Category Archives: Psychology Blog

On Blaming the Parents

I want to share a brief insight that I had while working with one of my clients recently. First, some background:
Quietly in the shadows of all my clinical work of the past few years has been a struggle to reconcile one of the oldest clichés in clinical psychology – that whatever ails you is your mother’s fault, with my own fervent hope that I wouldn’t one day be blamed for all the ills in my children’s lives. Of course – the real hope is that I wouldn’t BE the cause of ills in their lives, but since I inevitably will be the cause of some ills, I do hope for some compassion and leniency when the day arrives for them to realize this. Meanwhile, if we approach some psychological theories unscrupulously they do seem to suggest that the work of a psychologist entails uncovering just how the clients’ parents have traumatized them, and then coaching the client to take the shame, pain and rage they may have been turning inward, and turn it outward and back toward their parents. Then they get to walk away from the scene of the train wreck lighter and healthier, leaving the trauma (and their ignoble parents) in the past.

This is a major, shameless and odious exaggeration and “cartoonization” of therapy (I believe this is a new word – you’re welcome), but the point is that this image of therapy does exist out there, and while I would love to say that social media, regular media, and whoever else I might conjure is to blame, this is not strictly true. We, mental health professionals, bear some blame for this too. Some of our writing and case presentations and discourse is unkind to parents and I am as guilty of this as the next person.

So with this background in mind, here is my dilemma represented as A vs. B.

A. It is undeniable that a good number of people I see in my work are suffering now in direct consequence of poor treatment, erroneous lessons, harsh speech, general meanness, various forms of deprivation, and general lack of foresight that was practiced by their parents when they were young. When people do not appreciate that certain wrongs were done to them through no fault of their own, they tend to blame themselves for things they have no culpability for, so understanding the circumstances of childhood would appear to be very important.

VS.

B. I am starting to have serious doubts that diving too deep into our childhood experiences is as useful as I once believed it was on the grounds that I think it might inspire people to rewrite their memories in the spirit of trauma and victimhood and it might inspire people to sever some emotional ties with their parents that would have served them better if they were whole. A caveat: I have seen some people who were terribly abused by their parents and what I say here does not apply to them. There are people for whom healing calls for the severing of ties with abusers. However, thankfully, this is not true for the majority of people.

I have been pondering how to reconcile these two observations and this brings me to the insight I had recently during a session with a person whose family had been severely dysfunctional and traumatizing in many ways, but who has a beautiful way of maintaining love in her heart for individual members of her family:

A parent’s love is a great gift for a child. In simple terms, it is the gift of esteem – of knowing that you are worthy of good things in your life and that you have value to others. The trick is that, just as with any physical gift, having it is not enough. You have to actually give a gift to the person for whom it was intended. If you have it but you don’t deliver it – you might as well have not had it to begin with.
To give a regular gift you need to purchase it, wrap it and find a way to physically transfer it into the intended receiver’s possession, maybe by mailing it, or by bringing it over and giving it to them. Well, in order to give the gift of love you need to create a loving environment. A loving environment is the conduit by which love travels from the heart of the one who has it and into the psyche of the one intended to receive it. In the case of a child, once a parent’s love travels, by means of a loving environment, and arrives into the child’s psyche, it settles there and causes the child to feel worthy, safe and deserving of good things.
Unfortunately, there are many parents out there who have love for their children, but they were not able to create a loving environment and so the gift was available, but it was never delivered. It is still lying around in the parents’ basement collecting dust.

The insight I had is that it is okay to go back and explore the shortcomings of one’s childhood environment as long as the purpose of this exploration is to lead us back to this love that was never delivered. I personally feel a lot better conducting therapy when I view my job this way and it feels much less likely to descend into cold and needless condemnation of the parents (again, if no love was ever there – if this was an abusive household for example, then it is a different, but fortunately rather rare situation).
I am now starting to view therapy like this: Somewhere in a dark basement lies a gift of love that was intended for this person in front of me but was never delivered. The conduit for love, the road that would make it possible for this love to travel into this person’s psyche – the loving environment – just wasn’t there. Our job then is to travel back far enough that we can find this dusty package and help the client take it. Maybe they are going to have to steal it – that’s okay. It is fair that it should go to them. Once they retrieve it though, and once they start being able to see more clearly that they were worthy all along and deserving all along, they don’t really have to go back to the basement anymore. They certainly can, and they might, but we don’t really have to keep going back there in order to do good therapy.

The Skill of Having a Good Day

***I want to preface this blog by saying that it may be more relevant for people who are not what we might call clinically depressed and are generally capable of experiencing joyful moments. If you are deeply depressed and any joy or warmth is presently eluding you, I would like to hold hope for you that you will soon find help and I still think that some parts of this blog could be useful. However, I want to recognize that in this present moment happiness might mean a different thing for you and that this conversation about skills may ring hollow.***

When people think of the variety of things that require some skill or learning, there is usually no dearth of things that come to mind. Some of you want to become conversational in a new language for example, or learn to play a particular sport. In the realm of life skills there is also no shortage of things that people know would require skill-building: Planning, time management, anger management, relationship-building, having a healthy relationship with food are all examples of things that you probably wouldn’t be surprised to hear require some skill – after all, this fact is incorporated into our daily discourse.

What is not incorporated into our daily discourse at all is the notion that being happy also requires skill. Being happy is certainly a state of mind (and chasing the feeling of happiness can be counterproductive, as I’ll soon show), but it often starts with specific actions. You might be thinking of someone you know whom you believe to have been born “happy.” Some people have genes that give them a leg up, it’s true, but if we examine them closely, we often find that their success can be explained by some behavioral choices and some specific ways of relating to the things that happen to them.
It is important to note that when I say “being happy” I am not referring to “calming down from a state of anxiety” or otherwise learning to overcome a challenge and feeling relieved. Neither do I mean some ephemeral state of unmitigated joy or pure bliss. What I mean here are things such as:

Being able to say “this was a good day.”
Knowing what to do with a day off.
Knowing how to enjoy a trip.
Knowing how to enjoy your food.

My clients often believe that if they could just learn to manage their time and schedule a day off, enjoyment of this day off would come naturally. When they finally do manage to take a day off and then spend the whole day being unmoored and miserable they find themselves puzzled and often even more upset than before. “What kind of person am I that I cannot even enjoy a free day? I must be more ill than I assumed!” To that I tell them that they should belay worrying about their desperate character for just a moment. Have they practiced having a good day? Has anyone ever talked to them about it? Have they spent time trying to figure out how they personally process good and bad and what amounts to a good day for them? In short – how much time have they spent developing the skill of having a good day?

Some of the ideas below deserve their own blog, but for now, here are some ways of relating to life that people who know how to practice the skill of having a good day seem to have developed, either consciously or unconsciously, for example by observing a parent. The list, of course, is not exhaustive.

1. Continuous happiness is impossible. If you are waiting for a “perfect day” – stop it. That is a very tall order for a day to fill and having that expectation sets you up for disappointment. In reality, in the course of a good day people experience multiple moments of negative emotions, multiple small things go wrong, they might experience some negative bodily sensations, untoward things are said to them, etc. In essence, what you are doing when you walk around telling yourself that you are meant to be enjoying every moment of something is you are telling your brain to focus on the question of whether you are happy moment by moment and your brain starts paying special attention to all the things that are “out of place” or “not good.” Ever noticed that some of your best days are days you never planned for? Days when you never expected to be happy? This is why.

2. We are not entitled to happiness. We are entitled to basic respect, to basic fair treatment, and to safety from physical harm. That’s it. Happiness is a privilege. People who tend to be better at having “good days” tend to view moments of happiness as gifts and not as something that was due to them. In other words, they say “even if nothing particularly joyful happens to me again today, I am grateful that this joyful moment came to me” as opposed to “I worked so hard to clear my schedule this day and managed to have a nice cup of coffee in the morning, but then this annoying call came my way. Why couldn’t it wait?”

3. It works better to define a good day behaviorally, instead of emotionally. We can control our behavior but not really our emotions. Therefore, if we say we want to have a day where we wake up later, have a nice breakfast, watch a particular movie and at night try a new restaurant , it is not unlikely that we will succeed in whole or at least in part and the day will go down in the record as a “good day.” If, however, we chase the subjective feeling of happiness we find ourselves in murky waters and are likely to come to the conclusion that we have failed.

4. You have to structure some, if not most of your “unstructured time”. If on your day off you are still in bed at 11:30am, haven’t showered, haven’t eaten breakfast and haven’t made a move on anything that you might have wanted to do that day then the noon hour is very likely to find you dehydrated, with low blood sugar, sluggish and sleepy and with a distinct feeling that you are running out of time to enjoy your day. There is definitely a time in everyone’s life when to stay in bed all day IS the plan, and then it can work great. Everything else requires a plan. The plan can, and probably should be less rigid than a work plan. It can, and should allow for flexibility and should be held lightly, such that if a better idea pops into your head you can pivot on a dime and do the better thing. However, a plan nonetheless you will need, especially if you know that you might struggle with getting out of bed but you don’t want to spend the day in bed.

5. Sitting with pleasure can be as challenging as sitting with pain. When we sit with pain we are consumed (usually) with the desire for it to go away, and when we sit with happiness many of us are quickly become consumed by the fear that it will go away, which of course makes the happiness go away. It takes active practice and skill-building to allow yourself the happiness that comes your way.

There is a lot more to say about this topic and some of the ideas above can be greatly expanded (so perhaps part II to this blog is warranted), but the basic takeaway if that it takes practice to be happy and if you struggle with being happy but upon reflection you realize that you never worked on it and no one has ever endeavored to teach you anything about it (because it “should come naturally”), then you might want to find a way to start learning and practicing before you decide that you are just not capable.

Being Symptom-Free is Not Your Life Goal

When people suffer, they become very focused on getting rid of their pain. That is understandable and very human. When the source of suffering is short-term and acute, this response is also very adaptive and to some extent it is hard-wired, like pulling your hand away from a hot stove.

When the source of suffering is not acute and/or not short-term, the situation is much more complicated, and here we have choices that will influence the flavor and mood of our lives. Take for example a person who suffers from a chronic illness that creates a lot of discomfort – suppose he or she has chronic back pain. Of course, this person will be wise to invest effort into making his situation better. They would be wise to see a doctor. Maybe the doctor will recommend physical therapy. Maybe the physical therapist will recommend some exercises. But no matter what this person does, the fact will remain that their suffering is not something that will go away quickly. They might have to contend with some pain for a long time. The question then becomes – how should they define their life goals in light of having this pain? Do they become primarily a chronic pain patient, a chronic pain fighter, or primarily whatever it is they were before they were afflicted, such as a parent, but one who now has to parent with chronic pain?

Now, let’s extend this to the realm of mental health. Nature has gifted us humans with an assortment of torturous mental health conditions that can be chronic and desperately painful, as anyone with severe anxiety, depression or an eating disorder can attest. People who suffer from these and other mental health disorders need help and often benefit from good mental health treatment, which often involves medication, but often hinges on therapy. But what should be the focus, or the goal of therapy?

When people first come in for treatment (and I never underestimate how hard it was to even show up in my office to begin with), they often come in with a very human and very simple assumption, which contains within it their expectation from me: “I am coming in so that you will help me to get rid of my anxiety/depression/anger/existential angst etc.” That is their goal for treatment, and it sounds like a very appropriate goal, doesn’t it? A doctor’s job is to get rid of physical suffering, so shouldn’t my job as a psychologist be to get rid of emotional suffering?

As I already said, even with a physical source of suffering if something cannot be treated quickly (like a surface wound or a broken bone), the question of goals and subjective choices becomes relevant. But at least anyone would agree that it is possible (and pleasant) to imagine a world in which a person’s pain is completely healed. But can we really say that about someone’s existential angst? Would I ever be able to say that it is ethical or desirable to rid someone of the doubt or painful memories that cause them to suffer? I am exploring this question as though it were possible, which it is not. But if I could promise you – my reader, that I could wave a wand and rid you, yes YOU, of some part of yourself, even a painful one, wouldn’t you at least think hard about this before consenting?

This is not to say that psychological suffering is inevitable or that is cannot be improved. It surely can improve and I have seen patients of mine improve tremendously. But it does mean that we have to be very careful about how we set goals in therapy. Making someone into a different person who doesn’t feel things deeply is not a good goal. Making this person in front of me – just as they are with all their experiences, memories, and idiosyncrasies suffer less, now that is a good goal, but it implies that we can’t just march in and start condemning parts of a person and trying to throw them out.

When my clients hear that I am not so quick to sign up for the therapy goal of “getting rid of” their anxiety, they become alarmed. “Are you telling me that I finally made my way here and you are not planning to make me suffer less?” To that I say – “No. I do hope that I will help you suffer less. But let us see about the specifics of that plan. When you die, would you like your memorial to say “here lies John who bravely fought against anxiety and finally passed away anxiety-free?””

Well, that would be ridiculous! Most people say, no. They would like it to say that they achieved their career goals, raised their kids well, were kind to their partners, did right by their families and friends, contributed to society… the list goes on. “Well then,” I say. “But a really bad thing has recently happened to you. You have been hurt badly and a person who has been hurt as you have usually (and appropriately) becomes anxious about being hurt again. This anxiety takes time to dissipate, just like chronic pain from a physical injury. Do you really want to wait so long to start going about approaching all those goals you have – advancing your career, having a family – all that?”

“It would be great if I could start working toward those goals, but I cannot because of this anxiety. Now, once you help me get rid of my anxiety – then I will be free to start achieving my real goals. That is exactly why I am telling you that I want you to help me get rid of my anxiety.”

“So, what you are saying to me is that you have all these goals that you are letting slip away from you as a result of your anxiety?”

“Yes! Exactly!”

“And what percentage of your suffering do you suppose is currently being caused by the fact that you know that time is slipping away and you are letting go of your true goals?”

“But haven’t you heard me??? I CANNOT approach my goals. I get anxiety attacks every day. I am nauseous and exhausted all the time. I cannot sleep. Do you expect me to go ask for a promotion when I am like this? Crazy!”

Well now. This is a good start. This is a very good goal for therapy. If you have values and dreams and goals – those are integral to who you are. How about we agree to do absolutely everything we can so that you can go ask for that promotion, anxiety or not. Maybe you will need to practice some skills first. Try an easier thing first, try medication, change your exercise routine. We will surely have to work very hard. But we are working not toward a goal of you being anxiety free – because then what? What is being anxiety free good for? Is it good for being “happy”? But didn’t you say that in order to feel good you would need to have achieved your career goals, been a good parent, seen the world – whatever it is that is true for you? Well – that should start right now, not at some amorphous later point. Remember – your true goal is not to be symptom free. Your true goal is to become able to do those things that you value.

On the Misuse of Suffering

My work with young people – people in the “climbing” stage of their lives, has crystalized for me a phenomenon that I think exists everywhere in our society – the misuse of suffering as a proxy for effort, success, worthiness, etc. Let me explain what I mean:

Think of a role you play in your life that matters a lot to you. It might be your role as a parent, a student, a practitioner of your profession, a citizen, a friend, an artist – these are just a few (and we all play multiple roles in our lives). Now, in each of these areas there are some markers of success that are easily quantifiable. For instance, if you think back to a time in your life when you were a student (e.g., in school) you will probably recall that grades are one such quantifiable marker of success – it may not be easy to get an A, but it is quite easy to define what an A is and you can easily know whether you got it or not. It is also easy to quantify how much time, in hours and minutes, you are spending with your child/spouse/friend etc. For that matter, it is easy to quantify how much gross time you spend doing anything (stay in the office, for example).
The challenge is that some of these quantifiable markers of success are not necessarily the most meaningful, important or personally relevant. Grades are a compellingly simple reward system, but their relevance fades once we leave academic settings, or advance in them beyond the undergraduate level. Time spent is also simple, but if you think about it, it is a very crude measure of actual effort and even less good as a predictor of the value of someone’s contribution to any cause.
One thing that tends to be true of most people is that they struggle with ambiguity and tend to be driven to reduce anxiety-provoking doubt. Therefore, people on average, no matter how fervently they proclaim that they do not like to be formally evaluated (e.g., tested), tend to struggle with tasks that offer no built-in way to evaluate success or progress. And what do people do when an obvious way to measure progress does not exist? They try to create a way.

Unfortunately, it seems that there is a process in our society (and perhaps it is not unique to our culture – that may be a topic for another blog) that compels people to view suffering as an acceptable way to measure success. This makes a lot of sense. After all, what really does it mean to spend QALITY time with a child? That is a deeply philosophical question that requires deep reflection on what kind of person that child is, what kind of person you are, what each of your skill sets are, what both you and this child are most in need of in this particular moment in time, what your general goals for parenting are, what kind of adult you want this child to become, how long the child’s attention span is, and much, much more. Suppose that a deep reflection on all of these questions leads you to believe that this child would benefit most from seeing you take care of yourself so that they feel that they are allowed to take care of themselves too. What if quality time for this particular child right now means seeing you give yourself a manicure? But can you be sure that this is true? Can you be sure that this conclusion was not driven by your selfish desire to have a manicure?
The truth is, that we can have a pretty strong hunch, but we can never be 100% sure that we are succeeding, because almost everything in life that is meaningful (like raising children, building a career, being creative) is also complicated. But somehow, there seems to be a process in people’s minds that says that if they have suffered or made sacrifices while doing something it is more likely to be the right thing to do than if they enjoyed it. Therefore, people seem to be more likely to conclude that if they give up their date night to spend an evening with their child (whose only desire that night may be to chat with a friend), that is more likely to make them feel like better parents than giving themselves a manicure.
Even the way we talk reflects this bias. For instance, it is not very common (probably because it is not always viewed as socially acceptable) to openly compliment oneself on how WELL one has done something. However, it is perfectly acceptable to imply that one has worked on something more hours (and slept fewer hours) than anyone else at the office. It is not socially acceptable to praise oneself as a parent, but it is acceptable to expound on all the sacrifices one has made for one’s child and the suffering one has accrued while making said sacrifices.

I wish there were an easy way to get out of this pattern of thinking, but there may not be. After all, using suffering as a proxy is a shortcut, and people create shortcuts for a reason – because the alternative road may be long or complicated. The alternative to using this shortcut, in my opinion, is to reflect deeply on one’s values and goals, and to be mindful of what one truly wants to see as an outcome of a particular action or activity. This may require a good measure of honesty with oneself and general self-awareness. However, the benefits are considerable. Imagine what it would be like to give yourself permission to leave work on time, to take the weekend off without guilt, to invite a babysitter on a night you really need to recharge, to accept help from a loved one, etc.

I encourage all of us (myself included) to reflect on the moments of suffering in our lives and try to be mindful of which ones are driven by the inevitable pain of being human, which we cannot avoid (e.g., by painful life events), and which ones are instances of needless suffering driven by the desire to quantify success/progress in areas of our lives that may be inherently not quantifiable. This might be a necessary first step to suffering a little less.

First published here: https://www.mmcounselingcenter.com/mindful-living-blog/archives/10-2019

Why “Small” Choices Matter

One of the cornerstones of mindful living is living a life where we make conscious choices and then take responsibility for the choices we have made. The opposite of this is a type of existence where we let life happen to us and experience our life circumstances as inevitable. Often this kind of living leads to feeling trapped in some way.

Learning to open up to the possibility that we have choices when it comes to the big picture circumstances of our life (like our relationships, work, health, etc.) can be a lifelong process and often becomes an important theme in therapy (of note – when I say that we have choices I do not mean that we have ALL the choice. No one chose to be born into poverty or with an illness and they cannot choose to be born again richer or healthier).

But what about what seemingly is the minutia of our lives? What about the myriad daily tasks we perform, the small promises we make, the emails we send, the tiny insidious turns of phrase that roll off our tongue multiple times a day? I have been reflecting on the fact that we often don’t treat these small occurrences as real actions, and therefore often do not treat them as worthy of mindful consideration. However, I have come to reflect that these small habits, despite, and maybe even because, they are so small and so easily able to fly under the radar, have the power to train our brains to turn in a certain direction – to view the world through a certain lens. In particular, I have been reflecting on how our mundane choice posses the power to turn us toward, or away from, a stance of active choosing in our lives.

All of this sounds a bit abstract, so let me illustrate:

Let’s use the example of a simple email. Suppose you have been asked to join some optional activity at work and you are crafting a reply to indicate that you will not be attending. Now think of the first opening phrase that pops in your mind. For many people, the go-to opening sentence would sound something like this:

“Thank you very much for your invitation. I would love to attend your event, but unfortunately I am unable to attend….”

This is a great way to reply to an email – if it were true. However, hidden in this sentence is a message that you have NO CHOICE but to skip the event, that you are SORRY about that, and that if you COULD attend, you certainly WOULD. In other words, that you are a victim of circumstances that are keeping you from what you want to do. However, what if the actual truth, if you allowed yourself a moment of honest reflection, is that you have no interest in that event, that you would rather not take time to attend it, and that if you really wanted to be there you would have been able to swing it – you simply are choosing not to.

Now, one might ask, “So what? What would be the harm in writing a polite email and making someone else feel good? It’s only a small, innocuous white lie – everybody does it!”

That may be true. But I have been reflecting that the danger of getting used to communicating like this is that the first one to get this message is our own brain. The person getting the email will soon forget all about it, but our own brain, through constant repetition, becomes imprinted with the idea that there is no such thing as WILL NOT – there is only CAN NOT. Put simply – if you become subconsciously convinced that the only way to bow out of a lunch meeting is by having a massive headache, your body can certainly deliver one for you.

In my own life, I have been practicing using more honest and choice-based communications, that are still perfectly polite. For example:

I cannot attend your event on Tuesday because of prior commitments (*note to reader: spending time with your partner is a perfectly legitimate prior commitment), but I hope that your event goes very well and that you have a wonderful time!

It will be hard for me to meet you so early in the morning, but I have a lot of flexibility from 10am onward – is there any time that works well for you? (*Here I am resisting saying that I am really sorry that I cannot meet this person at 7am – I am not sorry at all about that. I am very happy in fact that I plan to be sleeping at that time)

Can you think of examples from your own life?

Other situations where this becomes relevant include:

Telling your kids, for those who have them, that you CANNOT give them something they want because you are busy/not feeling well/angry at them when the truth is that you just want to read a book but are feeling guilty about that. Parents often feel that they need to find the justification for not doing something for their kids (the CAN’T), when maybe they could have said the truth – I can, but I don’t want to right now. This could have led to a productive conversation and taught the kid that they are allowed to take care of themselves too.

Telling yourself that you didn’t clean/exercise/do laundry/reply to your friend’s email etc. because you just couldn’t, having been too unwell/stressed/busy etc. when the truth is that you COULD have done those things but chose not to because you just couldn’t be bothered. It might not feel nice to admit this to yourself, and in admitting this you do admit to a potential moment of less-than-exemplary behavior. However, in doing so you are also allowing yourself to live in the full glory of having had a choice and of having made a choice, and being free to make choices in the future. If you don’t like a choice you made, you can choose differently next time. If convince yourself that you were a victim of negative circumstances outside of your control there is less you can do about that.