4. In the absence of evidence of familial disturbances or psychiatric illnesses. For example, if there's no evidence that the perpetrator had alcohol dependency or bipolar disorder or tendencies to pedophilia; 5. If some of the accusations are preposterous or impossible or they contain impossible or implausible elements such as a person being made pregnant prior to menarche, being forced to engage in sex with animals, or participating in the ritual killing of animals, and; 6. In the absence of evidence of distress surrounding the putative abuse. That is, despite alleged abuse going from age two to 27 or from three to 16, the child displayed normal social and academic functioning and that there was no evidence of any kind of psychopathology. Are these the kind of things you were asking for? TAT: Yeah, it's a little bit more specific. I take issue with several, but at least it gives us more of a sense of what you all mean when you say "false memory syndrome." Freyd: Right. Well, you know I think that things are moving in that direction since that seems to be what people are requesting. Nobody's denying that people are abused and there's no one denying that someone who was abused a decade ago or two decades ago probably would not have talked about it to anybody. I think I mentioned to you that somebody who works in this office had that very experience of having been abused when she was a young teenager-not extremely abused, but made very uncomfortable by an uncle who was older-and she dealt with it for about three days at the time and then it got pushed to the back of her mind and she completely forgot about it until she was in therapy. TAT: There you go. That's how dissociation works! Freyd: That's how it worked. And after this came up and she had discussed and dealt with it in therapy, she could again put it to one side and go on with her life. Certainly confronting her uncle and doing all these other things was not a part of what she had to do. Interestingly, though, at the same time, she has a daughter who went into therapy and came up with memories of having been abused by her parents. This daughter ran away and is cutoff from the family-hasn't spoken to anyone for three years. And there has never been any meeting between the therapist and the whole family to try to find out what was involved. TAT: If we take the first example -- that of her own abuse -- and follow the criteria you gave, we would have a very strong disbelief in the truth of what she told.

PATTERNS OF THE “SHY” What else is common among people who identify themselves as “shy?” Below are the results of a survey that was administered to 150 of my program’s participants. The results of this informal survey reveal certain facts and attitudes common among the socially anxious. Let me point out that these are the subjective answers of the clients themselves—not the professional opinions of the therapists. The average length of time in the program for all who responded was eight months. The average age was twenty-eight. (Some of the answers are based on a scale of 1 to 5, 1 being the lowest.) -Most clients considered shyness to be a serious problem at some point in their lives. Almost everyone rated the seriousness of their problem at level 5, which makes sense, considering that all who responded were seeking help for their problem. -60 percent of the respondents said that “shyness” first became enough of a problem that it held them back from things they wanted during adolescence; 35 percent reported the problem began in childhood; and 5 percent said not until adulthood. This answer reveals when clients were first aware of social anxiety as an inhibiting force. -The respondents perceived the average degree of “sociability” of their parents was a 2.7, which translates to “fair”; 60 percent of the respondents reported that no other member of the family had a problem with “shyness”; and 40 percent said there was at least one other family member who had a problem with “shyness.” -50 percent were aware of rejection by their peers during childhood. -66 percent had physical symptoms of discomfort during social interaction that they believed were related to social anxiety. -55 percent reported that they had experienced panic attacks. -85 percent do not use any medication for anxiety; 15 percent do. -90 percent said they avoid opportunities to meet new people; 75 percent acknowledged that they often stay home because of social fears, rather than going out. -80 percent identified feelings of depression that they connected to social fears. -70 percent said they had difficulty with social skills. -75 percent felt that before they started the program it was impossible to control their social fears; 80 percent said they now believed it was possible to control their fears. -50 percent said they believed they might have a learning disability. -70 percent felt that they were “too dependent on their parents”; 75 percent felt their parents were overprotective; 50 percent reported that they would not have sought professional help if not for their parents’ urging. -10 percent of respondents were the only child in their families; 40 percent had one sibling; 30 percent had two siblings; 10 percent had three; and 10 percent had four or more. Experts can play many games with statistics. Of importance here are the general attitudes and patterns of a population of socially anxious individuals who were in a therapy program designed to combat their problem. Of primary significance is the high percentage of people who first thought that “shyness” was uncontrollable, but then later changed their minds, once they realized that anxiety is a habit that can be broken—without medication. Also significant is that 50 percent of the participants recognized that their parents were the catalyst for their seeking help. Consider these statistics and think about where you fit into them. Do you identify with this profile? Look back on it in the coming months and examine the ways in which your sociability changes. Give yourself credit for successful breakthroughs, and keep in mind that you are not alone!

The therapist seeking to offer a relationship at depth does not use the relationship as a means to treat, cure or change the client's problem. The clients problem is accepted and respected as a expression of their self-experience, but it does not define the person: the therapist remains oriented towards the whole person - not towards the client's specific symptoms or difficulties.

I believe that what the vast majority of the masses call life is just fiction. A therapist's work ends up being trying to bring them into nonfiction. Although I feel that many are just replacing a novel by another. Too many people tell me: 'Why do you talk like you know the truth? There is no truth'. It is as if they felt that I'm destroying their inner world by being direct. They feel the need to project a defense mechanism to protect it. Another common phrase is: 'You don't know me better than I know myself'. This one is also interesting. Because it is as if the person was saying: 'You don't know my novel better than I do because I am the author of it.’ Life pretty much follows the same principles — gravity, air, water, fire, weight, hight; all of which is represented in maths, physics, and other sciences. But most people these days consider a personal attack when you make them observe something that may touch their inner world. It's the oversensitivity paradox in which we live today, for people want to feel more alive but are afraid to live at the same time. Allegorically speaking, they need to float like a bubble of steel. And many times they are perfectly fine in discussing others' issues until those issues are projected at them for self-analysis. Quite often, we are not really talking to a human being, but to his alter-ego. There's not much difference between the real self and the alternate version of that self for such person. And how ironic when both the therapist and the patient play the same game from different perspectives. This is why people don't want the truth anymore, but an alternate version of reality where they can merge themselves as if they were merely a chemical solution melting with another. They are too afraid of the truth because they have often been hurt when trying to find it. However, the concept of truth merges with the personality of the individual. And that is why having a personality is now an outdated concept, often falling into the realm of the abstract — Everything is relative, everything is fine, and everyone is everything you can decide for yourself. So why live if life has no meaning? Well, life does have a meaning, but won't be found by running away from it.

most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel.

stabilization, symptom reduction, and skills training; (2) treatment of traumatic memories; and (3) personality integration and rehabilitation (Boon & Van der Hart, 1991; Brown, Scheflin, & Hammond, 1998; Chu, 1998; Courtois, 1999; Herman, 1992; ISSTD, in press; Kluft, 1999; Steele & Van der Hart, 2009; Steele, Van der Hart, & Nijenhuis, 2001, 2005; Van der Hart, Van der Kolk, & Boon, 1998; Van der Hart, Nijenhuis, & Steele, 2006).

Some of the prominent ones that have been particularly useful for many trauma survivors include dialectical behavior therapy for borderline personality (Linehan, 1993); systems training for emotional predictability and problem solving (STEPPS; Blum et al., 2008; Bos, Van Wel, Appelo, & Verbraak, 2010 also for borderline personality; short-term psychodynamic treatment of affect phobia (McCullough et al., 2003); and mindfulness and mentalization-based treatments such as acceptance and commitment therapy (ACT; Follette & Pistorello, 2007). In the past decade, manuals that specifically address the

I smile, knowing exactly what he means. Relationships in life don’t really end, even if you never see the person again. Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others.

We strongly recommend that anyone using this manual become familiar with the updated International Society for the Study of Trauma and Dissociation Treatment Guidelines for DID and DDNOS (ISSTD Treatment Guidelines, 2011).

The worst part, however, was that I didn’t see anyone else struggling with such a peculiar load. I was ashamed of my wheelbarrow and did my best to make sure that nobody would notice it. After all, what could I answer if someone were to ask me how I came by so many frogs? To be honest, I hardly knew most of my frogs. I thought of them as green monsters and regarded them as no more than a burden that I had to bear.

realized that I could no longer do this alone and that I needed help from someone else to keep the wheelbarrow upright on this stretch of the road. It took a lot of courage and a great deal of trust to dare ask for that help—trust in that other person, but even more, genuine trust in myself.

Going to therapy and talking about healing may just be the go-to flex of our time. It is supposedly an indicator of how profoundly self-aware, enlightened, emotionally mature, or “evolved” an individual is. Social media is obsessed and saturated with pop psychology and psychiatry content related to “healing”, trauma, embodiment, neurodiversity, psychiatric diagnoses, treatments alongside productivity hacks, self-care tips and advice on how to love yourself without depending on anyone else, cut people out of your life, manifest your goals to be successful, etc. Therapy isn’t a universal indicator of morality or enlightenment. Therapy isn’t a one-size-fits-all solution that everyone must pursue. There are many complex political and cultural reasons why some people don’t go to therapy, and some may actually have more sustainable support or care practices rooted in the community. This is similar to other messaging, like “You have to learn to love yourself first before someone else can love you”. It all feeds into the lie that we are alone and that happiness comes from total independence. Mainstream therapy blames you for your problems or blames other people, and often it oscillates between both extremes. If we point fingers at ourselves or each other, we are too distracted to notice the exploitative systems making us all sick and sad. Oftentimes, people come out of therapy feeling fully affirmed and unconditionally validated, and this ego-caressing can feel rewarding in the moment even if it doesn’t help ignite any growth or transformation. People are convinced that they can do no wrong, are infallible, incapable of causing harm, and that other people are the problem. Treatment then focuses on inflating self-confidence, self-worth, self-acceptance, and self-love to chase one’s self-centered dreams, ambitions, and aspirations without taking any accountability for one’s own actions. This sort of individualistic therapeutic approach encourages isolation and a general mistrust of others who are framed as threats to our inner peace or extractors of energy, and it further breeds a superiority complex. People are encouraged to see relationships as accessories and means to a greater selfish end. The focus is on what someone can do for you and not on how to give, care for, or show up for other people. People are not pushed to examine how oppressive conditioning under these systems shows up in their relationships because that level of introspection and growth is simply too invalidating. “You don’t owe anyone anything. No one is entitled to your time and energy. If anyone invalidates you and disturbs your peace, they are toxic; cut them out of your life. You don’t need that negativity. You don’t need anyone else; you alone are enough. Put yourself first. You are perfect just the way you are.” In reality, we all have work to do. We are all socialized within these systems, and real support requires accountability. Our liberation is contingent on us being aware of our bullshit, understanding the values of the empire that we may have internalized as our own, and working on changing these patterns. Therapized people may fixate on dissecting, healing, improving, and optimizing themselves in isolation, guided by a therapist, without necessarily practicing vulnerability and accountability in relationships, or they may simply chase validation while rejecting the discomfort that comes from accountability. Healing in any form requires growth and a willingness to practice in relationships; it is not solely validating or invalidating; it is complex; it is not a goal to achieve but a lifelong process that no one is above; it is both liberating and difficult; it is about acceptance and a willingness to change or transform into something new; and ultimately, it is going to require many invalidating ego deaths so we can let go of the fixation of the “self” to ease into interdependence and community care.

You have a breakup, but you didn’t lose a spouse. So friends assume that you’ll move on relatively quickly, and things like these concert tickets become an almost welcome external acknowledgement of your loss—not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

Some people hope that therapy will help them find a way to be heard by whoever they feel wronged them, at which point those lovers or relatives will see the light and become the people they’d wished for all along. But it rarely happens like that. At some point, being a fulfilled adult means taking responsibility for the course of your own life and accepting the fact that now you’re in charge of your choices.

galvanized

impetus

Then one day, when I arrived at the biggest, deepest pothole in the road, I realized that I could no longer do this alone and that I needed help from someone else to keep the wheelbarrow upright on this stretch of the road. It took a lot of courage and a great deal of trust to dare ask for that help—trust in that other person, but even more, genuine trust in myself.

The authors of this book are such people. When you read what they have written, you will find that they have your very best interests at heart.

know my frogs now. If anything, they have turned from green monsters into dear green friends.

turn over the pages, and get to work. Believe in yourself, believe in all your parts, and believe in your therapist. I know you can. I trust in you. —Jolanda Treffers

If you are using this manual in your individual therapy rather than participating in a group, you may ignore the agenda at the beginning of each chapter, as well as the entire Part 8, chapters 33–35, which are focused on group participation. Some topics may not be relevant to you.

Awareness of these obstacles is the first step in overcoming them.

glance at the bees pressed up against the glass and think of my father again and how once, when I was complaining about the way a relative would try to make me feel guilty, my father quipped, “Just because she sends you guilt doesn’t mean you have to accept delivery.” I think about this with Charlotte: I don’t want her to feel guilty for leaving, to feel that she has let me down. All I can do is let her know that I am here for her either way, share my perspective and hear hers, and set her free to do as she wishes. “You

In the course of psychotherapy with children, innumerable transactions between child and therapist result in an emotionally corrective, relational healing experience. What happens when therapists respond in the expected way?

...it's not surprising that Charlotte wants me to be the mother for her now. I can be the "normal" parent who safely and lovingly drives the car, and she can have the experience of being taken care of in a way she never has before. But in order to cast me in the competent role, Charlotte believes she has to cast herself as the helpless one, letting me see only her problems -- or, as Wendell once put it in relation to what I do with him: "seduce me with her misery." Patients often do this as a way to ensure that the therapist won't forget about their pain if they mention something positive.

Dissociation is a word that is used for many different symptoms, and at times, it is understood differently by various professionals. We will begin by explaining integration, which is what you strive for as a major part of your healing.

Relationships in life don’t really end, even if you never see the person again. Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate

Every therapy session belongs to both patient and therapist, to the interaction between them. It was the psychoanalyst Harry Stack Sullivan who, in the early twentieth century, developed a theory of psychiatry based on interpersonal relationships. Breaking away from Freud’s position that mental disorders were intrapsychic in origin (meaning “in one’s mind”), Sullivan believed that our struggles were interactional (meaning “relational”). He went so far as to say, “It’s the mark of a senior clinician that he or she is the same person in their living room that they are in their office.” We can’t teach patients to be relational if we aren’t relational with them.

There’s another related concept that I share with John: impermanence. Sometimes in their pain, people believe that the agony will last forever. But feelings are actually more like weather systems—they blow in and they blow out. Just because you feel sad this minute or this hour or this day doesn’t mean you’ll feel that way in ten minutes or this afternoon or next week. Everything you feel—anxiety, elation, anguish—blows in and out again. For John, on Gabe’s birthday, on certain holidays, or simply running in the background, there will always be pain. Hearing a certain song in the car or having a fleeting memory might even plunge him into momentary despair. But another song, or another memory, might minutes or hours later bring intense joy.

If the eating disorder is concretized by the "not-me" ED, the patient is allowed the safety to look around comers, to follow this "other self' into the kitchen; the bathroom; yes, even the bedroom; to observe. Shame and blame are reduced; curiosity is enhanced. Conceptually this is interesting. Many patients are able to observe once allowed to look. They know well who they are at these moments. Relationally, however, they have never been entitled to look, and, as a result, self-observation and understanding have been thwarted by relational constraints and consequent immediate behavioral enactments. Ongoing, the patient is asked to consider what alternative behaviors can replace eating, purging or restricting. If the patient weren't thinking about food or weight, what else would she be thinking about? What else is needed? As the patient begins to consider concrete alternatives to symptomatic behavior, "contracts" are developed between patient and therapists.

As unpredictable as the content of the LSD reaction is its intensity; the individual responses to the same dosage level vary considerably. My experience indicates that the degree of sensitivity or resistance to LSD depends on complicated psychological factors rather than on variables of a constitutional, biological, or metabolic nature. Subjects who in everyday life have the need to maintain full self-control and have difficulties in relaxing and “letting go” can sometimes resist relatively high dosages of LSD (300 to 500 micrograms) and show no detectable changes. Occasionally, a person can resist a considerable dose of LSD if he has set this as a personal task for himself for any reason. He may decide to do this to defy the therapist and compete with him, to demonstrate his “strength” to himself and to others, to endure more than his fellow patients, or for many other reasons. Usually, however, more relevant unconscious motives can be found underlying such superficial rationalizations. Another cause for a high resistance to the effect of the drug may be insufficient preparation, instruction, and reassurance of the subject, a lack of his full agreement and cooperation, or absence of basic trust in the therapeutic relationship. In this case, the LSD reaction sometimes does not take its full course until the motives of resistance are analyzed and understood. Occasional sudden sobering, which can occur at any period of the session and on any dosage level, can be understood as a sudden mobilization of defenses against the emergence of unpleasant traumatic material. Among psychiatric patients, severe obsessive-compulsive neurotics are particularly resistant to the effect of LSD. It has been a common observation in my research that such patients can resist dosages of more than 500 micrograms of LSD and show only slight signs of physical or psychological distress. In extreme cases, it can take several dozen high-dose LSD sessions before the psychological resistances of these individuals are reduced to the point that they start having episodes of regression to childhood and become aware of the unconscious material that has to be worked through.

The sheer scale of the family wealth makes Jonathan’s concerns about losing it seem pretty irrational. But emotions are emotions. “You put the walls up and you want to guard it and protect it and defend it and heaven forbid somebody should take it from you,” he says. “You’re fear-based now.” In some ways, being very rich and very poor are strangely similar. Just as having not enough money creates fear and anxiety, so can having more than you know what to do with. At both ends of the spectrum, money tinkers with our notions of self-worth, our egos, our social lives, the stability of our marriages, our relationships with children, parents, and siblings—even our mental health. Raising that difficult child properly requires a network of friends and relatives, teachers and advisors, except in the ultrawealth world those teachers and advisors wear business casual and charge substantial fees. “I’m a lawyer, not a therapist,” one estate lawyer who caters to ultra-high-net-worth clients told me. “Although the fact of the matter is, you become one.

Thankfully, I eventually realized that I had unresolved attachment issues, and sought out a Relational therapist who valued the use of her own vulnerable and emotionally authentic self as a tool in therapy.

It’s a complicated disorder. After reading the literature, viewing tapes, and consulting with experts, I concluded that several phenomena have to happen simultaneously for it to arise. The patient has to have a complex PTSD, such as what Danny suffered—meaning that they’ve experienced severe emotional, sexual, and sometimes physical abuse over a prolonged period. That same patient must exhibit great natural tenacity and resilience, thus refusing to go completely insane. It also correlates with a good memory, creativity, and a relatively high IQ. This unusual combination of variables doesn’t come along that often, which is one of the reasons why the disorder is so rare. It’s a sophisticated way to make the unbearable bearable—a way to protect your mind and keep a piece of yourself, the largest piece, safe.

I just officially completed my physical therapy!” Colby shouts gleefully, and everyone applauds and cheers. He gestures to me. “Thanks to the professionalism and expertise of my wonderful physical therapist, I’m as good as new!” He flexes his muscular arms. More cheers and applause. “And now that Lydia’s no longer my physical therapist, guess what?” Colby’s smile lights up his entire face. “I can finally engage in romantic relations with Lydia Decker!” I throw my palms over my cheeks, flabbergasted, as everyone in the clinic cheers and laughs.

Carl Jung coined the term collective unconscious to refer to the part of the mind that holds ancestral memory, or experience that is common to all humankind. Whereas Freud interpreted dreams on the object level, meaning how the content of the dream related to the dreamer in real life (the cast of characters, the specific situations), in Jungian psychology, dreams are interpreted on the subject level, meaning how they relate to common themes in our collective unconscious. It’s no surprise that we often dream about our fears. We have a lot of fears.

Carl Jung coined the term collective unconscious to refer to the part of the mind that holds ancestral memory, or experience that is common to all humankind. Whereas Freud interpreted dreams on the object level, meaning how the content of the dream related to the dreamer in real life (the cast of characters, the specific situations), in Jungian psychology, dreams are interpreted on the subject level, meaning how they relate to common themes in our collective unconscious. It’s no surprise that we often dream about our fears. We have a lot of fears. What are we afraid of? We are afraid of being hurt. We are afraid of being humiliated. We are afraid of failure and we are afraid of success. We are afraid of being alone and we are afraid of connection. We are afraid to listen to what our hearts are telling us. We are afraid of being unhappy and we are afraid of being too happy (in these dreams, inevitably, we’re punished for our joy). We are afraid of not having our parents’ approval and we are afraid of accepting ourselves for who we really are. We are afraid of bad health and good fortune. We are afraid of our envy and of having too much. We are afraid to have hope for things that we might not get. We are afraid of change and we are afraid of not changing. We are afraid of something happening to our kids, our jobs. We are afraid of not having control and afraid of our own power. We are afraid of how briefly we are alive and how long we will be dead. (We are afraid that after we die, we won’t have mattered.) We are afraid of being responsible for our own lives. Sometimes it takes a while to admit our fears, especially to ourselves. I’ve noticed that dreams can be a precursor to self-confession—a kind of pre-confession. Something buried is brought closer to the surface, but not in its entirety.

We speak with the authority of our training and clinical experience, to be sure, but we’re grounded more deeply in our own relational recovery. We’re more like twelve-step sponsors than blank-screen traditional therapists. Look at the power we give away when we therapists hide behind the wall of “professionalism” and “neutrality.

I was finding it hard to manage my negative thoughts because, outside of Wendell’s office, they didn’t have much of an outlet. Breakups tend to fall into the category of silent losses, less tangible to other people. You have a miscarriage, but you didn’t lose a baby. You have a breakup, but you didn’t lose a spouse. So friends assume that you’ll move on relatively quickly, and things like these concert tickets become an almost welcome external acknowledgment of your loss—not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

The R in NARM is about the therapeutic relationship, which includes both client and therapist. NARM is an approach based in intersubjectivity. This process invites the possibility of deepening connection to Self and others. As we teach in NARM—and will detail throughout this book—connection is both our deepest desire and greatest fear.

Future chapters will explain other factors that influence the working hypothesis, such as the client’s psychobiological capacity, the role of shame as an adaptive survival strategy, unresolved needs and emotions, and the therapist’s capacity for self-inquiry. Remember, the working hypothesis is cultivated through curiosity and openness to the client’s internal world—and not through interpretations, which can be distorted by the therapist’s unconscious biases and countertransference reactions. Therapists hold the working hypothesis in a way that does not simplify the client’s experience but encourages the therapist and client to be present with increasing complexity, nuance, and depth.

You can begin to learn to stop yourself from spacing out and eventually to overcome much of your dissociation by learning to stay present.

When you start to feel spacey or otherwise not very present, a pleasant smell is a powerful reminder of the present.

People with dissociative disorders encounter a number of problems that interfere with being present. When you are under stress or faced with a painful conflict or intense emotion, you may have a variety of ways to retreat from the present in order to avoid it.

Although retreat may feel better in the moment, in the long run you will become increasingly avoidant of the present, which can make your problems worse.

There may be times when you feel spacey, foggy, or fuzzy.

It may seem as though you are present and not present at the same time!

Connection survival style themes to show up in an atmosphere of safety and consent. The use of contracting emphasizes the therapist’s attention, interest, and concern about truly understanding the client. Contracting provides an opportunity to shift old relational patterns of feeling completely alone. This process of intersubjectivity supports a shift away from objectification toward subjectification. Clients are invited to be active collaborators with their therapist, which provides a sense of control over the therapeutic process. Attunement: The contracting process invites clients identified with Attunement survival style themes to check in with and express their needs and feelings. From the very beginning, this process provides an opportunity to shift old relational patterns of feeling that they cannot express their needs and feelings. Contracting helps clients feel seen and heard—by their therapist but also themselves. They are invited, welcomed, and encouraged to reflect on their authentic needs and wishes. Trust: The contracting process gives clients identified with Trust survival style themes the power to set their own course for therapy. The collaborative nature of contracting provides an opportunity to shift old relational patterns where they felt they had to control others in order to feel safe. They are welcomed to modulate their level of openness and vulnerability according to their own sense of comfort and trust. Autonomy: The contracting process encourages clients identified with Autonomy survival style themes to share their authentic Self in an environment of openness, understanding, and respect. Inviting the client to determine their intention and goals for therapy provides an opportunity to shift old relational patterns of having to control against other people’s agendas. Love-Sexuality: The contracting process supports clients identified with Love-Sexuality survival style themes with a sense of not having to be perfect to be accepted and loved. Contracting provides an opportunity to shift old relational patterns where they felt pressure of having to perform and achieve. Clients are welcomed to share from a more open-hearted and intimate place.

teachers hanging in with challenging students, such as Marcus, are not therapists, but we must behave as therapists; that is, we must provide an emotionally safe environment in which our students can become their best selves, intellectually and emotionally. We, the adults, are the most significant force for honesty and integrity in the classroom. We have to display a professional self that is authentic. This does not mean that we talk about our personal lives—we are not leading students, with details of our lives, into a friendship—but that we share our professional hopes, fears, and expectations with all the passion and sadness and sincerity in us. If we behave professionally so that students trust us and seek to relate to us, we offer them a path to find a healthy place for themselves in the less-than-ideal world the adults are bequeathing to them. Succinctly put, "Relationships are the means and ends to our development" (Nakkula & Toshalis, 2006, p. 95).

Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel. I

I have lived and worked in the Washington, D. C., metropolitan area for almost four decades. During this period I have watched families and institutions recycle their problems for several generations, despite enormous efforts to be innovative. The opportunity to observe this firsthand was provided by my involvement in the major institutions designed by our civilization to foster change: religion, education, psychotherapy, and politics (I have been here since Eisenhower). That experience included twenty years as a pulpit rabbi, an overlapping twenty-five years as an organizational consultant and family therapist with a broadly ecumenical practice, and several years of service as a community relations specialist for the Johnson White House helping metropolitan areas throughout the United States to voluntarily desegregate housing, before Congress passed appropriate civil rights legislation. Eventually, the accumulation of this experience began to show me how similar all of our “systems of salvation” are in their structure, the way they formulate problems, the range of their approaches, and their rationalizations for their failures. It was, indeed, the basic similarity in their thinking processes, despite their different sociological classifications, that first led me to consider the possibility that our constant failure to change families and institutions fundamentally has less to do with finding the right methods than with misleading emotional and conceptual factors that reside within society itself. For

(Therapist:) "It's interesting that you drew yourself with this little golden crown on your head. What does the crown mean to you?" "That's not a crown," she told him. "That's a nimbus of outrage.

Groups are, in a sense, a microcosm of the real world. In all groups, there are leaders and followers . . . and many people who fall somewhere in between. Some groups are professionally led, and some are self- or volunteer-directed. In every group, there will be people you like and people you don’t, people who seek you out, and people who do not. Understanding and joining in the group process and making it work for you is what is important. Experiment with several groups, if you like, to find the ones that you enjoy the most. Strive to find a group in which you think you would feel comfortable expressing yourself or interacting with others and which has an appropriate meaning for you (a self-help group should address your particular issues; a hobby club should focus on something you enjoy). Attend the group a few times to get a sense of how members interact with each other. If the thought of doing so still causes you anxiety, continue working on stress management, and remain fairly passive in the group until you feel more comfortable. In my own social therapy group program, our purpose is to help individuals learn how to control social anxiety and refine their interactive skills. Social anxiety is a people-oriented problem, which makes group experience important both theoretically and practically. Some traditional therapists have called my program unorthodox because it encourages patients to talk to and learn from each other—as opposed to the isolation and protection offered by many of the more conservative therapies. But I say that social interaction is something you learn by doing. My groups are places to practice, make mistakes, and experience success in a supportive yet challenging environment. Of course, even in such a supportive setting, resistance still arises. In a “friendly” forum, stressors can be explored and confronted more easily, however, and I have found that the degree to which a person uses the group is often a good indicator of how well he or she is progressing therapeutically. Good attendance shows effort and commitment; poor attendance indicates that a person is giving in to anxiety. I’ve heard all the excuses and manipulations—canceling plans is typical of people with avoidance problems related to social anxiety. (I’m sometimes tempted to open a garage to repair all those cars that break down on group night!) Yet often, after overcoming the initial stage of anxiety, many participants enjoy the process. As you consider the option of incorporating various kinds of groups in your community into your self-help program, remember that groups can be a very important component of your map for change. Groups can provide you with the opportunity to practice the skills that are crucial to your success. Make sure that your expectations are realistic and that you understand the purpose and the limitations of whatever group you join.

The attachment to parental figures I am trying to describe here is an attachment to parents who have inflicted injury on their children. It is an attachment that prevents us from helping ourselves. The unfulfilled natural needs of the child are later transferred to therapists, partners, or our own children. We cannot believe that those needs were really ignored, or possibly even trampled on by our parents in such a way that we were forced to repress them. We hope that the other people we relate to will finally give us what we have been looking for, understand, support, and respect us, and relieve us of the difficult decisions life brings with it. As these expectations are fostered by the denial of childhood reality, we cannot give them up. As I said earlier, they cannot be relinquished by an act of will. But they will disappear in time if we are determined to face up to our own truth. This is not easy. It is almost always painful. But it is possible. In

Via the role of therapist, individuals with a diffuse self-concept can, in a sense, be "all things to all people." Coming into contact with a wide range of personalities, they may vary how they relate to others according to the needs of the situation. Depending upon the type of the phase of treatment, the clinician may function as teacher, healer, advisor, confidant, psychic masseur, devil's advocate, audience, or teddy bear.

Individual differences in beliefs among

Virginia Satir, one of our most famous family therapists, said, “Families are people factories.” She meant that we learn how to relate to others during our early experiences of our families. The patterns of interacting that we use today were set up early on in our lives and were reinforced over and over again until they became automatic and part of our unconscious. Our peers and others influence us as well, but the basics are learned very early on and inform much of how we think about ourselves and others later on in life.

Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

The main differences between a self-psychological approach and an object-relational one with respect to deficits is that in self-psychology one strives to understand the subjective experience of the patient, putting aside one’s own preconceptions, whereas in object relations the therapist addresses the patient’s distortions and misperceptions at face value.

We can still consider it a pause,” Wendell replies, then adds the part that’s hardest to say. “Even if we don’t meet again.” I smile, knowing exactly what he means. Relationships in life don’t really end, even if you never see the person again. Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

Schore emphasized that when the caregiver is unable to help the child to regulate either a specific emotion or intense emotions in general, or – worse – that she exacerbates the dysregulation, the child will start to go into a state of hypoaroused dissociation as soon as a threat of dysregulation arises. This temporaily reduces conscious emotional pain in the child living with chronic trauma, but those who characterologically use the emotion-deadening defense of dissociation to cope with stressful interpersonal events subsequently dissociate to defend against both daily stresses, and the stress caused when implicitly held memories of trauma are triggered. In the developing brain, repeated neurological states become traits, so dissociative defense mechanisms are embedded into the core structure of the evolving personality, and become a part of who a person is, rather than what a person does. Dissociation, which appears in the first month of life, seems to be a last resort survival strategy. It represents detachment from an unbearable situation. The infant withdraws into an inner world, avoids eye contact and stares into space. Dissociation triggered by a hypoaroused state results in a constricted state of consciousness, and a void of subjectivity. Being cut off from our emotions impacts our sense of who we are as a person. Our subjective sense of self derives from our unconscious experience of bodily-based emotions and is neurologically constructed in the right brain. If we cannot connect to our bodily emotions then our sense of self is built on fragile foundations. Many who suffered early relational trauma have a disturbed sense of their bodies and of what is happening within them physiologically as well as emotionally. The interview moved along to the topic of how we can possibly master these adverse and potentially damaging relational experiences. Schore replied by explaining that the human brain remains plastic and capable of learning throughout the entire life span, and that with the right therapeutic help and intervention we can move beyond dissociation as our primary defense mechanism, and begin to regulate our emotions more appropriately. When the relationship between the therapist and the client develops enough safety, the therapeutic alliance can act as a growth-facilitating environment that offers a corrective emotional experience via “rewiring” the right brain and associated neurocircuits.

final problem of cognitive therapy is that it is generally a short-term treatment so it is unable to build a strong enough therapeutic alliance to allow the patient to experience the corrective emotional experience. Deep change does not happen when a patient is consciously reflecting on an emotion. Rather it happens when the patient actively experiences the emotion and when a resonating emotionally present therapist recognizes and regulates that emotion, thereby modeling new ways of being with another while one is under stress. There is no interpersonal space for this repair of attachment ruptures in current models of cognitive therapy, where left brain insight dominates over right brain interactive regulation. Coming to the end, Sieff asked Schore what message he would like people to take home from this interview. Schore answered that the earliest stages of life are critical as they form the foundation of everything that follows. Our early attachment relationships, for better or worse, shape our right brain unconscious system and have lifelong consequences. An attuned early attachment relationship enables us to grow an interconnected, well-developed right brain and sets us up to become secure individuals, open to new social and emotional experiences. A traumatic early attachment relationship impairs the development of a healthy right brain and locks us into an emotionally dysregulated, amygdala-driven emotional world. As a result, our only way to defend against intense unregulated emotions is via the over reliance on repression and/or pathological characterological dissociation. Faced with relational stress, we are cut off from the world, from other people, from our emotions, from our bodies and from our sense of self. Our right brains cannot further develop or grow emotionally from our interactions with other right brains. Too many people suffer alone with their desperate pain due to their early relational trauma. For somebody struggling with such emotional dysregulation, the way to emotional security, and to a more vital, alive, and fulfilling life, does not come from making the unconscious conscious – which is essentially a left brain process

her takes a good deal of clinical experience. More importantly, the therapist needs to have worked deeply with her own early life experiences, and has to actively work with it throughout the life span. A successful therapeutic relation precipitates emotional growth not only in the patient but also in the therapist. Sieff refered to the fact that short-term cognitive behavioral therapy (CBT) is currently very popular and widely used. Can it help with healing relational trauma? Schore answered that CBT is grounded in cognitive psychology, and its research base is grounded cognitive processes such as explicit memory, rational thought, language, and effortful conscious control. Cognitively based therapy’s basic theoretical assumption is grounded in the assumption that we can change how we feel by consciously changing how we think and what we believe. This means that cognitive therapy focuses on language and thought, both of which are located in the left brain. People who have trouble regulating their emotions typically have a left brain that is already more developed than their right brain, and they may well have learned to use rational thinking and words to obscure the deeper emotional experiences and to keep them dissociated. Cognitive therapy may strengthen the very strategies that keep the affect dampening defense of dissociation in place. Even if the left brain becomes more able to control the emotions of the right brain, it can only control emotional arousal that is of low or moderate intensity. As a rule, when emotional arousal reaches a certain level of intensity the left brain goes off-line and the right brain becomes dominant. Changes made in the cognitive strategies of the left brain are unavailable when this happens. At these times, emotionally-focused therapy may enhance the neural connections between the right amygdala and the right orbifrontal cortex which allows the patient to more effectively tolerate and regulate intense emotions. Cognitive therapy which exclusively focuses on the ability of the left brain to control the right cannot directly alter changes within the right-lateralized limbic system. The

– rather, it arises through physically restructuring, growing and expanding the emotional unconscious itself. The most effective way to achieve these changes is through relationally-based, emotionally-focused psychotherapy with an empathic and psychobiologically attuned therapist who is willing and able to be an active participant in this process.

He thought I was a modern-day version of Freud’s female hysteric, experiencing what’s known as conversion disorder. This is a condition in which a person’s anxiety is “converted” into neurologic conditions such as paralysis, balance issues, incontinence, blindness, deafness, tremors, or seizures. The symptoms are often temporary and tend to be related (sometimes symbolically) to the psychological stressor at its root.

I was recently reminded of one possible reason that so many therapists are so insistent on arriving at a clinical diagnosis, and, not surprisingly, it’s directly related to problems with the health care system in America. A licensed professional counselor who has worked in the mental health field for many years wrote to say that even though she grew up in a family who strongly believe in the paranormal and in their own psychic gifts, “working with [psychic] kids is definitely a challenge in a pure clinical practice since this is not something you can bill insurance for.” Her point is very valid. Medical and mental health professionals must provide a clinical—and billable—diagnosis in order to receive payment from insurance companies. It is frightening to imagine how many children have been misdiagnosed, mislabeled, and mistreated because of the need to satisfy insurance guidelines!

Breakups tend to fall into the category of silent losses, less tangible to other people. You have a miscarriage, but you didn’t lose a baby. You have a breakup, but you didn’t lose a spouse. So friends assume that you’ll move on relatively quickly, and things like these concert tickets become an almost welcome external acknowledgment of your loss—not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

(symbolically or literally)—all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

Behavioral marital therapy is a relatively brief treatment in which the therapist meets regularly with the depressed person and his or her partner. In the first phase of treatment, the therapist tackles the biggest strains on the relationship and helps the couple have more positive interactions. The couple may be given a homework assignment to figure out what activity they have enjoyed doing together in the past and then going ahead and doing it. When this phase is successful, the depressed person is already feeling brighter and both partners are expressing positive feelings toward each other. This boost serves as the foundation for the second phase, whose aim it is to restructure the relationship—for example, to improve the way that the couple communicates, handles problems, and interacts on a daily basis. Sometimes this is done by having the couple write a behavioral “contract,” agreeing to change aspects of their behavior. When successful, this phase will leave the couple feeling more supportive and sensitive to each other’s needs, more intimate, and better able to cope with future difficulties. Finally, in the third phase, the therapist helps the two partners prepare for stressful situations that might come to pass and encourages them to attribute their improvement in therapy to their love and caring for each other. Interestingly, behavioral marital therapy has been found to be at least as effective as individual therapy at lifting depression. However, it has the additional benefit of bolstering marital satisfaction. Indeed, a number of studies have shown that the boost in marital happiness (or favorable changes in the marriage related to that boost) is in fact the reason that the marital therapy works.

Is there any other place where a more vibrant palette of human behaviour can be observed than the Scottish pub? Our drinking holes are social spaces, shelters and, with the rise of flexible working and free WiFi, informal offices. The pub is a courtroom, a therapist's clinic, a place to let socks dry out after an arduous day orienteering. Relationships begin and end in its confines. Pub dogs become celebrities. If we run with the myth that there are languages with fifty words for snow, Scots could match that with their own terms related to the act of drinking.

Both the client and therapist are not primarily seen as human persons in relation to each other and the socio-cultural world around them. Instead, they are viewed as defined by their intersecting group identities and, importantly, the differences and inequalities these identities create. Dynamics of oppression are at the heart of the CSJ-driven therapy relationship.

McIntyre,” he replied. Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel.

The primary focus is empathy, attachment, attunement, and positive emotions related to interpersonal relationships. The therapist must emphasize face-to-face gaze, eye-to-eye contact, matching facial expression, matching tone of voice, and using reflective responses. Also effective are play and play activities, such as singing, music, enjoyable social activities, playing with a pet, telling stories, special handshakes, playing with stacking blocks, Legos, or manipulatives, games that allow taking turns, playing with a cardboard box maze, playing social games (Red Light, Green Light; Mother,

Relationships in life don’t really end, even if you never see the person again. Every person you’ve been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally) - all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

Some people hope that therapy will help them find a way to be heard by whoever they feel wronged them, at which point those lovers or relatives will see the light and become the people they’d wished for all along. But it rarely happens like that.

Sullivan believed that our struggles were interactional (meaning “relational”). He went so far as to say, “It’s the mark of a senior clinician that he or she is the same person in their living room that they are in their office.” We can’t teach patients to be relational if we aren’t relational with them.

Relationships in life don't really end, even if you never see the person again. Every person you've been close to lives on somewhere inside you. Your past lovers, your parents, your friends, people both alive and dead (symbolically or literally)--all of them evoke memories, conscious or not. Often they inform how you relate to yourself and others. Sometimes you have conversations with them in your head; sometimes they speak to you in your sleep.

a condition in which a person’s anxiety is “converted” into neurologic conditions such as paralysis, balance issues, incontinence, blindness, deafness, tremors, or seizures. The symptoms are often temporary and tend to be related (sometimes symbolically) to the psychological stressor at its root.

Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience.

Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. “The greatest sources of our suffering are the lies we tell ourselves,” he’d say,

in 2020, Robert F. Anda, the co–principal investigator of the initial ACE study, came out with an article and a YouTube video stating that ACEs were a relatively crude way of measuring childhood trauma.[6] The scores are remarkably helpful epidemiologically—for people to understand the overall significance of childhood trauma on public health. But Anda underlined that ACEs are not a good measure of an individual’s life span or health outcomes. There is a wide level of variation for each score. For example, a person with an ACE score of 1 who had extremely frequent instances of their trauma might be just as traumatized as someone with a score of 6 who witnessed a broader breadth of events but experienced them on a much rarer basis. As the following chart shows, there is a lot of overlap. Clearly, people with higher scores do face genuinely larger risks. But the scores are not hard-and-fast determinants. ACE scores also don’t account for whether a child had good resources, such as adults who provided them with safe and loving relationships or therapists who taught them to manage their stress better. They don’t account for gender variation, as PTSD manifests differently in men and women. In his article, Anda cautioned that using ACE scores as an individual screening tool has several risks, including that ACEs “may stigmatize or lead to discrimination…generate client anxiety about toxic-stress physiology, or misclassify individual risk.”[7]

This means that relatively safe bets include becoming a teacher, nurse, doctor, dentist, scientist, entrepreneur, programmer, engineer, lawyer, social worker, clergy member, artist, hairdresser or massage therapist.

Getting through Burnout I’ve heard burnout manifests itself differently in different people, but for me it felt like a mix of depression and frustration. Not the kind you can clear up with a weekend away, but a long-term, deep sense of tiredness, lack of motivation, and feeling just a little pissed off at all times. This led to my aforementioned stints of staring at Trello for hours and a lack of presence at home. I would be home with the family, but most of the time my mind was elsewhere. I tell this as a cautionary tale: if you find yourself listless, unmotivated, or constantly frustrated as you endure the stress of building your company, it’s unlikely to fix itself. The best remedy for burnout is significantly changing your habits and patterns related to work, including stepping away for weeks, which feels like the last thing you can do when everything is going crazy (whether it’s good crazy or bad crazy). If you find yourself in this situation, you need to address it, or it will get worse. If unaddressed, burnout can lead to terrible outcomes, including long-term damage to your brain. If burnout is a situation you find yourself in, consider reaching out to a professional who works with founders on the mental game of entrepreneurship. Dr. Sherry Walling is one (she happens to be my wife, and she knows her stuff), but there are many other executive coaches and therapists who work with high-performing individuals to manage stress, burnout, and everything else that comes with our line of work. I’ve only started to touch on burnout here, but for an entire chapter about it, check out my third book: The Entrepreneur’s Guide to Keeping Your Sh*t Together: How to Run Your Business Without Letting it Run You.

To nurture a healthier way of connecting in romantic relationships, consider how your current or future relationship might be better if you had a more secure style of attachment. As you think about this, however, it’s important for you to know that you do not need to be the model of secure attachment to find happiness. But whatever style works for you, it will probably need to be closer to a secure one on the attachment-related anxiety and attachment-related avoidance dimensions. Fortunately, as I’ve mentioned, you can develop this more secure style as an adult. This process is what psychologists call “earned security.” There are two basic pathways, and they intertwine. First, you must look to the outside world. You need to begin by developing a relationship with at least one emotionally available attachment figure. If not a partner, then you can start with someone else, such as a family member, friend, clergyperson, or therapist. It could even be God. Remember, attachment figures are those you feel you can turn to in times of distress and who are supportive of your attempts to expand your personal horizons. The more you experience feeling accepted and protected, the more you will believe that you are worthy of love and that capable others can be available to truly love and comfort you—giving you some “earned security.” The second approach to developing “earned security” is to directly nurture a part of yourself that makes you more aware of your experiences and to respond to those experiences in a more accepting and compassionate way.

Occasionally, I give kids days off. If a child seems to be losing ground at school, return him home for a few days or even a week or two to recoup. He rests from so much outside contact, and gets recharged to cope with the world in a constructive way again. Parents usually only use a few days a year, so school progress is not much affected. For the occasional child who is out ten days in a year, the problems are serious enough that school achievement is secondary to health. In these cases the school is the communication loop with parents and therapist. Working parents have used sick days to stay out with their child. Some parents have asked a grandparent or relative to come in while they work. Often the regression has so worn the parent down, that a two-day break is a welcome respite for both of them to sleep in and recharge. Using these breaks has helped keep kids from ruining the gains that they have made in the school and community over a series of months. While these breaks need to be used judiciously, they have helped children to keep friendships and reputations that would otherwise be at risk.

There is no simple way to determine when and where to get help. Many factors come into play, including the child’s age, family’s financial status, insurance, knowledge of resources, religious affiliation, availability of services in community, and so on. Parents may seek outside assistance for their adopted child when other factors such as a divorce, job loss, or other stresses compound the family needs. Parents are generally in the best position to determine when to get help, but advice from relatives, family physicians, teachers, and others in a position to know the family should be carefully considered. Services for children with special needs are provided by a variety of professionals. A physician—pediatrician or the family practitioner—is usually the place to begin. Families may be referred to a neurologist for a thorough assessment and diagnosis of neurological functioning (related to cognitive or learning disabilities, seizure disorders or other central nervous system problems). For specific communication difficulties, families may consult with a speech and language therapist, while a physical therapist would develop a treatment plan to enhance motor development. A rehabilitation technologist or an occupational therapist prescribes adaptive aids or activities of daily living. Early childhood educators specializing in working with children with special needs may be called a variety of titles, including Head Start teachers, early childhood special education teacher, or early childhood specialist.

Of course, not all failures in integration result in dissociation. Integrative failures are on a continuum. Dissociation involves a kind of parallel owning and disowning of experience: While one part of you owns an experience, another part of you does not. Thus, people with dissociative disorders do not feel integrated and instead feel fragmented because they have memories, thoughts, feelings, behaviors, and so forth that they experience as uncharacteristic and foreign, as though these do not belong to themselves. Their personality is not able to “shift gears” smoothly from one response pattern to another; rather, their sense of self and enduring patterns of response change from situation to situation, and they are not very effective at adopting new ways of coping. They

Carl Jung coined the term collective unconscious to refer to the part of the mind that holds ancestral memory, or experience that is common to all humankind. Whereas Freud interpreted dreams on the object level, meaning how the content of the dream related to the dreamer in real life (the cast of characters, the specific situations), in Jungian psychology, dreams are interpreted on the subject level, meaning how they relate to common themes in our collective unconscious.

In my opinion, it would take a very determined therapist twenty years or more of intense psychoanalytical therapy to completely rehabilitate a serial killer and to restore his disturbed object relations. This is impractical.

The following are guidelines to finding a sponsor, therapist or counselor who will usually tend to be helpful rather than harmful. The person will tend to have or be: 1) Demonstrable training and experience. For example, a clinician or therapist has training and experience in helping people to grow mentally, emotionally and spiritually, as well as being effective in helping with specific problems or conditions, such as being an ACoA or an “AC” (Adult Child of a troubled family). 2) Not dogmatic, rigid or judgmental. 3) No promises of quick fixes or answers. 4) While you sense that they genuinely respect you as a human being and your recovery and growth, they are firm enough to push you to do your own work of recovery. 5) Provide some of your needs (listening, mirroring, echoing, safety, respect, understanding and accepting your feelings) during the therapy session. 6) Encourage and help you learn to find ways outside the therapy session to get your needs met in a healthy way. 7) They are well progressed in healing their own Child Within. 8) They do not use you to get their needs met (this may be difficult to detect). 9) You feel safe and relatively comfortable with them.

The lesson for psychotherapy is that the therapist may well have as great an impact through her presence as she does through her problem-solving skills. Especially when the root of the patient’s emotional predicament lies in the basic fault, in experiences that were preverbal or unremembered and that left traces in the form of absence or emptiness, the therapist’s ability to fill the present moment with relaxed attentiveness is crucial. It is not just that such patients tend to be extraordinarily sensitive to any falseness in relating, but that they need this kind of attention in order to let themselves feel the gap within themselves. It is much too threatening otherwise.

Yes, as distasteful as it is, it is beneficial to talk to people who disagree with us. So if you hate conspiracy theories and run into someone who believes that we faked the moonlanding and Einstein plagiarized relativity from his mailman, don't tell him, 'You life is a cruel joke' and walk away. Have tea with him. It can broaden your style of thinking, and it's cheaper than seeing a therapist.

During a belated New Year’s cleaning, I come across my grad-school coursework on the Austrian psychiatrist Viktor Frankl. Scanning my notes, I begin to remember his story. Frankl was born in 1905, and as a boy, he became intensely interested in psychology. By high school, he began an active correspondence with Freud. He went on to study medicine and lecture on the intersection of psychology and philosophy, or what he called logotherapy, from the Greek word logos, or “meaning.” Whereas Freud believed that people are driven to seek pleasure and avoid pain (his famous pleasure principle), Frankl maintained that people’s primary drive isn’t toward pleasure but toward finding meaning in their lives. He was in his thirties when World War II broke out, putting him, a Jew, in jeopardy. Offered immigration to the United States, he turned it down so as not to abandon his parents, and a year later, the Nazis forced Frankl and his wife to have her pregnancy terminated. In a matter of months, he and other family members were deported to concentration camps, and when Frankl was finally freed, three years later, he learned that the Nazis had killed his wife, his brother, and both of his parents. Freedom under these circumstances might have led to despair. After all, the hope of what awaited Frankl and his fellow prisoners upon their release was now gone—the people they cared about were dead, their families and friends wiped out. But Frankl wrote what became an extraordinary treatise on resilience and spiritual salvation, known in English as Man’s Search for Meaning. In it, he shares his theory of logotherapy as it relates not just to the horrors of concentration camps but also to more mundane struggles. He wrote, “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances.” Indeed, Frankl remarried, had a daughter, published prolifically, and spoke around the world until his death at age ninety-two. Rereading these notes, I thought of my conversations with Wendell. Scribbled in my grad-school spiral were the words Reacting vs. responding = reflexive vs. chosen. We can choose our response, Frankl was saying, even under the specter of death. The same was true of John’s loss of his mother and son, Julie’s illness, Rita’s regrettable past, and Charlotte’s upbringing. I couldn’t think of a single patient to whom Frankl’s ideas didn’t apply, whether it was about extreme trauma or an interaction with a difficult family member. More than sixty years later, Wendell was saying I could choose too—that the jail cell was open on both sides. I particularly liked this line from Frankl’s book: “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

There’s another related concept that I share with John: impermanence. Sometimes in their pain, people believe that the agony will last forever. But feelings are actually more like weather systems: They blow in and they blow out. Just because you feel sad this minute or this hour or this day doesn’t mean you’ll feel that way in ten minutes or this afternoon or next week. Everything you feel – anxiety, elation, anguish – blows in and out again.

Comparatively few physical therapists have knowledge in pelvic pain syndromes, pelvic floor muscle dysfunction, and pelvic floor rehabilitation.

Just one example of this is the proliferation of the U.S. Black maternal health crisis. According to the CDC, Black women in the United States are three to four times more likely to die from pregnancy-related causes than their white counterparts.21 When Black women are seen as stronger and less worthy than their white counterparts, it is no wonder that this translates into the medical field. As Harris-Perry writes in Sister Citizen, “Therapists are less likely to perceive a black woman as sad; instead they see her as angry or anxious.”22

Without thinking about it, what three adjectives come immediately to mind in relation to your mom’s [or dad’s] personality?” These off-the-cuff answers have always given me (and my patients) helpful insights into their parental relationships.

Angela Liberatore” Says, In today’s digital age, establishing a robust online presence is essential for therapy centers looking to connect with clients and expand their reach effectively. Digital marketing strategies, when integrated strategically, can not only enhance visibility but also foster meaningful engagement with potential clients seeking mental health services. This article explores the synergy of SEO (Search Engine Optimization), Google Ads, Facebook, and Instagram in crafting a holistic digital marketing approach tailored for therapy centers. Understanding the Power of SEO in Mental Health Services Search Engine Optimization (SEO) forms the foundation of any successful digital marketing strategy. For therapy centers, optimizing their website and content for relevant keywords and search queries is crucial in improving organic search rankings and attracting qualified leads. Personal Experience: At our therapy center, investing in SEO yielded noticeable results. By researching and incorporating keywords such as “therapist near me,” “mental health counseling,” and “therapy services,” we saw an increase in website traffic from individuals actively seeking mental health support in our locality. Leveraging Google Ads to Target Potential Clients Google Ads provides therapy centers with a powerful tool to reach potential clients who are actively searching for mental health services. By creating targeted ad campaigns based on location, demographics, and specific keywords related to therapy, centers can increase visibility and drive relevant traffic to their websites. We launched Google Ads campaigns focusing on keywords like “counseling services” and “psychologist sessions,” tailored to our local area. By monitoring ad performance metrics such as click-through rates and conversion rates, we optimized our campaigns to attract more inquiries and appointments. Engaging with Audiences on Facebook: Building Community and Trust Facebook remains a cornerstone of social media marketing for therapy centers, offering opportunities to build a community, share valuable content, and engage directly with potential clients. Creating a Facebook business page allows centers to showcase their services, share client testimonials, and provide educational content on mental health topics. Example: Through our Facebook page, we regularly post informative articles, tips for managing stress, and updates about our therapy programs. This content not only educates our followers but also encourages interaction through likes, comments, and shares, fostering a sense of community and trust. Visual Storytelling on Instagram: Connecting Emotionally with Audiences Instagram’s visual-centric platform provides therapy centers with a unique opportunity to connect with audiences through compelling visual content and storytelling. By sharing behind-the-scenes glimpses, therapist profiles, client success stories, and inspirational quotes, centers can humanize their services and resonate with potential clients on a deeper level. We launched an Instagram campaign featuring short video clips of our therapists discussing common mental health challenges and treatment approaches. These videos not only sparked meaningful conversations but also attracted new followers interested in our holistic approach to therapy.

The external therapeutic relationship remains a template for the kind of supportive companionable relating it needed internally. At the same time, this stage facilitates the role of the therapist as a consultant to the system [person with dissociative identity disorder].

My aim for this archaeological project is twofold. Contrary to what many think, diagnoses are helpful but by no means necessary for the work of psychotherapy. They are crucial if one is to prescribe medication or bill an insurance provider, of course, but they don't play nearly as large of a role in two people talking to one another. When a client comes to me and tells me that they have bipolar disorder, depression, or the like, I file it away as necessary data. However, that categorization is far less interesting or meaningful to me than exploring what gives their life purpose and how they could better live into their values. To paraphrase the British psychoanalyst Donald Winnicott, the business of therapy is really just two people playing together. I have found that the fear of diagnosis, what it might mean to be labeled as "depressed" or "anxious," much less "psychotic," prevents many people from consulting a therapist when they need help. A label that isn't all that useful to my work serves as an impediment to those in need. Perhaps it's time to rethink the utility of those labels, or at least how we relate to them. Once I know the person sitting in front of me has schizophrenia, the focus becomes fixed on treating their hallucinations and delusions, on helping them best integrate into society. We thus exempt ourselves from considering everything that came before they entered our office. What if it was possible to both acknowledge their suffering while also condemning the injustices and inequalities that have helped lead them here? That is the task that I have set for myself in the following pages.

And so we as mental health professionals across all of our different disciplines, are in a position of opportunity to use our skills and our knowledge, and actually push our field to address some of the most pressing issues, for example, racism, slavery, violence, climate change. . . these issues are actually all, including climate change, related to the human mind. The way that you change a system is from the inside out. You change a system by changing the minds of the human beings in that social human system. That's our field: the mind. . . Your work as therapists is completely relevant to what the human family needs to do on the global scale to deal with the climate crisis. So don't think that the work you do has no impact on the world.

As I talked, I found that no matter how distressing the details I related, I could feel nothing. I was disconnected from my emotions, like a hand severed from a wrist. I talked about painful memories and suicidal impulses—but couldn’t feel them. I would, however, occasionally look up at Ruth’s face. To my surprise, tears would be collecting in her eyes as she listened. This may seem hard to grasp, but those tears were not hers. They were mine. At the time I didn’t understand. But that’s how therapy works. A patient delegates his unacceptable feelings to his therapist; and she holds everything he is afraid to feel, and she feels it for him. Then, ever so slowly, she feeds his feelings back to him.

Angela Liberatore Melbourne says, In today’s digital age, social media platforms like Instagram offer therapy centers powerful tools to connect with potential clients, build community, and share valuable insights into mental health. With its visual appeal and engaged user base, Instagram presents unique opportunities for therapy centers to showcase their services, educate their audience, and ultimately attract new clients. This article explores affordable Instagram marketing strategies tailored specifically for therapy centers, drawing from personal experiences, anecdotes, and practical insights. Harnessing the Power of Visual Storytelling Instagram’s visual-centric platform provides therapy centers with a compelling medium to tell their stories and connect with audiences on a deeper level. Visual storytelling through photos and videos allows centers to showcase their facilities, introduce therapists, and highlight the compassionate care they provide. At our therapy center, we started sharing behind-the-scenes glimpses of our therapy rooms, therapist profiles, and client success stories through Instagram posts and Stories. These visuals not only humanized our services but also resonated with our audience, sparking meaningful conversations and inquiries about our therapy programs. Creating Educational and Inspirational Content Educational content on Instagram can position therapy centers as trusted resources for mental health information and support. By sharing tips for managing stress, insights into different therapy techniques, and inspirational quotes related to mental well-being, centers can engage their audience while providing valuable content. We launched a weekly series called “Wellness Wednesdays” where we posted practical tips for improving mental health and self-care practices. This series not only garnered positive feedback from our followers but also attracted new followers interested in holistic wellness solutions. Engaging with Followers through Interactive Features Instagram‘s interactive features such as polls, quizzes, and Q&A sessions provide therapy centers with opportunities to engage directly with their audience and foster meaningful interactions. By encouraging participation and responding promptly to comments and messages, centers can build rapport and trust with potential clients. Example: We hosted a live Q&A session with one of our therapists where followers could ask questions about anxiety management techniques. This interactive session not only educated our audience but also showcased our expertise and approachability, leading to increased engagement and inquiries about our therapy services. Leveraging User-Generated Content and Testimonials User-generated content (UGC) and client testimonials are powerful tools for building social proof and credibility on Instagram. Encouraging clients to share their therapy journey through photos, videos, or written testimonials can provide authentic insights into the positive impact of therapy services. We created a hashtag (#TherapyJourney) and encouraged clients to share their progress and experiences with our therapy programs. Reposting UGC on our Instagram profile not only celebrated our clients’ successes but also demonstrated the effectiveness of our services to potential clients considering therapy.

That’s the part of depression people don’t consider, that at times it physically hurts. My therapist helped me understand that the back pain and the headaches I developed were most likely related to stress, and stress hormones like cortisol and noradrenaline contributed to my apathy and exhaustion. Which exacerbated my depression.

Exploring Love in the Digital Age: A Review of Masseporno In today’s digital age, the concept of love is no longer confined to books and movies. Instead, it has found a prominent place in the online world, with various websites dedicated to exploring its multifaceted nature. One such site that stands out is masseporno.com, a platform dedicated to delving into the many dimensions of love—romantic, platonic, self-love, and everything in between. User Experience and Design The first thing that strikes you when you visit masseporno.com is its clean, modern design. The website uses soothing pastel colors, elegant fonts, and a minimalist layout that immediately sets a calming tone. Navigation is straightforward, with clearly defined sections on love advice, relationship tips, personal stories, and even psychological insights into the science of love. The homepage greets users with a welcoming message and a featured article, making it easy for visitors to dive right into topics that interest them. The website is fully responsive, meaning it works seamlessly across devices, whether you're browsing on a smartphone, tablet, or desktop. The pages load quickly, and the design remains consistent and user-friendly, making for a smooth browsing experience. Content Quality and Relevance Masseporno.com stands out for its rich and diverse content. Articles are well-researched, thoughtful, and often backed by expert opinions from relationship therapists, psychologists, and even sociologists. Whether you're looking for advice on how to maintain a long-distance relationship, seeking ways to boost your self-esteem, or exploring deeper philosophical questions about the nature of love, the site covers a broad spectrum of topics. One of the standout features of the site is its blog section, which features personal stories of love, heartbreak, growth, and healing. These stories are relatable and often serve as a source of comfort for individuals who may be experiencing similar emotions. Interactive Features and Community Engagement What really sets masseporno.com apart from other websites in the genre is its interactive features. Users can engage with the content through comments, polls, and forums where they can share their experiences and seek advice. This sense of community is invaluable for those seeking validation or connection, especially when navigating the complexities of love. Conclusion Overall, masseporno.com is a thoughtful and comprehensive resource for anyone looking to explore the many aspects of love. It's easy navigation, high-quality content, and interactive features make it a standout in its category. Whether you’re in a relationship, exploring self-love, or simply curious about love in all its forms, this website offers something valuable for everyone.

So why is this important? For one thing, if you can become what I call the primary caretaker of your own parts, then you free intimate partners (or therapists, children, parents, etc.) from the responsibility of taking care of raw and needy exiles. Those people then can act as the secondary caretakers of your parts, which is a much more enjoyable and feasible role. Most of us have that reversed. Our exiles don’t trust our Self and consequently they and the protectors who try to get them to calm down are looking outside of us to get what they need. When we encounter a person who resembles the profile exiles have of their ideal protector, redeemer, or lover, they feel elated, infatuated, and relieved. Through what’s called positive transference, our parts put distorted images on such people, who can’t help but disappoint those extreme expectations. Then comes the negative transference from angry protectors. There are actually a number of people leading workshops on Self-led parenting. When parents are Self-led, they relate to their external children in the same way they do their internal ones—with patience, calm, clarity, love, firmness, and reassurance.

Dating today can feel like a maze, full of twists, turns, and unexpected dead ends.

The Ghosting Phenomenon: Disappearing without explanation has become a disturbingly common occurrence in online dating.