Hellhole… the one we put ourselves in.

Self-imposed isolation is more destructive and debilitating than you might imagine.

The March 30,2009 issue of the New Yorker magazine contains a disturbingly informative article by Atul Gawande titled HELLHOLE, in which he describes the psychological horrors of long-term solitary confinement.  His focus is on the American penal system, and his article makes a compelling argument for changes that should and could be made if we are to reject the  infliction of torture on our own citizens – even those who have committed heinous acts. 

Though perhaps not intended by Mr. Gawande, his article also brought me some insight into the destructive force of a different kind of isolation:  the self-imposed, emotional kind.  This is not the complete physical isolation represented by the solitary confinement discussed in Atul Gawande’s HELLHOLE, yet may be more prevalent and in its unique way just as destructive.  This kind of self-imposed isolation happens when a person retreats within themselves and ceases to communicate with others in any meaningful way.   This kind of “emotional sheltering” is a core symptom of psychosis, but can also happen when an otherwise well-functioning person simple stops maintaining congruence between his/her inner life and the daily reality they live.   According to one prisoner Mr. Gawande interviewed, “After a few months without regular social contact…. he started to lose his mind.”  While the meaning is clear in the context of the article, it begs the question of what constitutes “regular social contact.” 

Self-imposed emotional isolation – being a form of social isolation – can be presumed to cause mental and emotional suffering as well as interpersonal alienation.  These in turn, though perhaps falling short of causing one to lose ones mind,  can be presumed to potentially cause serious mental distress. 

Mr. Gawande goes on to state something commonly accepted by psychotherapists:  “Everyone’s identity is socially created:  it’s through your relationships that you understand yourself…”.  So we can then again presume that self-imposed emotional isolation can result in the loss of our sense of identity.

The point is, it can be crucial to your mental health and emotional well-being to have relationships that allow the free expression of ideas and feelings, and provide us a reflection back regarding our congruence or incongruence with personal and community standards.  Not that we must always adhere to those standards, but so that we will know, from the feedback of others, when we do and when we don’t.  Only then can we make informed and thoughtful decisions about our thoughts, feelings and conduct, and to the possible positive and negative consequences we may face. 

The “hellhole” of isolation and alienation from those around us can also be self-perpetuating, in that some isolation can result in increasing isolation, until the alienation is more profound that we ever expected or intended.

If you are feeling alone, and also feel that no one else could or would want to listen to you if you really said what you think and feel, it’s important for you to find someone who will help you to see that everything you feel can be spoken aloud and considered for it’s meaningfulness to you.  Starting with one person will help you to learn how to speak your truth to others (even if they are “selected” others), and will end your deep feeling of loneliness and alienation.

A qualified professional psychotherapist, who will listen and reflect but will not judge, is a safe place to start to let a little sunshine in.  You’ll be surprised how quickly the shadows recede.   Make an appointment today.

The Dignity of Daring… one more reason for psychotherapy.

Engaging in psychotherapy should be both challenging and affirming.  

You can learn about yourself in unexpected ways, becoming more aware of the impact you have on others and how your thinking and actions can impact your own future.   Some people who have not yet made the commitment to therapy with a professional therapist ask a reasonable question: do I really need a qualified professional psychotherapist to help me see myself more clearly?  Why not just ask my good friends for some honest feedback?

Of course it’s a great idea to talk with close friends about difficult feelings and personal challenges.  It can help to bring you important perspectives on your thinking and feelings, and on your behavior.  It can also help to strengthen the bonds between you and your friends that will sustain your relationship over time and help those relationships to weather periods of strain so that you can come to trust the durability of the friendship.

Still, having a professional therapist, not centrally involved in your life, who will both support  you and challenge you, help you search for answers and, more importantly, help you to ask the right questions, is a unique feature of psychotherapy that offers you a chance to achieve a different kind of personal growth.  The words of Karl Von Durkheim so nicely state this phenomenon: 

“The man, who, being really on the Way, falls upon hard times in the world will not, as a consequence, turn to that friend who offers him refuge and comfort and encourages his old self to survive.  Rather, he will seek out someone who will faithfully and inexorably help him to risk himself, so that he may endure the suffering and pass courageously through it.  Only to the extent that man exposes himself over and over to annihilation, can that which is indestructible arise within him.  In this lies the dignity of daring.”

This then is the element of psychotherapy which is not reliably found among the most well-meaning of friends and family.  This intent and capacity to both support and encourage you to risk your emotional comfort so that you might discover new and important things about yourself is central to effective therapy.  When your desire for personal growth, or your determination to end your emotional pain, moves you to talk about it, try both kinds of help: 

Talk to your friends for support, and make an appointment with a qualified psychotherapist to get the kind of help that will challenge you to change yourself and thereby change your life.

Call today to make an appointment.

Couples Counseling: How tender are dreams?

 Couples counseling is common these days.  Many couples engage in couples counseling with an aim toward improving the quality of their relationship.  There are of course those times during the ups and downs of a relationship when couples feel they have entered a period of persistent downs and may seek counseling to help get things back on track.   They may even feel the burgeoning of the pain and anger that has been sitting in a quiet recess for too long a time, and the impending dissolution of the relationship if they do not seek professional assistance.  This is when the therapist is called, consulted and asked to help the couple find out what, if anything, will reduce their conflict and re-kindle their romance.  Most therapist are familiar with these situation even though the particular pertinent issues differ.   What in the past was less typical, but now is increasingly common, is a call asking for assistance in solidifying the mutual love and contentment that is already in place,  as a prophylactic measure against anticipated stresses on the relationship.  These new and anticipated stresses may take the form of a planned pregnancy that will change and challenge the couple’s everyday routines and assumptions, it could be the anticipation of a lengthy separation as when one spouse is deployed to active military duty, or it could be the early discovery and diagnosis of a long-term illness that has not yet made its impact felt. 

What is also common is that under these stresses couple can forget the tenderness and gentle tentativeness with which they first came together to commit to nurturing and nourishing each other.   In so many instances, though now surrounded by seemingly permanent people and things, it was those tender, tentative dreams that grew into the relationship that now feels like everyday life.  Lives seem so cluttered, with nice and not so nice events, with hopes that still thrive and those that have withered for one reason or another.    Sometimes we have but to re-capture the moment when we had only ourselves to offer,  in order to remember what love really is.  W.B. Yeats put it this way: 

Had I the heavens’ embroidered cloths,

Enwrought with golden and silver light,

The blue and the dim and the dark cloths

Of night and light and the half light,

I would spread the cloths under your feet:

 But I, being poor, have only my dreams;

I have spread my dreams under your feet;

Tread softly because you tread on my dreams.

 

When a couple decides to explore ways, or even reasons, to rekindle the romance they once felt, or to inoculate that romance against an anticipated storm of stress, it’s often helpful to begin with the simple dreams that you once spread before  one another and rebuild your romance as new rather than patch what it has become.  Perhaps Yeats will help to remind you of those earlier times, and of the importance of seeking professional assistance sooner rather than later.

 

 

 

 

 

 

 

 

 

 

 

 

 

Anxiety treatment: simple common self-care tips.

Intense anxiety, such as in Panic Attacks, can be scary and can undermine your ability to live a happy and productive life.  But even mild unnecessary anxiety can interfere with your day-to-day contentment and peace of mind.  Some amount of anxiety in normally provocative situation is to be expected, but when there is no apparent or reasonable cause, feeling anxious is an unwelcome and troublesome experience.

Here are some tips for reducing everyday stress and anxiety that just make sense for improving your general health:

• Try to exercise regularly, whether it is in an organized or competitive sport or simply walking briskly for at least 30 minutes several times a week.  You should challenge yourself “just a little” in terms of distance and pace, but don’t over do it.
• Reduce your intake of caffeine and sugar.
• Eliminate or reduce  your use of alcohol and illegal drugs.

These simple self-care steps are the beginning of any serious treatment for anxiety, and for these you don’t need a professional to talk you through them!  So go ahead and take better care of yourself, and reduce your stress and anxiety as a benefit.

Panic Attacks? Treat it with progressive exposure.

Do you sometimes have Anxiety Attacks or Panic Attacks, but usually in specific situations?  Perhaps when you get on an elevator, or when you’re entering a parking garage.  When you experience intense anxiety in particular situations it is often possible to successfully treat these attacks through what is called Progressive Exposure.   Progressive Exposure is a technique that uses small steps of increasing similarity to the place or situation that causes you anxiety.  As you get comfortable with the beginning steps, you then move to the next step, then the next, until you are better able to tolerate what previously was frightening.

There are important elements to Progressive Exposure treatment:

• Start small – engage in a small enough part of what frightens you that you can endure it and eventually relax with it.
• More frequent exposures will help you make changes faster.
• Move on to a higher step once you have relaxed with a lower step.

Progressive Exposure treatment, in the beginning, often works best with the guidance and coaching of a qualified mental health professional, but once you understand the technique and have mastered the initial steps it is easily done on your own.  Just remember to start small, go slowly, and use positive Self Talk (see previous post on Panic Attacks and Self Talk).

Panic Attacks can be successfully treated.

Panic Attacks? Treat it with positive Self Talk.

Do you sometimes feel panicky, and afraid that you will “lose it” or be unable to get to safety?  Perhaps you then tell yourself “I can’t make it” or that “Something awful is about to happen.”

 The inner conversation we sometimes have with ourselves  is called “Self Talk.”  Self Talk can be both beneficial and detrimental to your ability to cope with circumstances confronting you, depending on the kind of Self Talk you do.  When you encourage yourself, and remember positive experiences, Self Talk can be supportive and can even serve as a method for reminding us of the proper sequence of steps toward a successful outcome.  This happens when we “pre”-talk ourselves through a difficult phone call, or a golf shot, or making a toast at a wedding.  Sometimes though our Self Talk can turn negative.  This especially true when we have lost confidence and are now facing a challenging situation, as when we feel an Panic or Anxiety Attack coming on.  Then we can frighten ourselves with Self Talk that undermines our confidence that we can manage our anxiety. This negative Self Talk usually takes the form of dire predictions like “I’m going to die”, or “I’m losing control.”

Learning to identify and change your negative Self Talk will help you to maintain control of  your responses to anxiety provoking situations.  You can learn to identify and change your Self Talk by thinking about it as soon as you begin to feel anxiety.  Ask yourself what you are “saying”, and then change the message to one that you know is more accurate.  For example, when your heart starts pounding, instead of listening to Self Talk telling you you’re going to pass out, change the message to “I notice my heart is pounding, which means I’m feeling anxious.  Even though this is uncomfortable, I know that I am not in danger, so I can relax a little.”   This new Self Talk message both validates your physical experience and, importantly, cancels the negative internal message that undermines your self confidence  and self control.   The best part is that for many people who have Panic Attacks this technique works to reduce the number and the severity of the attacks! 

Learning new Self Talk skills is best done with assistance and coaching from a qualified mental  health professional.   If you are experiencing Panic Attacks make an appointment today and learn to talk more nicely to yourself.   By doing so you will begin taking back control of your life.