Showing posts with label Emotional Well-Being. Show all posts
Showing posts with label Emotional Well-Being. Show all posts

Saturday, June 23, 2012

Emotions in Therapy

http Emotions and Therapy:/www.psychotherapynetworker.org/magazine/currentissue/item/1702-the-power-of-emotion-in-therapy


The Power of Emotion in Therapy

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MJ2012-1How to Harness this Great Motivator

By Susan Johnson

Neuroscientists have recently established that emotion is the prime organizing force shaping how we cope with challenges. Now psychotherapists are learning how to work with emotion, rather than trying to control it. 

“God guard me from those thoughts men think in the mind alone. He that sings a lasting song, thinks in a marrow-bone.”—W. B. Yeats.
Mike leans forward, and in a low, intense voice, says, “Look. It wasn’t my idea to see a couples therapist. And I hear that this therapy you do is all about emotions. Well, that about counts me out. First, I don’t have them the way she does.” He points to his wife, Emma, who’s staring angrily at the floor. “Second, I don’t wantto have them or talk about them. I work through problems by just staying cool. I hold on tight and use my little gray cells.” He taps his head and sets his jaw. “Just tell me what’s wrong with us—why she’s so upset all the time—and I’ll fix the problem. Just tell me what to say, and I’ll say it. We were just fine until we started to have kids and she started complaining all the time. All this spewing of ‘feelings’ just makes things worse. It’s stupid.” He turns away from me, and the silence is filled with the sound of his wife’s weeping.
The irony of this type of drama never fails to intrigue me. In one of the most emotional scenarios ever—a couple trying to talk about their distressed relationship—here’s a partner insisting that the solution to distress is to ignore the emotion! Worse still, I’m getting emotional! This client is upsetting me. I breathe in and get my balance. After all, I remind myself, what he’s saying is so normal.
Mental health professionals would agree with him. In fact, I agree with him, to some extent. Venting strong, negative emotion—usually called catharsis—is nearly always a dead end. More than that, most of us are wary of strong emotions. Emotions have traditionally been seen, by philosophers like RenĂ© Descartes, for example, as part of our primitive animal nature and, therefore, not to be trusted. Reason, by contrast, has long been thought to reflect our higher spiritual self. In neuroscientific terms, the implication is that we’re at our best when we live out of our prefrontal cortex and leave our limbic brain behind. More specifically, emotion is often associated with disorganization and loss of control. As Latin author Publilius Syrus, known for his maxims, wrote in the first century B.C., “The sage will rule his feelings; the fool will be their slave.”
All this is now changing. We’re in the midst of a revolution, as far as emotion is concerned. Antonio Damasio, one of the great scholars in the emotion field, notes that this revolution began in the 1990s, when the inherent “irrationality” of emotion began to be questioned. We’re now at the point where emotion—the apparently crazy, irresponsible sleazebag of the psyche—has been identified as an inherently organizing force, essential to survival and the foundation of key elements of civilized society, such as moral judgment and empathy. Emotion shapes and organizes our experience and our connection to others. It readies us for specific actions; it’s the great motivator. As the Latin root of emotion, movere(to move) suggests, strong feelings literally move us to approach, to avoid, to act.
Way before this emotion revolution, many therapists accepted that there was more to emotion than simply learning to control it—that directly working with emotion was somehow central to the task of therapy. We recognized that old Publilius was wrong: it’s not always good to control your emotions rigidly, and it’s not always foolish to listen to them! The idea that some kind of “corrective emotional experience” was necessary for any kind of effective psychotherapy was repeated endlessly, at least in the more dynamic psychotherapies. But exactly what the key elements of this experience are and how we get there with our clients remains difficult to define.
Even with this more emotion-friendly attitude, it seems to me that, as a field, we still tend to err on the side of bypassing or containing emotion, rather than actively using it for change. For many years, this seemed to be particularly true in couples and family therapies. It makes sense, in that emotions are especially intense in difficult interactions with loved ones. Therapists have to deal with powerful attachment dramas, which unleash rivers of emotion in their clients, and their own emotional issues can be triggered as they watch these dramas unfold. Such therapists had better know their rivers, and how to swim! Otherwise, it’s safer to sit on the bank, hold on to the traditional distrust of emotion, and try to create change through purely cognitive or behavioral means. But these interventions may not be sufficient, given that emotion and emotional signals are the central organizing forces in intimate relationships and that changes in emotional responses, such as increased love and tenderness, are hard to generate if we don’t work with emotion directly.
For many of us, formal training doesn’t help much here. How many professional training programs—even now, when we know so much more about the significance of emotion—systematically teach how to understand emotion or to engage and use it to create transformation in clients? In clinical psychology programs, young therapists mostly seem to learn how to teach clients techniques for moderating out-of-control emotions. Even if we look at a master therapist who explicitly values emotion, such as the great Carl Rogers, we see less direct focus on emotion than we might expect. So it makes sense that many of us remain a little intimidated or off-balance in the face of the compelling experience of emotion. It’s difficult for us to embrace it as a positive force and use it as a powerful tool for shaping growth in our clients.
“Research tells us that when therapists help clients deepen emotion, clients attain better outcomes in therapy. If we can become comfortable with the power of emotion, it becomes the therapist’s greatest ally, rather than a disruptive force to be contained.”
It’s self-evident that emotion is captivating. If we can tune in to and address clients’ deeper emotions, the therapy process is at once tangibly relevant, and they engage. Research tells us that when therapists help clients deepen emotion, clients attain better outcomes in therapy. When we shape powerful emotional interactions in Emotionally Focused Therapy (EFT), we see seismic shifts in the core interactions that define lifetime relationships. Emotion takes us to the heart of the matter. New emotional mosaics create new perceptions and meanings. Even more important, they move us—psychologically and physiologically—into new response modes. If we can become comfortable with the power of emotion, it becomes the therapist’s greatest ally, rather than a disruptive force to be contained.
Even if we view emotions as essentially problematic, damping them down or circumventing them is no small task. Therapists often try to defuse negative emotion with such techniques as structured skill-building exercises, but the emotion usually seeps through and takes over anyway. We’ve all seen empathy or positive communication exercises miss the mark when they’re done with flat facial expressions or hostile tones. Physiologically, the attempt to suppress emotion is hard work, often resulting in increasing arousal. James Gross, a key researcher in affect regulation, finds that interactional partners pick up on this increased arousal and become more agitated themselves. We can all relate to the argument that goes: “You’re mad,” “No, I’m not” (said with clenched teeth), “Yes, you are; I don’t even want to talk to you.” But perhaps even more important than the effort required to regulate emotion is the fact that new, positive ideas and actions that emerge in session remain peripheral, unless we feel their force and connect with them on an emotional level.
What do therapists need to know to harness the power of emotion in therapy sessions? I remember when I was an idealistic young therapist starting to work with couples and suddenly coming face-to-face with such tsunami-like emotion that, to be able to stay with and focus on the wave, I needed to see the order, the patterned structure of this experience. As I came to understand emotion better, I gained understanding about the way in which key emotions were constructed and processed. I became less intimidated and learned to embrace and ride the wave, using its force to create change. By learning about emotion, I was able to help clients order these experiences and use them positively in their lives.
I could do all of this because I’d been given a great map: I had Attachment Theory—a systematic framework for personality and relationship development—as a guide. This theory of self in relation to others places emotion and its regulation front and center. John Bowlby, its father, saw emotion as the great communicator. It gives us a “felt sense” of our own physiology—our “gut wisdom.” It connects us with our preferences and longings. It links us to others with lightning speed. For Bowlby, the dance of connection and disconnection with loved ones plays a pivotal role in defining who we are; emotion is the music that organizes this dance and gives it rhythm and shape.
In the case of Mike and Emma, I feel more grounded and calm when I can track exactly how Mike regulates his emotions: he dismisses and denies them. This affects how he frames his signals to his partner—a process that elicits particular negative emotional responses from her. These responses then confirm his need to “hold on tight” and deny his emotions. Emotions aren’t just inner sensations and impulses; they’re social scripts. Self and system are molded in an ongoing feedback loop, which neither Mike nor his partner are aware of. The attachment framework sets out the deep logic of seemingly unpredictable emotions and tells me how and why Mike and Emma deal with them the way they do. There are only so many ways to deal with emotional starvation and the universal experiences of rejection and abandonment. When I know the territory, I feel confident enough to explore the terrain.

Friday, June 22, 2012

Finding Strength in Vulnerability

"When we were children, we used to think that when we were grown-up we would no longer be vulnerable.  But to grow up is to accept vulnerability...to be alive is to be vulnerable."  ~Madeleine L' Engle


The definition of vulnerability...having the capability to be hurt...implies our need for protection, our inherent need to shield ourselves from danger so that we will survive. We are born with the will and instinct to protect ourselves.  So you might say that it runs counter to our natural inclinations to allow ourselves to be vulnerable, to lower our defenses and become open to intense emotions like fear, loneliness, or insecurity; sadness, shame or grief.  Sometimes it's even difficult to open ourselves to what would be considered the more positive or desired feelings, like compassion, or love.  So we are faced with a dilemma.  Do we continue to protect ourselves as we are naturally wired to do...possibly remaining disconnected or isolated in efforts to avoid rejection or pain?  Or do we somehow allow ourselves to live fully, to experience the most whole version of our selves and our lives, opening ourselves up to feel our feelings, to express our feelings and then to experience purpose and possibility?







Monday, November 28, 2011

It is a joy to be hidden, but a disaster not to be found. ~D.W. Winnicott

I am reading a wonderful book right now entitled How To Be An Adult In Relationships: The Five Keys To Mindful Loving, by David Richo.  He explains in his book that we all need the "five A's"...attention, acceptance, appreciation, affection and allowing... to have a successful and healthy adult relationship.  But what exactly does "successful and healthy" mean in regard to relationships?  It means a lot of different things.  To have boundaries--allowing each other the space to grow and be individuals in the midst of real connection, closeness and togetherness; to accept one another fully--whether or not we understand or agree with the other's feelings or choices; being open to giving and to receiving; knowing what we need to feel loved and learning how to ask for it--not expecting our partners to be mind readers...and on the flip side learning what it is that our partner's need to feel loved and giving this to them; loving someone the way they are--letting go of control and trying to change our partners or getting them to be the way we think they should be; allowing our partners (and feeling the freedom ourselves) to express our feelings or to disagree and to fully be ourselves.  
Richo connects all of these essential elements in intimate adult relationships to our early childhoods-whether or not our parents were able to allow us to separate and individuate to become the unique people we were meant to be.  As one might imagine-this process of separation and individuation does not always go smoothly, or even well.  Our parents might have been overprotective and afraid to let us venture out to explore the world around us, sending us the message that the world was too dangerous and that we could not trust ourselves to know what we needed or wanted; or they might have had difficulty seeing us for who we were, needing us to be what they wanted us to be, presenting us with the challenge of becoming and later being our true selves, so that we became dependent upon other's evaluation/approval/reassurance rather than knowing within ourselves our worth, who we were and what was right for us.

The question always comes back to, so how do we get there?  How do we do it?  How do we create the kind of relationship that allows for individual freedom and continued growth while also fostering true closeness, intimacy and connection?  How do we let go of our need to cling and control or to distance and withdraw to get what we think we need from another?  

The answer might be surprising-but perhaps it will make a lot of sense.  
Richo posits that "in healthy intimate relationships we do not seek more than 25% of our nurturance from a partner; we learn to find the rest within ourselves."  So while we all need another to  feel mirrored, safe and to help define us...to allow us to come out of hiding and to be found...we cannot rely on this "other" to do all of these things for us.  The main source of these experiences needs to come from within ourselves.  The reassurance that we are worthy, special and will be "OK" in light of whatever occurs externally resides most fully inside of us.  For many of us, this is a new concept!  Scary, maybe, but also exciting, as we can have more control over our wellbeing and happiness than we ever thought was possible.  As Richo states, rather than relying on ourselves,  many of us have been looking for the "perfect partner"  to fulfill all of our needs, the oasis that will offer us everything we lack--total happiness and emotional fulfillment.  We have not had the opportunity while growing up to develop this strong inner sense of security, and we have learned to search for or to rely upon someone else to give it to us...often ending up frustrated, dissatisfied or even desperately disappointed that another was not fully capable of filling all of our needs for wellbeing and emotional satisfaction.   
Now, as adults, we have a renewed opportunity to revisit this space within ourselves, and rather than allowing our fear to create distance from ourselves by looking for another to fix us or to fill us up, we can face our fear--by allowing ourselves to feel it--and we can look within for our own wellbeing and comfort.  We do not have to be as reliant on another for how we are going to feel from one moment or one day to the next, but rather look within ourselves for this reassurance.  Instead, we can turn toward our partners for support, love and closeness--which can free us up to do the emotional work that we were meant to do to become fully ourselves.

Sunday, June 12, 2011

Calming our anxious minds and bodies

“I am an old man and have known a great many troubles, but most of them never happened.” ~Mark Twain

Anxiety is necessary.  It helps us to accomplish tasks that need to get done, it often helps to motivate us to make decisions or changes, and it can be very helpful in letting us know that our stress levels are too high or that things are out of balance in some way in our lives.  In the best of circumstances, this can help us to slow down, take time to breathe and reflect on our situation in efforts to understand how we need to proceed.  Anxiety acts as an internal warning sign for us of danger or trouble, and it can prevent us from doing things that may cause us physical or psychological harm.  We need a certain level of anxiety to stay safe, progress and move forward in our lives.  When the level of anxiety gets too high, though, it can get in the way and stop us from living the life we truly want to live.

Anxiety can manifest in many different forms.  It can occur in our thinking, through recurring negative thoughts, a.k.a. worry and/or rumination; it can occur in our bodies in symptoms of stomach upset or pain, headaches, back pain, chest pain, heart palpitations, general restlessness or fatigue.  It can affect our appetite causing us to eat more or less, it can affect our sleep patterns, making it difficult to fall or stay asleep or causing distressing dreams; it can interfere in our relationships and our sex lives and negatively impact our general ability to function at work, school or home.  When anxiety seeps into many or all of these areas in our lives, it can cause other symptoms, as well, such as phobias, panic, irritability and depression.  Anxiety can be extremely uncomfortable, which makes it difficult to let ourselves just feel it and move through it.  It can sometimes leave us not knowing what to do or where to turn for relief, which can lead to quick fixes like food, drugs, alcohol or spending.  Most of us have soothed an anxious mind or relaxed from a stressful day with a drink, some chocolate, a trip to the mall or some combination of all three.  These calming strategies can be helpful in moderation, but if we start to rely on them too heavily or too often, they can become new problems layered upon what was once just an uncomfortable feeling.  They can also rob us of the ability to learn how to handle these challenging feelings in a natural and healthy way.

Here are six proven strategies for relief of anxiety that you can start to practice right now:

1)    Deep, slow diaphragmatic (abdominal or “belly”) breathing (This is the type of breathing taught in yoga or singing, that originates in your belly rather than in your chest.  Inhale slowly through your nose for five counts, hold the breath for five slow counts, exhale through your mouth for five slow counts.)
2)    Mindfulness Meditation (This is simply the process of being present in the moment, and letting go of thoughts of the past or future.  Paying attention to your breathing, noticing your surroundings-sounds/smells/sensations-bringing your awareness back to your breath each time your mind wanders to past or future.)
3)    Regular exercise (aerobic/yoga/dance/running/sports etc)
4)    Identifying your negative, distorted, repetitive thinking habits and learning to challenge them and replace them with more accurate, positive and soothing thoughts.
5)    Learning to identify and express your feelings/needs appropriately and assertively.
6)    Analyze your diet / habits and modify intake of caffeine/alcohol/nicotine/other drugs.  Get help with this if necessary through a support group like AA, NA or MA; or with the help of a physician or therapist.

Recent Studies from the Norwegian University of Science and Technology have found that attending theatrical performances, art shows or other cultural events, volunteering or participating actively in the creative process oneself can significantly lower levels of anxiety.  What creative pursuits do you enjoy?

You probably already have quite a few ideas of your own on how you might lower your current level of anxiety.  Identifying and organizing them can help.  Try making a list of activities that help you relax and start doing them.  Here’s my top 10 (other than the one’s named above):

-Taking a hot bath or shower
-Calling a friend or family member
-Collaging in my journal
-Listening to and discovering new music
-Spending time with my dog
-Writing
-Reading
-Watching a movie
-Musical Theater
-Completing a task that I have been putting off, like cleaning my house