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Friday, July 22, 2011

Tuesday, July 19, 2011

Do You Feel Better Now?

FD and I were bantering about them. You know, the bad drivers, the ones who drive poorly, cut you off and then "flip you the bird." It doesn't happen to me very often because I opt out, ride a bike.  But it did last week.

"You know what you should do?" FD tells me. "You should get that vanity plate, the one we talked about years ago."

He's talking about the one that says,
GET THERAPY
I had always wanted that one.

"Except that people who rage like that aren't going to connect the dots," I reply.

"Then a bumper sticker," he continues. "It's bigger, more visible." He suggests:
Slow down, you'll live longer.
This is also something we have talked about in the past.

The real issue, I tell him, isn't the occasional road-rager, because he's so obviously out of control and we'll never see him again, and who cares? The real problem lies in everyday communication, where we're struck by insults or barbs, non sequiturs out of the mouths of people we actually know. They are generally just letting off steam, and it's usually displacement. I.e.,
The boss makes you work overtime, you come home tired and angry and kick the dog.
Kicking the boss will get you fired.

Online today a blogger opines, It is much easier to displace anger online, to cause tremendous psychological pain via viral messages, malicious gossip, or exposure and shame, and the audience can reach thousands. Beats the schoolyard for impact.

In that situation, the violence of bullying isn't coming out of nowhere. It is planned. Most verbal and emotional violence, however, isn't like that. It isn't premeditated, it isn't intentional bullying. Outbursts are the outcome of emotional overflow. Tears are more mature, to be honest. When the flood is anger, not tears, look for displacement.

But it isn't always displacement, of course. Any of us can be triggered, might have a difficult time holding back our words in many different situations. All of us are capable of becoming a little over-reactive, or a lot, especially when a memory or an event lights up those neural pathways. Or when we're just tired.  Or drink too much.

In family therapy, when one family member complains about another member's frequent verbal assaults, the recommended response is variable; it depends upon the circumstances.  But often we suggest assertiveness-- labeling what's going on without emotion.

Overt and covert permission from our parents to be colorfully expressive, adds to that emotional vortex that rises to overflow. We learn from our parents, and from our teachers, and now from the media (what we see in the movies and on television), that lashing out sometimes feels really good. Raging families unconsciously know this and can be fairly robust, meaning members become immune, in their way, to feeling emotional or verbal abuse. It is the toughening up process of childhood.

That doesn't make it a better way to communicate, of course.  At some point, no question, going off will be dysfunctional, somewhere, somehow, and may even cost the rager a job, or a relationship, an account or a recommendation.  Loyalty, trust.  Bye bye.

Which is why I told FD, "The bumper sticker I'd really like to see would be more to the point, process-wise. How about something like this?"
Do you feel better now?
Because that's what it's all about, discharging negative energy. It's hard to contain negative emotion and we feel better when the arousal, the irritability is gone, the baby delivered. And that's okay, letting it go, assuming everyone knows that nothing is really meant by it. Nothing personal.

Big assumption.

Safer, we suggest, to wait it out. The irritability will go away.

Forget the bumper sticker! It's a good idea, but make it an intervention. In situations that seem safe, when we're fairly sure there will be no retaliation, when someone insults us or flings blame, or just lets loose with a couple of well-timed expletives, we should ask . . .
Do you feel better now?
With concern.  Make it come from the heart.

Then overflow-ers, aka ragers, get a pass with people who love them. Sometimes. 

But you know, you can take back the words, the memories still stick. People have long memories for this sort of thing.

If I remember correctly, it was a white Honda, maybe an Accord with a beat up bumper, and there was one of those bobbing things in the rear window.  No chains dangling from the mirror.

therapydoc

Sunday, July 10, 2011

What I Did For Love

Wow, it seems my vacay from blogging never was, it's so easy to come back to this. But I needed a break, just some time to attend to things, like shredding twenty-five years of old tax receipts, returns.  That was fun, bringing those boxes out of the attic.  I approached it like I do everything else, with a broom.

While I was away I did an Anniversary Post. Not a blogging anniversary post, but a Marital Union Anniversary Post. What you will get out of it are prime examples of conflict avoidance. Or do you prefer: Synchrony of Emotion. Empathy. All depends upon what color glasses you're wearing.  We prefer something in pastel.


June 22, 2011

FD and I have been married for 36 years.

You should know that the number 36 is considered a lucky number, because it is twice 18, and 18 is a lucky number. If you're Jewish you understand that multiplying things has tremendous psychological power. The number 18 is lucky because it is the numeric equivalent of chai (hard "ch", rhymes with fly), the Hebrew word for life.

How does a word become a number? Each letter of the Hebrew alphabet is associated with a number. Add up the numbers that correspond to the letters of a word, and you get numbers with feeling.  You can imagine the speeches at the Bar Mitzvahs.

What we do to celebrate our life together is regress, stick it to the whole idea that we're getting older and crankier. Meaning, we take off and do what we used to do when it wasn't as hard to do it, with less intensity.  We cancel our appointments, sign out, give over coverage and run away for a day and a half, never too far away.  The Midwest is a lot prettier than people think.  We met in the cornfields of Illinois, two and a half hours southwest of the city of Chicago, in school.

FD does most of the work as I put together a cooler of fish salad and fruit.  He somehow gets our bicycles to stay on the back of the car using an ancient bike carrier. I make a big deal about making the salad while I talk on the phone. It does take forever, right, to make a decent lunch?

We drive away.   This particular anniversary morning follows a night of severe storms all across the western suburbs.  We have reserved a  bed and breakfast in the western suburbs not far from Fermilabs.  FD has discovered that there are extensive bike trails near the nuclear reactor.  Finding the trails is easy, choosing the B & B is hard.  My job.

Do we go to Marcia's Bed and Breakfast in Ottawa?  When I ask Marcia how much, she asks if we're bringing our horses.  I like her right away.

If not Marcia's then perhaps Oscar Swan's in Geneva, where the service is said to be iffy, but we might catch a wedding.

To be honest, Marcia's is a little too far away for a day trip, and frankly, I don't travel well anymore.  So I tell her another day, and we book at the Oscar Swan.  Then FD gets sick, and there is no going anywhere.

But being a doctor, he gets well!  How he does this, I'll never know, but he goes from looking like death warmed over to, "HEY!  Let's go someplace!  I haven't had fever in two hours* and the antibiotics are working, and it's our anniversary!"

I'm saying, "Dude, we should totally stay home, and if we're adventurous, measure the kitchen floor. We take the money we save at Oscar Swan (significant!) and apply it to the new floor."

He goes, "Yeah, but it's our anniversary." He says it with a certain nostalgia.  Or is that a whine.

We settle on a show.  Yes!  Let's go see a show!  We live in a big city, Chicago.  There are many of these.  I suggest Chinglish, a comedy set for Broadway, soon.  He's good with this, but we can't get cheap tickets.  He finds The Outgoing Tide, a play about Alzheimer's with John Mahoney.  John Mahoney is best known as Frazier's father.  He's an older television star.

"Fine, dear. We'll see a play about something depressing.  That's cool.  I'm good.  Truly."

I cancel our reservation at the Oscar Swan.  I have already discussed our issues with Marcia in Ottawa, the proprietor who asked about our horses.  She knows we'll be back one day, probably with grandchildren.  We have a relationship.   We spend more money than we should at the Northlight Theater, thinking that if the weather is good and he still feels good, we can get out during the day and ride somewhere and still make it back to get dressed up for the show.  I love getting dressed up for a show, although this is a passing trend, at least at the Northlight.

The night before, as we've already indicated, the storms are fierce, make religious animals out of Chippy and Dale  and everyone else who doesn't live in our attic.**  We wake up to find that our neighborhood quite possibly has the best weather within a hundred miles.  The sun is shining.  The skies are blue, and the weatherman is telling us otherwise for all of Chicagoland.

But we can't stay here. We have to go someplace we haven't been before, somewhere only we know, as the song goes.  I watch the Weather Channel with great interest.  "If we're going to ride, it seems to me that Antioch might stay clear for awhile."

This is Chain of Lakes in Illinois, where he takes the grandkids fishing sometimes. Before we blink the food is ready to go, and the bikes are hanging low on the Nissan; this is an old drill.  "Drive slowly," he warns.  "The bikes are hanging low." Noticed that, between us, didn't say a word.

And it is, as it always is, just fantastic.  We find the park, get out and air out.  There are three hiking/riding trails within seven miles and check them all out via pedals.  He complains that I ride too slow.  I tell him that I have to stop to take pictures.  It's an addiction, remembering.  We lose that ability all too soon.





It is lovely, we're having a good time.  Neither of us cares much who is trying to reach us when we miss those calls.

It is all good until we hit what feels to me is a highway.  At this point FD tells me that we have to ride on the shoulder of this Route, whichever it is.  The traffic is whizzing by.

No, dear.

He tells me there is no other way to get to where we want to go, and I still insist, Not Me.  Now We.

We look at one another.  Stalemate.  We both want to go.  We want to keep exploring the area.  We rarely ride on the busy streets, but occasionally are forced into it and there is this thing they call a shoulder.  To turn back is white bread, there is no fiber to this trip yet.  We're not white bread people.  Our eyes turn, once again, to the highway.

All of a sudden there is NO traffic.  Of one mind we hightail it across and in moments are comfortably riding west on the shoulder, not a care in the world.  It will be a mile and a half to the next official trail.

The traffic, of course, catches up with us, but we're within three feet of the nearest flying automobile, and we've been here before.  We have faith.  We'll be fine.

Except for the flash flood.  We should have seen it coming.  The sky had changed.


We feel the moisture, we can tell that the water on our skin is rain, we just aren't prepared for a flash flood in the middle of nowhere while riding on the shoulder of a highway as trucks kick what have become rivers onto the shoulder. 

We get off our bikes, rapidly hunt for our parkas, soon a little more protected.  Except that it is pouring and we're in the middle of nowhere and a parka is only good from the waist up.

"What now?" I ask, hoping he knows what he's doing.

"We find a shelter and have a picnic, of course."

Of course.

"We're not riding to this shelter," I inform him.

"No, we can walk there."

And the rain keeps pouring down.

There is no shelter.  But by the time we get to the park, five minutes away, really, the rain is quite finished.  The sun is out, and we're drying off.  It helps to ride standing up, and who can't do that?

I'm wary of another storm, keep my parka on, but FD stops to tell me that this is slowing me down.  He hates that I ride so slowly.  I give in, take it off, hoping that this really is the end of the bad weather.  We have vacationed for thirty-six years in all kinds of weather, weathered all kinds of storms.  A little drop of rain can hardly hurt me now.

At some point we're lost.  My Iphone has a compass that tells me we're heading south and I know we need to go northeast.  FD tells me that my compass is wrong, that we're heading east, which is fine.  "How can a compass be wrong," I ask, suspicious.

"I don't know, but it's wrong."

This inspires confidence, obviously.  I am tired, and a little hungry, and not totally dry, although the sun is doing what it is supposed to do, and there is a lamb on a farm that is basically saying, Come take my picture.  But by the time I get to doing that, he disappears.

Seeing a lamb makes me happy.  We reach the car and FD begins the process of loading the bikes on the car carrier.  It is beginning to rain.  I get in the car, hope he doesn't get too wet, and he doesn't.  We pass the home grown fruit stand, stop to buy some berries, and of course, nothing is home grown, but you have to love that, too.  Home grown bananas.  Right.


therapydoc

*Actually, FD came down with this ridiculous illness the day before and started treating it immediately. Loathe to use unnecessary antibiotics, we know he wasn't faking.

** The Is it a raccoon?  Or  Is it a squirrel? story is priceless, but not for today.

Sunday, July 03, 2011

Process Over Content: De-shaming

Let's address those questions from the last post.  In my excitement, coming back to blogging after a nice hiatus, apparently I never got to the point.  It is why therapists should shut up and listen.

The post is about blurting and embarrassment in couples therapy.  There are therapy rules, The Therapy I Ching, that predict the process of positive change.

The therapist is an authority, has proprietary knowledge, which is why she is paid the big bucks (this is surely relative and not always deserved, and sometimes no amount of money is enough, but that's another topic for another day).  As the authority, she lays down therapy basics at the beginning of treatment, and reinforces them.  One might be:
Nobody Gets Hurt Here.  
 This is the essence of the therapist/doctor/rabbi's obligation,
Do No Harm.  

Extend that obligation, Do No Harm, to everyone in the room, and we have a shot at getting something done.  We don't want anyone to become even more hurt, embarrassed, or depressed in the name of healing.  
No one should get hurt while getting better. 
Hurt can be prevented, but it isn't always, and isn't usually cause for calls to the Department of Professional Regulation.  But when someone gets hurt in therapy, it has to be discussed.

The blurt, the cause of the suffering we're talking about today, is associated with the emotional pain of a long-suffering partner.  She (for the sake of simplification, make it a she) is fed up, her angst, palpable.  It bubbles over with the blurt.  She has to inform the therapist, get to the point, how bad her partner really is.  Her partner's privacy is violated in the process.

It happens and it is a recovery moment.  To her dismay, we have to divert from content, that embarrassing thing she says he does, and roll to the process, that he has been shamed in front of the therapist.  How do you de-shame?

Embarrassment is emotional abuse.  But it isn't particularly therapeutic to tell someone, You are emotionally abusive.  Some people do come to therapy expecting a beating by the doc.  If we know that we'll gladly oblige.  For example, many who work 12-Step programs use the language: working on character defects. They see this work as laudable, the goal of all therapy, and it is incredible, great stuff.  Much healing comes from fixing ourselves, changing, becoming better people.  So people who work a program welcome criticism.

But others don't need it, not consciously, and don't come to therapy for it.  Safe to say that most of us don't want criticism and judgement in therapy. 

Yet there it is, in your office, a huge traffic accident and you have to clean up the mess.

I start with a process statement.  Process is the opposite of content.  It is the verb to the noun, the interaction.  Content is the detail.  He steals!  That's content.  She just outed him, embarrassed him.  That's process.  The therapist wants to make the process, which is usually unconscious, conscious. Anyone can deal with content.

As soon as the secret is out, the therapist gets it and directs the process. 
"What just happened there?"  

As if we didn't even know.  But we act as if, truly,  we need help here.  Help us figure out what just happened.

It is a diagnostic question, What just happened there?   We're seeking out how sensitive and how aware the patients are.  Most of the time the one who blurted will answer right away, "He's angry because I told you that he _____ (fill in the blank).  I told on him."

And the therapist can say, "He's angry?  Is it anger?  Are you sure he's angry?"

Then we can talk about emotions, which is an awesome thing to talk about in therapy.  We let this one go on, and on, and on.  When we hit embarrassment, or shame, the mother lode,  I say, "Ooh, this is a great place to go, a great thing to discuss!  Let's talk about life's embarrassing moments!  Who wants to begin?"

Silence.  Usually, if you want to think of something embarrassing, it is hard.  We repress these events, a gift.  The therapist must begin.

Since we're talking about me now, I might start them off with one of my great embarrassing moments:  Second grade. Too afraid to ask the teacher for permission to use the bathroom. 

The stuff of a reality TV show, no?  Everyone wants to join in.

The fun of disclosure, real intimacy between partners, is about to begun.

therapydoc