Clumsy Solutions

For many years now, I’ve noticed something that I think is pretty interesting.

We all have similar problems.  Problems of love, death, loss, fears, mistakes, power, our bodies, work, school, relationships, resources, abuse, abandonment, depression, addiction, self worth and the like.  In one way or another, most of these touch all of our lives.  Our responses to them too, seem common between us- we all have “bad” feelings and “good” feelings associated with these experiences.

It appears to me, that we also have solutions in common.  But what’s strange about it, are the solutions themselves.  If we just look at the “problems” (for shorthand purposes) we have in our lives, and our response or “reaction” to them (or as I’m calling them here, “solutions”, though we may not see them as such in the moment), the way we deal with them from this perspective is tragically ineffective.

Here’s what I mean, more specifically.  The way I see us (and of course, have done myself in many cases), is that we respond to perceived problems with (in no particular order):

  1. Avoidance, procrastination.
  2. Using our limited human intellect, and our limited human will, coupled together as a salve we cover everything with.
  3. Drugs, alcohol, food, spending, money, property, prestige, gambling, etc. ad nauseum.
  4. “Codependent” behaviors (oversimplifying: doing things for others that they can and should do for themselves, so that we don’t have to feel bad for one reason or another).
  5. Lying (or, in addict nomenclature, “manipulating”… insert tongue-in-cheek emoticon here), often, when telling the truth would be easier.
  6. Perfectionism.
  7. Control.
  8. Enduring untenable circumstances or relationships.
  9. Isolation.
  10. Ruminating.
  11. Reasoning with “unreasonable” people, or in circumstances that may not always be subject to such (there’s a large philosophical question here that can’t be addressed in a blog, hope the spirit of the thing comes through…).
  12. Self obsession.
  13. Being critical.
  14. Thoughts or attempts of suicide or related self harm.
  15. Worrying (the behavior… not to be confused with being afraid- as John Bradshaw once opined, “Worrying is like beating the drums to keep the evil spirits away.”).
  16. Pride or ego.
  17. Lashing out verbally or physically.
  18. Intellectualizing…

Et cetera.  This is clearly a truncated list, but am hoping most of us can see our most frequent responses here.  What I’m hoping to get across (at the risk of reiteration) is that these are our responses to perceived problems, and arguably, when observed, appear to be solutions that we employ to a whole host of life’s difficulties.

More striking to me is what’s absent from the list:

  1. Emotional availability, disclosure, and the like.
  2. Asking for help (having a “responsibility partner”, other similar ideas).
  3. Responsibility.
  4. Having “boundaries”.
  5. Kindness.
  6. Critical thinking skills.
  7. Service focus on others.
  8. Writing (and preferably, sharing that writing with one or more people).
  9. Art (painting, sculpture, music, performances, poetry, etc).
  10. Honesty.
  11. Support groups, 12-step meetings, or other types of community.
  12. Amends.
  13. Mindfulness.
  14. Meditation.
  15. Diet, exercise, natural healthy sleep.
  16. Being self supporting through one’s own contributions mentally, emotionally, physically and “spiritually” (for lack of a better term).
  17. Acceptance.
  18. Therapy, counseling, coaching.
  19. Community, relationships.
  20. Intimacy.
  21. “Non intervention”, being still.
  22. Forgiveness, “letting go”, and other similar solutions.
  23. Gratitude…

Seems I’m laboring the point here (hopefully in a continued effort to be helpful).  Have long looked at my own old behavior (though it still shows up sometimes!), and of course the behavior of others, and as I see “problems” come up, inevitably, I see the first set of responses above.  Often, repeatedly and perpetually for the same problem and/or new ones.  Have also observed that these responses almost inevitably make things worse, or create new problems.

While the second set of ideas don’t always “solve” things (sometimes, when honest, simply in the shadow of our own limited perspective), when practiced, my experience is that we all start to feel better about things, and certainly act better.  Very rarely, do I see the second set of  ideas create or perpetuate more problems.  Making a practice of replacing our first responses in the first section with the ideas in the second section, has been life changing for me, and lots of my clients.  If the theme rings any bells for anyone, would love to hear/see other ideas.

Clinical Supervision: A New Intern!

One of the better ways I think I can be of use to the community is by training other therapists and interns.  Have now hired and am doing clinical supervision with a new Marriage and Family Therapist Intern, Sarah Wood, MS, MFTI (#66300).

Am really happy about getting to do this.  With the Partners in Recovery program for interns sunsetting at the end of the last school semester, there’s been less opportunity to get to work with folk that way.  Am double excited about getting to do so with Sarah, because she’s already great at what she does, and really has a taste for The Work.

She comes on the recommendation of one of our last interns, Melissa Lamoureux, who was also at Partners in Recovery.  Sarah did her graduate work at the amazing program at Cal State Fullerton.  She’s done a lot of great work in the community already, specializing in therapy with children, trauma services for all ages, eating disorders/other addictions and more.

I feel like it’s a stroke of luck to get to work with her, am happy to get to recommend her services.  Please go by her website and learn more about Sarah at sarahwoodtherapy.com.  Welcome Sarah!

Difficulties, Diagnoses, the DSM.

In a New York Times Op-Ed piece from today, one of the leads on the DSM-IV (the “Diagnostic and Statistical Manual”, the current edition of an industry standard tool for mental health, primer here) task force wrote about the upcoming changes in the DSM-V (likely to be released in early 2013).  Summarizing, Allen was suggesting in part, “…after the changes approved this week, it will introduce many new and unproven diagnoses that will medicalize normality and result in a glut of unnecessary and harmful drug prescription.”, and that the American Psychiatric Association was  arguably no longer in a place to be singularly in charge of the meting out of diagnoses, calling it a “monopoly” (offering that an agency akin to the FDA or National Institute on Mental Health might be examples of ways to provide oversight in the efforts to insure some science around diagnosing emotional and mental problems).

Am with Allen on quite a bit of this.  What comes to me often too, is that we have equally large fish to fry with the DSM and the profession than just the pathologizing and monopolizing he suggests.  We have been over-diagnosing ADHD (attention deficit hyperactivity disorder) and bipolar disorder, among others.  Our differential diagnosis (rationalizing one diagnosis vs another) has also been resulting in much harm to people by way of treating issues unneeded, and/or incorrectly.  We are also arguably guilty as a discipline of using interventions that are more “intrusive” than necessary (for instance, medicating a problem before efforts at traditional talk therapy and/or other interventions have yet to be tried).

It seems to me that in reviewing the DSM, we are more currently in need of insuring the accuracy and value of our diagnoses, in terms of insuring that those so suffering are treated more appropriately.  We do know ways to treat depression, anxiety, addictions, bipolar disorders and etc.  We do have means of helping people through grief/loss, communication problems, abuse, suffering with stress and etc.  As the saying goes though, the “cure” (a dubious word to begin with) is only as good as the diagnosis, and with the numbers of the diagnosed only increasing in the US year after year, either our diagnosing or treatment (or maybe a bit of both) are not faring as well as they might.

A quick aside here- not all of the missed treatment opportunities are about the above issues.  Some of them are due to the influence of Big Pharma (an intense imposition by the pharmaceutical industry), access and funding of mental health treatment, the insurance industry and more.

Specifically related to the DSM though, my hope is that we’d simply be better at a lot of the material we already have.  Adding diagnoses, or simply separating them into finer and finer constellations of symptoms seems both unnecessary and unhelpful, philosophically speaking.  Part of what I’m getting at above is that I think we have some good ideas about how to help many ills- I just wish we spent more time treating them, and less time diagnosing new ones.

Recognition for Partners in Recovery

Last Monday (9-26-11), Judy McGehee MFT, Melissa Lamoureux MS, Erika Gayoso MA, Ted Aaselund PsyD, Michael Cardenas, Jeffrey Craig, Jessica Wilson, Elvia Cortes MA and myself were recognized by the board of the Glendora Unified School District at their monthly meeting.  Formally, the agency is called “Partners in Recovery”, a nonprofit organization of clinicians providing services in Glendora and surrounding communities.

Judy, and I have been providing clinical supervision (a necessary component for grads and soon-to-be grads to get their “hours of experience” to sit for licensure as therapists or social workers) for the above mentioned interns and trainees.  Trainees are obtaining hours to graduate with their Masters degrees, interns are working on their hours (3000 hours of service over 104 weeks) to sit for the licensing examination with the Board of Behavioral Sciences.  In turn, the supervisees (the ones above and others from previous years) have provided thousands of hours of free services to the Glendora Unified School district, from elementary thru high school.  The supervisees from Partners have been assisting with issues of depression, abuse, family discord, eating disorders, suicide, addiction, grief and loss, bullying, self esteem, anxiety problems and more.

The program has been running since 2009 with Judy at the helm, and will continue at least through this year.  Judy, Ted, and the interns/trainees are all highly skilled clinicians.  It is a fantastic way for people to get services that might not have otherwise.  Nicely done everybody.

New Office Space

Have to start here with some gratitude. As many of you know, The Work is really a mission of sorts for me- trying to put myself out of a job so to speak. So many have been so kind and encouraging about my work. Clients, colleagues, friends. It’s really important to me to have a clearsighted and organized way of being a partner with people in eliminating suffering, having principles… preferably both.

Left doing inpatient full time in April, in favor of doing private practice full time. The folk above (and more) have responded by sending a lot of folk my way to do service with/for. As a result, my longtime office space with Brendan Thyne MA, and his dad Rick Thyne MFT (Patrick Thyne and Associates) became too small (time wise) to accommodate my clients.

Noting this because getting a new space wasn’t just a task- it is a loss in a lot of ways. Brendan and Rick are relatives (of choice and affiliation)- and fantastic therapists. The space across the street from Pasadena City Hall has been beautiful, and I really enjoy the surroundings. Between losing the familial contact and the space, is a big deal.

That said though, have found a fantastic space to do The Work in. Am hoping that it will bring an energy and space that can be filled with whatever it is that people need. Want to send some appreciation specifically for Yvonne, my dad, Judy McGehee LMFT, Erika Gayoso/Michael Cardenas/Ted Aaselund and Elvia Cortes. Also appreciation to Jeff Boxer Esq, David Wolf, Ed Wilson PhD, Sue Stauffer, Barbara Waldman PhD, Barbara O’Connor MFT, Tricia Hill, of course Lali and Sadie. A special note for my clients though- you all continue to humble me deeply, and have been fantastic supporters of my work.

Here’s a pic of the new space- near the end of the 110, the 134/210. New address is 547 S. Marengo Ave, Pasadena, 91101:

Preaching Prudence but Practicing Evasion

Just by virtue of having eyes and ears, we have emotional responses to everything. When we have experiences that create loss, damage, violate our sense of self or ethics (prompt an experience of feeling “less than” or being broken, also known as “shame”), frighten us or etc, we have to do something with how that feels. Just like falling off a bike and skinning our knee, we hurt in part because that’s the healing process in action. Many therapists and others refer to these unresolved hurts as “issues”.

If we don’t have a means of healing/dealing with these, there are lots of unintended consequences. Not healing “hurts” (shame, fear, sadness, etc) causes “neurotic” behavior. “Acting out”, drug use, manipulation, self-ful-ness, isolation, “codependent” behavior, “anxiety”, avoidant behaviors, etc. Long term and in the wake of continued losses/traumas, these can turn into more serious problems- depression, relationship issues, “mental illnesses”, addictions and etc.

Sometimes these other problems and behaviors are simply ways of surviving or “coping” with our feelings about things, sometimes they become problems in and of themselves. Exercise, church (etc), self-help books, “will”, diet and nutrition, hobbies etc are all efforts that can be helpful in varying degrees, but for reasons too long for a blog post, they’re insufficient and/or incomplete for this task. Some of these things sometimes turn into means of avoiding our feelings as well.

If we don’t have a fairly organized (and effective) means of transforming or eradicating our experience in this way, as above, we create or perpetuate problems in our lives. Different therapists have different “tools” suggested to help resolve or diminish the intensity of these issues. My sense of this process though, goes something like this:

List the behaviors we use that put distance between us and how we feel. Some of these are external- but some are internal. Some examples are food, alcohol, work, spending, sex, focus on others, perfectionism (whether imposed on ourselves or others), TV, turning our feelings into anger, etc.

Diminish (or preferably, maybe necessarily) or stop those behaviors. There’s many, many ways of making this happen- see my blog “Wanting to Stop” for some suggestions. As has been said in other blogs, “letting go” means little for something we are not fully letting ourselves “have” in the first place.

Give the feelings we’re experiencing/left with as simple, and common a name as possible. I encourage mad, sad, glad (happy), afraid, ashamed, and/or hurt. And/or because we can certainly feel more than one at a time. Simple, because we often use euphemistic or complicated language as just another means to dissociate (separate) us from our feelings.

Share those feelings, as much as possible with the person we’re having the feelings about, as close to the time we experience them. It’s also really important that we’re actually allowing ourselves to have the feelings as we’re expressing them. Of course this isn’t always appropriate because of time or circumstance. Sometimes, it’s not appropriate because of the person we’re with. Be careful though not to “preach prudence when practicing evasion”.

As has been said by many, “you can’t heal what you can’t feel”. This process is assisted by doing it with a professional who has has both education and experience in doing so not just as a therapist, but hopefully as a person as well. We are trained in various means that facilitate some really important parts of this process that are sometimes not intuitive to our friends, families, loved ones. Am getting at a fairly simple list of ideas here- stop doing what we do to not feel, have an organized way of naming and letting go of or diminishing their intensity.

Speaking of Service…

My friend and colleague Judy McGehee MA, LMFT (www.mcgeheepartners.org) along with Ted Aaselund LMFT have been providing clinical supervision (completing hours for graduation and/or eventual licensure) for a great group of interns and trainees at Judy’s office in Glendora, California.  They have been providing sometimes up to 40 hours of services to local schools with these Masters level folk to students and families who might not get these services at all otherwise.

I have been truly humbled by the work of these people, and lucky to get to participate in part of the supervision.  We have been discussing the obvious concerns about professional standards, law and ethics concerns, types of interventions, philosophy, differential diagnosis, addiction, depression, abuse and etc.  What has been so remarkable though is the intensity of the losses and difficulties these students and families have had, but equally, the grace and commitment of the interns and Judy insuring that these folk get taken care of.

It appears now that eventually, on top of the individual services that are being provided to the educational institutions, students, and families, there may be an opportunity for a multi-family group therapy at low cost for these individuals.  This is such a great service, but sadly, there is no funding available for this to happen (space may be made available at a school).  Of course I can’t discuss the details but, there have been some huge losses for these families that they are getting little support for treating from a public standpoint, the responsibility of both the service and the internship being largely on the shoulders of Judy and the interns, a little on Ted and I (as we didn’t take this on from the beginning).  The families served aren’t just getting low-level services- they are getting truly insightful, wise, professional services thanks to the good heartedness of the people involved.

Providing clinical supervision is such an important part of what I’m lucky enough to get to do.  It means much to me that I’m in a place where I’m not just empowered to help people, but that I am empowered to help people, who can further be of service to others.  What I do, I hope, matters a great deal, and the opportunity to share some of that with other people who might further use some of that to help yet other people is amazing.

Flickr Photos

Available Tuesday through Saturday

626-676-0541
Hours vary, depending on the day.
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