Sunday, September 18, 2011

Symptoms Part II

Symptom as Teacher, Friend, Gift
Symptoms of illness or distress can be viewed as messengers coming to tell you something important about your body or your mind. Killing the messenger, denying the message or raging against it is not an intelligent or responsible way of approaching healing. The real challenge when we experience symptoms is to listen to their messages and make the connection fully.
The ways we use language tell us a lot about the automatic way we personalize our symptoms and illnesses. For instance, we say “I have a headache” or “I have depression” when it would be much more accurate to say “”the body is headaching or “I am depressing.”
When we unconsciously link each symptom we experience to I and my, the mind is already creating a certain amount of trouble for us. We have to perceive this identification with the symptom as it occurs and intentionally release it in order to listen more deeply to its message, free from our exaggerated reactions.
Symptoms are often our best teachers, guides or friends. Instead of getting rid of them, perhaps we can be grateful for them and see them as gifts. Symptoms give people another chance, another opportunity to self-correct if they are openly received, accepted, acknowledged, honored and respected.
Thanks for reading “Is It Just Me Or…?”

Tuesday, August 23, 2011

Symptoms Part I

Respecting Symptoms
One of the major contributions modern psychiatry has afforded individuals, couples, families and groups in clinical settings is the reduction of symptoms through psychopharmaceutical drugs. One of the tenets of modern medicine is the relief of symptoms. In fact, this is a multibillion-dollar industry. The slightest ache or pain sends people scurrying to the medicine cabinet, doctor’s office, or pharmacy in search of something to make it go away.
There are over-the-counter medications, prescription drugs and illegal drugs that can be obtained to relieve pain, reduce anxiety and depression and even speed one up as in the stimulant medications.

People want instant gratification and they don’t want to do the hard work which would be working with the symptoms, working through the thoughts and emotions.
The trouble with the widespread use of many such drugs is that the underlying problems that are producing the symptoms may not be getting addressed just because the symptoms are temporarily relieved. Don't forget about the dire "side effects" these drugs often induce.

The practice, or as I would label it, the habit or compulsion, to reach for a drug to relieve a symptom reflects a widespread attitude that symptoms are inconvenient, useless threats to our ability to live life the way we want to live it and that they should be suppressed or eliminated whenever possible.
There are two major problems with this perspective:
1.   First is the common human error of causation which states that because my brain chemistry is out of balance, I am depressed. This has not been proven. Our mind-body-brain system is integrative and complex. It is much more likely that because we are experiencing symptoms of depression due to some sort of loss, denial, etc. the chemicals in the brain reflect that and adjust accordingly.

2.   The second problem with this attitude is that what we call symptoms are the body’s way of telling us something is out of balance. They are feedback about dis-regulation and dis-ease. Ignoring our body’s messages, or worse, suppressing them, may only lead to more severe symptoms and more serious problems later on. The person doing this is not learning how to listen to and trust his own body. Our bodies are wise and will always tell us what we need.
Thanks for reading “Is It Just Me Or…?”

Thursday, August 11, 2011

Amy's Winehouse Part III - Playing Games

Amy’s Winehouse Part III - Playing Games
The Role of the Substance Abuser
If all behavior is goal-oriented and all behavior (including substance abuse) serves a purpose, we can view the individual who abuses substances as playing a particular role in a game. Eric Berne, founder of Transactional Analysis, believed that all games have an important and probably decisive influence on the destinies of the players under ordinary social conditions; but some offer more opportunities than others for lifelong careers and are more likely to involve relatively innocent bystanders. This group is called Life Games and includes the game of “Alcoholic.”
In game analysis, as in Choice Theory, there is no such thing as alcoholism or “an alcoholic” but there is a role called Alcoholic in a certain type of game. Because it has not been proven that biochemical or physiological abnormality is a prime mover in excessive behavior its study belongs in the field of internal medicine. No behavior is disease – including compulsions or addictions. Game analysis interested in something quite different – the kinds of social interactions that are related to such excesses, hence the game “Alcoholic.”
The treatment of a substance abuser lies in getting her to stop playing the game altogether, rather than simply change from one role to another. In some cases this is feasible, although it can be a difficult task to find something else as interesting to the substance abuser as continuing her game. Because she is classically afraid of intimacy, the substitute may have to be another game rather than a game-free relationship. The criterion of a true game cure is that former substance abuser should be able to drink socially without putting herself in jeopardy. The usual total abstinence cure will not satisfy the game analyst – or the Choice Theorist.
From a transactional point of view, after careful preliminary groundwork, the correct therapeutic procedure is to take the “Adult” contractual position and refuse to play any of the roles, assuming that the client will be able to tolerate a new game.  The therapist’s role in playing “Adult” is to break up the game rather than play “Rescuer” with the client.
In the “Adult” contractual position, the therapist can guide the client toward awareness, spontaneity and intimacy. Awareness requires living in the here and now and not in the elsewhere i.e., the past or future. Spontaneity means option, the freedom to choose and express one’s feelings from the assortment available. It means liberation from the compulsion to play games. Finally, intimacy means the spontaneous, game-free candidness of an aware person, the liberation of living in the present moment.
For a clever and witty introduction to Transactional Analysis, please read Berne’s Games People Play.
Thanks for reading “Is It Just Me Or…?”

Monday, August 1, 2011

Amy's Winehouse Part II - Psychology

Mental Illness as Metaphor
In my last post regarding Amy Winehouse’s demise I discussed philosophy; in particular, a philosophical perspective on happiness. Seeking happiness from an external entity, whether it comes in the form of  a person, relationship, work, money, alcohol, drugs, food, sex, gambling, shopping etc. may achieve a fleeting high, but  as soon as that high fades the individual will set on yet another quest.  
If the search for happiness is one of the chief sources of unhappiness, perhaps wise living consists less in acquiring good habits than in acquiring as few habits as possible.

People use mental illness as a language because they have not learned to use any other or because it is especially useful for them in their situation. How is mental illness learned? What does it mean to the person? Among a diversity of communicative forms each has its own reason and because of the particular circumstances of the communicants, each may be as valid as any other.

In discussing the clinical treatment of addiction (chemical or process addiction) the perennial frustration of therapists as well as the client’s partner, family, friends, coworkers, etc. comes down to the simple fact that they often try to teach new languages to people who have not the least interest in learning them, i.e., “resistant to treatment.” Recall Winehouse’s lyrics from one of her most popular songs…”They try to make me go to rehab I said no, no, no!”

For many people, playing psychological games is a perfectly reasonable and acceptable thing to do. There are moral choices inherent in psychiatric symptoms and syndromes. Game-playing habits should be seen more as habits clients actually want to keep rather than as happenings they want to lose.

The aim of psychotherapy is three-fold:

·         To illuminate behaviors and the thoughts and emotions which trigger them
·         To understand behaviors are goal-oriented and serve a purpose
·         To maximize the client’s choices in the conduct of her life         

The goal is not to indiscriminately enlarge the individual’s choices but to enlarge her choices by enhancing her knowledge of herself, others and the world around her and her skills in dealing with the important people in her life, her thoughts, emotions and behaviors.

The concept of “mental illness” undermines personal responsibility and precludes an inquiring attitude toward conflicts which her symptoms at once conceal and reveal.

Thanks for reading “Is It Just Me Or…?”

Monday, July 25, 2011

Amy's Winehouse Part I - A Philosophical Understanding

We mourn the death of Amy Winehouse.

Insodoing, it gives us the opportunity and ideal platform in which to discuss psychology and philosophy. Nowhere better do these fields converge on the concepts of fight or flight, avoidance, hedonism and Buddhism. Seemingly strange bed partners until you grasp the underlying concepts. Let's start with philosophy.

Hedonic happiness occurs when one is primarily seeking pleasant feelings and avoiding unpleasant ones, while eudemonic happiness is conceptualized more in terms of optimal functioning.  Eudemonia can be described as the striving for perfection that represents the realization of one's true potential. These two views of happiness illustrate two traditions whose philosophic roots are significantly divergent.

While in hedonistic philosophy the aim of life is to maximize pleasure (Aristippus, Bentham, DeSade, Hobbes) other philosophers and religious thinkers do not agree with this conception. Atistotle, for example, considers hedonic happiness as vulgar insofar as it condemns man to be a slave of his desires. According to the stoic Epictetus, happiness does not involve enjoying pleasures, but rather occurs when one is free from desires.

The Buddhists use the term sukha to qualify authentic happiness, and this term closely resembles eudemonic happiness. Sukha can be defined as a state of flourishing that arises from mental balance and insight into the nature of reality. Rather than a fleeting thought or emotion, aroused by internal or external triggers, sukha is an enduring trait that arises from a state of mental balance and entails a conceptually unstructured and unfiltered awareness of the true nature of reality.

In terms of Amy Winehouse's descent and self-inflicted demise, we can view her behavioral process through the lens of these two distinct psychological states. By trying to maximize pleasure and avoid displeasure, the hedonic approach induces a fluctuating happiness in which phases of pleasure and displeasure alternate repeatedly.

The experience of pleasure is by nature fleeting and dependent upon circumstances - but I would argue here more specifically, it is dependent upon one's perception of those circumstances. It is unstable and evokes a constant striving to attain pleasure and avoid pain.

Hedonism is based in stimulus-driven pleasures of all kinds and does not allow one to achieve authentic and durable happiness. Clinging to such stimuli as the actual source of one's happiness can easily give rise to at least intermittent, if not chronic anxiety as one faces the possibility, likelihood or certainty that stimuli will not last.

Authentic happiness on the other hand is not dependent upon circumstances, but rather gives a person the inner resources to deal with whatever comes his or her way in life. It is not linked to an activity but reflects a state of being, a profound emotional balance.

It is a state of durable plenitude based on a quality of consciousness that underlies and imbues each experience, thought, emotion and behavior and allows us to embrace all the joys and pain with which we are confronted in the full catastrophe we call Life.

Thank you for reading "Is It Just Me Or...?"


Tuesday, July 19, 2011

Response versus Reaction

More than 90% of human behavior is reactionary.

Human behavior generally falls into two categories: responding or reacting.
At first glance, these two may seem quite similar, but in fact, there is a great deal of difference.
The difference can make or break us.

To respond is to be in a state of mind which is 
  • thoughtful
  • conscious
  • aware
  • accepting.
It is creative, powerful and full of options.

To react is to be in a state of mind which is
  • impulsive
  • unthoughtful
  • irresponsible
  • unconscious
  • in denial
It is uncreative, wreaks havoc and limits one's behavioral repertoires.

Our thoughts and emotions do not hurt us or others but our behavior can.

It is our perception or interpretation of an external event that triggers a thought, which triggers an emotion  and finally a behavior. Events can come in myriad forms such as a situation, relationship, person, job, task, finances and so forth. It is important to recognize that events are always neutral but the meanings we assign them dictate our relationship to the event.

The goal is to work toward responding versus reacting. And this is where mindfulness comes in. Being mindful helps us to create space and time between an event, thought, emotion and behavior. Mindfulness allows us the opportunity to respond rather than react.

The first step in breaking free from a lifetime of reactivity is to be mindful of what is actually happening while it is happening. At any moment, an individual may be encountering a combination of internal and external stressors that can trigger a cascade of thoughts, emotions and behaviors that can be called the stress reaction. People do not have to go the route of the fight-or-flight reaction nor helplessness every time they are stressed or anxious.

We can actually choose to cultivate moment-to-moment awareness that grants us the power to exert control and to influence the flow of events at those very moments when we are most likely to react automatically and plunge into hyperarousal and maladaptive attempts to cope.

Thank you for reading "Is It Just Me Or..."


Sunday, July 10, 2011


All human behavior is purposeful. Behaviors are not diseases. The diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, are more accurately read as a collection of descriptions of behaviors.
People choose, sometimes consciously and other times unwittingly, their behavior and their behavior always serves a purpose. It is much more interesting and helpful to inquire into one’s behavior and patterns to understand how it is goal-oriented. From this perspective, the change process becomes much more powerful and meaningful.
The therapist helps the client to cultivate a sense of curiosity, awareness, acceptance and growth. Behaviors that serve a person well can be maintained while those that are harmful to self or others can be discarded for new more adaptive ones.
This perspective of change has several important implications. First, an individual can only control or change himself.  External control psychology is not only ineffective but manipulative and irresponsible. True change and growth comes from an internally motivated psychology.
Second , this theory of human behavior brings dignity, respect, freedom, responsibility and choice to the individual. Simply put, no matter who you are, where you’ve been and what is happening, you are ultimately responsible for your life including your thoughts, emotions, choices and behaviors.  No more victimization, stigmatization or pathologization.
Thanks for reading this week's post to "Is It Just Me Or...?"