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March 10, 2015 By Susan O'Grady 9 Comments

Psychotherapy, Love, and Healing

 

Psychotherapy takes place by holding the space for healing to occur.Nothing is more natural than the urge to be held and comforted by someone who understands our suffering. Whatever the painful situation (a relationship breakup, medical scare, financial disaster, the death of a loved one) we want to turn toward someone who will hold us and let us cry in loving arms.

Sometimes we need to seek that understanding from someone other than a lover, parent, or friend. These figures may be too close to your issues or otherwise unsuitable for receiving confidences and providing nurturance. Psychotherapy provides a safe, confidential, neutral relationship to explore what hurts.

Therapist and client sit together in a quiet space being present to whatever feelings come up. The noise of the outside world is put on hold for an hour: no ringing phones, text messages, TV, or other distractions. This environment invites opening up the parts of ourselves we keep shut down, secret, or tied up in knots. Tears are likely, but so is laughter and joy. Therapy is not only about pain but also learning to live well with the inevitable difficulties that life holds, and finding the laughter that lives alongside pain.

Good therapists with proper boundaries will not gossip about you, laugh at you, seduce you, or allow themselves to be seduced by you. At the same time, psychotherapy at its best gives room for love to be present. In fact, love is an important aspect of all good psychotherapy. In a letter to fellow psychoanalyst Carl Jung, Freud wrote that “Psychoanalysis is, in essence, a cure through love” (1906). In the client–therapist relationship, love, and gratitude are healthy human emotions just as they are in the world outside of the therapist’s office, although the client expresses his or her feelings while the therapist experiences them privately.

Many forms of love may be possible: that of a parent toward a child, of siblings, or adults with erotic feelings, or narcissistic self-love. Discussing such feelings is sometimes difficult—in part because love is fraught with vulnerability, in part because we have all been injured in our loving feelings. In therapy, it is helpful to both respect and be curious about this range of feelings for what it reveals. Much can be learned about how one loves, about how one contends with the fears and anxieties over love, about how one chooses a person to love, and about what it is that one loves (beauty, truth, kindness.)

Ultimately, the therapeutic process will lead to reclaiming the self that became lost, whether through years of living inauthentically, practicing unhealthy behavior or through emotions such as depression and fear that hold us back from living fully. Another way of putting it is that therapy is about putting life back together again based on a clearer understanding of ourselves.

Reconstructing identity is, as Plato wrote, a kind of remembering of what we’ve forgotten about ourselves; through therapeutic dialogue and listening to our intuition, we remember that self. Sometimes, for example, we lie about what our lives are because we need to create something to give us the comfort of that longed-for love.

When we live life that’s not in accordance with who we are, we are doomed to fall hard, cracking the veneer of the perfect life. If, like Humpty-Dumpty, we fall tumbling from perches too lofty (narcissistic) or too unstable (based on fantasy) all the king’s horses and all the king’s men will not be able to put us back together again.

A successful outcome of therapy is to find comfort in your aloneness because we are never truly alone if we know ourselves. The self, or soul, is with us all along, walking beside us. Throughout life, we are given glimpses of this companion self.

As Juan Ramon Jimenez wrote in his poem “I Am Not I”:

 

I am not I.

                  I am this one

walking beside me whom I do not see,

whom at times I manage to visit,

and whom at other times I forget;

who remains calm and silent while I talk,

and forgives, gently, when I hate,

who walks where I am not,

who will remain standing when I die.

 (Juan Ramón Jiménez, “‘I Am Not I’” from Lorca and Jiménez: Selected Poems. Translation copyright © 1973 by Robert Bly.)

Perhaps the therapist models this companion self for the client until the client can better become his/her own companion. The best psychotherapy creatively facilitates developing the disposition for happiness by encouraging self-transformation and self-integration. Ultimately, the therapeutic relationship ends and the client moves on in life with a strengthened sense of self that can better tolerate being alone with both good and painful feelings.

Filed Under: Depression & Anxiety, Dr. Susan O'Grady's Blog, Psychotherapy, Uncategorized, Well-being & Growth

March 3, 2015 By Susan O'Grady 5 Comments

“I’d be better off single”: Distress-maintaining thinking

6523102125_059d03f888_bHow may times have you gone to bed thinking that you hate your partner, fantasizing how you would live on your own? Your thoughts snag on difficulties like how to tell your kids, your family, and the neighbors, and how much it would cost to live in two households.

If you’ve had such thoughts, you are not alone. Transient feelings of anger, dislike, or even hatred toward a partner are not uncommon. “Transient” is the important word: we all have those feelings from time to time, but they don’t become harmful unless we nurse these feelings of discontent, disappointment, and grievance—until they add up to a permanently negative perspective. Therapists call this “distress-maintaining thinking.”

The fantasy that life would be better without your partner feeds the cycle of negativity and keeps you unhappy. This is a huge danger zone, making our relationship vulnerable to secrets, even affairs. Thinking that there is a more perfect person out there who will meet your needs is usually wrong. Blaming your partner for your unhappiness is easier than understanding what role you play in the disharmony.

Fantasies of escape can abet distress-maintaining thinking, but so can fantasies of perfection. We grow up listening to fairy tales, and often form our expectations from them: The princess must love the toad, the knight gives freedom to the hag, and the beauty falls in love with the beast. Real marriage, though, requires confronting what you bring to the relationship—not just looking at your partner’s flaws or imagined imperfections. The fantasy of the perfect partner who always loves and understands you is a child’s fantasy. Children want to be loved unconditionally, but adult relationships take effort on both sides.

 For one human being to love another: that is perhaps the most difficult of all our tasks, the ultimate, the last test and proof, the work for which all other work is but preparation.

Rainer Maria Rilke, Letters to a Young Poet

 Equally distress-maintaining is simply giving up on a relationship. I had a client who had grown so detached from his partner that he was paralyzed by his inability to leave the marriage. In his despair, he told me the phrase I was to hear many times from other partner-providers: “It’s cheaper to keep her.” He had resigned himself to a passionless life because paying spousal support would have significantly diminished the retirement accounts and portfolio he’d taken years to build. But despair and casting oneself as the victim also means taking no agency in improving the relationship.

Relationship Enhancing Thoughts

In contrast to distress-maintaining thinking, cultivate relationship-enhancing thoughts. This practice doesn’t deny a relationship’s problems, but allows you to think about them in a way that brings understanding and insight to the challenges you face. Giving time and attention keeps friendship strong, leading to more engagement and more passion.

Don’t wait to redefine yourself by imagining a life with a different partner. Don’t just give up. Look at what you want for yourself now. How can you change the way you think about your marriage? As I was writing this post, a friend called to tell me about something I said to her several years ago that really stuck with her. I had mentioned the importance of making bids for contact and the “turning toward” concept, and how failing to do this will weaken connections, leading to negative perspective. She told me the image that come to her mind was one of a stack of neglected vinyl records stacked on top of each other without their sleeves, collecting dust and warping. Each time she ignored a bid or turned away from her lover, it was like adding another record to the pile, making the music increasingly unplayable.

Expecting perfection and continually ignoring opportunities to appreciate and admire each other compounds our marital problems, setting us up for escape fantasies. When we do the work of love by making a conscious effort to notice how attracted we are to our mates, when we make a point of noticing their positive traits, we feel comforted and loved.

Filed Under: Couples & Marriage & Family, Dr. Susan O'Grady's Blog, Psychotherapy, Relationships, Sex and Intimacy, Well-being & Growth Tagged With: Conflict in Marriage, Couples, Couples Communication, Dealing with Conflict in Marriage, Distress-maintaining thinking, Gottman Couples Counseling, Intimacy

February 24, 2015 By Susan O'Grady 7 Comments

Standing Behind the Waterfall: Learning to Change Distorted Thinking with Mindfulness

Giving yourself a ledge to stand on as you watch your thoughts will help get perspective.
Getting a Different Perspective

Thoughts are not facts. When we’re upset, our thoughts seem valid—yet it’s exactly when our emotions get stirred up that our thinking can easily become distorted. Conclusions based on distorted thinking can’t be trusted.

When my friend Sharon returned from a business trip, she was feeling disturbed and uncomfortable. As she described her experience, she clarified why: She had been working remotely in Africa and knew few of the other participants in her company’s conference. She wanted to be included, but wasn’t part of the main team; she felt uncharacteristically shy and felt that her participation wasn’t up to her typical style. Sharon was aware of the tremendous talent that surrounded her and wished she’d had more opportunity to interact with her co-workers.

Taking a Different Vantage Point Gives Perspective When Thoughts Are Overwhelming

Sharon observed her feelings and thoughts with great skill, teasing out the mixture of sometimes conflicting emotions she felt, but importantly, she wasn’t condemning herself or anyone else. If her thought had been “I’m so inept, I can’t compare to these other people,” she might have gotten carried away with ruminations about her inadequacies. By asking herself “What is this I am feeling, in this moment?” Sharon gave herself a vantage point—feeling anxious is not the same as being worthless.

Teachers of meditation often use the image of the sky to illustrate how thoughts, like clouds, come in and out of our mind. The sky is always there, even when dark clouds momentarily obscure the sky. In another moment, the sky might be a brilliant blue with white downy clouds moving slowly or swiftly across its surface. We use these images to show that clouds come and go changeably, just like our thoughts, but mind and sky always remain. Sitting in meditation, we witness the changes of thought and feeling but don’t partake in them, just as the sky is unchanged by the clouds.

One of the exercises used in mindfulness-based cognitive therapy is that of standing behind a waterfall. Standing behind the rushing water and watching it without getting swept away by the torrent gives us a ledge to stand on, just as meditation gives us the perspective to look at our thoughts. We don’t have to believe everything we think, and we don’t have to be deluged by ruminations arising from anxiety or depression.

Try this short meditation:   

Filed Under: Blog, Depression & Anxiety, Dr. Susan O'Grady's Blog, Health Psychology, Mindfulness & Meditation, Psychotherapy, Stress, Well-being & Growth Tagged With: Anxiety, Depression, Meditation, Mindfulnees-Based Cognitive Therapy, Mindfulness

February 17, 2015 By Susan O'Grady Leave a Comment

Building and Keeping a Strong Relationship After Having Kids

Couples counseling to help cope with disappointments with partner. Marital conflict is bad for kids. While every marriage has conflict, especially after the first baby, persistent difficulties in the marital relationship expose children to increased chance of depression, poor communication skills, and conduct disorder later in life.

Cindy and Max came to see me after their daughter Sophie started pre-school and teachers called them in to discuss her inability to speak in class or to play with other kids. Cindy and Max thought she was just shy, but Sophie was diagnosed with a form of social anxiety. I learned that the couple, not wanting Sophie to suffer the anxiety of being left with a babysitter, had never gone out on a date after her birth. They were never alone together and had even stopped entertaining friends. At home, Cindy and Max spent no couple time, except perhaps when bickering about who was going to do certain chores. Most meals were eaten in front of the TV; when the family did all sit down at a table together, Sophie would be the focus of their attention.

Cindy and Max responded to these tensions by stonewalling. Conflict lingered without any closure. Sophie observed all this, of course, and her separation anxiety increased until she became mute in front of anyone but her parents. It was only the diagnosis of anxiety that spurred her parents to look at their unhappiness and how it was affecting their daughter.

The Best Way to Take Care of Your Kids is to Take Care of  Your Marriage

The most important thing you can do is to stay good friends with your partner. Handle conflicts with gentleness and positivity; repair arguments when they become nasty. These seemingly simple things can create a climate that fosters intimacy, romance, and emotional engagement because these things grow out of a couple’s friendship and their ability to manage conflict.

Couples of today expect a lot from marriage; in previous generations when roles were more clear-cut, expectations were lower. People become partners because they value time together, but a new baby shifts the balance. Couple time recedes and baby time takes the lion’s share. For women, marital satisfaction goes way down, from 62% of childless married women reporting being very happy to only 38% of new mothers reporting feeling happy.

Please note: While many women get the “baby blues,” a relatively brief emotional letdown after childbirth, some 8 to 19% of women reported having frequent postpartum depressive (PPD) symptoms in a CDC survey. These symptoms include having scary or negative thoughts about the baby, worrying about hurting the baby, and feeling ashamed about not being a good mother. PPD is a serious problem that can not only affect the sufferer but also impair infant-mother attachment and the marriage. If a woman has this more severe depression, it is important she discuss her symptoms with her physician, who will refer her to a psychologist for counseling and a psychiatrist for medication evaluation.

Protecting Your Sex Life is One Way to Stay Connected When Children Take So Much

Having kids puts a damper on a couple’s sex life in several ways. Nursing shifts the hormonal balance by suppressing estrogen, increasing prolactin, and lowering testosterone levels. This combination results in vaginal dryness, which can cause pain during intercourse and lower libido. Breastfeeding is literally draining, and it’s additionally tiring to have sole responsibility to feed or even pump, especially on a newborn’s two-hour feeding cycles. Nursing does increase oxytocin, the feel-good hormone. With the baby meeting the mother’s needs for happiness, warmth, and intimacy, fathers can feel left out. However, fathers can experience rising oxytocin levels when cuddling their babies—they don’t have to feel left out http://www.livescience.com/10784-dads-hormone-boost-caring-baby.html. Many women, whether they nurse or not, feel “touched out” by the end of a day full of clingy young children.

While it’s not possible to change your hormonal balance, looking at what you can change will go a long way. Understanding that loss of desire is normal and that it will return is reassuring. It can also be reassuring to know that couples can maintain good sex lives without gymnastics. As Dr. Helen Fisher says, “If you want to start a very active sex life with your partner, don’t wait for your sex drive to get you to the bedroom. Just get to the bedroom.” Quickie sex releases all the feel-good chemicals of long gourmet sex. I tell my clients that meat & potato sex is fine (or gluten free.) Not every meal is gourmet.  Even if you aren’t in the mood, the closeness you feel will increase warmth and affection when not in the bedroom.

There are many other ways to protect your relationship after having children. In future posts, I will discuss other important ways to take care of your children by caring for your marriage.

Filed Under: Couples & Marriage & Family, Depression & Anxiety, Dr. Susan O'Grady's Blog, Psychotherapy, Relationships, Sex and Intimacy, Well-being & Growth Tagged With: Couples, Family, Gottman Couples Counseling, Intimacy, Parenting, Post-partum depression, Separation anxiety in children

February 10, 2015 By Susan O'Grady 4 Comments

The Effect of Having Kids on a Marriage

Marriage is Strained After Having Children

Sweetness
Sugar & Spice

Being a parent is hard. But being a parent is really hard on a marriage. New parents report eight times more arguments than non-parents. Studies show that relationship quality plummets by nearly 70% after the birth of the first child, when couples experience more conflict, less intimacy, and growing disappointment. The demands of parenting mean less time for individual and couple recreational activities such as social time, workouts, and sex, putting more stress on both partners. Arguments over household chores can devolve into tit-for-tat, quid-pro-quo bickering. This hurtful cycle can easily end with a negative perspective about your partner and your marriage.

Adding to all that is the financial toll of having a family. Raising a child is expensive. Based on housing costs, food, education through high school, healthcare, childcare, clothing, and other expenses (such as grooming, technology, and recreational activities—but not, say, birthday parties), the average cost is to raise a child born in 2013 in the United States until the age of 18 is $245,000. (The range is $455,000 for high- income families and $145,500 for low-income rural families. That doesn’t include college expenses: The National Center for Educational Statistics estimates that the annual current price per year of undergraduate tuition, room, and board ranges from $14,300 at public institutions to $37,800 at private nonprofit schools.

Couples report that the best years of their marriage are before they have kids, then as the kids enter their late teens, with satisfaction rising upward when the kids are launched. Marriages have several pivotal points when they are more vulnerable to divorce. The first is about six years into the marriage, and the second is when the kids leave home—reflecting many couples’ desire to stay together for the kids.

Why Stay Together When Things are So Hard?

Couples stay together until the kids are launched for many reasons. Those that often come up in my work with couples are:

  • Fear of failure. Couples don’t want to fail in the eyes of their families and community. ”What would people think?” is a bad reason but a powerful motivator for staying together.
  • The drive to provide a stable family life for children is almost hard-wired. We want our kids to be happy, not go through the trauma of divorce and kids shuffling between two homes. Parents don’t want to live half the week without their kids and divide up holidays. Many parents are children of divorce themselves and don’t want to visit the unhappy times they remember upon their own kids.
  • Divorce is expensive. California, for example, is a community property, no-fault divorce state—so divorce means losing half your equity, half your savings, half your retirement. And in most cases, the wage earner (or higher wage earner) will pay spousal support for years, depending on the length of the marriage and the age of the kids. (California courts do require a spouse in this situation to make efforts to become self-supporting, no matter how long the marriage lasted.)
  • Anticipatory pain. Whether it be fears of sexual jealousy, loss of love, loss of the life unlived—for example, being grandparents together—couples set up disaster scenarios in their minds that serve as glue to keep even unhealthy relationships stuck in place.

With or without divorce, parental unhappiness disturbs children, which is why “keeping together for the sake of the kids” serves neither parents nor children. Luckily, there are several ways to keep your marriage healthy and protect it from divorce after having kids. In my next post, I will describe ways to build and keep your relationship strong after kids.

Filed Under: Couples & Marriage & Family, Dr. Susan O'Grady's Blog, Relationships, Sex and Intimacy, Well-being & Growth Tagged With: Couples, Dealing with Conflict in Marriage, Divorce, Gottman Couples Counseling, Parenting, Romance

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Dr. Susan J. O’Grady is a Certified Gottman Couples Therapist

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