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How To Succeed in Business...By Trying!

Presenter: Patricia Tidwell, PhD, LCSW
June 4, 2010
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Walking the Tightrope of Acceptance and Change:   Using DBT to Treat the Multi-problem and Suicidal Individual

Presenter: Sara Steinberg, PhD
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Wednesday
Jan252012

TEENAGE OBESITY

Recently there was an article about an obese teenager who chose to have the controversial lapband surgery to help her lose weight. The article was full of statistics about nutrition, the obesity epidemic and issues with this type of surgery. They also quoted the girl’s trepidation about the procedure.

“I’m just so nervous to fail my own diet.  There’s a diner downstairs from my apartment, and a Dunkin’ Donuts.”

“The key is moderation, having a little mashed potato but not a portion,” the doctor said.

“I’m not good at moderation,” she replied.

She has not been able to comply in spite of going through a surgery, being exhorted by physicians and others, and receiving nutritional counseling, etc.

Many people commented on this story. A large number focused on her being lazy, stupid, lacking in will power, unknowledgeable about nutrition; or criticized her mother for not providing the right foods. What was missing was an understanding of the nature of eating disorders and the addictive process, about which this girl has no control.  She would need a lot of emotional help; maybe also a twelve step program, like Overeaters Anonymous. For starters, this would be essential  her to success.

If this were your loved one, how would you support them?

 

Friday
Jan132012

15 WAYS TO DESTROY THE RELATIONSHIP

Just saw “Carnage”. A great demonstration on how couples can fight in order to destroy each other. Spoiler alert: here are just some of the rules, according to the movie:

1. Treat the other with contempt and sarcasm; bully them overtly or covertly
2. Engage in character assassination
3. Expose and pick on your partner’s areas of self-hate
4. Tease your partner about their values or aspects of themselves that matter to them
5. Change the focus to unrelated, but awful, issues, making them seem as if they are part of the conversation, thus throwing your partner off balance
6. Throw up on something that was valuable to the other person
7. Keep your phone on and pick up all calls, or text throughout
8. Belittle or dismiss the other
9. Start drinking heavily in the middle of the fight

10. Call your partner names or insult them: “You’re DISGUSTING!” “That’s the most idiotic thing you’ve every said!”

11. Distort the meaning of what they are trying to express into something hateful

12. Do this in front of other people

13. Do something to deliberately provoke the other like handing out cigars to your guest when it’s always been a house rule not to smoke in the house

14. Say nasty things about your partner to the other people, like, “She’s always hysterical like this”

15. Throw a punch at your mate                                   

                                                                                                                  V.L.F.
.

Tuesday
Feb152011

Choosing Thoughts??–and Feelings???


The idea of our choosing thoughts and/or feelings is a strange one, especially in a psychoanalytic setting, where free association, or the spontaneous free-flowing outpourings of the mind, is so valued. However, I have found, for example, in starting a couple session, that it is useful for the couple to voice an “appreciation” of each other, even when, or especially when, they come in tense and angry with each other. It is remarkable how the atmosphere changes when people can summon up some positive thoughts and feelings about the other in the midst of hard feelings. It helps a process of more open, creative airing of difficulties with less blaming. John Gottman, the prominent marriage researcher, has found that couples who are able to insert comments of lightness and bonding in the midst of a argument, are more likely to stay together in the long run.
There are other reasons for consciously changing a thought or a feeling. It is a well established tenet in Alcoholics Anonymous that when the thought of picking up a drink hits, the person can take control of it by changing it either by substituting a new thought like a prayer, a calming image, a mantra, or any (preferably positive) idea. The thought/impulse can also be altered by changing one’s behavior in the moment such as picking up the phone to call someone to talk to in that dangerous moment, or–and this is one I’ve always enjoyed– as one sponsor said to her sponsee, “If you’re sitting down, stand up; if you’re standing up, sit down!”

Since feelings give rise to thoughts, changing a thought can change the underlying feeling. This can be thought of as a mental discipline, like meditation, in which one is changing thoughts  by noticing them and refocusing on the breath. There is evidence that putting this aspiration into practice actually changes the way the brain works. We are all subject to familiar thoughts, feelings, beliefs and behaviors based on neural pathways in our brains that have been “hard-wired” in our lives by repetitive experience, particularly in the presence of intense negative emotions. Psychotherapy aims to produce this change. Psychoanalytic neurobiological researchers, among them Dr. Susan Vaughn, in “The Talking Cure”, have shown that that is exactly what happens in therapy.

A most striking example of  purposefully changing aspects of one’s personality is described by Dr. Jill Taylor Bolte, a brain scientist herself, in her book “My Stroke of Insight,” in which she details her experience and observation of her left brain shutting down as a result of a stroke. She then recounts her recovery, which entailed her having to learn, literally and painstakingly,  how to establish new neural pathways in the course of getting her left hemisphere and its functions back “online.” She says

Although I wanted to regain my left hemispheric skills, I must say that there were personality traits that tried to rise from the ashes of my left mind that, quite frankly, were no longer acceptable to my right hemispheric sense of who I now wanted to be…the question I faced over and over again was, Do I have to regain the affect, emotions or personality trait that was neurologically linked to the memory or ability that I wanted to recover? For instance, would it be possible for me to recover my perception of my self, where I exist as a single, solid, separate from the whole, without recovering the cells associated with my egotism, intense desire to be argumentative, need to be right, or fear of separation and death? Could I value money without hooking into the neurological loops of lack, greed, or selfishness?…My stroke of insight is that at the core of my right hemisphere consciousness is a character that is directly connected to my feeling of deep inner peace. It is completely committed to the expression of peace, love, joy and compassion in the world. [Bolte, Jill Taylor (2006 ) My Stroke of insight: A Brain Scientist's Personal Journey, The Penguin Group: NY, NY]

She goes on to document many techniques she employs–it’s a lifetime job–to engineer new neural pathways which will regulate her thoughts, feelings and experience; ones she feels will be in her best interest, unlike ones she had before. I mentioned a few of these techniques earlier.

Changing our thoughts and feelings (and often, accompanying behavior) is hard work, but anyone can do it, and it yields extraordinary benefits, when possible. There are some caveats to this whole endeavor, however. Sometimes it is not possible. Some things are quite entrenched in our psyches and can only be changed with the help of a healing process and another person. If we can turn a negative into a positive by whatever means that’s great. But sometimes negativity does not give way just like that and needs to be respected, aired, explored and understood.

VF



-- 

Monday
Nov292010

Emotional Attunement vs. Emotional Dissonance

A patient recently reported to me the following story:
Her 20 year old daughter and friends got stuck in the building's elevator as the group was returning from a scavenger hunt, a party activity that was part of the girl's birthday celebration.
The fire department had to be called to get them out. The next day, a neighbor who knew the party had taken place, asked my patient how the party went. The mother told her it had been great except for the part about the elevator. The neighbor responded, "Why didn't they take the stairs?" The mother was a bit flummoxed by this, and answered, "Well, I'm quite sure had they known the outcome in advance, they would have taken the stairs!" The neighbor repeated her question. The mother responded, "I guess they wished they had, once they were stuck." She walked off, puzzled and annoyed. Why didn't the neighbor ask, for example, "Were the kids OK?" "Did it take long to get them out?" These would be emotionally attuned responses.
     The neighbor created what I am calling Emotional Dissonance. The emotional message behind the response has nothing to do with the emotional message underlying the first communication. There is, in fact, an implied criticism, the exact opposite of what might ordinarily be expected. The mother was annoyed and felt validated in her general sense of wanting to avoid contact with this neighbor. However, think about what effect such ongoing communications would have on a child. At the very least, confusion. At worst, feeling pretty crazy and doubtful of her own instinctual reactions.

                                                                                                                                          VLF

Friday
Oct292010

COMMITMENT

Commitment in a relationship is like a rubber band. Picture two people  encircled by a large, flexible, but strong, rubber band. The band allows each to pull away and come back comfortably and to twist and turn individually. However, the fact of the band remains constant. Each knows the other is there regardless of the comings, goings and twists. I liken the going out and back and the "twists" to people living their own lives and trying out new aspects of their personalities while always having the bond of the commitment there to hold them. The bond actually enables more individuation to happen, on the one hand, and a deepening of the relationship, on the other.     

                                                                                         VLF