O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

By Leave a Comment

Psychotherapy and Choice: The Journey to the Self

I often hike the trails below Mt. Diablo and am not a stranger to seeing snakes on the path, and have been told that in stretches of certain trails, rattlesnakes peer out from under the rocks. But on a recent hike, I was startled to actually make eye contact with a rattler! It was hiding in the hole underneath this gnarled tree trunk.

While snakes themselves have a rich symbolic history, today I want to talk more about the scary underground place it comes from.

I was reminded of a story I read to my daughters when they were young. The fable inspired lots of discussion in our home, and I believe it was formative for them.

The story was originally told to Rumi, the 13th-century Persian poet.

A caravan of men and camels crossed a desert and reached a place where they expected to find water. Instead they found only a hole going deep into the earth. They lowered bucket after bucket into the hole, but the rope each time came back empty—no bucket and no water. They then began to lower men into the hole but the men, too, disappeared from the end of the rope. Finally a wise man among the party volunteered to go down into the hole in search of water.

When the wise man reached the bottom of the hole, he found himself face to face with a horrible monster. The wise man thought to himself, “I can’t hope to escape from this place, but I can at least remain aware of everything I am experiencing.”

The monster said to him, “I will let you go only if you answer my question.”

The wise man replied, “Ask your question.”The monster said, “Where is the best place to be?”

The wise man thought to himself, “I don’t want to hurt his feelings. If I name some beautiful city, he may think I’m disparaging his hometown. Or maybe his hole is the place he thinks is best.”

So he said to the monster, “The best place to be is wherever you feel at home—even if it’s a hole in the ground.”

The monster said, “You are so wise that I will not only let you go, but I will also free the foolish men who came down before you. And I will release the water in this well.”

Wisdom and Choice

What made the wise man wise? He had a choice. He could go down into the darkness or not. He chose to descend into the hole even though it was doubtful that he would come back up again. He also chose to remain aware. He said, “I can at least remain aware of everything I am experiencing.” He showed kindness and compassion, without an agenda to beat the monster at his riddle. Through awareness and courtesy, he sets free his companions and releases the water.

Healing Comes from Confronting our Difficult, Dark Sides

Symbolically, this story illustrates a path to healing. In psychotherapy, we are often confronted with feelings that come from deep in the unconscious. By taking the difficult route into the darker places within, we can come back with deeper self-knowledge. When people begin individual therapy, they are often hesitant to look at the dark, secret places they keep tucked away. Psychotherapy is an opportunity to dig deeper and to face the darkness within, to remain aware and open to experience in the search for insight.

When we start down the path of self-understanding, we must choose to look at the discarded parts of ourselves. In this process, we can free ourselves from the things that hold us back from being truly alive. No one is without stain—without what seems like a monster inside. It is by entering the darkness that we can release the water, the substance of life, thereby slaking our thirst for wholeness.

By Leave a Comment

The Fourth Horseman: Stonewalling

"The Great Wall"During lectures about marriage, I have used this photo of the Great Wall of China to illustrate Gottman’s fourth horseman of the apocalypse: Stonewalling.

When we were in China a few years ago, we had the good fortune to see this magnificent stone wall when there were no other people around. It helped that our driver got hopelessly lost, and we ended up going several hours out of our way. But happily, we ended up at this stretch of the Great Wall that was not on the typical tourist path.

Putting up Walls

Walking up the steep steps gave me a view of the entire countryside, but scaling a partner’s emotional wall isn’t that easy. I reflected on why we put up walls and how these walls get maintained over the years. Walls are built for protection—to keep others out—and to keep control. In marriage, partners who have trouble with emotional self-regulation get overwhelmed emotionally, but also physiologically, even if they’re unaware of the raised heart rate and adrenaline that are making them feel literally attacked.  That’s why they put up walls.

Learning to Self-Soothe During Difficult Conversations

Emotionally checking out of the conversation creates the illusion of safety. Ignoring the difficult discussion, looking or turning away, or even leaving the room, puts the overwhelmed person back in control, but doesn’t solve anything. Learning to be aware of uncomfortable feelings, then how to self-soothe and maintain composure, helps partners stay in a heated conversation and also to listen and respond. That way, the discussion can move ahead without getting gridlocked.

A good technique for self-soothing to manage anxiety is Mindfulness-Based Relaxation Training, something I often recommend to clients who want to stop stonewalling. Learning this form of meditation is very useful in helping stay in control, calmly, without having to create a distancing wall—even when discussing the most upsetting topics. 

 

 

By Leave a Comment

The Four Horsemen of the Apocalypse: Shortcutting Criticism

In the biblical Book of Revelations, the Four Horsemen of the Apocalypse signal the end of the world through conquest, war, famine, and death. The Four Horsemen that Dr. John Gottman’s research has identified as signaling the end of a relationship are criticism, contempt, defensiveness, and stonewalling—communication styles that threaten a marriage’s health and longevity.

When I first see a couple for relationship counseling, I assess their communication behaviors by using a set of questionnaires developed from the research of Dr. Gottman. To evaluate criticism, for example, each client answers yes or no to statements such as “I feel attacked or criticized when we talk about our disagreements” or “My partner uses phrases like ’you always’ or ’you never’ when complaining.”

Defensiveness is seen in statements like “Many of our issues are just not my problem” or “I have to defend myself because the charges against me are so unfair.” Statements such as “I try to point out the flaws in my partner’s personality that need improvement” or “I feel disgusted by some of my partner’s attitudes” assess contempt. Stonewalling is when one partner just tunes out and ignores the other, usually after a barrage of criticism. Putting up a wall of silence is an attempt to protect the stonewaller from getting flooded by physical and emotional over- reactivity. Of all the Horsemen, Dr. Gottman says this is the most likely to end a relationship.

The good news is that each of these Horsemen has an antidote. The first step is recognizing these interactions when they occur. Often when couples are stuck in a cycle of negative communication, each person is unable to see his or her own part in the problem. But with gentle coaching, clients learn to notice when they are criticizing, being contemptuous, on the defensive, or stonewalling.

Next, I show couples alternative ways to expressing themselves by using a specific antidote to each Horseman. Today, let’s talk about the antidote to criticism.

Learning to complain without blame is key to short-circuiting criticism. Any relationship may give rise to legitimate complaints. But the key to avoiding defensiveness in your partner is to complain in a way that does not place blame.

The formula is pretty simple: “When _________ happens, it makes me feel____________. What I would like from you is_________________.” For instance, when Judy says to Mark, “You’re always putting your parents’ needs before mine. You’re such an inconsiderate jerk,” the likely response from Mark might be, “I do not! And if I do, it’s because you don’t take any time to connect with them, so I have to do it all!” Placing blame just engenders defensiveness, continuing the cycle of criticism.

Helping Judy to find a different way to express her feelings might sound something like this: “Mark, I miss feeling connected to you when we are with your family. Do you think that this weekend when we see them, we can stay close? It would help me if you’d check in with me every once in a while.”  In this version, Judy takes responsibility for her feelings and then asks directly for what she wants without making Mark out to be the bad guy. Mark, in turn, can listen to Judy’s request without feeling he has to justify and defend.

Antidotes to the other three Horsemen will be taken up in another post. But understanding how these concepts affect communication in marriage goes a long way to helping couples manage conflict.

 

By 2 Comments

Preventing infidelity: Open the sliding door to love

 Dr. John Gottman recently sent me a complimentary copy of his latest book, What Makes Love Last? I read it with great interest. Couples often come to my office struggling with trust and betrayal. While infidelity is a common reason couples seek counseling, it does not have to portend the end of the marriage. Before an affair strikes, women and men adamantly proclaim that they would divorce their partner if they caught them cheating. The discovery of an affair has been described as ”waking up to one’s worst nightmare.“ There is no doubt that this fundamental betrayal produces cataclysmic changes in the relationship. But what comes as a surprise, after the initial shock, is that couples often fight for their marriage, not so quick to divorce as they assumed.

How to Prevent Affairs

In What Makes Love Last?: How to Build Trust and Avoid Betrayal by John Gottman and Nan Silver (Simon & Schuster, 2012), Dr. Gottman makes the case that trust is a powerful protective antidote in keeping marriages healthy and affair-resistant. This seems obvious. But there are clear ways to encourage trust within a marriage. How does trust develop? What keeps it alive? And how do you rebuild it once it has been damaged? In this blog post and the next, I’ll address these questions.

Developing Trust is Central

Central in developing trust is how individuals in a relationship react to what Dr. Gottman refers to as “sliding-door moments.” where “one partner expresses a need for connection [and] the other’s response is either to slide open a door and walk through or keep it shut and turn away” (32). These expressions, or “bids for contact” in Gottman’s phrase, happen all the time as partners ask each other in words and deeds for support and understanding. A small bid would be something like, “Hey, isn’t that a lovely flower?” or as intimate as “I need you” after a difficult day. Each one offers a chance to step through the door.

All committed relationships have an abundance of sliding-door moments, and of course, partners will not always be able or want to step through. They could be busy, preoccupied, angry, or just not paying attention. What puts a relationship in trouble is when most of these moments end poorly. If over time, bids are ignored without the benefit of discussion, one or both partners may begin to wonder if they matter in the marriage. Compounded, these lost opportunities for connection will lead to feeling unloved and unappreciated.

Feeling that way creates fertile ground for an affair. For example, a co-worker shows interest and understanding during a time when a partner is absorbed in their own life stressors. What starts as an innocent work friendship can lead to betraying the marriage as the unmanaged conflict between a couple chisels away mutual trust and struggles become set in stone.

Negative Sentiment Override

Research shows that we are more likely to remember things that are unfinished—such as an argument that never gets resolved or discussions that end poorly with misunderstanding and hurt. The memory of the event leads to an increase in negative attitudes about the marriage. This is referred to as negative sentiment override (NSO). The friendship couples once felt is diminished and they see each other in an increasingly negative light. This NSO leads to one partner feeling threatened—perhaps her partner is involved with someone else?

When Joe and Lisa came to therapy for the first session, she was convinced he was having an affair. While his outside relationship had not become sexual, the risk was high that it could do so if they didn’t attend to their relationship. Many years of poorly managed communication about the division of labor conflicts led to feelings of being unappreciated and unloved by both Lisa and Joe. The more Lisa complained the more Joe pulled back—which served to make Lisa more insecure. During one session they described a recent tussle. After a particularly exhausting week, Lisa spent all Saturday cleaning and grocery shopping. She prepared Joe’s favorite dinner. But Joe was frustrated with Lisa because earlier in the day, when he needed her help getting their daughter ready for swim lessons, Lisa continued to Skype with her sister, ignoring him. By the time they sat down to eat, Joe was steaming, Joe has trouble expressing his feelings when he feels them. In this case, he stewed for most of the day. By the time they sat down to dinner, Joe was boiling mad. He didn’t realize that Lisa was trying to create a sliding door moment for them to connect at dinner. She didn’t know that Joe felt ignored.

Loss of Emotional Intimacy

This dynamic is not uncommon when couples start therapy. The loss of emotional intimacy is usually preceded by years of a subtle weakening of the friendship system in the marriage. Couples stop sharing their intimate feelings. Criticisms, gripes, and defensiveness erode fondness and admiration. Rather than thinking loving thoughts about each other, their thoughts are dominated by what therapists call “distress-maintaining thinking” In other words, the more you see your partner and your marriage in a negative light, the more distress you feel. In turn, the negative thinking gains traction, leaving little space for thoughts and behaviors that would increase expression of fondness and appreciation. If Lisa doesn’t express appreciation to Joe for the time he spends with their daughter, and Joe can’t express what he feels, both the loving and difficult feelings, they will grow apart. The door will shut tight. When sliding door moments are repeatedly missed, negative thoughts about the marriage will slip in, squeezing out affection and love.

The good news is that you can take definite steps to build back trust and protect your marriage from betrayal. Couples therapy is often the first step toward building back the foundation of your relationship. Stay tuned for the next post to see how you can protect your relationship.

 

By 3 Comments

The fullest experience of the adventure of life: Eleanor Roosevelt, Blogging, and Mindfulness

I just returned from Rhinebeck, NY, where I took an intensive professional training course in Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse. The five-day course was developed for health-care professionals who already have experience with mindfulness-based approaches.

Many years ago, I studied Mindfulness-Based Stress Reduction with its developer, Dr. Jon Kabat-Zinn. Since that time, research has continued to demonstrate the effectiveness of mindfulness training in treating many forms of emotional difficulties. Offspring treatments that involve mindfulness as a major component to their treatment protocol include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT).

Taking a course in MBCT  gave me the opportunity to study with one of the major researchers and writers in the field. It was given by Zindel Segal, PhD, and Susan Wood, MSW, LCSW. Dr. Segal is the author of Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, 2002, The Guilford Press.

While the course was valuable and added to my skills in teaching this treatment approach, the highlight of the trip was my excursion to Val-Kill, the unpretentious, comfortable home of Eleanor Roosevelt. Just down the road in Hyde Park, NY, stands the opulent estate of her husband, Franklin Delano Roosevelt. Ms. Roosevelt created her separate home in a style that reflected her sensibilities, not those of her husband. Set among trees and brooks, the house contains simple furniture and cozy, intimate rooms.

I was fascinated to learn that Eleanor Roosevelt was a kind of pioneering blogger extraordinaire. She wrote a daily letter to Americans that came to be called “My Day,” one of the most popular syndicated columns of the time. She wrote her column six days a week, often dictated in any free moment she found. She published over five hundred words per column, at least six days a week for 26 years from 1936-1962. Personal as well as socially relevant, her work communicated her thoughts, joys, and intimate concerns.

As a beginning blogger, I have wondered about my urge to write. In a previous post, I talked about how this form of writing allows me to take my many years as a psychologist and put words to this experience that can go beyond the confines of my confidential private office. Social media has provided a means for anyone to make his or her thoughts and opinions public, taking journaling to a new level—but not an unprecedented one, as I saw by Eleanor’s example.

Pleasant and Unpleasant Events Calendar

I often suggest that my clients journal. Collecting thoughts and feelings by observing them and taking the extra step to write them down allows insights to emerge. In MBCT, one of the first homework exercises is to write a daily note about a pleasant and an unpleasant experience that occurred during the day. By noting the thoughts, feelings, and sensations associated with such experiences, we bring mindful awareness to daily life. This can allow us to experience and appreciate the moment simply as it is, without adding further elaboration in the form of wishing, dreading, or judging. It is often our mental elaboration that triggers rumination, a common symptom in depression. We can begin to realize that even unpleasant events can be tolerated. Bringing awareness to each situation, whether we label it good or bad, is an important step in learning to relate differently to them. This takes practice. And curiosity.

The Fullest Experience of the Adventure of Life

As Eleanor Roosevelt writes in You Learn by Living: Eleven Keys For a More Fulfilling Life, “There is no experience from which you can’t learn something. When you stop learning you stop living in any vital and meaningful sense. And the purpose of life, after all, is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience. . . . The experience can have meaning only if you understand it. You can understand it only if you have arrived at some knowledge of yourself, a knowledge based on a deliberately and usually painfully acquired self-discipline, which teaches you to cast out fear and frees you for the fullest experience of the adventure of life.”

Being attentive to thoughts and writing them down takes discipline. When keeping a journal (or a thought record of daily events, or writing a blog) our life experience is enlarged and enriched. For people struggling with depression, being able to notice even slightly positive things during the day allows them to see that such events are already there for them. For some, it may be noticing the song of a bird, or the stars on a clear night—these simple experiences are always within reach, but for someone who struggles with depression, they go unattended. Writing is a vehicle of self-expression.

References:

Roosevelt, E. (2001). My Day: The best of Eleanor Roosevelt’s acclaimed newspaper columns, 1936-1962. D. Emblidge (Ed.) Cambridge, MA: Da Capo Press.

Roosevelt, E. (2011). You learn by living: Eleven keys for a more fulfilling life. New York: Harper Perennial.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.