O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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We Fear What We Cannot Control: Acknowledging Pain and Suffering

Learning to live with the things we have no control over.The German airplane crash by a suicidal pilot, the Florida shootings, the Boston bombings. Every week, we read about innocent people getting hurt or killed. We try to avoid pain and suffering; we teach children to look both ways before crossing the street, wash their hands after using the bathroom, and not to get into strangers’ cars. Even as we reassure our kids that no monsters live under their beds, we know that in the apartment down the street, there lives a convicted sex offender. How do we cope with life’s uncertainty and fear?

 

The Monster Under the Bed

We are saturated with information. Not long ago, we’d read a morning or evening newspaper and maybe watch the evening news; today, the news cycle is 24/7. And, because dramatically scary stories get our attention, the media makes sure to foreground them—not just what’s happening locally, but world-wide. We end up perceiving fearful threats all around us. The truth is, though, that we tend to overestimate certain kinds of risk while underestimating others. For example, as the Vancouver Sun notes, “We warn our kids not to talk to strangers even though 90 per cent of sexual abuse is committed by someone a child knows. And we freak out about plane crashes despite the fact driving is about 65 times more dangerous.” (“How much risk do you live with?”)

Studying how people evaluate threats, or “risk perception,” helps show why this is so. Psychologist Paul Slovic has studied the subject for many years; here, blogger Sara Gorman sums up his findings: “People tend to be intolerant of risks that they perceive as being uncontrollable, having catastrophic potential, having fatal consequences, or bearing an inequitable distribution of risks and benefits.” Plane crashes feel more uncontrollable than car crashes; strangers feel scarier than people we know. But control is an illusion. Life is full of uncontrollable things, people, and events, so how do we handle risk?

We cope by using reason and denial. Reasonably, we know that life always involves some risk and that we have a natural tendency to inflate threats. You can probably think of one thing you tend to worry about needlessly or unproductively. Can you really do anything about it? Needless worry robs us of a sense well-being; straining to control things beyond our reach only creates tension. But wait—denial? Isn’t that supposed to be a bad thing? Yes, denial is counterproductive when it keeps you from acknowledging harm that you’re doing to yourself or others, like smoking, cheating on a spouse, or abusing your child. But psychologists recognize that the use of denial can be advantageous in many situations. According to the Mayo Clinic, “A short period of denial can be helpful. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information . . . . For example, after a traumatic event, you might need several days or weeks to process what’s happened and come to grips with the challenges ahead.” Be patient and gentle with yourself in the wake of trauma.

We also must learn to balance risk against what we lose by being too careful. When we’re too sensitive to fearful possibilities, we become paralyzed. Not letting your daughter walk home from school with her friends because a car could run a red light, or a vicious dog might be on the loose, may seem protective. But overprotectiveness is harmful because it deprives children of practicing the mastery and independence they need to grow up successfully. And, more subtly and unintentionally, your anxiety seeps into her without either of you knowing the source.

 

What if the monster under the bed survives because your imagination feeds it every night?

 

Kids need to find their own strength by testing themselves in the world. That can start as early as learning to sleep alone, in their own beds. (While in some cultures sharing a family bed is the norm, children may be given other opportunities to practice self-soothing and frustration tolerance.) Kids and parents often resist the stage when they need to soothe themselves to sleep. When we know our child is distressed and may be fearful, we rush to give comfort. But allowing a child to sleep between her parents can come at the expense of intimacy in the marriage. By resisting letting a child sleep alone, parents deprive them of learning to calm themselves and tolerate frustration. For a fuller explanation of this problem and how to address it, see Dr. David O’Grady’s “Help Your Child Sleep Alone: The Snoozeeasy Program For Bedtime Fears. ”The important thing is that we convey trust that our child can manage the little and big things that come their way and feel they have the ability to self-regulate their emotional reactions.

Of course, being able to manage emotions doesn’t mean that bad things don’t happen. In mindfulness practices, we teach that suffering is an inevitable part of living. Sickness, accidents, money problems, frustrations, and worries: There is much in life that we have no control over, and as if worrying about the present isn’t enough, we tend to ruminate over past events or future possibilities.

Even spiritual people who actively practice mindfulness can’t escape suffering. In fact, “life is suffering” is the first Noble Truth of Buddhism. I remember listening to an audio interview with the Dalai Lama, the Tibetan Buddhist leader known for his calm serenity. He coughed and hacked his way through the interview, clearing his throat every few minutes. It was an unpleasant sound, but because I was on my treadmill, I didn’t want to stop and find another CD. I suffered along with the Dalai Lama. At the conclusion of the interview, he took questions from the audience. The question was asked; “Dalai Lama, do you suffer?” He answered, “Of course I suffer, I have been coughing this entire time and it is very uncomfortable.”

And as if present suffering isn’t enough, letting worry about the past or future take hold leads to more suffering. When we suffer from the fears we have about the dangerous, uncertain world we live in, we may think the answer is to run away somehow: shopping, clicking, using drugs or alcohol, or eating when we’re not hungry, for example. But pursuing pleasure doesn’t make our painful fears go away. Instead, our efforts backfire because we feel guilt, or dig ourselves deeper into debt, or become unhealthy—and the fear still exists.

Learning to look at our suffering and accept that it exists is a skill. Meditation or relaxation training can help us develop the skill of self-soothing, thereby enabling us to feel less afraid of both real and imagined monsters. As we do this, we also help those around us to be calmer and stronger.

 

How to Self-Soothe

 

Practice some form of deep relaxation, meditation, or yoga daily. This will change your psychophysiological baseline so that you are generally more resilient when worry or stress takes over.

  1. Accept that that suffering is part of life. We suffer, our children will suffer, and strangers we hear about in the news suffer. Acknowledging suffering helps because we are not pushing fears down, which paradoxically only makes them grow larger.
  2. Develop a spiritual practice. This helps us develop the strength to look deeply at our suffering; the insights gained about ourselves provide perspective and something to hold onto when our fears run amok.
  3. During difficult moments, use a short breathing practice (such as the Three-Minute Breathing Space or just silent focus on your breath) to stay calm during difficult moments. Being conscious of our breathing brings mindfulness to the present moment and helps pause the thought stream of rumination.
  4. Recognize your suffering without judgment. Some fears are truly awful, yet by staying in the present moment, we avoid getting trapped by our thinking. Look deeply at the source of your feelings, find their roots, and work on transforming the fears that need to be changed. This will allow space to nourish the feelings that bring peace and well-being.

This short relaxation exercise may help you to develop skills to relax in moments of anxiety and worry, as well as provide a foundation to help change the automatic, reflexive ways your mind and body respond to stress.  https://youtu.be/TCCA1kGSnB8

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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.

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“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.

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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:   

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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.