Wednesday, December 19, 2012

In response to Newtown, CT

The shootings in Connecticut have put a spotlight on a number of issues which had been in the shadows of our collective minds, those of gun control and mental health among them.  Tragedies such as this connect us on a deep level, because we all were children at some point, and we all can remember the feelings of innocence and comfort with loving teachers, parents, neighbors or even strangers.  What we struggle to understand, however, is how one man can so ruthlessly exterminate this innocence in one fell swoop.  As I read somewhere, the children were in the age “between the world of magic and the world of reality.”  The magic was stolen and replaced with a terrifying reality.

Whether it’s because of this connection or something else, we as a society have begun to focus on the elephant or elephants in the room.   We look at what could have caused a man to kill not just one person, but a whole classroom worth of kids, along with their mentors, all at once.   There is no doubt that gun laws need to be modified.   People with guns kill other people, and that has become increasingly frequent in the United States.  Apart from that, people look to how the gunman was different from the rest of us, and what readily comes to mind is his mental state.  While that certainly played an important role in his rampage, mental illness itself does not cause people to become violent.  Less than 5% of mass murders are committed by those with a diagnosed psychiatric illness.  Another idea that has been tossed around, however, is that it was the threat of being hospitalized for his mental illness that caused him to act violently.  Regardless of whether it was in fact the reason, this makes more sense.   He likely felt trapped and scared, as many would in that situation.

Anger and violent behavior come when people are feeling alone, disconnected, misunderstood, and isolated from the ones with whom they most want to connect emotionally.  Certain mental illnesses may make it almost impossible for the individual to connect meaningfully with others, but the desire to do so remains strong.  It is not that there weren’t mental health services available to this person (he lived in a well-to-do town in a well-to-do state).  A simple search on lists 27 therapists in Newtown, a city of 60 square miles.  That’s about one therapist for every 2 square miles, not counting the other therapists in other directories or not listed at all in the internet.

As far as mental health is concerned, the problem has not been access to services, but rather access to effective services.  Innumerable studies, books and articles have come out during the past 20 or so years, citing discoveries in neurobiology and neuroplasticity, discussing how neural pathways in the brain are always reforming and reshaping in response to experiences, and conversely, how responses to experiences are reshaped as a result of the changes in the neural pathways.  (While much has been written about this, an excellent book is The Brain that Changes Itself , by Norman Doige, MD. ) 

Effective psychotherapy aims at rewiring the brain, so that disturbing emotions are reduced or eliminated completely.  It is the way that the mind responds to experiences or events that causes people to feel whatever emotion they feel.  Although I admit I am biased, Rapid Resolution Therapy is, as far as I’m concerned, by far and away the most effective in eliminating disturbing emotions and in instilling clarity and peace, by reorganizing the mind’s response to those events.  Yoga, mindfulness meditation, and other disciplines which focus on the awareness of one’s self in the present moment all work to this same end.
I envision a time in the not-too-distant future, when all mental health therapists will be practicing effective therapy, so that no client/patient resorts to violence.

On another note, a silver lining—if there may be one—is that the families of these children have each other.  They share the same tragedy forever.  They have received support from the world at large, but even after that fades, they have each other.   The death of a child is one of the most difficult, lonely and isolating experiences one can ever have, but to share that suffering with a group, to connect with the only others who could come close to understanding, is tremendous.

Wednesday, October 3, 2012

The Paradox of Indifference

Indifference doesn’t always happen on its own.  Sometimes it has to be discovered and, when useful, illuminated.  

As far as disturbing or bothersome sensations are concerned (tightness in the throat, sweaty palms, butterflies in the stomach, weak knees, etc.), sometimes indifference is a beneficial attitude to take.  Insofar as one can recognize what the sensations are about and the message they are sending, action makes sense.  Beyond that, nothing needs to be done.  Focusing on the sensations while wondering why they are there and wondering what they mean usually serves to intensify them.  In other words, contrary to popular belief, indifference can be useful.  

Take Travis.  He was feeling the jittery stomach and clammy hands while he was walking in the mall with his friends.  There was no recognizable cause for these feelings, and because he didn’t understand them, he worried about them, thereby making them even stronger and more severe.  Typical of anxiety, the more he worried about them, the stronger they became.

He came to me saying “I wish I didn’t have this anxiety!  I hate it!”  So I worked with him.  Once he learned to become indifferent to those sensations, the anxiety left completely.  It has been two years, he told me recently when I bumped into him at a bookstore, and no recurrence of the anxiety.  He has felt mild sensations similar to previously, but they have been small blips in his day, short-lived, minor and insignificant.
Once you get it, you get it.  The work I did with him “clicked” his mind into place, quite literally.  He finally felt the peace and comfort he had been longing for.  And once this happened, the feelings of nervousness went away.  “It’s impossible to feel calm and nervous at the same time,” he told me with a laugh.

Indifference in relationships is different, however.   In relationships indifference can be deadly.  The importance of movement and connection in relationships cannot be understated.   Relationships, by definition, are dynamic; they are always in a constant flow, or dance, moving to the music of each partner’s emotions.

Love cannot endure indifference. It needs to be wanted. Like a lamp, it needs to be fed out of the oil of another's heart, or its flame burns low.” Henry Ward Beecher

Many couples come for therapy when they at a standstill, when either both or one of them refuses to engage with the other in any way, maintaining that he or she is “done” and no longer interested in the relationship.  This presents a particular problem for both of them, because the other partner is oftentimes either at a loss as to what to do or tries extremely hard to get the partner’s attention.  Either way, the end result is that the two of them are not communicating in any meaningful way.

As in any relationship, both of the partners long to be heard and understood.  As one client said to her partner, “I want to feel connected again.  I want to feel love from you and to feel that the love I return is accepted.”  The feeling of connection, what is known as a secure attachment, is universal throughout life, but the ways in which we express this need are sometimes not greeted by our partner as we would like them to be.

Effective couple therapy, which focuses on the emotions and the communication which stems from these emotions, helps partners to deepen their understanding of each other, while at the same time learning more about themselves.

Sunday, August 19, 2012

An antidote to abuse

Relationships with violence don’t usually start out like relationships with violence.  They typically start out as any relationship: there’s an attraction between two people, they spend time together, like each other and decide to spend more time together.  Oftentimes it feels like a magnetic attraction, where they can’t stop thinking about each other and want to be together all the time. 

At some point in the relationship, though, one partner (let’s say a male partner, although it can be male or female, gay or straight) begins to think that his partner isn’t exactly as he would like her to be, and he thinks that he can mold her and shape her into his ideal partner.   Let’s take Kim and Steven (fictitious names, not based on anything more than composites of a number of clients).  Their relationship begins with the two being happy, fairly content people.  They meet at a party, through a mutual friend, and they start dating.  Steven treats Kim well, tells her how beautiful she is, what a nice, special person she is, and how lucky they are to have found each other.  Kim is flattered by this attention. Although she’s a little skeptical of Steven’s attention, she chalks it up to her own insecurities.  She’s having fun, for the first time in her life.  

Soon, Steven begins to say how disappointed he is that she showed up late for a date.  He questions if she’s been seeing someone else.  No, she hasn’t, she says.  She was just late because she had to get gas on the way and it took longer than she thought.  He doesn’t believe her and accuses her of being whore, a slut, a manipulative bitch.  He points to other times in the relationship where she has not done exactly as he expected, and she thinks that maybe he’s right, and maybe she has been insensitive to his feelings.  His words may have been kind of strong, but she’ll let it slide and try to be a better partner.

But the harder she tries to fit into his ideal of her, the more he criticizes her.  And the more he criticizes her, the worse she feels and the harder she tries to please him.   Sometimes he hits her; sometimes he just threatens.  She cries.  He apologizes and promises never to hurt her again.  He does, though, invariably.  The cycle repeats itself, and each time she hopes that he has finally changed, that this time he gets it.  He never does, though.

Kim wonders what’s wrong with her that she stays with him.  Her friends tell her she’s either crazy or a saint to put up with his abuse.  She thinks she’s an idiot, and she is convinced that there must be something very wrong with her because she keeps choosing to stay.  This is, in fact, how most people think.  Not just Kim, but others like her, as well as those friends and relatives who feel powerless to help.  When the friends, powerlessness turns to frustration and anger, Kim feels even further alienated and even worse.

So why does she stay?  Because she’s hoping that he’ll “get it.”  In the face of all evidence to the contrary, she still maintains the hope that if she tries a little harder, or if she approaches him in a different way, or at a different time, maybe when he’s in a better mood, that he will become the kind, compassionate man she fell in love with.  “I know he’s capable of it,” she cries.   

Her staying is based on a hope that something completely out of her direct control will somehow change.  What she doesn’t get fully get is that he won’t because he can’t.  Steven may not be able to change in relation to Kim, but Kim can in relation to Steven.  Rapid Resolution Therapy, which communicates to all parts of the mind, helps people like Kim to see herself and her relationship clearly.  Once clear, Kim is free.  And with clarity comes strength.