No Detours

Dedicated to LC who didn’t live very long but inspired many

Many years ago Linda was a client that I was working with. She was a very complicated young woman. She had chemical addictions, eating disorders and an assortment of other significant issues. Her chemical addictions were getting out of hand and she needed to go to detox. Linda agreed and assured me that she would go on Monday. On Monday, after she didn’t arrive at the detox, I called her and the conversation went something like this:

Me: What happened?
L :  You know
Me: You took a detour?
L:   Yes
Me: Ok, (pause, pause, pause,)but really you need to go to detox
L:   I know
Me: How about tomorrow
L:   Ok
Me: So you’ll call them now so you can get in tomorrow?
L:   Yes
Me: So you are going tomorrow?
L:   Yes
Me No detours?
L:  No detours

Linda did arrive at detox the next day, she looked like, someone who was on the highway to hell. She completed detox, but soon her multiple issues and continued detours led her to her final highway. She died way too young, unable to deal with many issues that she could not even speak about.

Linda’s detours sadly led to her undoing in a permanent way, but many people that I see don’t listen to their internal gps settings. They appear to be on the verge of getting better only to get off of “Healthy Road” and make several turns on to “Self-Defeating Avenue” or “Self-Destructive Boulevard”. These detours tend to last way longer than necessary and ultimately lead to lots of guilt, shame, remorse, and self-loathing. When people drive back and find “Healthy Road” they generally have to clean up the messes they made from their detour. As people start to clean up those messes they begin to ask themselves the following questions:

• Why did I do that?
• What’s wrong with me?
• Why can’t I succeed?
• Am I doomed to always do this?
• Can I be healthier?

When people bring these questions to my office, we need to do some probing for the answers. We need to look at how their detouring behavior is “wired”— that is what causes this behavior? Is it something from their past? Is it a long standing issue with their self –esteem? Is it from some traumatic event that has occurred? There may be hundreds of hypotheses about the reasons this behavior exists and the mechanisms that keep this behavior going. Once we have an idea about why a person may detour, then we need to identify how to change this. This can be a very painful process because some the issues have never been addressed. It takes great courage, patience, and trust to work through the pain.

Linda never got the opportunity to do this. Her detours to hell, ultimately led to her demise. Her fear and shame led her to take her secrets with her to her death.

As we head for the New Year, we can work to stay on “Healthy Road” with frequent turns towards “Self-Improvement Street” and “Feeling Better About Myself Avenue”. Whatever the issues are, they can be identified, and healed. No one needs to keep detouring from the right path.

Change is possible

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The Other Side

 

There is a light flashing on the answering machine. Wow. Could it be a referral? Is it someone I can see? Is it someone I can help? Will our schedules match up? I impatiently go to the message “Hi this is Lois, I got your name from Dr. Don Henry at St. Paul’s medical center. He said you specialize in couples therapy and addictions. I’d like to make an appointment” My heart races, my breathing increases. I’m a specialist? I am, I guess. I call Lois on the telephone. We discuss some of the clinical issues, insurance, and scheduling. I feel awkward trying to communicate the key points. I have to remember to tell her my address, give directions to the office, and tell her where to park. I successfully accomplish all of this and Lois and her husband Bill come in. I get to share my “expertise” with them. There are so many issues—Bill’s drinking, Lois’ control, and the impact on the relationship. Where do I start? Can I help these people? I’ve helped hundreds of people like Bill and Lois when I worked for someone else. But this is about my name, my reputation, my career, my future.

I see Bill and Lois and their multiple problems. They get better. My initial fears get smaller. Week after week, the phone keeps ringing. There are more messages. A man with an angry sounding voice named Tom, calls saying “I gotta come see you; my boss is such a jerk; he’s gonna fire me if I don’t come” He comes in, and over time, he’s not so angry. A sweet, soft sounding woman named Joan, calls to get help for her panic attacks. She comes into my office and is not as sweet as she sounds. In fact, she’s quite angry, in fact about everything. People continue to call and ask interesting questions “Can you see my son and not tell my ex-wife that he’s coming for therapy even if she calls you”? “Can I tell you a secret that my husband doesn’t know”? “Do I have to be honest during therapy, I mean tell you everything?” These questions and their answers all test my therapeutic skills and challenge my knowledge of both ethics and the law. (if you are scoring at home, it’s no, yes, and no)

Among the other new challenges is the business part of the practice. This includes billing, collecting, marketing and advertising I listen to my colleagues who share the ongoing debate ” I have too many clients to be part time, but not enough to be full time” I wonder ” Will I suffer the same fate?” “What if I do too good a job, and all of my clients get better?” “[pullquote align=”right” cite=”” link=”” color=”#9370db” class=”” size=””]What if the phone stops ringing?”[/pullquote]
What if the phone stops ringing? (It actually did once for a period of 12 days). Will I be like other therapists in private practice, here today, closing up shop tomorrow?

Over time, my fears get smaller, and more clients attend. I begin to realize that as a result of information that I learned from continuing education classes and from reading journal articles, that prospective clients want to find a therapist who has good clinical and interpersonal skills. They want to find a practitioner who is also human. They want to find someone who has the following characteristics:

Characteristics of desired therapists:
• Positive
• Shows empathy
• Respectful
• Genuine
• Non judgmental
• Keeps good boundaries
• Good interpersonal skills
• Is human
• Trustworthy
• Hopeful
• Sensitive
• Open to other viewpoints
• Self-aware

The above characteristics seem obvious to me, but many clients have reported that they have had poor or unsatisfactory experiences with previous therapists. Some are robotic. Some are non-communicative. Some only care about getting paid. I’m glad that’s not the feedback that I have received over these many years of being a therapist.

Time has passed; technology has given us new ways of communicating. We now have voice mail, text messaging, and email, all direct ways for new clients to begin their journey towards change. Over the last few years I have discovered that two trends have started to happen. I have been receiving calls from second generation clients. These conversations usually start the same way “you saw my mother/father some years ago and I would like to make an appointment.” It’s funny to see the adult version of a person who their parent once described to me. The other interesting trend is the returning client. This is a person who I met with more than ten years ago. Those conversations too have a familiar sound to them “Hi my name is Sue and I don’t know if you remember me but I saw you 15 years ago. You helped me so much then and I have some issues that I know you can help me with again.” These two trends are very gratifying to me because they demonstrate my beliefs about change. If two people work together on a problem, and there is good “therapeutic chemistry”, change will occur. This has been proven over my entire career. I am grateful to be a part of that chemistry.

If you are looking to find a therapist, use the “characteristics of desired therapists” list to find your person.

Change is possible.

 

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The truth shall set you free

Honesty is such a lonely word
Everyone is so untrue
Honesty is hardly ever heard
And mostly what I need from you

Billy Joel

Honesty. A vital construct that improves the quality of people’s lives. Seemingly it should be easy for people to acknowledge their wrongdoings and say ” I messed up” However this seems to be harder than I think since famous people (Brian Williams, Lance Armstrong, #13) have the hardest time doing so. (This lying issue has been covered in an earlier blog–go to lies lies and more lies to read more)

Honesty in interpersonal relationships is critical to intimacy, growth and change. It seems to me that many people tell half-truths, white lies, and justify their dishonest behavior. As you would expect, the lies grow, the relationship gets further apart, until the big BOOM occurs. The truth that sets you free causes a boat load of pain to the other person.

Take infidelity. I have never worked with a person who wanted to be unfaithful to their partner. Distance and misery breeds close connections with another. Lack of communication and dishonesty breeds incentive to cheat. At the end, you have an unfaithful partner leading a double life of lies and deceit and an unknowing partner whose life will change dramatically when this affair is discovered. A simple remedy is in order– telling the truth. Saying “I messed up” or those seven difficult letters “I’m sorry” is far simpler than delivering a trauma laden truth bomb destined to crush everyone within a family!

Why don’t we do this? Why is it so hard to say “I messed up” or I’m sorry”. Are our self-centered ego’s so out of whack that we cannot deliver honest bad news and “feel bad” moments? Are we really protecting a softer fragile ego which would make us look bad? Are we so afraid of the shame and guilt that will occur?

Addicted people are aware that in order to have a meaningful recovery, people have to make amends. They have to say “I’m sorry”. They have to say “I messed up” They have to make the relationship better. They need to work on forgiveness.

Forgiveness is one of those words that we all think we know about, but we really don’t. In the most recent tragedy in Charleston, Arthur Hurd, the husband of his murdered wife said to the murderer, Dylann Roof ”I forgive you” . He added “I would love to hate you but hate’s not in me. If I hate you I’m no better than you.” In this moment. Mr. Hurd freed himself. Forgiveness is the elixir to pain. It does set you free.

In order to forgive, we have to be ready to do so. We have to be able to let go of bitterness and pain and hurt. It doesn’t excuse the injury; it makes us better because we’ve freed up the resentment and pain. In relationships this works best as a dual process. The offending spouse apologizes, the hurt spouse forgives. They then work on healing together. Forgiveness is very powerful. I can heal my hurts without another. I have to make the decision to forgive. Once I make the decision, I get my power back. I am no longer the victim; I am the victor. Forgiveness is the truth that sets ME free!

Change is possible.

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The Storm and the Sun

The sky is clearing and the night has gone out.
The sun, he come, the world is all full of light.
Rejoice, rejoice, we have no choice but to carry on.

Stephen Stills

Recently, I was watching many weather forecasts for a celebratory event that I was attending. There were many conflicting reports, most involving rain. I heard the meteorologist on one channel say ” the nicer the day, the stronger the storms we will have.” I thought “wow that’s an interesting metaphor for life.” We want to have a life filled with beautiful blue skies, sunshine and a slight breeze. However, we will also have times with stormy skies, and days that are dark, rainy, cloudy and cold. It is how we “weather” the storms that lead to how much sunshine we will have.

Many people who come to see me are in the midst of their personal storms. They are unhappy in some way and using whatever coping strategies they possess. Not all of these are the healthiest. Some people may use some “quick fix band aids”– addictions of some kind to numb or escape. In an effort to stuff the pain, the person may become anxious or depressed. These predictably unpredictable storms are counterproductive but ironically get the person to make a therapy appointment. Unfortunately, the weather may get worse as we start to explore the issues and identify the mechanisms of how the storm got created. It’s always hard to know if the problems are recent or long standing. The more recent issues clear up sooner, but the older the issue, the harder it will be for blue skies to appear. (I have written about weather and therapy before. For a more dramatic description go to:http://jeffbrandler.psychcentral.net/2008/02/08/you-cannot-have-a-rainbow-without-a-storm/)

As a therapist who has a website change is possible, you would hope that I’m looking for sunny days. Seeing positive change, and quality of life improvements are the “spring” of my work. I am well aware that positive changes have set- backs. Relapses are often signs that more changes need to be made. When the negative behaviors occur, it is an opportunity for the person to examine their own willingness to change. Some people are done at the first raindrop. They enter the “therapeutic witness protection program” and are never seen or heard from again. Others are willing to examine every facet of their life and understand how and why the negative change occurred. The clients who handle the wind and darkness end up with the beautiful weather days that they want and need.

The event went off without a hitch. The weather forecast of the apocalypse did not occur. We were all grateful that our weather was cloudy with no precipitation. Late in the afternoon, the sun peaked through the clouds. It was an unexpected joy. On this day, like many days in my office, when the sun came out, a tear came to my eye.

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Commitment to Excellence

Excellence is the gradual result of always striving to do better.
Pat Riley

The NFL season is about to begin. The summer brings optimism for all 32 teams who believe that they can win the Super Bowl.
One of those teams, the Oakland Raiders, became a dominant franchise in the 1970’s and mid -1980’s. The team’s philosophy was preached by its president, Al Davis. Davis told his players “Just Win Baby”. This goal- directed, arrogant approach produced 3 Super Bowl winners. The Raiders franchise promoted one other useful and famous phrase. This phrase was on a banner which was located in their home stadium, the Oakland Coliseum. This sign speaks to the organization’s goal:

raidersWhen a person commits, according to Webster, they promise to do something. “Commitment to Excellence” is an overall philosophy of being the best and not settling for anything less.

In my office, many of my clients carry their own “signs” with them. Most of these are self-fulfilling prophecies that describe their current beliefs. They accept these signs as being the script that they must follow.

Here are some examples of their signs:

  • I’m stuck
  • I’m afraid
  • I’m comfortable
  • I’m willing to have less
  • This is the best I can do
  • I’ll never be happy
  • I can’t ask others for help
  • I can’t get sober
  • I’ll settle for any relationship
  • I can’t leave this relationship
  • I’ll stay in this relationship even though it’s bad for me
  • I want what I can’t have

With these beliefs, there is no commitment to excellence. If anything, there is a commitment to mediocrity. It appears that it’s not ok to strive for excellence. People act and think that “less is better,” so familiarity wins out. “Why bother to do that something extra? It might not work anyway”.

It’s imperative to challenge these old patterns in order to make change. This challenge would sound like this: “Why only strive to be average? Why not try to be excellent? If you strive for excellence, what’s the worst thing that could happen?”
The worst thing that could happen would be having feelings. A person might feel disappointed, or hurt. Feelings like these never feel good. Having feelings however, means that you have moved out of your comfort zone. You took a risk. That risk may or may not work the first time. Sports franchises do not win all of their games. Through risk, dedication, and commitment to excellence they learn how to win. If you want to win and put down those old habits, behaviors and patterns, you have to start the process of change by taking that first risk. You can incorporate the philosophy of “Commitment to Excellence” each and every day. No more settling for less, no more accepting someone else’s idea of what’s good for you. Total self-care, and a COMMITMENT to change.

Change is possible.

 

 

 

 

 

 

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This Train

“There are many ways of getting strong, sometimes talking is the best way.”
Andre Agassi, Open

We all want to be stronger. In order to do that  psychologically, many people go to therapy.  However, according to recent studies less than 4% of the American public utilizes psycho-therapeutic services.  This  shockingly low number speaks to the ignorance of many people, and the apparent stigma of therapy.

In my 30 years of being a therapist, I have my own observations. Starting therapy is one of the hardest things to do. When people find the courage to pick up the 10,000 pound telephone to make an  initial appointment, they don’t leave messages.  Other people call, leave messages, and never return a follow up call.  If people return the call and make a first appointment, 15% of them  cancel late or do not show up at all.  Anxiety and fear of change  is running wild!

For years, therapists have made many statements about when people will attend therapy.    We have said things  like “when the person is ready to change, they will attend”, “when the pain is great enough..”  “when they hit  bottom…”  These well intentioned bumper sticker statements don’t help a scared and running like hell population. They only rationalize the person’s behavior and put little band-aids on our inabilities for more people to get better.

The question about how to get more of the population to attend therapy is a huge issue.  Psychological groups have started awareness days for disorders(alcohol, depression, anxiety, etc.) in an effort to give people access for help.  There is  “National Psychotherapy Day“(this year on 9-25-14)in which supporters of therapy are requested to wear turquoise to show support.  We’ve given people more opportunities to have health insurance and created parity laws to “level the playing field”. It is unknown if any of these macro movements produce change.   My pitch for more people to attend therapy comes via Bruce Springsteen.  Springsteen recently recorded a song entitled “Land of hope and dreams”  I think the refrain serves as a great invitation to come to therapy. Watch the video and see if you agree.

This train
carries saints and sinners
This train
carries losers and winners
This train
carries whores and gamblers
This train
carries lost souls

This train
carries broken hearted
this train
thieves and sweet souls departed
this train
carries fools and carries kings
this train
all aboard
I said this train
dreams will not be thwarted
This train
faith will be rewarded

this train
hear the steel wheels singing
this train
bells of freedom ring

 

The train will soon be boarding…

Change is possible

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Digging in the dirt

I’m digging in the dirt
To find the places I got hurt
Open up the places I got hurt

Peter Gabriel

 

 

Recently,  the Rock and Roll Hall of  Fame inducted Peter Gabriel.  As the front man for the band Genesis, Gabriel’s elaborate costumes got the band noticed.  His unique singing and writing led to the band’s success. In 1986, Gabriel left Genesis and released the album So which sold five million copies. His next album Us was released six years later.  On that album you will  find the  song Digging in the Dirt.

According to Gabriel,Digging in the Dirt  is a song about his therapy.  There are many interpretations about the song.  These include domestic violence, murder and many others.(you can find more of those here.)  Since there are no factual interpretations, please indulge my therapeutic perception .

This is the chorus of the song :

This time you’ve gone too far [x3]
I told you [x4]
This time you’ve gone too far [x3]
I told you [x4]

Don’t talk back
Just drive the car
Shut your mouth
I know what you are
Don’t say nothing
Keep your hands on the wheel
Don’t turn around
This is for real
Digging in the dirt
Stay with me, I need support
I’m digging in the dirt
To find the places I got hurt
Open up the places I got hurt

The beginning part,

This time you’ve gone too far [x3]
I told you [x4]
This time you’ve gone too far [x3]
I told you [x4]

Don’t talk back
Just drive the car
Shut your mouth
I know what you are
Don’t say nothing
Keep your hands on the wheel
Don’t turn around
This is for real

 

I believe  this is Gabriel’s fear and  shame  speaking.  He wants to run, avoid, and not deal with the places he got hurt.  Gabriel is shaming himself with the repeated yelling “this time you’ve gone too far/ I told you”.  He knows that he should not be sharing his innermost thoughts with anyone( a message perhaps that he received in childhood).  In the next part of the song, Gabriel sounds like a small boy who is hearing what he needs to do :

Don’t talk back
Just drive the car
Shut your mouth
I know what you are
Don’t say nothing
Keep your hands on the wheel
Don’t turn around
This is for real

Gabriel’s inner shame and self loathing have taken over.  He is worthless, afraid, and ashamed.

Although afraid and ashamed, Gabriel is aware that he is in need of the therapist’s help. Later in the chorus he finds his healthy voice:

Digging in the dirt
Stay with me, I need support
I’m digging in the dirt
To find the places I got hurt
Open up the places I got hurt

The phrase “stay with me I need support” is a request to  the therapist to be with him on this journey of “finding the places I got hurt”.  He knows that he is in a trusting therapeutic relationship because he not only wants to find those places, he wants to “open up the places I got hurt”.

Gabriel sounds calmer, less shamed, and very aware in the next verse:

The more I look, the more I find
As I close on in, I get so blind

He knows there’s a bunch of issues that he has to find.  He gets overwhelmed as he starts to uncover the pain.

This song is a great example of the therapeutic process.  The chorus is so appropriate for many people that I have seen over the years.

I  have seen  clients having a  “this time you’ve gone too far” reaction  many times by doing the following:

  •  having “hot flashes” (men too)
  • getting uncomfortable physically–fidgeting, playing with pens, keys, pillows, etc
  • needing an immediate bathroom break
  • standing up
  • abruptly changing the subject
  • leaving the session

Like Gabriel’s experience, therapy is scary.  It’s full of fear, pain, shame and guilt.  People keep looking and finding.  They keep asking “why” sometimes without answers.  Sometimes they find answers that they don’t like. Sometimes people become aware that they need to take action and those actions are overwhelming and scary.   Sometimes there are no answers, only questions.  Sometimes, my best and only contribution, is my understanding of the pain, sadness, and loss that my client is feeling.

I’ve seen many clients over the years go through storms in order to find their rainbow (If you’d like to read more on this topic,  go to one of my old blogs “You can’t have a rainbow without a storm”).   I enjoy the experience of seeing people make changes in their lives.  As we “dig in the dirt”,  we get to plant seeds and crops that grow year after year.  They are fruitful, they are plentiful, and they are healthy.  Don’t be afraid to dig–Change is Possible!

 

 

 

 

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