Thursday, February 28, 2013

When Mindfulness Isn't Helpful

Meditation:  Yes. Wonderful.
Hatha Yoga:  For sure, who can live without it?
Controlled breathing: A life saver.
Guided body focus: Best thing for you.
Containing, holding, focusing only upon depression, anxiety, or anger: Maybe think about drawing the line when this particular intervention is making you sick.

At least don't feel badly that you have failed the class, can't get all cozy with your negative emotions. Because that's the goal, understand, oneness, full acceptance. Mindfulness.

Tell yourself that it isn't your fault if you can't befriend your sadness, if you hate the training, if you aren't getting any better and want to run away, to be anywhere else than in that room full of mindful people.

Who could blame you?  Attending to pain won't  magically bring on peace, certainly isn't nirvana, not for every deep sufferer. It just isn't.  Fine, let's qualify. It works for some, certainly not all of us.

There, I've gone public about something that has bothered me for a long time. I held them in, my mixed feelings about this part of mindfulness, getting close to the pain, because I like the rest of the therapy, and I know that pain does lift and when it does, nobody tends to notice.  So say hello to unhappy moods because they have a shelf life. They also spontaneously regenerate, which is a shame, but it''s called being alive.

The mindfulness therapists will surely tell me I have it wrong, will spleen me for what is to come, but it is worth the risk, shouting to the blogosphere, reaching out and yes, relating to the confused and the angry, the still depressed and even more anxious, those who have plunked down their five hundred dollars to take the 8-session class, if not go on a weekend retreat.

But I'm giving you permission to Just Say No, to say I'm Not Doing This. To say, This Was Okay Until Now, But You've Crossed the Line asking me to lean into my bad feelings.

Lean into the pain?  You want to know who else leaned into the pain?  Aaron Swartz. He killed himself a little over a month ago.

Saying No! when told to embrace depression, anxiety, etc., should empower more than one somebody, and that process, asserting feels good.  Assertiveness is one of our more successful emotional management strategies, tried and true.

No question, each of us gives negative emotions their due in our lifetime. There is no escaping or denying, and those who battle their feelings regularly have spent countless hours in their presence, mostly fighting them, wishing they would go away. It makes a certain amount of sense, therefore, that changing one's attitude, which is what mindfulness is really all about, is worth a try. This is like any other behavioral technique or strategy, in that it deserves a try.

Rather than run, rather than medicate, if we get into it a little, feel the sadness, the anxiety, the anger, it will lose its power. Stop fighting it, it can't kill you unless you let it. Ironically, we tell alcoholics and drug addicts to do this all the time because using is truly hiding, avoiding emotion. So for them feeling is educational.  We tell addicts, Stay with it, feel badly for a change. It won't kill you and it won't mess up your life like substances does.

Staying with a bad emotion might not kill you, but staying in a bad marriage probably won't, either. That doesn't mean you should.

And then there's Aaron.

It is very unlikely, working with a professional mindfulness therapist, that you would do anything self-destructive in the process of getting well. Aaron had severe mental illness; he needed more help than he had, or he simply couldn't take it any more, that spontaneous regeneration. The mindfulness trainers who have trained with the best, and who hasn't, are setting themselves up if they know how seriously mentally ill their trainees are and still pretend it will all be okay. Close your eyes.

No matter, for those who are not severely distressed, it is still possible to feel like a big loser, a huge loser when making the mark feels impossible. If the sadness, anxiety, the anger is no better when you embrace it. If you feel like exploding or imploding while focusing on the pain and don't feel a whit better when it is all over, it is likely that you will feel worse.

Are you not embracing it enough?  Are you a poor embracer? If it feels worse because you are giving it your undivided, your full attention, worse isn't what you are looking for; it's not the goal. Less is.

Theoretically, the major disorders are compounds of negative thoughts and feelings. That's all. Sadness is just a feeling, no more no less, anxiety and anger, too. Emotions are realities like every other reality, anything else that grabs our attention. Hanging out with them should be seen in that light, a fleeting reality. One long moment.

Except that hanging out in this reality, watching pain, hurts a little more than say, watching a sunset or maybe visiting someone, holding someone's baby.

I prefer the sunset. The baby.

You could say that cognitive behavioral therapists who recommend distraction, the sunset, Modern Family (television), taking a walk around the block, or doing a crossword puzzle over embracing the pain are chicken. We also like anesthesia for surgery.

A patient says to me:
 Like I don't know what it is like to be consumed with anxiety?  Every day of my life I suffer from anxiety. And they want me to invite it in?  Makes no sense. I tried and it made me feel even crazier than usual.
Nice.

I recall being a young therapist, a hundred years ago. The patient is crying and I am saying, "It's okay, cry. Crying is good. You have a lot to cry about." And the patient continues, throughout the visit, weeping, and it won't let up, and she won't get up off the floor at the end of the visit, won't leave, continues to sob, and I have to call an ambulance to take her to the hospital.

Wouldn't it have been better if I would have taught her to manage her sadness? Would it have mattered? I think so. I'm pretty sure it would have been better if I had guided her to disengage from the pain, not embrace it.

Of course, I'm not a mindfulness teacher and hope to hear from someone who can clarify for me. But one thing I know. Give me a good distraction, a good procrastination, a good rewrite or a new script, a napkin full of obsessive thoughts, a hand on the heart, a phone-a-friend or any one of the hundreds of emotional management strategies we can all think up with only a little imagination, any day.

therapydoc







Monday, February 25, 2013

Marissa Mayer and Employee Morale

Seems just the other day we heard about a pregnant woman becoming the CEO of Yahoo.

Months later Marissa Mayer has rightly earned the title:

Tiger CEO.

You might remember the tiger mom, tag line: Practice that violin; birthday parties are for sissies. Tigers are popular now, thanks to Life of Pi, but nobody wants one for a mother, not for a CEO, either.

Ms Mayer insists that all mamas and papas work at the office, not from home anymore. To run a successful, cohesive company, everyone has to be on board, everyone should be there, within the friendly or not so friendly confines of the corporate address.
Proverbial Little Joey

She's the boss, but this sounds counter-intuitive to tried and true business success strategy. Modern work environmentalists suggest warm and almost intimate relationships between employees that begin at the water cooler, then progress at in-service training sessions (perhaps about sexual harassment and diversity) and culminate at expensive hotels, the company retreat.

Intimacy at work reduces separation anxiety from Little Joey and seeds the idea that checking in on Facebook can wait. Here are our friends, right here at the office.

To really meld the company, corporate pops for a vacation. Oprah would bring her entire staff on a cruise, pay for everything. She includes spouses, maybe not every time, but sometimes.

People work harder knowing there will be Cancun.

I like that Lisa Belkin of the Huffington Post, is taking her on, believes Ms. Mayer should know better than to ask employees to choose between family and career, so anti-feminist. On the contrary, Buzzfeed's Steve Kandell isn't worried at all that the no work from home concept will go viral. Parents don't all want to stay home, he reminds us, and parallel tasking, pounding out work in front of the television, attending a conference call and changing a diaper or making a bottle, isn't going to happen simultaneously. Mayer knows this by now.
Not everyone is off on President's Day. 

But surely there is a happy medium.
School holiday

Last Friday it snowed in Chicago and my daughter worked from home. Fridays at her company tend to be short days because overseas, where much of her company's business is conducted, employees are already deep into weekend-mode.

That doesn't mean she is free to take the kids sledding.

I told FD that I intended to do that, take the kids after school to one of the very few good sledding hills in Chicago, and he asked, "Isn't that their mother or father's job?  I think she's home today."

I had to explain to him that when she is home it is as if she isn't there. She calls in a babysitter and the kids aren't allowed to interrupt her. Women might be able to multi-task with one hand tied behind their backs, but not when tasks require concentration. Her arrangement is only possible because she has proved to her employer that she can and will do the work-- all of it-- when she isn't supervised-- and probably better.

My hunch is that when Ms. Mayer figures out which employees can do that, work from home yet still be there emotionally, cognitively, for most of the day, she will let up on the rules, allow her employees to address those inevitable emergencies--the sick babysitter, the car in the shop, the furnace repairman, a child's asthma, without having to fill out Family Leave papers.

And as her little ones get to school-age, let's see if she'll walk the walk herself.

therapydoc


Monday, February 18, 2013

The Perks of Being a Wallflower

I know. I promised to write about what therapists do when they get bored, but therapists are all different and handle boredom differently. The work, if we're busy, is never boring, not if we take it seriously. But when we're tired, perhaps on the verge of burn out, everything can seem ho hum. 

Knowing this, some of us (me) schedule get-aways and don't tell anyone much about them.  It is obvious to people who know me this is no cruise. We are talking an airplane, at least one night in a good hotel, two movies. The movies are yet another way to get away, kick it up, inflate, punctuate. Make it different.

The Perks of Being a Wallflower
The poster to the right hawks the screenplay/novel now film by Stephen Chbosky, and the acting expertise of Emma (Hermione!) Watson, Logan Lerman, and the unforgettable Ezra Miller. 

I didn’t read the book yet but it is on my list, and the movie, The Perks of being a Wallflower captured me in a good way, but didn't scare me, like Pi. Some of hate being scared.

When you’re a therapist, going to psychological movies is tough-the deep dark secret behind odd behavior in a story is predictable, at least falls within top three considerations-- and we don't want to spend free evenings working out yet another life's sadness. Why work when you don't have to work, when you aren’t technically working?

And in truth, this is a vacay. Visiting children and grandchildren isn’t a vacation in the traditional sense, meaning there’s no beach, no rain forest, not even golf. The big joke in my family is that when someone asks, Oh! Do you golf? (Note, there is always an Oh!) FD will say, No, but we do carry a few clubs in the trunk of the car. This from my obsession with driving ranges, as opposed to golf courses. Why would anyone golf on a golf course knowing full well that it will inconvenience others, slow them down?

http://Ezra-miller.net

Enough about that. I don’t know if any of you ever saw the short-lived television show Freaks and Geeks, but I loved that show, all about rebellious teens, good kids, working out their issues growing up. Being different, unpopular, they had each other, and as you know, when you have a friend or two, life is fairly livable. Without that, add up the inevitable traumas of living and you wonder how anyone gets by.

Not everyone does. We just read today that Mindy McCready, a young country singer, killed herself  not long after the father of her children killed himself. (She had been accused of killing her ex-lover in a jealous rage.)  Mindy had been battling her demons (code for depression and/or addiction), but we hear about her decline and surrender to alcohol and prescription meds, and wonder what happened, how did someone who had so much become so marginalized. 

Oh, but I'm on vacation, if only for a few more hours, so back to the show.

The Perks of Being a Wallflower is about a high school freshman. Charlie has already spent time in a hospital for depression, we assume, and is hoping to make a friend that first day in September. It is a hope against hope, although his English teacher (perfect as always, Paul Rudd) offers himself for the part and is accepted, with reluctance. We know that Charlie is in some sort of recovery, and that it isn’t a true social phobia, his wallflower-ishness, because he tries really hard to fit in, does things with others, and even has a pretty good time.

At some point FD remarks, There are no parents in this movie. He says this about the same time that I say, I think I hate this movie. It is just too slow for me and the story isn't evolving, and FD is right, there are few people over the age of sixteen, not that this is bad, but it can get boring for a family therapist.

SERIOUS SPOILERS ABOUT TO BEGIN

And then! As I am considering walking away, eating, perhaps, things heat up.

There is a breakdown and a psychiatrist, and Joan Cusak makes her appearance in that role, the doctor who is tough, who won't let the patient slither away, return to his head, not without having to explain himself, and you wonder why she is bothering with it, this role, because it is short and not terribly inspiring role, even though she is good at the job and Charlie gets better.

And then you realize that this film is about what you expected it to be about, the trauma of child abuse, and that Joan likely has a vested interest in seeing that JQ Public learns more about childhood sexual abuse, bless her. That is why she takes the role.

And that is why there are no parents in this film, not until the end, not until the secret is out about the aunt and the parents find out about the aunt's role in Charlie's life. Then, only then, do we see these people, the parents, because they are supporting their son, his version of the story, and he becomes well because they believe him, as does everyone else.  Which is the way it has to be, frankly.

Whether or not it is intentional, that Charlie's parents are mere shadows for three-quarters of a film, only the directors know.  The film supposedly deviates quite a bit from the book, and if that is how, then it worked. At least for this therapist, who is back, by the way, ready, once again, to be surprised.

therapydoc

Thursday, February 14, 2013

Hard-Wired to Boil Over

For those of you who are here for the The First and Probably Only Therapists Know Stuff Carnival hang on, we'll get to it. The idea: Let's hear from people who don't do psychotherapy who still call themselves therapists. Mostly nannies applied.

More importantly:

We listened as FD boiled over on the telephone with a resident who missed the most important piece of a work up on a patient. His voice got louder, his patience thinner. I turned to my daughter-in-law-to-be and pointed to my son, then back to FD, and said, "This is what you are choosing. Our long-suit, patience, only goes so far. Genetics can rule."

She shrugged.

This in response to the WSJ story yesterday, Are You Hard-Wired to Boil Over From Stress?

Among the suggestions to control anger (it makes you look less refined, so tailor it):
Avoid situations you know stress you out (traffic)
Replace negative thoughts with positive ones (I'll make a suggestion here--Thinking this is not helping me right now, better move it along).
Breathe deeply and exercise regularly.
All good stuff, but unless you catch the rise, none of it will help. I'll throw in that body-awareness, noticing the animal in you and caging him, shooting him with an imagined animal tranquilizer) is the real ticket with anger management. Oh, and learn how to meditate, at least learn hatha yoga.

Many years ago a vet snapped at me with a vicious glare, and told me, I'm trained to kill.
I asked him if he knew he was glaring at me. He didn't, we discussed it.

I promised to host a carnival and almost backed out because the links didn't match what I'd asked for, but some of the writing is good, and some of it is really funny, if not necessarily intentionally funny. And a promise is a promise.

A BlogCarnival is a post where bloggers help other bloggers, especially new ones, by linking over to their blogs/websites. We let them strut their stuff.

The best is from Nanny Jobs, 10 Telltale Signs You Might Be a Bad Nanny.  Sharon also writes  How to Lose Your Nanny Job  a natural follow-up. Lie on your resume, do a lot of kvetching and it is likely you'll be out the door in a week.

I didn't try any of these aps to make the job easier from FullTime Nanny, maybe they'll work no idea, don't click or download on anything that seems remotely suspicious.

If you think you want your nanny to clean up the dog __, think again. Check out the job description.  Now let's hear some nanny jokes or stories in the comments, friends.

Don't get me wrong, I never let anyone advertise on this blog, and it does seem the nannies are advertising, as is the hypnotherapist who sent us this link, How to Do Self Hypnosis.  But it seemed harmless enough, a walk-through on how to trance out. And  truly, I can't find anything for sale.  Maybe there's a CD or a download somewhere there, none of it endorsed, and the nannies aren't, either, just to reinforce that the BlogCarnival is not an endorsement of any particular website. Regarding self-hypnosis, just walk through that door and set a goal . . .Then walk out, of course, watching your back.

We've talked about fear of intimacy. Is it the same as fear of love? Shaun Rosenberg has a rather racy pic on his website (quite the embrace there, unforgettable). His tell all: How to Deal With the Fear of Love (Philophobia). 

And finally, a family constellation therapist Jana Moreno at Wisdom-Ink answers everything you've ever wanted to know about family constellation therapy. It is news to me.

That's it, this is over. Again, the links aren't endorsements, and no, I'll not do it again, unless it has something to do with substances or OCD, carnivals I hosted in the past, or something a lot more in line with this work you count on me to write about. You can't blame a girl for getting a little bored.

Next post:  When Therapy Gets Boring.

therapydoc








Monday, February 04, 2013

Death's Anniversary

Seems to have been a sweep of the malach hamavet (Angel of Death) in my hood the past few weeks. We're hearing eulogies about people we never expected would fail to make it to their next birthday parties, and it is a little scary. There's something about winter, too, that makes death all the more sad, all the more gray and gloomy.

Therapy is always rich, should be at least, and when a young patient walks in and looks you in the eye and says, "They killed my father in the hospital," you know you're in for angry, pathos-driven story. People go to the hospital because they are sick, some are literally at death's door. Then the slightest error, or fate, or something somehow goes awry, and there we have it, the worst of all possible outcomes.

We could have kept him home for this, they say.

Most of the time it isn't that cut and dried, the fault, the blame. The parents of kids who overdose, for example, never let it go, the thought that they could have done something. They rarely blame anyone else. It is clear, in their heads, that they messed up somewhere along the way. There's no convincing them otherwise, not for that first decade. Time helps, hushes the self-badgering to a whisper. Death and Time, clearly in collusion, buddies.

This happens to be the 43rd anniversary of my brother's untimely death, and the third anniversary of my father's. They died on the same day of the Hebrew calendar. There's no blaming anyone for either passing. Every year, not surprisingly, like clockwork, like most others who have lost loved ones, the week or two before Death's anniversary, I begin to sink. I told someone the other day that the word is pensive, thoughtful, mindful of the meaning of the life of someone who can't answer our questions anymore.

That's what anniversaries are about, thoughts and memories.

And thoughts, we know, are intrinsically tied to emotions, so there you go.

So we light a candle on the anniversary, or two in my case, and say a few special prayers, share a few memories with people who remember.

The memory that comes to my mind is how my father reacted when he saw me dressed up for a wedding.

Last week I bought a new dress for the upcoming marriage of my youngest son. Out of nowhere, driving home from Lord and Taylor, I pictured my father looking at me in the dress with approval, with love, the sight of me a reflection of him, for sure, but warm and happy nevertheless.

My father loved nothing more than this, a celebration for something truly worth celebrating. He loved putting on his tuxedo and dancing, gracefully, at somebody's wedding.

And to be honest, I loved that tux.

therapydoc