Counseling and Therapy Primer for Every-Body!

I often receive unsolicited emails through my profile on psychologytoday.com.  The vast majority are legit inquiries to obtain information regarding my psychotherapy practice.  Then there are those which makes me go "Hmmmmmm..???"  Since just receiving one of those emails the other day, I thought the timing was right to address the common misperceptions and faux pas to do with seeking out and requesting professional help for the first time from a mental health clinician/practice.

First, it is important that you understand "who" you are contacting.  I understand that the pandemic threw a monkey wrench into expecting to speak with and/or make an appointment to see a licensed provider within a reasonable time frame.  However, it is NOT helpful when a sender/caller doesn't even know exactly "who" he or she has just contacted because one is working off a series of phone numbers or emails of various and assorted providers.  I have actually had phone conversations where the caller suddenly asks me, "Which one are you again?"  I have to laugh, because this usually translates to the person wanting to set up an appointment with me.  Instead of  experiencing such an awkward moment, try being more clear about who you are specifically reaching out to with each initial inquiry for help.

Second, it is unreasonable to expect something for nothing from someone you do not know, but who is a professional in their field.  Would you expect a medical doctor or a plumber or a hairdresser to speak with you, as a prospective patient, client, or customer, for "just 15 minutes" so you can decide if you want to make a first appointment or not?  Ignorance in this case is not bliss...it's just plain rude.  If the provider asks you for information, then you are in a position to provide it and be grateful for the opportunity.  However, if you expect the provider to listen to you for 15, 20, or however many minutes gratis (that means for free) while you decide if you want to make an appointment or not---that's a no-no.  Everyone's time is valuable;  don't presume we somehow "owe" you however much time you want or need just because you got through to us.  I know that people who have never before been to see a professional psychotherapist are "not" going to understand the nuances of what constitutes appropriate versus inappropriate expectations in this regard, so now you know.  Kind of like being at a party and meeting a dentist, only to start showing him or her that tooth that's been bothering you for the past month.  Stop the madness.  Get a clue.  Our time matters just as much as anyone else's.

I am reminded of the time an acquaintence of a mutual friend called me at 10PM on a Sunday evening.  I inadvertently picked up thinking it was someone else.  When I realized my mistake, I suggested that the caller contact me the following morning, as I picked up in error.  I was told that I was being "completely unprofessional" for not being willing to listen to her on demand in that moment.  Of course, I chose not to work with this person who "expected" me to drop everything to attend to her at 10PM on a Sunday night.  If you are in a true emergency, that's what calling 911 is for.  I am not 911.

Third, recognize that the desire to pursue professional psychotherapy is not like going to the $2.99 dry cleaners.  You get what you pay for.  If you can't afford the standard rate (which is around $150/therapeutic hour for Masters' level clinicians)...then you can consider the alternative options available to you.  Also, please don't assume you can negotiate a lower rate because you think you are good at negotiating.  That won't work.  If you qualify for a sliding scale (discounted) rate and the provider offers it, you can ask about that.  To assume that psychotherapist's hourly rates are negotiable is both rude and disrespectful to the provider and his/her/their profession.  Also, if a provider is giving you specific information over the phone...don't make him/her/them "wait" as you have to find a pen or pencil or paper to write with.  Again, our time is valuable.  Be ready to write down whatever before you even make your first phone call.

Last, understand that the journey of getting and doing better is YOUR work to do, not your psychotherapist's!  We who are in the profession come up alongside you to encourage, inspire, and possibly motivate you to do the "right" thing instead of doing what merely feels "right" to you.  When clients expect us to have all their answers and solutions stuffed into a nice big box and tied up with a big beautiful bow...this is NOT doing your own work to heal, make positive changes, and grow as a person. The process of healing and recovery is not comfortable.  You will feel uncomfortable.  The process of healing and recovery is not "instant";  everything takes time and is part of a larger process of change from the inside out.

With that, if you have not yet before considered psychotherapy to help you make the changes you suspect you may need to pursue to be and do better as a person, perhaps the time is right now to send that email/text and/or make that phone call.

You are the author of your own book of life.  Make this page your best one yet.  Do your work.  You can do it.

Until next post...

 

When You Need to Be More Personally Responsible....

Personal responsibility is one of those realities of everyday life that we don't want to talk about much.  Why not?  In my business, we talk about "ATLs" often with certain clients (which means "activities of daily living" for the uninitiated).  Unless a person can successfully pursue their own ATLs, intervention is always a necessary component of the client's recovery journey.

Yet, when it comes to those of us who can otherwise get up, dress up, and show up to our own lives each day, we don't often think of what being more personally responsible can mean.  Today's blog post is about this issue because it is so easy to avoid what we'd rather not---be personally responsible about!

"Donna" is a successful lawyer.  She is also a slob.  I don't mean the kind of slob who shows up in court wearing her pajamas from the night before.  No, in Donna's life and world, she looks great and very well put together when she's out in public.  Yet Donna will never invite you over.  In fact, Donna is well known for the "Let's meet up at..." style of social interaction with friends and family.  Because Donna lives alone and has no children, she is free to pursue her ATLs exactly as she wants because there is no accountability.  Donna's extended family all live out of state, and her parents and elder relatives are long since deceased.  Even though Donna is involved with some community-based groups, she has not hosted anyone in her home for the past ten years.

It was when Donna met "Jake" that things became complicated.  Jake was highly interested in pursuing a romantic relationship with Donna, but could not understand her obvious reluctance at him visiting her in her home.  "I thought it was strange that this beautiful and charming woman suddenly went oddly dark when I mentioned coming over to her place.", Jake stated.  After a few months of dating "Donna's way" as Jake put it, he lost interest. "I got tired of trying to figure out what was going on with her," says Jake.  "If she wasn't going to tell me why she didn't want me coming over, I was not going to invest myself in figuring it out anymore."  Exit Jake.  

Yep, it can be like that when we avoid some personal responsibility, or group of personal responsibilities, that we'd rather not pursue.  Living within a hoarder's paradise, not regularly cleaning up one's private places and spaces, and/or treating one's residence like a landfill is NOT going to help Donna find someone to share her private life with, just sayin'!

"Billy" has had a heavy duty porn addiction since he was in high school.  "I knew it was wrong, because it changed the way I felt about and behaved around women my own age", he claims.  Billy hasn't been in a meaningful romantic relationship for years, and he is turning 34 on his next birthday.  "People presume I'm gay, and in a way I'd rather have them think that about me than the fact that I can't stop doing porn."  Billy has spent thousands of dollars subscribing to various sites involving women he does and does not know in real life.  "I just paid $400 to a girl I used to know in high school when I thought it wasn't going to be more than $50!", he laments.  Besides draining his savings, Billy recognizes his need to detox and stop using porn as his only coping tool to emotionally regulate himself on demand.  "I know now it's no different than going to the casino or doing drugs", Billy says.  

So...did Billy take on the personal responsibility of seeking proper intervention and treatment for his porn addiction?  He keeps saying "I know I need to do this!", but he hadn't yet pulled the trigger (no pun intended there).  It had been recommended that he watch the film "Don Jon" while also finding a 12-step SAA group to join.  He was also referred to the classic read "Don't Call It Love" by Patrick Carnes to read, which is available at most libraries.  There was no "order" in which he was asked to consider pursuing these recommended options.  He just needed to do that something different and report back with his thoughts/feedback regarding what he had chosen to pursue.

When taking the time to just watch a movie and/or read a recommended book becomes a "challenge", one may safely deduce that personal responsibility IS a significant issue for the person choosing to avoid it!

We need to be more personally responsible when we are aware of and/or are clear about our "next steps" to make positive change(s)---and yet we don't pursue even one of those steps.  In fact, psychotherapists understand when pursuing personal responsibility IS a significant issue when a client says "Yes, yes, yes!" but does "No! No! No!" in response.  That is our literal first clue that something is rotten in Denmark.

In Billy's case, nearly a year passed until he actually watched Don Jon on cable.  He contacted his former therapist and claimed to be "blown away" that such a movie had even been made like it.  "I thought it was going to be like going to church or something, but it really made me think about how I have been destroying my view of everything and everybody because of porn."  Yep, grateful he understood that.  He returned to therapy and recently took the book recommendation with him on vacation.  Although it took nearly a year for Billy to take action on these suggestions, at least he finally has begun the "active" process of being more personally responsible for his own porn-related detox and recovery.

Whatever it is we need to be more personally responsible about, it begins with our own decision to do something different from what we've been doing.  Remember the Blind Melon lyric:  "When life is hard, you have to change."  No kidding.

Not all personal responsibilities are obviously tangible.  "Sue" is married to "Jeff".  Jeff doesn't like to talk about anything much outside of his own personal or work-related interests.  Sue says she feels like she lives alone, because Jeff rarely wants to talk anyway---let alone to Sue about things that she feels are important.  After two years of marriage, Sue is about ready to bail on the relationship before she has kids with Jeff.  "I think he's a narcissist", Sue states.  "I was talking to a friend of mine and she swears he's one of those."  Is he really Sue?  Maybe so, maybe not.  But the first step is to see if Jeff is willing to come to marital counseling so both parties can get clear and understand each other about the state of their current union.  If Jeff resists counseling with Sue, she can certainly pursue counseling for herself as a first step.  Ultimately, we either come to accept what is the reality of the situation...or we don't.  But to complain about something while at the same time claiming to "accept" it is NOT the way to actively love someone in an honest-enough monagamous and committed relationship.

When we make a lifestyle out of avoiding our own personal responsibility, our future IS going to be bleak.  No doubt of it.  We can't expect others to ignore what we ourselves are choosing to ignore that we are responsible for every single day!  We will end up losing friends, loved ones, and anything else that matters to us because of our own inability to face and take care of what we must face and take care of!

Don't be that person.  Don't be that person that spends the rest of your life belly-aching about "This is what happened to me boo hoo hoo!"  There are NO excuses.  If you are able minded enough and able bodied enough...you CAN do what you are supposed to do each and every day as a fully-grown adult person responsible for your OWN life and well-being!

Until next post...

When It IS Time to Truly Let Go...

Bitterness is not attractive.  We all have something or another we still feel bitter about.  I am reminded in this moment of every "star" wanna-be professional athlete in high school or college---yet it didn't happen.  You ever meet one of these folks?  When a person is bitter about an issue such as this one, it's a trip to listen to him/her/them.  No matter what is being discussed, the conversation seems to always circle back to what happened to him/her/them that did NOT work out.  Based on my last post, and in case you forgot, anyone with lingering bitterness about A, B, C, and/or D is also dealing with unresolved grief!  "If only I had..."  "If only that didn't happen to me at that time..."  "If only my parents hadn't..."  "If only my stupid surgeon didn't...."  As the old saying goes, "When you get to the end of your rope....it's time to let go!"

Letting go is very difficult for us, yet when we keep hanging on to "it" whatever it is---it does have the power to destroy us both figuratively and literally.  When the horse is dead, by all means dismount!  How many of your own old dreams, desires, and heart-felt "plans" died with the passage of time?  How did you move past what happened to you without bringing that anger, resentment, and bitterness over "it" with you into your present life?  You don't believe you have?  Think again!  Without being aware, you morphed into the person you said you'd never yourself become:  a bitter one!

There are many adults, reading this right now, who "changed" dramatically and for the worse as soon as they realized their experiences with other people (primarily their own peers) was more disappointing and hurtful than not.  For me and in school, it was the day I was "christened" a nickname I did not want or ask for by our class's #1 bully.  I was called that nickname throughout my childhood, but I decided to go with it rather than remain angry, resentful, and bitter about it.  By the time I reached high school, my classmates who called me that nickname shortened it (mercifully) so it didn't sound so obviously offensive.  Kind of like transitioning from "Lurch" to "Lure".  According to gain frame theory, I focused myself on the positive as a result of this change in my nickname status---and ran with it.  When new people I met in high school would ask me, "Why do some people call you "Lure"..?", I made up a story that made "cute" sense.  In my case, "I used to wear a lot of bows in my hair as a kid.."

Now I am reminded of another kid I grew up with who was always quite angry and distanced himself from others.  He didn't instigate drama, but he wasn't  kind either.  Seeing him periodically at social events over the years as an adult, he is "that guy" who is hyper-sarcastic, hyper- critical, and hyper-negative.  Word on the street is that he had a physically abusive stepfather as a kid.  Well, that would explain a lot.  But to spread his past pain onto  others even "now" as a retired senior citizen through his thoughtless, careless, and hurtful comments?  He thinks he's being funny when he is confronted;  he's not funny.  He's bitter.  And it shows.

Do you know about gain frame theory?  It's what allows us to change our thinking from negative (which comes so naturally to us!) to positive no matter what the topic under consideration is.  We either look at a glass as half full (gain frame) or half empty (loss frame).  Studies have shown that if you describe anything to people in terms of loss frame ("This device has a 30% failure rate.."), the people who hear that will develop a negative attitude towards the device and stick with that "fact".  On the other hand, if you take another group of people and describe that same device in terms of gain frame ("This device has a 70% success rate..."), those folks will develop and maintain a positive attitude towards the device and stick with that "fact".  Even when researchers went back to each group to offer the opposing perspective, the "negative Nellies" didn't change their minds about the device having a 30% failure rate rather than a 70% success rate.  Meanwhile, the "positive Pammies" remaind positive after hearing the device had a 30% failure rate.  Yep, it's like that.  When we focus on the "gain frame" moments of our lives which includes developing an attitude of genuine gratitude....we are actively working against anger, resentment, and bitterness wrapping their tentacles and tightening themselves around our very throats!

Letting go of our past hurts, disappointments, and lost dreams is not a job for cowards.  It really does take bravery to face the realities of our past choices which led us to where we are today.  "I wasted my life on being with him/her/them and now I'm 53 years old and I still don't know what I am going to do when I grow up!"  "I'm too old to grieve over something that happened to me 50 years ago!" (Really?  If it still affects you negatively "now"---even if those effects are limited to your own thought life---isn't it worth working on to reduce and/or eliminate now also?!)

Letting go (surrender!) is at the heart of learning how to accept whatever it is that happened to you and/or to someone else you love(d) and care(d) about.  "Surrender is that still small space between acceptance...and change."  That's the truth!  If you can't let go...if you can't surrender your will for what you wanted/want now but didn't or never received....you will be STUCK my friend in a whole lot of anger, resentment, and bitterness as time continues to pass you by.  

The time to truly let go of everyone and everything that causes you pain, misery, and suffering is now. It just is!  Your continued relationship with bitterness isn't working!  It never has worked for you in the first place!  You did become that person who is NOT a joy to be around!  You complain and moan and groan so comfortably that you don't even notice when you do it like you once used to notice!  You view it as "normal" human behavior.  It is NOT normal human behavior!   You were and are not meant to be isolated, alone, and still bitter about your life and what happened to you.  Come out into the light and receive your healing---before it is too late!

Until next post...

Why Completed Grief Doesn't Just Happen; It's a Process!

Navigating our way through the unresolved grief of our own past history is a process.  People tend to ignore it rather than to face it and work through whatever it is we remain traumatized about.  For example, when someone we love and care about suddenly dies, depending on what "else" is going on any one of the beloved survivors' personal lives.....our unresolved grief has the power to unhinge us.  Literally and figuratively speaking.  If you doubt this, take a look see at the latest documentary about Wendy Williams.  It is called "Wendy Williams:  What a Mess!"  After watching it, I felt horrible for what she went through in her personal life that she kept secret from every one who was closely connected to her.  

Then again, not everyone was or is a Wendy fan.  She was the equivalent shock jockette to Howard Stern, but as relating to her own chosen group of celebrity targets.  As she dished it out about who was doing what to whom in the R&B and rap music industry, her own life was unraveling bit by bit.  A self-professed cocaine user in her radio heyday, Williams herself states she was a "made" woman by the time she met her future husband Kevin Hunter when she was 29 and he was 23 years old.  Over time, that script flipped mightily and he became large and in charge of her personal and professional life.  Multiple miscarriages, serial cheating....it was "Hot Topics" fodder for Wendy who kept trying to keep it together professionally as her star kept rising while her personal life was crashing and burning.

If you haven't seen the documentary, I encourage you to do so.  By not pursuing her own unresolved grief work, she turned to the bottle in "coping" as she herself openly states.  "What would you do?" she keeps asking the camera while heavily sobbing.  Tough girl outside;  yet what a mess inside.

(Williams is alleged to being currently housed in an inpatient rehab facility for alcohol addiction as of June 2023..)  Her son has gone on record stating that he fears she will die because of her alcoholism and the people she has surrounded herself with who, he feels, are exploiting her financially.  How sad!  Yet how typical of someone who avoided facing what they preferred not to face when it came to processing their grief over their many life's losses....

I remember reading a tremendously powerful book called "Guilty By Reason of Insanity" by Dr. Dorothy Otnow Lewis many years ago.  Lewis, a forensic psychiatrist, dove deep into the minds of individuals on Death Row.  In her book, Lewis talked about the depth of denial these men had in common when it came to processing past trauma and loss through their own grief work.  Instead of honestly facing and then working through what happened to them, they stuck with the "My family was great!" narrative to maintain the family folklore.  Think about that.  Someone would rather go (at that time) to the electric chair than to admit that they were sexually abused, beaten, neglected, and/or otherwise treated like less than human---before they would rat out their father, mother, sister, brother, grandpa, uncle, auntie, cousin, or best friend's family member(s). 

Well, that's how it is with unresolved grief.  We are more afraid of walking our way through it than we are of getting over to the other side of it and to the point of genuine "acceptance".  Once you accept the reality of whatever "it" is that happened truly and deeply within yourself, it is impossible to stay stuck in the past.  You will move forward as you should.  Think about all the people you know, or have known, who seemed to be extremely "stuck" in their unresolved grief over----you name it!  A divorce that happened 18 years ago and she is still lamenting how he "ruined" her life....a son or daughter who just up and left home without ever looking back....the boss who sexually harrassed and threatened his employees for decades before being outed for his crimes..  THESE are just a few examples of life experiences that absolutely require grief work.  Don't we understand the importance of that yet?  Many do...and yet many of us still do not!

At my age, many of my peers are dealing with spouses showing signs of some form of dementia.  Well, ours was the generation that viewed drug and alcohol use as a right going back to early junior high school.  (That would be 7th grade for you Gen Z'ers out there..)  Not that alcohol and drug use is 100% a direct cause of dementia, but such a lifestyle sure doesn't work to prevent it!  So what is one supposed to do when your wife or husband of 30 or 40 years starts asking you questions that make absolutely no sense and/or talks about things that are not based in any form of real life and right now reality?  

I just heard about a wife who started screaming over the phone to her oldest daughter about "Clean out your bank account now..!!" because mom thought the American banking system was in the middle of financial collapse and everyone had to get their liquid assets out before midnight.  By the next day, mom was back to "normal" again without any memory of calling her daughter about the bank issue.

Grief can be complex.  Of course it can.  No "loving" relationship exists as a straight line.  There are curves and drop offs and all sorts of bumps and impediments which challenge one's personal trajectory between feelings of love---and feelings of hate.  This is what Otnow Lewis discovered in her work with death row inmates.  They could talk about their crime(s) without batting an eye or shedding a tear...but when it came to their own family of origin experiences, it was a very different story.  Usually one of denial and the stuff of legend and myth, which is much easier to navigate than authentically facing and then grieving our personal loss(es) from back there...

There are several grief books that are helpful for the person interested in beginning their journey into...and through the grief process.  "Bearing the Unbearable:  Love, Loss, and the Heartbreaking Path of Grief" by Dr. Joanne Cacciatore is one of them.  "Getting Past What You'll Never Get Over" is another great book by John F. Westfall.  Both can be ordered through mel.org and your local library.  As I have stated repeatedly in this blog, you can then receive the book for free from your local library when you order online through mel.org and retain it for three weeks post delivery.

Do your grief work as acceptance is the only reality that can move us past what we have endured so we can experience true hope for what remains of our own future....

Until next post....

To Think Of Yourself Less Often....

We are all narcissistic to varying degrees.  This is because we all have suffered through varying experiences of rejection, invalidation, neglect, and by being true victims of true injustice.  Narcissistic injury teaches us that it is not o.k. for us to exist, we are a/the problem to him/her/them, and that we basically have no real value or worth as a viable and contributing member of society.  Narcissistic injury also teaches us that we are no more than mere objects to be exploited and used by others for their own amusement and/or gratification in whatever forms that gratification takes.

Now, one might think that such difficult life experiences would encourage a person to be resilient, compassionate, humble, and committed to doing what's right first and always.  Wrong!  In fact, narcissistic injury more often causes us move in a completely opposite direction.  Instead of being resilient, we get stuck in the muck of our painful past.  Instead of practicing compassion, we care less and less about the well being of others.  Rather than being humble, we choose arrogance to cover up our genuine inner vulnerabilities.  And rather than doing the right thing in any given moment...we choose to do whatever makes us feel "right" in the quickest way possible.

Instead of thinking of ourselves less often, we think less of others more often!  And that fact, I must say, is at the root of how malignant narcissists are not born...but are made!

Let's take a look at the life of "Joe".  Joe's dad died suddenly when Joe was 9 years old.  Joe had one older brother, who had an ongoing anger problem since their father's death.  "He was always mad.  Mad at  our mother, mad at me, mad at the world."  Joe didn't realize that his brother's anger was complicated due to the demands of their mother once she became a single parent.  As Joe's brother Sam put it, "She told me I was responsible for Joe when she was working. I couldn't do anything or go anywhere after school because Joe was too young to be home by himself.  I couldn't believe it.  My life was going to be over because I had to babysit my brother?!"  Unfortunately, Sam figured out he could have his friends come over to the house when she was at work and until 7PM each night.

Joe's experience with his brother and his brother's friends quickly became nightmarish.  "I was violently molested by a few of them when my brother was downstairs getting drunk with the rest of them.." states Joe.  "I was too scared to tell my brother or my mother what happened, because these guys who hurt me said they would kill me if I told anybody."  Wow.  Needless to say, Joe started drinking with his brother and these same friends by age 12 and secretly began cutting himself to "just feel something".

By the time Sam was 18, he quickly moved out and relocated to the opposite coast.  "I was glad he was gone...and I didn't care if I ever saw him again", claimed Joe.  Joe, when he turned 21, got a girl pregnant who already had been married before and had a two year old son.  "My mother went ballistic", Joe says.  "She didn't come to the wedding, and she treated my wife like dirt pretty much for the rest of her own life."

By the time Joe and his wife completed their own family, he found himself feeling smothered by them and their needs whenever they were all at home together.  "I don't know what it was, but I couldn't stand being home.  It was like I had to go literally outside of my own house in order to feel o.k."  Needless to say, Joe found his own "crew" to go out with after work....and their group's activities over time often involved drinking, drug use, and other women and men to be sexual with.

Joe's wife was beside herself.  "I have these kids with the man I love more than life itself, and the best he can do is tolerate our presence every once in a while?", she stated.  Her protestations fell on Joe's deaf ears.  Joe was too busy trying to make himself feel good on demand by focusing on what he wanted and when he wanted it and how he was going to get it.  

When Joe finally came into therapy because he just found out his youngest daughter had been molested by his oldest stepson for several years during her childhood, he was a broken man.  "I don't know if I can believe her", he told his therapist.  "She was always very clingy as a kid, but I can't believe he would do that to her."

It took several months working with his therapist for Joe to realize how he came from a family whose primary legacy was malignant narcissism.  During this time, Joe did some research regarding his own father's death.  He found out from his last living "elder" relative (his paternal aunt) that his father was killed coming home from a rendevous with his long-time girlfriend.  Both were killed instantly, but the family shut down the truth immediately and just told everyone it was a heart attack.  "Back then, my aunt told me, car accidents weren't reported in the newspaper unless a lot of people were killed at the same time."  

How did Joe feel about this uncomfortable truth regarding his own father?  "Well, why should I be surprised?", Joe pondered.  "I don't even remember him ever at home with us.."

Joe managed to locate his brother to ask him about their lives before their dad died.  "He was surprised to hear from me, but he did answer my questions", says Joe.  "He told me that my parents fought a lot when they were together...and that our mother cheated on our father with her boss at work for not just years---but decades.  He also told me that is why he left home so soon after he graduated high school, because he couldn't take her lies about her boyfriend/boss anymore."

Talk about history and the epigenetic links of malignant narcissism repeating itself through the generations!  Double yikes!

To think of yourself less often is the first step in breaking the chains that bind you to your own complicated past.  This is why I often suggest that adult children start asking their surviving family members/elder family members "What happened here?" before the passage of time prevents the truth from coming out as it should.  When we become blind to what our family's history has to teach us, we are pretty much doomed to repeat and re-enact the same patterns of dysfunction that we've kept ignoring and/or denying....

Until next post....