O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

By 2 Comments

Falling in Love Again with Your Partner: Love Maps, Friendship, and Staying Connected

_MG_2038When love is new, we ask questions to get to know our partner well. As Mandy Len Catron wrote for The New York Times in her charming summary of a study 20 years ago by psychologist Arthur Aron, we like learning about the person we love, but over time we forget to keep learning. In Dr. Aron’s study, researchers tried to find out if they could make strangers fall in love with each other by having them ask and answer a series of 36 questions that become more intimate and probing as they went. These questions get deep pretty fast. For people who hardly know each other, this is a low-risk exercise, but for couples once close and now estranged, it’s more challenging. I’ve seen this when I assign  couples the Love Map exercise at the end of our first session. Developed by Dr. Gottman, these 62 questions range from super-easy ones such as “Where was your partner born?” to more difficult ones like “Does your partner have a secret ambition? What is it?” I have clients answer the first two or three questions in the office, so I can coach them if they screw it up. As simple as these questions sound, if you don’t know where your partner was born, or what her favorite color, flower, or musical group is, the experience can turn from being fun and playful experience into hurt and disappointment, in turn leading to criticism and increased negative feelings. “She doesn’t know where I was born? After all these years?”

So I set some ground rules: One, it’s okay not to know all the answers—it’s even good—because you can learn something new about each other; it’s an opportunity to re-connect and update in a way that isn’t too challenging. If you don’t know something, make that a topic of conversation, even for just a minute or two.

The second ground rule is to understand that it’s not necessarily the fault of the partner who doesn’t know the answer! Communication is a two-way street. If you don’t take the time, or are passive about seeking knowledge about your partner, or just plain uninterested, preoccupied, or prefer to watch TV, then you need to make a your partner a bigger priority.

Third, I tell couples not to rush through this exercise the night before our next appointment. Take several nights over the week between our sessions to go through five to ten questions at a time, using them as a springboard for getting to know each other again. We refer to this exercise as updating our love maps. Daily obligations leave little time for talk, especially in our wired world, so we can’t expect to know everything about each other when our lives are busy and changing. When couples come back the next week, they usually feel good that they could get most questions right.

Expressing our Dreams Requires Vulnerability

What Dr. Aron’s study points to is that learning the deep, innermost feelings of your partner are what help us love them. When we express those ineffable or unspeakable feelings—those things we hardly tell ourselves—we make ourselves vulnerable, and that is attractive. Often couples have dim knowledge of their partner’s inner world. Dr. Aron’s 36 questions are the type we ask when getting to know someone—and spouses tend to already feel that job is done. Exploring the terrain of the soul with an attentive listener builds an emotional bond rarely experienced for some people with anyone but a therapist. This is why affairs feel rewarding.

As couples get further along in counseling, I have them do what Dr. Gottman calls the Dreams within Conflict exercise. This exercise, which takes place over several sessions, relies on the theory that gridlock results from life dreams in conflict. A powerful part of this exercise is to have each partner fully express a dream or wish that is fundamental to them. For this to happen, each partner needs to feel safe, because the dream is very close to the core of who they are, and it is fragile.

The first step is for one partner to pick a wish or dream, such as the desire for family connectedness, or the wish for adventure and travel, or to express their creativity. Once they think of the dream, their partners will ask a defined series of deliberately redundant questions, in order, without much commentary or discussion. This helps avoid an automatically defensive reaction.

For example, if one partner says “I’d really like to have more thrilling travel,” their partner may immediately respond with objections—and here’s what the mind does—“Oh no! How can we afford it? Will he want to take the kids zip-lining? What if he wants to go to a dangerous country? How can I take time off work? I really hate travel! I’d much rather stay home and have a stay-cation to putter in the garden and get caught up on all my novels… “ and on and on. This stream of thought can take place in seconds, but the effect can last a lifetime for the relationship.

So I ask the listener-partner to just ask the questions, not blurt out their thoughts and fears. Believe me, the stream of thoughts that go through the mind can if articulated, easily lead to squashing their partner’s elaboration of their dream. This Dreams within Conflict process opens up long-shut windows, allowing fresh views of each other, helping return the sweet to a relationship gone sour.

By 3 Comments

The New Year, Rebirth, and Obstacles

Photo credit: Bahman Ferzad
Photo credit: Bahman Ferzad

By the third or fourth week of January, many of us are reevaluating our lives. We’ve either made resolutions (and perhaps already broken them) or we are resisting this ancient practice with awareness of the years of collapsed intentions when previous New Year’s hopes didn’t pan out.

Yet we continue to be drawn to the symbolic cycle of each New Year because we crave growth and change. Like the snake, the symbol of healing (seen in the Rod of Asclepius), we long to shed our skin and emerge from the constraints that hold us back.

Stories of rebirth offer hope that change is possible, and that we can be made new again. The parts of ourselves that we’ve outgrown—the aspects of our personality and our life that keep us stuck, can be discarded, making room for new growth. With each new year, we imagine ourselves in new light—and set intentions to change.

Images of rebirth in faith traditions, in myths, and in nature symbolize the cycle of death, liberation, and ultimately rebirth. The Phoenix, for example, is a mythical bird that was said to live 500 years, burst into flame, and then arise from its own ashes after three days. This image represents the recurring cycle of resurrection, immortality, and the indestructible nature of the spirit, as well as the pain and destruction necessary to this cycle.

In the Gospel of John, Lazarus is raised from the dead after being buried four days in a dark tomb. Jesus tells Lazarus—still wrapped in the cloth that bound him—to get up and come to the entrance of his tomb. He commands Martha and Mary, Lazarus’s sisters, to unbind their poor brother so that he can be free to live life with fullness. Imagine that you can unbind yourself from whatever darkness holds you.

The lotus flower is another symbol of rebirth.  The Sanskrit word for lotus, pankaja, means “mud-born.” Although rooted in mire and nourished by decomposed matter, the lotus rises each day and opens radiantly into the light. Throughout the day the flowers turn to face the sun as it moves across the southern sky. After sunset the petals close into a tight bud before the lotus descends into the murky soil of the pond or river. We are not separate from the earth. We grow from it and each day is a new beginning. All arises and passes away.

We must be willing to let go of parts of ourselves that do not serve us well. That might mean something as seemingly small as forgoing coffee in the afternoon so we sleep better at night, or as large as leaving a job or relationship that no longer fits who we are becoming. Growing into our fullness requires that we accept the mud from which we come.

Photo credit: Bahman Ferzad
Photo credit: Bahman Ferzad

The butterfly is a ubiquitous symbol of transition, growth, and rebirth because of how the crawling caterpillar enters its cocoon and is transformed into the delicate and graceful winged butterfly. But this process needs effort to work, as Paulo Coelho describes in his Dec. 2007 blog entry “Lesson of the Butterfly.” A man watches “a butterfly struggling to emerge” and decides to help it by cutting open the cocoon, but the butterfly never flies, never even opens its wings, remaining shrunken and shriveled:

What the man – out of kindness and his eagerness to help – had failed to understand was that the tight cocoon and the efforts that the butterfly had to make in order to squeeze out of that tiny hole were Nature’s way of training the butterfly and of strengthening its wings.

Psychotherapy is not painless. People wanting to change must face fundamental aspects of themselves that no longer (or never did) serve them. The obstacles we confront help us to be whole; avoiding them never does.

It’s popular in social media to present lists of “5 ways to cure” this or that. Such lists simplify and distort what is often difficult inner work. Some psychotherapy sessions are smooth and feel-good, but if every session is like that, the work may not be deep enough—for surely change involves difficulty.

We can be born anew each day, and in every moment. Many traditions teach lessons about renewal. Mindfulness meditation, when done regularly, can provide the foundation to live each moment and then let go of it as the next moment comes.

What are the important images in your life, and what do they say about you? Find the images that form inside you, as you listen to stories, poetry, or in the silence of the meditations. Your image could be a butterfly, a lotus flower, even a humble loaf of bread (which can’t be made without punching and kneading). Allow images to form in your awareness, and then bring insight and understanding to what they might symbolize.

Think of a story that was central to you and your development. For me, the tortoise and the hare was important, and one I have returned to many times in my dreams and as I face challenges.

You cannot live without dying. You cannot live if you do not die psychologically every minute. This is not an intellectual paradox. To live completely, wholly, every day as if it were a new loveliness, there must be dying to everything of yesterday, otherwise you live mechanically, and a mechanical mind can never know what love is or what freedom is.

~ J. Krishnamurti

We need stories to grow.

Habits are hard to change. There are ways to help you keep realistic resolutions. This NY Times article summaries several studies that show ways to make good habits stick.

By 1 Comment

Every Ornament Tells a Story: Coping with Holiday Stress

ornament

Two weeks into December, and I had no holiday spirit. I had no desire to decorate or to do what I have done for the last 25 years. I am not a bah-humbug person! I love the holiday season: the tree with its hodge-podge of ornaments hiding in the branches illuminated by colored lights; magic memories from my childhood; reading “The Night Before Christmas”; and the magic come newly alive in my own daughters.

That magic was never just about presents. It lay in the expectation, the surprise, and the stories, like the ones I created about each small ornament, tucked into the branches. The glass moose was grazing on the evergreens, the pink elf was watching over the skiing Santa, and the rat king was just inches away from the prince. Every ornament has a history that began from its entrance into our household, and I remember most every one.

But this year was different. I dreaded getting out the boxes or ornaments and mantle decor. I dreaded the holiday parties. I was not inspired by any of it. And while it may have been unusual for me, I know that the holidays are fraught for many. For example, our feelings might not match up with the ones we’re supposed to have. When our emotions aren’t congruent with our expectations and the mood we perceive around us, they feel inauthentic and out of synch. Instead of being the one time of year when everyone comes together in love and support, the holidays can throw a spotlight on a year’s worth of things left unsaid, hurtful words that should never have been said, and all the ways last year’s New Year hopes didn’t pan out. And of course, there is the nearly ubiquitous overconsumption (food, alcohol, shopping) which can create conflicts, guilt, debt, or other problems.

Expectations, Overconsumption, and Depression

In my psychotherapy practice, I often see people who don’t just dislike but hate the holidays. For some, the season reminds them of childhood Christmases when mom and dad would argue, or maybe dad fell off the roof putting on the lights because he was drunk. For others, their kids have left the nest, and all the seasonal rituals feel empty without them. And some parents make the horrendous mistake of using the holiday to announce to their kids that they’re getting divorced, leaving terrible associations for my clients. Although Christmas music and decorations dominate the month of December, holiday stress bleeds into our culture so that people who don’t celebrate Christmas are affected. Families who celebrate other holidays, or none, can feel mixed emotions around this time of year.

I work with people who are experiencing loss of various kinds during the season: loss of an elderly parent; a marital separation; a job loss. The analogy I sometimes use is that this period of their lives may be like a tree weathering a bad year. Growth rings aren’t always even; drought, disease, or just a northern exposure can affect the ring’s thickness and shape, and so the tree trunk’s straightness. In time, their lives would be like that tree, incorporating the unique patterns formed in the process of living.

Nothing is ever perfectly straight. If it was, Christmas trees would be like the artificial ones in shops decorated with perfectly matched bows and garlands. There are no broken ornaments, but also none made by a child’s hands, or passed down from grandma, or chosen together by a young couple. Finding the joy in the season doesn’t require perfection. The imperfect family, the broken ornament, or the crooked tree all offer opportunities for reflection and stories told around the fire.

This poem by Rabindranath Tagore expresses some of the complexities of the season. In living alongside the joy and sorrow it becomes easier to find meaning in a season that remembers so many stories.

 He it is, the innermost one, who awakens my being with his deep hidden touches.

He it is who puts his enchantment upon these eyes and joyfully plays on the chords of my heart in varied cadence of pleasure and pain.

He it is who weaves the web of this maya in evanescent hues of gold and silver, blue and green, and lets peep out through the folds his feet, at whose touch I forget myself.

Days come and ages pass, and it is ever he who moves my heart in many a name, in many a guise, in many a rapture of joy and of sorrow.

      Gitanjali, with an introduction by W.B. Yeats, Scribner Poetry, 1997.

Gradually, almost imperceptibly, I came out of my funk and realized that I felt like my usual self again. Recognizing that emotions can be mixed during this time of year, allows for acceptance of feeling that doesn’t fit the season’s glitter and glam. As Tagore wrote; days come and ages pass, and enchantment joyfully plays on our hearts in the varied cadence of pleasure and pain.

If you are having difficulties coping with holiday stress, this article from APA has some good suggestions.
—

By Leave a Comment

Procrastination: Scratching Items off the Mental To-Do List

When tasks overwhelm
Getting Unstuck: Finding Flow Again

A lot of our stress comes from holding our undone tasks in mind; the more we have, the more they weigh upon us. Sometimes it’s not our actions but the actions we’re not taking that cause us stress. If we can generate ways to off-load the things on our to-do list from working memory, we are freed to focus on one thing at a time, relieving a sense of burden and at the same time allowing us to be more productive.

Full Engagement & Wholeheartedness

This idea of doing one thing at a time with full engagement of attention has been seen as crucial to a sense of well-being by many observers. In David Whyte’s book Crossing the Unknown Sea, he describes an exchange with Brother David Steindl-Rast, who says: “You know that the antidote to exhaustion is not necessarily rest? . . . The antidote to exhaustion is wholeheartedness.” (p. 132, emphasis original)

Finding Flow in Difficult or Unpleasant Tasks

This idea of full engagement as a part of well-being was observed by psychologist Mihaly Csikszentmihalyi, who researched the concept of “flow.” Tapping into this idea, he observed that when people are engaged in an activity that is moderately challenging( neither too easy nor too hard), allows some creative problem-solving, and absorbs the mind, they report that they can be lost in a task with little sense of time passing. On emerging, they feel a sense of satisfaction: pleasure in achievement, but also pleasure in the intrinsic reward of being fully engaged in something interesting.

It’s important, then, not just to focus on the product of your work—the outcomes, the problems solved, the things you get to cross off your list—but also the process. If in addition to achieving good work you are also using your skills and challenging yourself to improve, that, in and of itself, is gratifying.

A recent study, reported on in a New York Times piece, explored how people make decisions—and turned up some surprising findings. Researchers asked subjects to carry a bucket down an alley; they could pick a bucket close by, or an identical one closer to the alley’s end. Believing that people are inclined to save physical effort, the researchers expected that people would pick the bucket farther away, which would require less carrying. Instead, most people chose the bucket near them at the alley’s start.

Working Memory- The Mental Scratch Pad

They tried this experiment in eight different ways with the same result. Why? Researchers believe that people engage in “procrastination”—taking on tasks ahead of time because it feels so good to get it off our minds, even if it’s more work. We can also call this “offloading working memory.” Working memory refers to holding information in mind for a short span of time, just long enough to complete a brief task, as opposed to short-term or long-term memory, which stores information for later use.

Working memory is a mental scratch pad: once an item is completed, it’s crossed off and thrown away. You may remember from Psych 101 the magic formula 7 +/- 2. On average, humans can hold seven bits of data in mind at one time—plus maybe two on a good day, or maybe just five if you’re tired or stressed. There is a limit to what you can hold in your head at one time. That’s why phone numbers are seven digits.

If we try to hold too much information in our heads at once, it feels stressful, so we’ve developed strategies to offload tasks from your working memory. If you can confidently say, “I know I can get to that later; I don’t have to think about that now,” then you’re freed to focus on just the one thing in front of you. This is the reason behind to-do lists.

The Myth of Multitasking

The idea of doing one thing at a time is something we come back to again and again. It is impossible to do constantly but is something to aim for because of the greater feelings of satisfaction it produces. Multitasking is a myth: when you divide your attention between tasks you are less productive and less accurate.

It’s understandable that people want to offload from working memory, but answering trivial emails (tweets, phone calls), sharpening pencils, and so on, may seem like accomplishing things, but they pull focus from the important tasks. We have to select which of these to respond to and which will get done later.

Of course, a lot of what makes us human—and so successful—is our ability to plan and think ahead: we inhibit automatic, impulsive responses in favor of thoughtful, controlled responses. The kids in the famous impulse-control study who were more successful at inhibiting had higher GPAs, SATs, and higher-paying jobs in comparison to the kids who couldn’t stop themselves from going for the marshmallow. At the same time, we know that scholastic achievement does not necessarily make people happy and that restraining all impulses can make for a life without spontaneity and joy. Finding the balance is a crucial component for happiness.

What is it that makes us feel happy? Maybe it’s the wrong question. It is not happiness we should be seeking; we need to engage in meaningful work. As Eleanor Roosevelt wrote, “Happiness is not a goal, it is a by-product.”

By Leave a Comment

Chronic Pain: Talking About Pain

Synapse process over neuron connection background – 3D rendering

Treating pain is difficult for several reasons. Narcotic painkillers bring with them addiction and other problems, but the medical system isn’t set up to handle behavioral interventions that can help pain management, as I wrote a couple of years ago in a post on “A Behavioral Approach to Treating Chronic Pain and Medical Problems.”

Another reason brought out by Joanna Bourke in her July 13, 2014, New York Times Sunday Review column “How to Talk About Pain,” is simply how difficult it can be to put pain into words that other people can hear. Partly, Bourke writes, this is due to the introduction of effective anesthetics and analgesics, which paradoxically turned describing into complaining:

In earlier periods, doctors regarded pain stories as crucial in enabling them to make an accurate diagnosis. But within a century, clinical attitudes had radically changed. Elaborate pain narratives became shameful, indicative of malingering, “bad patients.”

How are patients encouraged to describe pain today? Often, it’s by picking a number on a scale—sometimes according to a series of increasingly distressed-looking cartoon faces. This might be enough for emergency use, but there’s more to the experience of a chronic pain patient beyond “6. Hurts even more.”

A study published in Proceedings (Baylor University. Medical Center) underscores these findings: “Acute and chronic pain not properly assessed can result in inadequate pain management outcomes and can negatively affect the physical, emotional, and psychosocial well-being of patients. Pain assessment is the cornerstone to optimal pain management.”

For Bourke, assessing pain means listening to the patient:

Pain will always be with us, and by listening closely to the stories patients tell us about their pain, we can gain hints about the nature of their suffering and the best way we can provide succor. This is why the clinical sciences need disciplines like history and the medical humanities. By learning how people in the past coped with painful ailments, we can find new ways of living with and through pain.

Fanny Burney (1752-1840), the English novelist and diarist, wrote a searing account of her breast-cancer operation—sans anesthetic—in 1811. Reading it with a sense of history should give any clinician a better sense of the nature of suffering.

I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still! so excruciating was the agony. When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound – but when again I felt the instrument – describing a curve – cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose & tire the hand of the operator, who was forced to change from the right to the left – then, indeed, I thought I must have expired. (The Oxford Book of Letters, 1995, p. 203)

Modern medicine has impoverished the language we use to describe our suffering.