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  • May 08, 2011 1:15 PM | Anonymous
    By Michelle Lane

    Growing up I sensed my mom was happy in spite of many struggles. I saw that her values and appreciation of life's simple pleasures played an important part. Even so, I needed to personally experience what she modeled before I could apply her wisdom to myself and others. From a young age I observed human nature, always wondering, "What does it take for a person to feel happy?" My quest for that answer has continued.

    Now, as a Marriage and Family Therapist, I have the privilege of sitting with clients every day who share with me the intimate details of their lives. Clients come to therapy in part because they want to feel happy! They come to seek solutions to regular life problems. They may need support and guidance to achieve their life goals. Whatever the case, they benefit from talking with a therapist. It is my belief that each individual is the expert on their life and ultimately the best solutions will come from within them. I also know if we can change our self-defeating thoughts, our feelings and lives will also change. Dale Carnegie said, "Remember happiness doesn't depend upon who you are or what you have; it depends solely on what you think."

    Thoughts are powerful! In therapy people can develop the tools, self-awareness, outlook and confidence to transform life's challenges into a meaningful life infused with energy and optimism. As a therapist, part of my work is to listen and pose pertinent questions to help clients accomplish their goals. Sometimes the issues are more complex and many layers need to be gradually uncovered. What follows are ten healthy practices people find of benefit as they navigate the variety of challenges in their lives.

    Practice #1:

    TAKE CARE OF YOUR-SELF

    To feel happy, it is important to pay attention to the basics---sleep eight hours a night, eat healthy foods, and exercise daily. This will sustain the energy you need to accomplish your goals. It also helps stabilize your mood. Eliminate or reduce substances such as alcohol, caffeine, sugar, marijuana or other drugs that may be draining your energy and distracting you from self-care. Repeat the mantra "Breathe, just breathe" while taking slow, deep breaths to relax your body. Other techniques such as visualization are useful as well. Think about what relaxes you, what makes you feel good and incorporate those things into your daily life. When we prioritize these basics, we take care of ourselves on a daily basis. Without self-care, other parts of life may dominate, to the detriment of our physical and mental health.

    Another part of self-care is time management. Our society is fast paced and demanding of our time. When we are so busy or overwhelmed and do not take time to rejuvenate, we are likely to burn out or become less effective. In the wise words of William Wordsworth, "Rest and be thankful". List the things that drain your energy and find ways to appropriately delegate or eliminate them from your life. It is also important to ask for help when needed!

    As infants, we are dependent on our caretakers, usually mom or dad. As we become independent some of us are reluctant to ask for help, thinking it a weakness. In fact, "interdependence" is necessary for success in life. As stated by Isaac Newton: "If I can see further than anyone else, it is only because I am standing on the shoulders of giants."

    One thing you can do right now is make a list of the people you rely on. Then you can make use of it when you feel stressed or unhappy. Recognize that we are all social creatures who are connected and need each other. Mental health improves when we are involved with a healthy community. Do your best to distance yourself from people who are destructive or drain your energy. When you connect with supportive people and disconnect from toxic people it makes a world of difference.

    Practice #2:

    FIND BALANCE IN DAILY LIFE

    There are many areas of life that need our attention, yet too often we focus on one thing at the expense of others. Work and children can be the squeaky wheels, but what about our physical, mental, emotional, spiritual, and relational health? Ernest Hemingway enlightens us: "I still need more healthy rest in order to work at my best. My health is the main capital I have and I want to administer it intelligently." Americans work more hours than people in other countries and are the most productive, yet all too often our health and relationships take a back seat. This contributes to illness and divorce. When you maintain balance in your life, even if you struggle in one part of it, you can feel good that the rest of your life is going well. Continuing to invest in the good parts of your life helps you feel strong and satisfied, all of which helps you deal with your difficulties.

    Marital research by John Gottman suggests that to sustain a marriage, couples need a 5 to 1 ratio of positive to negative interactions. When counseling couples, I help them increase positive interactions while they are developing skills to transform the negative ones. Get a babysitter, take dance lessons, express your appreciation of each other, do things you know your partner will enjoy. If things are basically going well between you and your partner except in one or two areas, be sure to spend time together enjoying what is positive. Your worries or disappointments may diminish, and you will feel happier.

    In addition to the practices that lead to happiness, developing flexibility will help you adapt to the challenges you face in life. "Extraordinary flexibility is required for successful living in all spheres of activity." (Peck, 64) Parenting tends to focus on structure, routine, and consistency. By the same token, if nothing else teaches us the need for flexibility, parenting will. When people are inflexible they get stuck in one mode all the time. Be willing to learn, grow, bend, change your perspective or even admit when you are wrong. Not only is it no fun to be around people who lack flexibility, it is not healthy. When we allow ourselves to change, we not only surprise others, we might also surprise ourselves with how enjoyable life can be.

    Practice # 3:

    BE PRESENT; ONE MOMENT AT A TIME

    Take a look at how much you "stay and be" versus how much you "go and do." We tend to get so busy that self-care, rest, and time with friends and family may fall to the wayside. Most religions and spiritual guides talk about the value of prayer, meditation and other rituals of just being still and quiet or Being. A book I recommend on this subject is The Power of Now, by Eckhart Tolle.

    Those who have not found their true wealth, which is the radiant joy of Being and the deep, unshakeable peace that comes with it, are beggars, even if they have great material wealth. They are looking outside for scraps of pleasure or fulfillment, for validation, security, or love while they have a treasure within that not only includes all those things but is infinitely greater than the world can offer. (9)

    This practice of "Being" is accomplished by "staying in the moment," which is simply being in, and bringing our attention to, the present. In Taoism, there is a term called wu wei, which is usually translated as "actionless activity" or "sitting quietly doing nothing" regarded as one of the highest achievements or virtues. (Tolle, 179) When overwhelmed, we worry about all the things that might go wrong in the future. Try to surrender to the moment and determine what you need right now. More often then not meeting your current needs will lift your spirits.

    Practices that may be savored in the moment include eating, drinking, sleeping, dancing, playing, painting, drawing, coloring, exercising, reading, writing, gardening, and being with other people, animals, and nature. As I write, my cats linger at my ankles, looking for attention, as the setting sun lights up the tree outside in a magnificent golden hue. In this moment I can honestly say I feel truly happy. While you seek this kind of awareness in daily life, you are not consumed with the past or future, but are present in the moment, and this is where you can find peace.

    "Surrender reconnects you with the sourceenergy of Being, and if your doing is infused with Being, it becomes a joyful celebration of life energy that takes you deeply into the Now." (Tolle, 173)

    In their play, children and animals teach us to celebrate the moment. Find joy in doing what you need to do today! You have the power of choice, and every moment is valuable. "Whatever you can do, or dream you can, begin it. / Boldness has genius, power, and magic in it." - Goethe

    Another book that speaks to the benefit of making the most of our time and energy is The Power of Full Engagement, by Jim Loehr and Tony Schwartz. They assert that we actually become less productive if we do not take breaks or change activities every thirty to ninety minutes. Our physical and mental health are related and we must commit to taking care of both. Persistent stress actually kills neurons in the brain, and multitasking impacts memory. Therefore taking one moment at a time is part of selfcare, contributing to our overall health and happiness.

    Practice # 4:

    SEE THE BIG PICTURE -- VISION

    Albert Einstein knew that intelligence and imagination are highly correlated: "Imagination is everything! It is the preview of life's coming attractions." Living with a vision for your life gives it meaning and purpose. Imagination connects us to our gifts and passions where we discover our love for living. A lot of research supports the power of intention and visualization. If your current situation is difficult and you are at a loss as to what you can do, remember your past strengths and imagine where you want to be in the future. This can help you realize what you can do today to get you where you want to go.

    Self-discipline is accomplished when you can delay gratification, knowing your hard work will pay off in time. Sometimes we enjoy the immediate, other times we make different choices that lead to our long-term satisfaction. Learn to trust yourself when deciding what you need to balance today's pleasures with tomorrow's goals. "Every moment is a golden one for him who has the vision to recognize it as such." (Henry Miller)

    Practice # 5:

    APPRECIATION

    When I was young, each morning as she drove me to school my mom would say, "Look at the morning glories." Tired, and still trying to wake up, I would roll my eyes and wonder why she said this every day. Later, when I moved away to college, I thought of her when I saw morning glories----finally appreciating her desire to share with me on a regular basis the beauty in nature. Now I walk as often as possible in lovely neighborhoods, by the ocean, lake or mountains, to appreciate and connect with nature to remember what a beautiful world we live in. Baby ducks or geese waddling around always lift my mood. Weekly I play fetch with a dog and daily I pet my cats and bask in their peaceful purrs.

    "Do not pollute your beautiful, radiant inner Being nor the Earth with negativity. Do not give unhappiness in any form whatsoever a dwelling place inside you." (Tolle, 178) Stop and smell the roses and observe the miracle of life around you, regardless of your circumstances. Be grateful in everything. "Not what we have But what we enjoy, constitutes our abundance." Epicurus

    This is one of the most powerful tools in life and relationships. Focus on the good, and more good will come. Ancient religions and modern spiritual guides will tell you the same. The Dali Lama, in The Art of Happiness describes it this way:

    Happy people in contrast, are generally found to be more sociable, flexible, and creative and are able to tolerate life's daily frustrations more easily than unhappy people. And, most important, they are found to be more loving and forgiving than unhappy people. (17)

    When you focus on and give voice to what you appreciate about someone, it reinforces their positive behavior and creates intimacy. No one enjoys being criticized. Find the good in others, express the positive, and you will have long lasting relationships. Jesus said, "Turn the other cheek," and promoted servant leadership, with humility and love. Compassion for your enemies is difficult but forgiveness can lead to your own sense of peace. "Peace of mind or a calm state of mind is rooted in affection and compassion. There is a very high level of sensitivity and feeling there." (Dali Lama, 26)

    Others who know our strengths and weaknesses can help us view things in a more positive way. As a child I was playing outside when a bee stung me. I ran inside crying to mom. She sat me on the counter, pulled out a glass in which she began catching my tears. She held the glass up to the sunlight shining in through the window and said Look at how beautiful they are! I saw the rainbow of colors in my tears and suddenly I was laughing. There was joy and beauty even in my pain. It was one of the most valuable lessons I have learned.

    Practice # 6:

    ACCEPTANCE

    "The pain you create now is always some form of non-acceptance, some form of unconscious resistance to what is," (Tolle, 27). The story I shared about my mom catching my tears in a glass to show me their beauty also taught me that it is okay to cry. One of my roommates told me she felt uncomfortable when I cried because she did not know what to say. I told her, "Just tell me I am beautiful when I cry!" From then on we enjoyed the experience of laughing and crying, knowing tears are a natural physical release offering relief. Now my child clients will tell their parents when they cry It's okay to cry. "It makes you feel better."

    Scott Peck s A Road Less Traveled begins, Life is difficult. Once we accept this fact, we are no longer so disturbed by it. The first step in both Science of Mind and 12- Step programs is to relax, or surrender, and come to know our limitations. Sometimes this feels strange but once we do it, the steps that follow are manageable, as we realize we are a small part of a much bigger picture. It helps put things in perspective and allows us to focus on our place in the universe. For a year my mantra was Let it be, as Paul Mc- Cartney sang so eloquently. Now I frequently recite the Serenity Prayer: God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

    Serenity, courage and wisdom allow me to problem solve when I feel unhappy. Therefore, unhappiness can be an indication of a need to change---if not my thoughts, then my circumstances. I figure out what I can not change, focus on what I can change and how to go about it. Problem solving gives meaning to our lives and develops courage and character. When problems are avoided, mental illnesses and destructive patterns develop, stunting our growth, rather than relieving our discontent. For more on this topic I recommend reading The Road Less Traveled (and the other books listed at the end of this article). Self-help reading is also known as biblio-therapy and can add to the tools you develop to bring about changes that you choose to make.

    We make our choices, but we cannot determine the paths of others. Couples often come into counseling wanting the other person to change. They struggle with the truth that they must change themselves in order for their relationship to change. It is the same with families. If only my son would listen. Or my mom just needs to back off and leave me alone. While these certainly provide clues to relational dynamics that are not working, the key here is that they are dynamics. If you change, the dynamic changes. No longer are you at the mercy of and frustrated by someone else. Now you are empowered to do something yourself, and to know you cannot change the other person s choice, regardless of what it is.

    Practice # 7:

    BE PATIENT, REALISTIC AND KIND TO YOURSELF

    Many people are hard on themselves and actually make themselves, and others, miserable. As the Serenity prayer reminds us, much of life is beyond our control, and what others think of us is "none of our business." People have their issues. They will sometimes try to project them on you so as to blame you for their problems. Many are neither aware of their issues nor willing to take responsibility for them.

    Learn to be true and good to yourself. You are on a journey. It is perfectly normal that you will fall down sometimes. Just pick yourself up, dust yourself off, and keep walking. If you are not making mistakes, you are probably playing it too safe and may not be challenging yourself by taking risks in order to learn and grow.

    You do not have to be perfect. You can be human; we are all human! It is more interesting than being perfect anyway. If you do not love and accept yourself, how can you expect anyone else to? You cannot give to others what you do not have yourself. Take responsibility for your life, and have compassion for yourself and others. Be as kind to yourself as you are to others. Recognize that even failures are accomplishments because you are taking risks, living courageously, and learning lessons.

    "There are cycles of success, when things come to you and thrive, and cycles of failure, when they wither or disintegrate and you have to let them go in order to make room for new things to arise, or for transformation to happen." (Tolle, 152)

    Just as nature has four seasons, in life there is a time for everything and everything has its time. We must trust we are divine creatures, a part of larger community, where not everything makes perfect sense, but in every sense we are being perfected. Like gold that goes through fire to be refined, we grow stronger as we overcome obstacles, building character and integrity. Realistically we are all sad at times, but overall we hope to have the joys in life outweigh the sorrows, and often a change in perspective can shift things dramatically. There are mountains and valleys, but within each experience, whether high or low, joy can be found.

    "Honor your inner worth. Let your heart's desire breathe. Cherish your gifts. Treat yourself with tenderness, gentleness, and forgiveness. Open your heart and listen. Love is calling you to the mountain top" (Peck, 29).

    Practice # 8:

    PERSONAL RESPONSIBILITY

    Ultimately people choose to be happy: to find the silver lining in each cloud. If you continue to wait for happiness to arrive, you will be waiting a long time and wondering why you are not happy yet. You are responsible for creating a life that makes you feel happy, accepting the life you have, and finding the joy in each moment.

    "The happiness that is derived from some secondary source is never very deep. It is only a pale reflection of the joy of Being, the vibrant peace that you find within as you enter the state of nonresistance." (Tolle, 156)

    Some people do not take pleasure in their time alone. However, we need to stay connected to ourselves. When we are too busy, or always around others, we may lose perspective on what is most important to us. Taking some down time allows us to focus, think things through and be more aware of our choices. I have learned that down time, time I spend alone and contemplative, restores me emotionally and spiritually, helping me stay honest with myself, and on the path that is best for me.

    Self- awareness is necessary in order to "own your part" in conflict with others. It is easy to blame others for our pain, avoiding personal responsibility, yet as adults we have the power to choose who we relate to and how we relate to them. We must empower ourselves to take responsibility for our choices and let go of trying to change others. It takes courage to admit our faults and to recognize we have the ability to shape our own lives.

    While limitations exist and there are things beyond our control, we can always turn things around for ourselves if we are creative and brave. When we are honest, and have the integrity to do the right thing, even when it is difficult, we discover solutions we can feel happy about. We need to challenge ourselves, stop blaming others and see what we can do to create change. Mahatma Gandhi led by example and persuades us to "Be the change you want to see in the world." This is essential to personal growth.

    Practice #9:

    COMMITMENT TO TRUTH -- OPENNESS, HONESTY, AND INTEGRITY

    Trust is the foundation for healthy relationships. I have found tremendous healing in relationships where we have both been true to ourselves, direct, open, and honest with each other. If I am not being honest or doing the things I said I would do I feel bad about it, and I am sure the other person is not happy either. Sometimes we do not want to be around people who challenge us because we are trying to stay in our fantasy world where there is no pain or suffering.

    "Insofar as the nature of the challenge is legitimate (and it usually is), lying is an attempt to circumvent legitimate suffering and hence is productive of mental illness." (Peck, 56)

    I strive to be a person of integrity, dedicated to being truthful. I can also find it difficult to admit my faults and trust others with my more vulnerable feelings. I understand the desire to lie, withhold, hide, avoid or pretend to be someone you are not. What I have learned is that sooner or later the reality of those choices catches up with us and we must face the consequences. The truth always reveals itself in time.

    It is difficult to assess or treat a client if the therapist does not know the reality of the client's situation. When relevant information is left out, the therapist's guidance may be ineffective or compromised in their ability to challenge a client's thoughts, feelings and behaviors. The healing of the spirit has not been completed until openness to challenge becomes a way of life. (Peck, 54) If you are not dealing honestly with your therapist about your most important and often painful issues, you might want to examine your relationships and ability to trust. It can be difficult to be vulnerable and trust the therapist with secrets, yet this is where change and growth can occur.

    Addiction is well-documented as an illness where people lie to themselves and others. Justifications and deception allow a person to continue their behaviors and ignore the destructive nature of their choices. Families who keep secrets are confusing to be around because nothing is as it seems. As the therapist challenges these behaviors you are able to develop trust, honesty and integrity which will translate into your personal life. Healthier, open and direct communication will allow people to feel safer and happier.

    Practice # 10:

    COMMUNITY SERVICE AND GIVING TO OTHERS

    Once you are grounded in joy and peace, you are ready to spread joy and peace to others. The best way to sustain happiness is to help others feel happy too. Pass it on, pay it forward. Thich Nhat Hanh reminds us, " If we are peaceful, if we are happy, we can blossom like a flower, and everyone in our family, our entire society, will benefit from our peace." (3) We are social creatures who need others, and they us. Random acts of kindness can change the course of a bad day into a good day. Simple things like smiling, treating others with respect, or offering to help can spread happiness. When I first moved to California I had the unexpected pleasure of a having my bridge toll paid by the stranger in front of me. It immediately lifted my spirits and I talked about it for several days. Often people say, "If I were rich I would give generously to others." Money is not the only thing people need. Kindness and giving of your time to another person can make a world of difference. Do what you can. Compassion for others will help you feel better, distract you from your problems and expand your perspective. We find joy in the journey, not in the destination.

    I hope this article encourages you and brings you closer to feeling happy more often. Like a boat whose rudder is moved slightly to change coarse, small changes in life can lead to entirely different experiences. The more you incorporate these healthy practices, the more you will find yourself laughing and enjoying your life. Best wishes as you enjoy your journey and spread the joy to others!

    Bibliography:

    Burns, David D., M.D. Feeling Good. New York: Avon Books, 1980, 1999.
    The Dali Lama and Howard C. Cutler, M.D. The Art of Happiness. New York: Riverhead, 1998.
    Gottman, John. Why Marriages Succeed or Fail: And How You Can Make Yours Last. New York: Fireside, 1994.
    Loehr, Jim, and Tony Schwartz. The Power of Full Engagement. New York: Free Press, 2003.
    Moore, Thomas. Care of the Soul: A Guide for Cultivating Depth and Sacredness in Everyday Life. New York: Harper-Collins, 1994.
    Nhat Hahn, Thich. Being Peace. Berkeley, CA: Parallax Press, 1987.
    Peck, M. Scott, M.D. The Road Less Travelled. New York: Touchstone, 1978
    Ryan, M.J. The Happiness Makeover. New York: Broadway Books, 2005.
    Tolle, Eckhart. The Power of Now. Novato, CA: New World Library, 1997.

    2007 Michelle Lane, Licensed Marriage and Family Therapist

    If you are ready to pursue the life of your dreams, develop the tools, self-awareness, outlook and confidence to transform your challenges into a meaningful life infused with energy and optimism, get started now by going to www.michellelanemft.com
  • May 06, 2011 1:32 PM | Anonymous
    By Pete Walker

    One of the most difficult features of Complex PTSD is extreme susceptibility to painful emotional flashbacks. Flashbacks are painful layers of reactions C physiological, behavioral, cognitive, and emotional - to the reemerging danger and despair of childhood abandonment. This article maps out these layered, defensive reactions and offers a treatment strategy for managing the depression that underlies them. Here is a model of the layering of an emotional flashback. Experiences of depression and abandonment trigger fear and shame, which then activates panicky Inner Critic cognitions, dedicawhich in turn launches an adrenalized fight, flight, freeze or fawn trauma response [subsequently referred to as the 4Fs which correlate respectively with narcissistic, obsessivecompulsive, dissociative or codependent defensive reactions].

    Here is a common example of a flashback. A complex PTSD sufferer wakes up feeling depressed. Because childhood experience has conditioned her to believe that she is unworthy and unacceptable in this state, she feels anxious and ashamed. This in turn activates her Inner Critic to scare her with perfectionistic rants: No wonder no one likes you. Get your lazy, worthless ass going or you ll wind up a wretched bag lady on the street! Retraumatized by her own inner voice, she then launches into her most habitual 4F behavior; she either lashes out domineeringly at the nearest person [Fight/ Narcissistic] C or she launches busily into anxious productivity [Flight/ Obsessive-Compulsive] C or she flips on the TV and foggily tunes out or dozes off [Freeze/ Dissociative] C or she selfabnegatingly redirects her attention to a friend's problem [Fawn/Codependent]. Unfortunately this dynamic also commonly operates in reverse, creating perpetual motion cycles of internal trauma as the dysfunctional behaviors of 4F acting out beget new self-hating criticism, which in turn amps up fear and shame and finally compounds the abandonment depression with prolonged experiences of self-abandonment. Here is a diagram of these dynamics: Triggered ABANDONMENT DEPRESSION ← → FEAR & SHAME ← → INNER CRITIC Activation ← → 4Fs.

    This article describes a treatment approach that decreases retraumatizing reactivity to the internal affects of the original abandonment depression. It describes a Mindfulness practice for somatically metabolizing feelings of depression and fear. This in turn promotes the ability to feel through abandonment experiences without launching into inner critic drasticizing and 4F acting out.

    The etiology of a self-abandoning response to depression. Chronic emotional abandonment devastates a child. It naturally makes her feel and appear deadened and depressed. Functional parents respond to a child s depression with concern and comfort. Abandoning parents respond to it with anger, disgust and/or further abandonment, which in turn create the fear, shame and despair that become characteristic of the abandonment depression. A child who is never comforted when she is depressed has no model for developing a self-comforting response to her own depression. With no connection to a nurturing caretaker, depression steadily increases and sometimes devolves into the Failure to Thrive Syndrome. In my experience failure to thrive is not an all-or-none phenomenon, but rather a continuum that stretches from excessive depression to death. Many PTSD survivors thrived very poorly, and had painful bouts of lingering near the end of the continuum that feels death-like. Several of my clients commonly quipped that they feel like death warmed over when they are in a flashback.

    When a child is consistently abandoned, her developing superego eventually assumes totalitarian control of her psyche and carcinogenically morphs into a toxic Inner Critic. She is then driven to desperately seek connection and acceptance through the numerous processes of perfectionism described in my article Shrinking the Inner Critic in Complex PTSD [downloadable from www.eastbaytherapist.org or www.petewalker. com]. Imitating her parent s contempt for her emotional pain, she also becomes emotionally perfectionistic and judges her dysphoric feelings as the cause of her abandonment. Over time her affects are repressed, but not without contaminating her thinking processes. Unfelt fear, shame and depression are transmuted by the inner critic into thoughts and images so endangering, humiliating and despairing that they instantly trigger escapist 4F acting out. Eventually even the mildest hint of fear or depression, no matter how functional or appropriate, instantly morphs into the danger-ridden overwhelm of the original abandonment. The capacity to selfnurturingly weather any experience of depression, no matter how mild, remains unrealized. The original experience of parental abandonment devolves into self-abandonment. The ability to stay supportively present to vital aspects of inner experience gradually disappears.

    Deconstructing self-abandonment. We can gradually deconstruct the self-abandoning habit of reacting to depression with fear and shame, inner critic freak out , and 4F acting out. The processes described in this article and my paper: Managing Emotional Flashbacks in Complex PTSD [also available on the aforementioned websites] awaken the psyche s innate, developmentally arrested capacity to respond amelioratively to depression and the fear and shame that attaches to it. This is typically a long difficult journey, however, because our culture routinely humiliates any expression of fear, and depression is often seen as an unpatriotic violation of the pursuit of happiness . Taboos about depression even emanate from the psychological establishment, where some schools strip it of its status as a legitimate emotion C dismissing it simplistically as mere negative thinking, or as a dysfunctional state that results from the repression of somewhat less taboo emotions like sadness and anger.

    Healing progresses when we learn to distinguish depressed thinking C which can be eliminated C from depressed feeling C which must sometimes be felt. Occasional feelings of enervation and anhedonia are normal and existential - part of the admission price to life. Moreover, depression is sometimes an invaluable harbinger of the need to slow down, to drop down internally for rest and restoration. At its healthiest, depression accesses a unique spring of intuition, such as that which informs us of the obsolescence of a once valued job or relationship.

    Overreaction to depression essentially reinforces learned toxic shame. It reinforces the individual s belief that he is unworthy, defective and unlovable when depressed. Sadly this typically drives him deeper into abandonment- exacerbating isolation. Deep level recovery from childhood trauma requires a normalization of depression, a renunciation of the habit of reflexively reacting to it. Central to this is the development of self-compassionate mindfulness C the practice of staying in one s body, of staying fully present to all internal experience. Mindfulness cultivates our ability to stay acceptingly open to our emotional, visceral and somatic experience without 4F acting out.

    A relational approach to healing abandonment. Most Complex PTSD clients have never had a safe enough relationship. Healing their attachment disorders requires a reparative relational experience with a therapist, partner or trusted friend who has the capacity to stay unreactively present to their own depression and the various affects that attach to it. When a therapist has this level of emotional intelligence, she can guide the client to gradually release the learned habit of automatic affectrejection and defensive reactivity. Safe and empathic eye and voice connection with an individual with good enough emotional intelligence provides a working model and a limbic resonance to help her stay unreactively present to all her affects. Daniel Siegel calls this the coregulation of affect. Moreover, as Susan Vaughan s avers in The Talking Cure, such work appears to promote the development of the inner neural circuitry necessary to healthily manage and integrate depression and its attenuated affects.

    Somatic mindfulness. Therapists can guide clients to focus on and stay present to their somatic experience of abandonment fear and depression. Because depression commonly morphs instantly into fear, early work involves staying present to the kinesthetic sensations of hyperarousal and the psyche s penchant to dissociate or distract from them. Dissociation is either the classical right brain distraction of spacing out into reverie, fogginess or sleep C and/or it is the left brain, cognitive distraction of worrying and obsessing. Particularly notable here is the inner critic s dissociative transformation of fear and depression into drasticizing scenarios about the client s imperfections. Over and over, we need to guide the client to rescue himself from dissociation [left and/or right], and to gently bring his awareness back into fully feeling and experiencing the sensations of his fear and noticing his reactions to them. Mild sensations of fear are muscular tightness or tension anywhere in the body, especially the alimentary canal. More intense sensations of fear are nausea, jumpiness, wired-ness, shortness of breath, hyperventilation, electric shock and diarrhea. Although sensations of fear typically feel unbearable at first, persistent focusing with nonreactive attention ameliorates or resolves them C as if awareness itself is digesting and integrating them.

    It is important to note here that this type of kinesthetic focusing often triggers memories and unworked through feelings of grief about the client s abuse and neglect in his original abandonment. This provides many invaluable opportunities to ameliorate PTSD by more fully grieving the losses of childhood. Therapists can also use the results of such explorations to foster the creation of an egosyntonic and self-compassionate narrative that deconstructs the shame and self-blame the PTSD client typically assigns to her suffering. I describe a safe, efficacious process for this type of grief work in my book, The Tao Of Fully Feeling: Harvesting Forgiveness Out of Blame.

    With considerable practice, the client eventually begins to exhume from his fear, an awareness of the more elemental, underlying sensations of depression C hypoaroused sensations exceedingly subtle and barely perceptible at first. These sensations are initially as difficult to stay present to as those of fear. With guided ongoing practice however, focused attending also digests them as they are integrated into consciousness. As practice becomes more proficient, these feelings and sensations of depression can morph into a sense of peace, relaxation and ease - and sometimes open to underlying, innate core emotional experiences of clarity, confidence and belonging.

    Introspective Somatic Work.
    Therapeutic gains in reducing self-abandonment are augmented by individual work. I was daunted in my own mindfulness work at the frequency with which my awareness yo-yo vacillated between my body and my mind C between tense sensations of fear and the myriad fear-tainted mentations of my inner critic. These catastrophizing thoughts and visualizations were my critic s misinterpretations of my fear, based on unconscious beliefs that I was still stranded in the dangerous abandonment of my childhood. My critic excoriated me incessantly to launch into flight-mode and strive for safety through productivity and perfection. In the first year of this practice I frequently had to white-knuckle the handles on my chair to stay somatically present to my feelings - to stop myself from self-medicating into excessive adrenalization. I had survived my childhood with ADHD-like busyness C with marathons of activity that kept me one step ahead of my fear- and shame-saturated depression. Gradually as I used my focused awareness to ameliorate my fear, I experientially discovered the rock bottom underlying core sensations of my abandonment depression itself. Over and over I focused on sensations of heaviness, swollenness, exhaustion, emptiness, hunger, longing, soreness, deadness. Sometimes these sensations were intense, but more often they were very subtle. With time I noticed how instantly my depression scared me and lead me to echo my parents contempt: You re bad, worthless, useless, defective, ugly, despicable . Blessedly, with ongoing practice, I gradually learned to disidentify from the toxic vocabulary of the critic. I found myself more accurately naming these revisited childhood feelings: Small, helpless, lonely, unsupported, unloved. Over time, this in turn rewarded me with a profound sense of compassion for the abandoned child I was.

    Camouflaged Depression.
    Feelings of abandonment commonly masquerade as the physiological sensations of hunger. Hunger pain soon after a big meal is rarely truly about food, but rather about emotional hunger and the longing for safe, nurturing connection - for the satiation of abandonment. Even after a decade of practice, I still find it difficult to differentiate this type of attachment hunger from physical hunger. One, often reliable, clue is that the sensation of longing for the nourishment of attachment is usually in my small intestine, while physical hunger s locus is a little higher up in my stomach. [I believe sex and love addicts desperate pursuit of high intensity relating is also often an attempt to self-medicate deeper abandonment pain and unmet attachment needs].

    Pseudo-Cyclothymia. On a parallel with false hunger, feeling tired is sometimes an emotional experience of the abandonment depression, and entirely unrelated to sleep deprivation C although over time the two can become confusingly intertwined. The emotional tiredness of not resting enough in the comfort of safe attachment and belonging, often masquerades as physiological tiredness. When our abandonment depression is unremediated, any kind of tiredness C emotional or physical - can trigger us into fear, which the inner critic then translates into endangering imperfection , which in turn triggers us into one of the 4F responses. Ironically, over-reacting to emotional tiredness eventually creates real physical exhaustion via a process I call the The Cyclothymic Two-Step. This is the dance of flight types who habitually overreact to their tiredness with workaholic or busyholic activity. Self-medicating with their own adrenalin, they run to counteract the emotional tiredness of unprocessed abandonment depression. Eventually however, many exhaust themselves physically, and become temporarily too depleted or sick to continue running. At such times, they collapse into an accumulated depression so painful, that they re-launch desperately into flight speed at the first sign of replenished adrenalin. Such clients sometimes pathologize themselves as bipolar because of their abrupt vacillations between adrenalin highs and abandonment- exacerbated lows. Also noteworthy here is the futile journey that many survivors undergo treating emotional tiredness with physiologically- based methods. The limited efficacy of such an approach however typically augments their shame: What s wrong with me. I've changed everything in my diet and in my sleep and exercise regimen. I ve seen every type of practitioner imaginable and I still wake up feeling dead tired. I believe the healthiest way out of this cul-de-sac of self-destructive and unwarranted efforting lies in cultivating selfcompassionate acceptance of the inexorability of sometimes feeling tired, bad, lonely, or depressed. In this regard, the notable AA 12 Step acronym, HALT - Hungry, Angry, Lonely, Tired C can remind us to assess whether these feelings are actually signals that our abandonment depression has been triggered and needs the quiet, internal, self-compassionate attention described above.

    Conclusion.
    We can sometimes gain motivation for this difficult work by seeing our depressed feelings as messages from the developmentally arrested child who is flashing back to his abandonment in hopes that his adult self will respond to him in a more comforting and protective way.

    Through such practice, clients can gradually achieve the healing that the Buddhists call separating necessary suffering [normal depression] from unnecessary suffering [unconscious stuckness in hopelessness, toxic shame and fear, retraumatizing inner critic acting in, and 4F acting out].

    Pete Walker is director of the Lafayette Counseling Center, a sliding-scale agency that specializes in working with complex PTSD, codependency and recovery from childhood abuse and/or neglect. His website www.pete-walker.com, contains many downloadable articles on these subjects. He is also the author of The Tao of Fully Feeling: Harvesting Forgiveness Out of Blame. Information on his CEU class in Relationship Supervision is contained in the classifieds of this issue. He can be reached at (925) 283-4575.
  • May 04, 2011 1:36 PM | Anonymous
    By April Wise

    April Wise Ned and Carla came to their first session looking like other successful 50-something couples in their upper middle class community. They were well dressed and socially appropriate. Their amiable introductions belied sadness and a sense of failure which quickly became clear as we started to talk. Their son, Eric, now 28 years old, had moved back in with them again, this time while being treated for a detox prescribed by their M.D. for withdrawal from addictive prescription drugs. As their story unfolded, I noticed the similarities of their story with others, now all too familiar.

    Eric had partied in high school. Carla and Ned had worried, but saw him start into college hopeful that he'd find his way and not get any deeper into drugs and drinking. Then followed several years of not making grades, dropping out of classes, some legal skirmishes; an arrest for possession, a DUI. Each time he returned home, Carla and Ned tried to be understanding, and employed different strategies to help. In between starts and failures of school, Eric sometimes worked for short jobs which never seemed to last, and had many reasons why he couldn't commit to anything. Seeing his frequent mood swings, his worried parents decided he was depressed, and offered counseling and/or medical help. They moved him to other towns and supported him with rent on apartments. They tried not to interfere but became reluctant to leave him home alone when he was living with them because of disturbances when they were gone, and/or money and property missing or damaged when they came back. Carla described living with Eric as feeling like a hostage in my own home. At the same time, she and Ned wondered what they were doing wrong that Eric could not succeed at anything. His failures became their failures.

    The crisis precipitating their call to me started when, several months prior, Eric's landlord called complaining of non-payment of rent. Suspicious and concerned since they had been sending money regularly to Eric for support, Ned decided to make a surprise visit to Eric's apartment. To his dismay, he found Eric in the apartment, clearly high on drugs, with paraphernalia cluttering the filthy room. He persuaded his son to come home, and contacted their M.D. who diagnosed opiate dependency and put him on buprenorphine and what s called an ambulatory detox. With little information about his prognosis, Ned and Carla were adrift about what to do next.

    When seeing parents, whether couples like Ned and Carla or single parents, first (and throughout) I try to help them rebuild a sense of selfempowerment.

    Empowering includes frankly discussing what the parents know about their child's problems with drugs/alcohol and the extent of the involvement . I recommend that they become educated on chemical dependency and treatment options. I refer them to websites such as www.SAMHSA.org and www.nida.nih.gov to give them reading lists on the subject. This also helps the parent to make clearer and less reactive decisions on how to help and when. (Example: paying rent for an apartment in another city isn't going to help just by providing a change of scenery. ) I refer them to support groups, which helps them feel less isolated with the problem.

    Empowering the parents to act includes assessing what's worked and what has not. For Eric, early attempts at counseling had not helped; nor had the financial support for school, rent, car payments. Moves, advice, and threats had been equally ineffective.

    Much has been written about caring for spouses who are alcoholic or drug dependent, and similarly for children who are still minors. Unique to the failure to launch family is this dilemma: the child is no longer a child; he/she is legally an adult but not living as a responsible adult. Usually the parent is living in fear that if they do not continue to support this child, he/she will end up on the street. Simply put, the child is emotionally too young to handle life's responsibilities, leaving the parent feeling obligated to continue to take care of them. This Boomer generation of parents often did drugs or alcohol themselves, grew up with enough financial security to make life relatively easy, and feel a tremendous guilt from that combination, which makes it difficult for them to say to their adult children; enough is enough.

    Children who come back to Mom and Dad because they ve finished school/trade but can t afford to live on their own, or who have been self-sufficient but had some life-event that makes them dependent on a temporary basis is certainly a different story. In those cases, agreements about how long the child might be staying, and for what purpose, is usually enough to allow a healthy transition to happen. Young adults who are responsible but need a temporary hand up , will be willing to pay rent and participate in the household as equals. In most of my Failure to launch families stories, there is a continuing pattern of under-responsibility on the young person's side, superimposed by a parent/parents who are over-responsible and have bailed them out of financial, emotional, social, and sometimes legal trouble time and again.

    As Ned and Carla began to understand that drug abuse was a major contributor to Eric's difficulties, they also understood that his failures weren't necessarily their own. In the following weeks I suggested and we worked on the following goals; a structured approach which I find helpful with parents of struggling young adults:

        1. Make a realistic plan about what treatment, if any, should be supported and offered. Make another plan for the eventuality that treatment is refused. Professional help is especially beneficial at this point.

        2. Reduce fear by looking at the resources their child already has. The we can t let him live on the street argument is often very far-fetched when we talk about what their son/daughter has been able to come up with on their own, when left to their own devices! At the very least, we look at what is actually available in the community that would afford shelter if the family makes a decision at some point to withdraw living at home as an option.

        3. Learn and practice emotional detachment . As Milam and Ketcham state in Under the Influence, if the alcoholic's family or friends become emotionally embroiled in these excuses and denials or believe they are somehow responsible for causing the alcoholic's unhappiness, the real problem-the physical addiction- will get sidetracked, and the psychological symptoms will be mistaken as the source of all the trouble.

        4. Refocus their time and energy on themselves. Often the marital relationship is suffering as a result of the stress. The partners, or single parent and other family members may have different opinions on what help to give, or how much money should be spent. Not uncommonly, the son or daughter becomes the confidant of one parent, and uses this to manipulate getting what he or she wants, driving a wedge between the parents. For the single parent, there is the added burden of not having support, and sometimes fear of not wanting to sever a relationship with the child, however tenuous. Parents need to look at what they are giving up in service to their child, and reconsider their own lifegoals.

        5. Understand that their credibility to encourage their child will be less if they are abusing substances or alcohol themselves. However, lapsing into guilt and accepting blame beyond honest acknowledgement will not help their child deal with his/her own issues.

        6. Get support from others, especially Al- Anon, Nar-Anon, or similar organizations. Many treatment programs offer on-going family support and free educational sessions.

    Eric's parents decided, after learning about his addiction and the need for on-going intensive support after detox, to offer him 30 days to get into a residential facility or a TLC (clean and sober home for people in recovery 30 days or more). With support, they came to realize that keeping him at home longer would be reinforcing his dependence on them.

    In essence, by gaining a new sense of empowerment, the parent/parents are also learning to detach in a healthy way. Jane Adams says in When Our Grown Kids Disappoint Us, Detachment demands that we rethink our priorities and shift them from our kids to ourselves. It requires us to see them for who they are, which is not us, and even if she has her mother's gift for languages or he is the spitting image of his father; we are separate individuals with separate lives on which neither has a permanent claim. Our detachment forces them to take charge of their own lives. It allows us to go on, despite the fact that our questions about why this happened to our kids-and yes, to us- will probably never be answered...

    Carla and Ned continue to work on feeling empowered to make changes. Eric did decide to live in a TLC. His recovery, like most, has its ups and downs. His parents are feeling more at peace with letting him make his own decisions, and imparting that stance is allowing Eric to have more confidence in himself. Meanwhile, they have begun to take more enjoyment in their friends, activities and each other.

    April Wise, MFT is a Psychotherapist, EMDR Consultant and Instructor. She has been in practice for twenty years, specializing in family relations, addictions, and co-occurring disorders. She is adjunct faculty at JFKU, and has taught for U.C. Berkeley Extension and Cal State East Bay in Addictions Studies and Treatment of Trauma. For more information about April Wise see: www.aprilwisemft.com.

  • March 03, 2009 4:24 PM | Anonymous
    Marriage and Family Therapists (MFTs) are dedicated to advancing the welfare of individuals and families. They respect the rights of those persons seeking their assistance, and make reasonable efforts to ensure that their services are used appropriately.

    MFTs do not disclose client confidences except as required by law, or when permission has been granted by the client.

    MFTs terminate or transfer a client when it is reasonably clear to the therapist that the client is not benefiting from their therapeutic relationship.

    MFT's are legally and ethically prohibited from having sexual contact with clients or their spouses. For further information, the California Department of Consumer Affairs publishes a pamphlet about this entitled, "Professional Therapy Never Includes Sex." To obtain copies of this pamphlet, contact the board of Behavioral Sciences, at 400 "R" Street, Suite #3150, Sacramento, CA 95814

    For the complete text of ethical standards, go to www.camft.org and click on "What Is CAMFT?" 
  • March 02, 2009 4:22 PM | Anonymous
    All of us in the course of our lives go through a series of normal and expected challenges. These challenges have possible pitfalls, and many individuals and families need support and guidance to cope. Events such as a new baby in the family, troubled adolescent, or coping with an aging parent will affect how people function. We may also face other problems and crises such as unemployment, a sudden or chronic illness, divorce, or a death in the family.

    People facing these and other such problems can often benefit from the professional services provided by MFT's.

    Some signals of distress are:
    • Overwhelming anxiety or fear
    • Feelings of hopelessness
    • Sleep disturbances
    • Sexual disturbances
    • Unexplained fatigue
    • Excessive alcohol or drug use
    • Lack of interest in previously enjoyed activities
    • Excessive loss or increase in appetite
    • Excessive weight gain or loss
    Seeking professional assistance is a courageous step and shows an awareness and a willingness to grow and change.

  • March 01, 2009 4:16 PM | Anonymous
    Seeking a Marriage and Family Therapist or other mental health professional to assist with life's difficulties is a sign of courage and a step in the right direction to deal with the many challenges of life.

    When to Seek Help

    All of us in the course of our lives go through a series of normal and expected challenges. These challenges have possible pitfalls, and many individuals and families need support and guidance to cope. read more

    Ethical Standards for Marriage & Family Therapists

    Marriage and Family Therapists (MFTs) are dedicated to advancing the welfare of individuals and families. They respect the rights of those persons seeking their assistance and make reasonable efforts to ensure that their services are used appropriately. read more

    What Is a Marriage & Family Therapist?

    Marriage and Family Therapists (MFTs) are relationship specialists. MFTs are trained to assess, diagnose, and treat individuals, couples, families, and groups to achieve more satisfying and productive marriage, family, and social adjustment. Our practice also includes such areas as premarital counseling, child counseling, and divorce or separation counseling.

    Marriage and Family Therapists are licensed by the State of California. The requirements for licensure are a two-year master's degree or a related doctoral degree, 3000 hours of supervised experience, and passing a comprehensive written and oral examination.

    A Registered Intern is a person who has an approved masters degree and is in the process of accumulating his or her hours of supervised experience. They are permitted to do counseling with clients while under the direct weekly supervision of a licensed MFT or other licensed practitioner.

    The letters MFCC after a therapist's name stand for Marriage, Family, and Child Counselor. Marriage and Family Therapist (MFT) is synonymous, and can be used interchangeably.

    Psychotherapy services of licensed MFTs are eligible for insurance reimbursement in most instances.

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