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Friday
Sep142012

What You Think, You Are

Here is a word of advice from me to you; Be careful of what you say to yourself, and do not say anything about yourself that you do not wish to be true.

Did you know that we all have a sort of internal dialogue that goes on while were awake and asleep? Some people refer to this as their "conscience' or "conscious" and when people first enter therapy, they are often ashamed to admit it.

Not to worry, this is quite normal and expected. Some of us are more attuned to it and aware of it, sometimes we even talk to ourselves out loud, I have been caught in this act many times. Other's do all that they can to get away from ignore or blot out this voice.

I suggest to people that they become aware of their internal dialogue because it has a profound effect on our outlook, sense of self and way we interact with others. If you listen carefully your internal dialogue will evidence your values beliefs and expectations about yourself and life in general. Become vigilant about this for you are not the only one who is listening.

Our brains develop in two phases; the early primitive brain that takes in the environment which is mostly effected by the people whom little children spend most of their time with, their primary caretakers for many of us. This brain is limited and concrete and stuck in time. Than as we grow and become more sophisticated, we learn from life experience, are capable of thinking abstractly, are able to consider various alternatives etc... Our primitive brain does not know about the outside world and takes what we say to ourselves to be reality. Think of it, this is your "child brain." If your parents told you that you were useless as a little kid, you believed it. They made your reality. If you, as an adult, tell yourself you are useless, your old brain (primitive or child brain-all mean the same thing) is still listening and takes it as reality. This then effects how you feel.

Also your body is listening. So if what you are saying to yourself invites a bodily reaction, say the fight or flight adrenaline system, you will begin the physiological changes of fight or flight, even if you are not in a real life or death situation. This is why when people say things like "I cant take it," "This is horrible," "This is the worst day of my life," "I cant wait to get out of here" and such, its no wonder they start to breath more shallow, sweat, have a racing heart and might become irritable, impatient or anxious.

This is the key concept of "Cognitive Behavioral Therapy." It is not the person, place, thing or event itself that causes the distress, it is what we say to ourselves or think that does.

Want examples of this process?

Tune in to my next post.

 

 

Friday
Sep072012

Thank Goodness, it's not a Relapse, only a Slip

It may seem like semantics to discuss the concept of "relapse" versus the concept of "slip." In recovery circles, the general idea is that a slip is a brief return to using in the context of strong active recovery, with an almost immediate return to active recovery. A relapse is a change in attitude and behaviors that move away from active recovery and return eventually to active use lifestyle.

Of course there is hope in both situations. However for those close to the person, including people in their recovery network, close friends, family and treating professionals, the difference often dictates the amount and type of response/support given and the subjective emotional experience. Again, it cannot be overstated the profound effect addiction has on almost all people who are close with the addict. Often times after a period of sobriety their is a collective sigh or letting of the guard down. This does not mean that a person is "recovered," this is never so, recovery is a process. However, a slip can bring back many of the memories and feelings associated with active use and there may be another collective holding of the breath to make sure that the person gets back on the horse of recovery.

On the surface it would seem that a relapse is worse then a slip, and in some ways this is true. But there have been countless times that slips have eventually turned into full blow relapses, so though the storm clouds may quickly pass (when the addict quickly gets back into recovery) there are no guarantees.

Think of it this way-if you have abstained from eating cookies for a year and have one, there is a much greater chance you will have another shortly thereafter that. Once you get that taste in your mouth again, its harder to walk away from it. So after a slip extra diligence is probably needed to shore up a person's recovery (more meetings, more therapy, etc). Often when a person is working with sponsor, the sponsor will suggest reviewing step work or even going through the steps over again, not as punishment, but as a means to keep the reality of active addiction vs. active recovery, fresh in the persons mind.

There is a whole other area that needs to be addressed, which is the process of slip or relapse. This happens long before the actual use. This may take a lot of work on the addicts part and much digging on the professionals part. When I work with people I try and chart out the process, sometimes on a piece of paper, because when it is in black and white it is easier to see small cracks, as it were, that eventually lead to the damn breaking. There is an entire sphere of recovery work dedicated to "relapse prevention" and I will talk in more detail about this in a future post.

I'll get you started, there is an expression "recovery is an inside job." Therefore, many things that point towards active recovery versus stagnation and possibly slips are in the form of attitudes, values, beliefs, self talk patterns and behaviors.

More to come...

Friday
Aug312012

Parental Figures-Reality Makers

I suspect that the importance of healthy parenting cannot be understated.  For the most part, we all do the best we can and our views of parenting are always informed by those who parented us.

There are obvious cases, such as abuse or neglect, in which there is no question about the negative impact this parenting will have upon the children. There is a more common and pervasive parenting circumstance though and that is one of chaos or inconsistency. This is most often found in the homes of people who struggle with addiction. Children learn about the world through the grown ups who they spend most of their time with, this is the process of parenting (though these adults may not necessarily by the children's biological parents).

It is important to understand that to a small child, we big adults truly are all knowing and all powerful and many clinicians believe that there is a psychic dread or fear of death at the core of childhood anxieties and fears. Certainly if we know everything and are all powerful and quite large, we do hold the power of children's lives in our hands. I was once participating in a group exercise and I was asked to get on my knees in front of an adult who was standing. I indeed felt pretty powerless. That adult then stood on a chair and boy did I feel tiny.

Unfortunately children raised in alcoholic families receive lots of unhealthy messages, some overt and some covert and tend to live in dread of the rug being pulled out from under them. They may learn about honesty, the way to deal with conflict, the value of money, the various roles of adults in life, how to deal with stress, the way to communicate with others and how to express feelings under these circumstances. Again, what we say is reality for children, they have no point of reference, other life experience or the ability to think in the abstract.

Lets take one example; messages about money. If a child grows up in a chaotic or unstable home (as most children of addicts do), these homes may be financially stressed. They may have ripped the family apart leaving the child to fend for him/herself. The child may get the message that money is the cause of or solution to problems, leading them to fear, undervalue or overvalue money or material things. In another case parents may be begrudging about money often making the child feel a burden on the family. This child may grow to be confused about what their value is or see life a decision between family responsibilitiesand enjoying pleasurable things. Last, parents may have conflict over money. This has the unfortunate negative effect of connecting money, fear, anxiety and conflict in the child's developing psyche and brain. Later in life this child may have a very unhealthy relationship with money, in fact avoid the whole concept of money budgeting and finance because of the negative feelings it engenders.

Part of the work that I do with adults that were raised or parented by someone struggling with addiction issues (ACOA) is, in essence, to "re-parent" them.  We identify the messages they received and the environment in which they were given. Through awareness of the many unhealthy fallacies they learned and the consistent nurturing therapeutic relationship, as well as practical exercises for making change, much of these issues can be identified and resolved. You do not have to be an addict to raise your child in that way. If you were parented by someone with addiction, you may have the attitudes, values, beliefs and behaviors instilled in you from that experience. Without help, you may pass these along to your own children as well.

This does not mean you must be perfect or flawless as a parent or that your children should have a trouble free childhood (no such thing exists). In fact most research suggests overcoming challenges in childhood is the way children build their character.

However, keep in mind, whatever you do or say, your children are watching, taking it all in and developing their sense of reality. Nerve racking isn't it?

 

Friday
Aug242012

The Journey

It seems that often the most difficult process is to allow another, particularly a loved one, to take their own journey. This can take many forms, the most difficult are when a loved one directly expresses desire for feedback and when a loved one seems on a path to destruction.

How many times have I witnessed the lament of the loved ones of addicts as they watch the poor choices stack up and await the inevitable. In active addiction the consequence can be catastrophic. It is a very understandable response to want to make suggestions, provide answers or take control when we see the right path. Unfortunately, for an addict the drug of choice is the solution, not the problem and you become the problem when you get in the way, with rational mind and goodness of intentions, of that process. Some people have difficulty disengaging, watching the proverbial car wreck, and so they need to distance themselves, physically and emotionally, from that situation, lest their own lives be destroyed. One definition of co-dependency is an addiction to another person or an addiction to another persons life. Any close loved one of an addict knows all too well the constant fear, worry, projection, checking up on, double guessing and doubt that are a part of everyday life. Part of their push for the addict to get help is for the relief of their obsessions and compulsions.

This process is also seen in most close relationships, particularly in partnerships of significant others. I am working with a young couple who recently had their first child. The wife feels overwhelmed and isolated and expresses this when her husband comes home. His natural instinct is to fix the problem by providing suggestions such as joining a new mothers group or taking yoga, even going so far as to research these offerings and to assist in transportation and childcare. However, as we all know, men and women are from different "planets" and often times what she wants is to have her feelings validated and reflected back to her. Worse, when he makes suggestions there is an implicit expectation that she follow through with them, they seem to solve the problem, and therefore there is unspoken tension when she does not do so yet continues to express her unhappiness.

Each person has their own journey to take. There are myriad contributing factors to our personality's and habits (how we were raised, our genes, if we are insecure, hungry or tired at that moment, how behaviors have been modeled for us by our role models, how behaviors, both positive and negative, were rewarded in the past and present, the presence of depression or anxiety etc...), some of which we are consciously aware of and some we are not. Couples often get into trouble because one person speaks of unhappiness, the other offers suggestions to "fix" it. The first person doesn't feel heard or understood, and the second person doesn't feel valued. Then they either bicker at each other or start a negative dialogue within themselves about their partner. This is like a constant erosion of water on the foundation of a house, over time the bottom will wash away and the house will fall.

It is very difficult, sometimes a daily struggle, to allow others to take their journey, however painful it is, and to know when to offer advise and when to offer merely validation. Then you must let it go, or turn it over in whatever form is most useful for you. You make say a prayer for them, you may sit in quiet reflection or meditate, you can go to the gym or share your burden with a close friend, clergy person or therapist. (Note-when sharing with friends or family, be careful to do so in a constructive way, not with someone who will become your cheerleader or offer destructive comments. This is the reason many people share with professionals or with those in mutual support groups).

What are some of the ways you let things go or turn them over?

Friday
Aug172012

Empty Shell Relationships

Part of my job, when working with couples, is to find out if their relationship is an "empty shell." As you will see, these types of relationships are, to the outside view, pretty consistent and they usually develop gradually and seem to work for the people involved. Often times the thought of ending these relationships seems more difficult then keeping the status quo.  However, as you may presume from the description, these relationships are void of genuine depth and intimacy and are vulnerable to affairs and break-ups.

Empty shell relationships take a few different forms:

Some lack luster and excitement. The partners are essentially bored with each other, do not take any real deep interest in each other or the relationship and are generally apathetic towards each other and about the relationship. Serious discussions and dealing with real issues are non existent and so there are no arguments. Sexual intimacy is non existent.

Others are more congenial but are still passive and conflict avoidant. Any unpleasantness is swept under the rug or minimized. These partners are more like buddies or siblings, they take some interest, at a surface level, in each others lives and interests, but not in any significant meaningful way. These partners do not cut themselves off from their feelings towards the other in a manipulative way, they are so disconnected from their own feelings, there is no way they can be connected to their partners. Sex  is infrequent, not intimate and treated more like an obligation or favor to the other.

Still others are mired in conflict. The relationship is bitter, contentious and tense. There is no opportunity to share genuine feelings (aside from anger) or vulnerability and much energy is spent defending oneself and arguing ones point. This relationship is a sword fight, all the energy is focused on your next move by sizing up your opponent. Certainly any vulnerability or real connection is impossible in this atmosphere. That means putting down your sword and there is a likely chance you will get stabbed in the heart. Sex is infrequent and more an act of expelling negative emotions through physical means then an intimate gentle connection.

Not all empty shell relationships are doomed for disaster or to go on in perpetuity. When I work with couples, I learn about how/where they learned their styles of relating, types of emotional language they use and their history of attachment to significant others. These all contribute to how you think and act when in a relationship with a significant other. Then we work, with baby steps and often through therapeutic exercises, on getting in touch with feelings, fears and vulnerabilities and working towards healthy communication, connection and mutual validation.

All relationships ebb and flow, all have conflict of some sort. What's important is having a good connection, the capactiy to be vulnerable and validate each other and to deal with conflicts quickly, consistently and in a constructive  (rather then destructive) manner.