O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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The Buckeye: Intimations of Spring

In psychotherapy we go through the dark winter of our soul to find the spring and our wholeness.
The first California Buckeye of spring.

Spring is still a ways away where I live in northern California. The air is fresh; the sunlight brightens the green hills surrounding our mountain. The evenings are becoming just noticeably longer. The opposite coast, from Boston to Maine, saw 30 inches of snow in just a few days. Sensational news stories tell of people stuck in their homes with snow blocking doorways and covering cars.

It might be hard to believe in spring back east, but during my hike in the foothills this evening, the California buckeye trees—always the first to show their green leaves—were magnificently preening against the backdrop of a the late western sun. The Valley oaks will leaf out in a month or so, but until then, the buckeye takes center stage.

In the Greek myth, Persephone is the daughter of Demeter, goddess of the harvest. The beautiful young Persephone is abducted by Hades and taken to his kingdom in the underworld, where he makes her queen. Her mother grieves for her so intensely that nothing grows, introducing the first winter to the world. When Persephone emerges at last, Demeter relents and releases her stranglehold on the earth, letting the tender shoots and tendrils which had been underground unfurl toward the warm sun. The cycle repeats each year.

As for us, by mid-February the urge to shed accumulated winter layers of clothes, pounds, and clutter settle into the collective psyche. Days lengthen and we move outside, toward the grill, or to a patch of weeds. Weeding is therapeutic. Digging the damp dirt, just deep enough to feel the fragile weed roots and gently shaking off the dirt clumps while careful not to disturb those humble tillers, the earthworms, reminds us of the inevitability of change. And that while frost covers the earth, life continues to work underground, below the surface of what is seen. Like Persephone, we emerge from winter to notice the results of underground happenings.

Psychotherapy Provides a Safe Place to Grow into Wholeness and Fullness

When people enter psychotherapy, they are encumbered with layers of accumulated mud. It takes many forms—secrets, sadness, and shame—but alongside the difficulties that motivate people to seek counseling, there is a drive to be whole. It’s manifested in the desire to take care of yourself by reaching out beyond your circle of family and friends to move forward in life, to find a neutral, safe place to explore where you’ve been and who you’ve come to be.

Taking the step to make a call, to schedule an appointment, and to find a way to pay for therapy is a beginning. When new clients arrive in my waiting room, it is with mixed emotions—fear and dread certainly, but also excitement because they have taken the initiative to shake off the dirt and move toward the growth that will surely bring healing. The first appointment brings relief co-mingled with excitement about the prospect of change.

These hints, these intimations that spring is near—just around the corner of the calendar—reconnect us with the ancient knowledge that it is only by going into the dark places within that we can emerge into the fullness of our individual uniqueness. Along with cultivating our gardens, we can cultivate ourselves.

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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.

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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.

 

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Summer Travels and Travails: Tips for Stress-free Vacations

 

Tips for Making Summer Vacations Stress-Proof: or at least stress-resistant

By now, most of us have either taken the long-awaited summer vacation or are in the midst of planning the final details of packing.  Whether you are fantasizing or fretting at this final stage of planning your vacation, there are several things you can do to ease into a trip.  Despite the sub-title, it is highly unlikely that there is such a thing as a stress-free vacation.   But by keeping a few concepts in mind, you can minimize the strain of travel, whether you are traveling alone, or with your partner, and even with the whole family.

Frantic trips to the travel section of the local drugstore for more bottles of hand-purifier or TSA approved packing gear add to the tension that precedes a trip. Last-minute hunts for supplies often attempt to manage travel anxiety.  Travel anxiety is normal.  In a piece about in-flight emergency medicine, the (June 21st) issue of the New York Times revealed the extent of this commonality:  When the captain of an international flight asked passengers if anyone had a pain-reliever for a sick passenger, only two or three hands went up, but when he asked if anyone had anxiety medication, fifty hands shot up.

If your expectations for a much-anticipated trip are too high, you may come home disappointed. Whether you get lost and miss your reservation, or you just get too tired to do everything you hoped, things rarely go exactly according to plan.  However, we can combat anxiety and disappointment by both setting realistic expectations and by allowing for the unexpected.

Accept that when you travel you take yourself with you.  You will get cranky or may develop some form of ailment, as minor as constipation or as major as a broken bone or appendicitis.   Unfamiliar noises and foreign beds disrupt sleep and add to everyone’s irritability.

Accept that being in a new location does not eliminate familial disagreements. Unless you are taking along a nanny, or are planning a trip that includes childcare such as a cruise or a Club-Med vacation, be prepared for family strife and squabbles.  Kids are going to complain of boredom. They will roll their eyes. They will be embarrassed by you.

Don’t expect kids to want to do the same activities you want.  Travel is an opportunity to teach compromise.  Look for child-friendly activities but don’t deny yourself the activities you enjoy.  Take turns in picking activities for each day.  Look for activities that involve the whole family as well.  Our family made a habit of listening to audiobooks on every driving vacation we took.  We let our daughters pick the book and were delighted with their choices.  Listening to books became so absorbing, that often when we arrived at our destination, we would continue listening in the cabin, tent, or hotel room.  It became a shared experience.  When tension became elevated due to hunger, PMS, or general irritability, we could use the characters in the book to express our feelings.  When we were all invested in the plot, a discussion of the book would help us all get over any bad moods.  Over the years, our family has listened to over 100 books.  (If you would like a list of our favorites, please email me.)

One of the advantages of listening to books as a family is that it is shared. Unlike letting each kid have his or her own movie or game, you can talk about the book together. Video games and movies are solitary.   Many families I see will spend a week or two together during their summer vacation, but hardly interact, each immersed in his or her own activity.

Accept that even in the most spectacular location, being together 24/7 is challenging.  Enjoying that beautiful sunset sometimes takes effort when you are angry with your spouse. When my husband and I set off on a trip to Chile, we predicted at least one argument.  When it inevitably occurred, we were able to laugh it off and said, “at least it’s over with now”.  You will not agree on everything.  As I say to couples in therapy, “you will never resolve conflict, but you can manage conflict.”

Accept that being away from home and routine does not automatically improve a couple’s sex life. Couples will often fantasize about the great sex they will have once they are away from the stress of daily life.  This almost always leads to problems—one partner will feel let down, and the other guilty.  Look for opportunities to be intimate emotionally, and let the sex follow from that.

Most of all, accept that travel causes some degree of anxiety.  Anxiety will take a different form for each of us.  Unfortunately, rushing around town for travel supplies when you are down-to-the-wire creates more stress because it crams frenzied shopping into the final days before embarking, leaving little time to relax before your flight or drive.  Think about non-medicinal strategies that help you relax.  Weave those into the week before travel.

Travel is an opportunity to know yourself in new ways.  Allow for surprise.  Remind yourself to be in the moment, to appreciate the world from a new vantage point.

As you cover the ground outwardly, develop fresh interpretations of yourself inwardly.

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Appreciating the Absence of Pain

 

You don’t appreciate not having a toothache until you have a toothache.  Sitting in the endodontist’s chair last week, I was asked if my tooth ached.  I paused for a long moment, and then replied, “ache is a very vague term”.  We both laughed.  Pain is difficult to measure.  Equally difficult to measure is joy– elusive and fleeting.

Thich Nhat Hanh used the toothache analogy when he spoke to a group of therapists many years ago. “When you have a toothache, you are enlightened—you know something very important—that not having a toothache is a wonderful thing. “

He further elaborated; “when you do not have a toothache, you don’t seem to enjoy it—peace is there in the present moment, but we find it boring and that is why we look for something more exciting”.   It feels so good when a toothache finally goes away.  If only we could appreciate the absence of that pain all the time.

Not all pain can be resolved by a dental procedure.  We are surrounded by pain in our work.  We see so many varieties of suffering, some themes repeated like a familiar chorus, others particular and unique to a single human being.   Our hearts ache with the daily news from places both remote and in our own backyards.  But when we experience extraordinary pain, we remember how fortunate we were for the time when pain was absent. Most of the time, however, we slug through our days, not noticing the absence of pain.

During the root canal, I listened to a favorite playlist on my iPod.  Steve Jobs had died a few days before.  I could not help but silently thank him for the music that distracted and entertained me, drowning out the sound of the drill.  Like many, I shed tears when I heard the news of the great man’s death. Grief is too strong a word for my feelings.  Rather, I felt a tender softness for the man I never met, for he enhanced my life at almost every turn.  From the podcasts that enrich me, to the MacAirbook that keeps track of my notes and projects, power points and photos, to the iPad that keeps me from double booking my clients (most of the time) and gives me a library full of books, and finally to that most magical of devices, my iPhone—that lets me check the weather, the news, the map, and gives me countless sources of entertainment.

Technology has enhanced our lives.   We have become experts at multitasking.  But it is in the moments of quiet, when our senses are awake, that we can feel the absence of ache.

Autumn has arrived.  October is my favorite month.  It is the month of my birth, but that is not the main reason I love it.  I love the long shadows and the harvest moon.  The light and the darkness meld into one another as the center of day holds until it succumbs and leaves the evenings long, for soup, for hearth, for stories.

And with the arrival of autumn, the holiday season approaches.  Our clients feel the tug of opposing emotions—joy, gratitude, resentment, and disappointment. We listen.   And we try to help integrate their dark and light.

But at the end of the day, we must shed our helping selves for a time, so that we can appreciate the absence of ache.  So that we can enjoy the moments that, when strung together, give us that delicious taste of all that is good in our lives.

“Be hungry, be foolish.”  Mr. Jobs spoke that advice at Stanford after hearing of his cancer diagnosis.    As we head into this holiday season where autumn fades into winter, let’s remember to be hungry for creative urges, for love, and for all that feeds us around the hearth. In our consulting rooms as we listen deeply to our clients as they work with their pain let us be present.

I remind myself to be playful and look for newness even if it seems foolish.  Mindful living is to be in touch with life—in order to enjoy the presence of your non- toothache.

Originally published:  President’s Column October 21, 2011