Category: Psychotherapy

Golden Rules of Psychotherapy

If at the onset of the therapy treatment, you have diagnosed your client as a Delicious apple, then at the conclusion they might become a Macintosh apple, BUT, rarely a Banana.

A client’s behavior is always correct. Not good, and not bad. Just the best one can do at the moment. That applies to lying, swearing, hitting, singing, dancing, sulking and refusing to eat Kale!

The psychotherapist must be curious. Absent curiosity, most therapy sessions will be boring, even for the client.

When a client enters the therapy session, they will tell you the truth. Albeit, their truth. The search then begins for both you and the client.

 

Will the Real Shrink Please Stand

My Aunt Alice asked me to speak to a group of Hadassah women. She told me that the payment would be seventy five dollars. I accepted the offer, although I was dismayed with the fee. Alice then informed me that it was traditional for the guest speaker to donate the fee back to the Hadassah. At that point I was livid, though outwardly quite calm. I agreed, as I frequently do despite my total commitment to the opposing point of view. She didn’t even wince when she asked me to agree to the charitable donation, as if she knew of my basic passive-aggressive character. Alice took advantage of me, her favorite nephew.

I entitled the talk, “Reflections of a Shrink.” When I told her the title, she remarked, “…but I thought that only psychiatrists were called shrinks.” That did it! I smiled, even laughed at her verbal abuse. My outrage was totally smothered in charm and wit. Of course I was a “shrink “. I had a Ph.D. and not an M.D., but nonetheless, at that time, I had been a “shrink “for 12 years. At that moment I was quite proud of the title, “shrink “.

My aunts’ naiveté was forgivable, but I was left with several revived, yet unresolved conflicts. Foremost was the desire for the real title of Doctor. By that I mean the Doctor of Medicine, i.e. M.D. I had been granted a Doctor of Philosophy in 1969. The title sounded grand, but I had never taken a philosophy course. Besides, everyone knows that the only Doctor worthy of that title is the M.D. type. Veterinarians, optometrists, psychologists and rabbis are granted the title of Doctor, but there is something almost immoral about their use of the title; “Thou shalt not call thyself Doctor, unless thou hast laid bare a cadaver, and/or written a prescription.” (Quote from Hippocrates).

Another stressful monologue that I recited behind my eyes, were the implications of the word “shrink “. Witch doctors, cannibals, and voodoo priests were my images of head shrinkers. If I did anything to clients, it was mind expansion, and character enrichment, and not brain shrinkage. How did the word “shrink “become part of the lexicon of psychology and psychiatry? Perhaps “shrink” is derived from the Chinese, as in shrunk, as in, “My shirt is shrunk “as in the hand laundry sense of Chinese. Nevertheless, my Aunt Alice unknowingly raised serious concerns about popular confusions regarding psychologists and psychiatrists.

The initial confusion appears to be due to the shared first four letters, p-s-y-c-h. Both professions borrow from the Greek word, psyche; that is breath, life or soul. The ” trist ” in psychiatrist is derived from the Middle English word for sad, and Middle French, triste. That leaves us with Psychiatrists who ponder, “sad souls “. The “gist “in Psychologist is derived from the Latin, jacere, meaning more adjacent, or the essence of a matter. Enfin, the Psychologist concerns himself with the essence of souls. The linguistic approach clearly suggests that both Psychologists and Psychiatrists do not engage in “shrinking “anything.

There are several differences between the two disciplines that are noteworthy. Psychiatrists usually charge higher fees for a therapy session. Psychologists sometimes refer to their patients as clients. Psychiatrists never refer to their patients as anything other than patients. Psychiatrists can admit patients to a hospital mental ward, whereas Psychologists usually cannot. Psychologists administer and interpret intelligence and personality tests, and Psychiatrists give drugs. They have more drugs to administer, then Psychologists have tests. Many psychologists would gladly turn in their test kits for the right to prescribe drugs, and watch the ‘ cures ‘ roll in.

Every Psychologist envies the Psychiatrists prescription pad and the power it holds. One might ask, who came first, well I’ll tell you. At the beginning there were Philosophers, the likes of Aristotle, Descartes, and Kant. Following that philosophical tradition, the “science “of human behavior evolved to be studied by Psychologists.

The treatment of mental diseases has traditionally been the province of the medical profession that is psychiatry. Historical events, such as the World War II, prompted the rapid emergence of the Clinical Psychologist as a “shrinker.”  There now exists an uneasy truce between the two professions, and peace will reign as long as the number of patients and, or clients remains high. In recent years, the Social Worker has joined the fray.  The competition for “sad souls” will be fierce should humankind achieve a greater measure of self-worth and good will.

 

 

DREAM INTERPRETATION – IT’S YOUR DREAM

The screen hangs just behind your forehead, between your frontal lobe, and your skull bone.  When the movie is playing you are amazed, bewildered, terrified, joyous, despairing, tormented, hysterical and at times dying – but never dead! The movie seems to last forever, but at times it is a fleeting scene. Black and white, or glorious color. Silent, or loud.  Sometimes music that you know, and other times music of unknown origin. Many scenes repeat ad nauseum, and others are lost forever. The locations and sets are too numerous to list, and the characters, whether animal or human are both real or imagined, and sometimes seem to be both.

As the movie screen is such an intimate part of your being, so is the movie. A unique movie brought to the screen by you. You the director, the producer, the actors, the sets, the sound, the music, the sun, moon, stars, Mothers, Fathers, Gods, and every inhabitant of Noah’s Ark – plus some dinosaurs. Whatever occurs on that screen is your creation. You are totally in control of the movies content, even parts of the script that cause you much pain.

For the moment, I will offer a brief example of your movie, and your role in it. Just imagine a simple scene of and you are sitting in a Carvel store. Clearly you recognize yourself, but you must understand that you are also the vanilla Carvel, the sugar-cone, the store, the lights, the clerk, the cash register, the credit card, as well as the cute tabby cat sitting in the back corner of the shop. Suddenly, an elephant is standing on the sidewalk just outside of the store. Seated on the elephant is your Grandmother, Becky. She is blowing on a trumpet, and the music you hear is a piece by Vivaldi. Once again do not forget that you have created all that you see and hear, including Grandma Becky,  the elephant, sidewalk,  and Vivaldi.

There is no denying that you have created every aspect of the scene.  Who else could display that scene on your screen hanging in your head?  Thoughts are yours alone, as are feelings and such is the case with your dreams.

Now comes the difficult part, that is the Interpretation of your Dream.  While you are the writer, and performer, the movie presents such complexity of script, dialogue, set, character etc., that do not allow for immediate interpretation. You must give alot of thought to explain why you would produce such a movie. It will not be easy, but you own it!

THERAPY – HOW DOES IT WORK

I was recording some ideas on my Sony tape recorder, and suddenly the red record button wouldn’t depress. I pressed again, and nothing happened.    Something was stuck. I pressed several times, changing the force each time, and the button finally went down. I don’t know what was sticking, or why the button finally went down, but it worked.

Have you ever faced that kind of a situation, wherein you attempt a repair and you do something that you can see or feel, but you don’t really know what you’re doing. You just know that if you touch the thing in a certain way, pushing it backwards and forward four times other events take place and they are pleasing – they are right – they are good. Your effort doesn’t work every time, but when it works life is perfect again.

If you think about that kind of situation, such as pressing something yet not knowing exactly what it is attached to, yet you press it three or four times and something happens at some other level, in some other connectedness, in some other interface then something goes, something works. That is similar to the healing arts. The doctors frequently don’t know what the hell they are doing, but they press, push, probe, stick and something happens. That diligence and persevering occurs in psychotherapy.

“Yes, Mrs. Schutlz, I know it seems that we are just talking, but one of the things that happens is that you will undergo some genuine changes. Usually these changes are of a beneficial sort, and after some time everything will work out fine.

“Yes Doctor, but how does it work, how come the talking works.”

“It works – it just works! Don’t you like to be talked to; don’t you feel better when you get talked to? Don’t be silly now; everybody likes to be talked to.”

“But Doctor that’s just paying money to be talked to?”

“You’re right Mrs. Schultz, but something good happens. It is like pulling bones, pressing muscles, or stimulating a cell in the brain with three or four drops of a chemical. Two pulls, or press and three drops and something happens that is good. Who knows why, or how, or what actually happens?

Whatever happens, it feels good. If it doesn’t, we try something else until it feels good. Feeling good won’t happen every time, but sooner or later therapy will work just like my Sony tape recorder. Mrs. Schultz, did I ever tell you about my Sony tape  recorder?”

The Burden of Primary Residence…

During the divorce proceedings one parent may be designated as the Parent of Primary Residence. The other Parent will have some form of parenting time with the children. Surely there are court decisions wherein both Parents will share residency custody, but such a decision is less frequent.

The Parent who is awarded primary residence is now in an extremely powerful position as regards the life of the children. Daily decisions about schooling, health, and social activities are in large part mediated by the residential parent. Depending upon the age of the children, the Parent with whom they reside has not only extensive decision making power, but can significantly affect the quality of the child relationship with the ‘visiting’ parent.

As a simple example, the residential parent determines whether the child is well enough to have visitation with the non-residential parent. A simple cold, or tooth-ache can be used as the reason for cancelling a visit with the absent parent. Another typical situation involves access to phone calls from the ‘visiting’ parent. Often the non-residential parent will not be able to fulfill court ordered phone time with their child, and the gate keeper is the residential parent. Why not allow the phone call? The answer may be that the child is doing homework, punished, sick, busy on a computer game, or the child just does not want to speak with the calling parent. What is the actual case? Is the denial of phone contact due to malice, or a child suffering flu symptoms?

It is critical that when ordering a residential decision that the Parent awarded primary residence be advised that the role is not one of ownership, and ultimate control. The Parent of primary residence bears the responsibility to advance the child’s relationship with the non-residential parent.

The designation of Parent of Primary Residence does not necessarily mean a determination of ‘better’ parent. The decision has various determinants, such as age of the children, nature of the physical residences, and the work schedule of the parents.

Any existing alienation and bitterness felt by the residential parent must be suppressed so that the children can prosper with the non-residential parent. If the child support payment is late, or short-changed, the residential parent is not to use access to the children as retribution. If the non-residential parent must change the schedule, or comes late, or returns the children late, availability of the children cannot be used as punishment. It is important to appreciate that many children would not agree to the court’s decision regarding primary residence, and as such the residential parent bears an additional burden of having to deal with disgruntled children.

The consequences of divorce are fraught with anguish in the best of circumstances, and that is particularly true when children are involved. Faced with the loss of an intact home, and the comfort of knowing that both Parents are present, the artificial, but necessary fracturing of that life space requires a level of parental maturity that is all too often inadequate.