Category Archives: Therapy

Metaphors in psychotherapy

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Metaphors in psychotherapy

Good Friday to everyone! Are you ready for the weekend? IMAG0458

I have had a good day at work, with interesting meetings and memorable conversations. I have also had some time to read a bit, and came across two interesting metaphors. In addition, a doctor I work together with, also pulled a metaphor up his sleeve, and when I came down to my office, I had to write them all down. Then I got the idea? Wouldn`t it be great with a book full of metaphors (it probably exists already, but an update is always welcome) ? And then I started to wonder:

Do you have metaphors fitting for life in general and for psychotherapy?

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Life is like a camera

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The cloak of invisibilty

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The cloak of invisibilty

cloak

When she was little, her grandfather told her about the cloak of invisibility. A little girl wanted to get inside a palace, but as she was poor and never could get inside, she could only dream. One day a fairy appeared, holding a blood-red cloak, sparkling in the sunlight. She carefully draped it around the girls shoulders, and left. Three days later, when she by coincidence looked into a mirror in a hotel where she went in to wash her face, she startled when she could`t see herself in the mirror. In shock her cloak fell off her with a heavy thud, and she magically reappeared. Picking it up and taking it on again, she vanished once more.

The following days, she experimented with her cloak, and not only could she not see herself in the mirror when she put it on, no one else could either. With a thumping heart, she went to the palace. The cloak firmly around her slim body, walking with shaky legs, she stepped inside her palace of her dreams. Not only did her eyes rest upon beauty she never knew existed, but she also saw the prince himself. He was so handsome, that her cloak almost fell off her again, but she managed to avoid the disaster by clutching it tight. Three days later, she ventured into the palace again, and saw the prince sitting in the library, reading a book with tears streaming on his beautiful face. Without thought, she ran over to him, always eager to help. When she ran, her cloak made her trip and she fell, exposing the body she always tried to hide. The prince looked up from his book in shock from the loud thud, and the sudden appearance of a girl right in front of him. Their eyes met, and if there is such a thing as faith, this was it.

Three years later, they were happily married and had a girl, a little princess. The girl with the cloak, was never invisible again.

Her grandfather looked at his grandchild and smiled. She sat there, in rapt attention, dreams floating in her eyes. She looked at in him in awe and asked with a tender voice:

«Can I have a cloak like that?» He chuckled, stroking her hair and thinking he would give her anything, if he only could. On her 4th birthday a present was under a bed together with a little fairy doll on top of it. Eagerly she ripped off the paper, exposing a beautiful red cloak with glittering beads all over it. Before her parents, who always disapproved of her no matter what she did, could come in and realize that her grandfather had indulged in her once again, she hid it in the closet where she herself hid when her father roared in anger.

Later, she tried it on. She hid her bruises, misery and pain, and felt safe underneath the soft satin cloak. When she heard footsteps outside her room, she did not shiver like usual. She only put the cloak tighter around her, hiding in her closet, murmuring that everything would be okay. Like magic, her father left her alone, though he probably knew she sat there, and could have dragged her out to the bed like he sometimes did.

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She had always felt invisible, even without a cloak, but this time it felt good. When she recalled how much fear and horror she endured in her life, as an adult, she knew that she finally could change her future. Her cloak was always with her, no matter how dirty and ragged it became. Bit by bit, she felt safe enough to show small pieces of her invisible self to people who loved her. She managed to hide when someone untrustworthy came into her life, and slowly the bruises that had marked her body for so many years, faded. Sometimes, in the darkness before the dawn, she still put the cloak on, and little by little she managed to show herself to the world. She was like a broken mirror, but slowly the pieces came together again, and finally, one day, she was able to look at herself fully. Her husband, a kind man, helped her and found many of the broken pieces. Handling them with care, he fixed the mirror together with her, until they both could look into each others eyes without ever having to turn their gaze away from what they both hid inside.

At their third anniversary, he hid a present under her bed, with a little fairy on top. Her eyes filled with tears, as she saw the soft present underneath it. With shaking hands, she unwrapped it. A new cloak, even softer than the first one, appeared. Her tears flowed freely now, and when her husband came in with a birthday breakfast on a silver tray, he came over and held her hand. Carefully, he draped the soft silk around her shoulders. To her amazement, he wore a black cloak himself, shining in the sunlight from the new day. Together, they walked over to the mirror.

Her tears stopped flowing, and in that moment, life was good.

She never had to hide again.

This post was reblogged from my blog: Mirrorgirlblog

Perspectives…

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Boys carrying spaghetti in a macaroni factory in Naples, Italy. 1929

Psychological and philosophical point of view, brought to you in plain language…

http://www.raptitude.com/2010/10/9-mind-bending-epiphanies-that-turned-my-world-upside-down

 

The Therapeutic Alliance: The Essential Ingredient for Psychotherapy

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umbrellas

 I am currently writing on the ‘therapeutic alliance’ – its relation to mindfulness, psychotherapy, understanding, and ‘being listened to…’   What follows is an interesting article that I came across that may interest some of you…

Excerpt:

Have you ever tried to change the way you do something? It could be anything — the way you hold your tennis racket, blow into a flute, meditate — you name it. If so, think about that experience. No matter how motivated you were to change, and no matter how much you knew that it would help your serve, musicality, or sense of inner peace, it can be difficult and scary to change even the smallest thing. In order to change, you have to give up your old way of doing something first and then try the new way. That means that for a while you’re in a free fall — you no longer have your old habit to rely on and you don’t yet have the new one.

The anxiety of trying to change something as complex and entrenched as how you relate to people close to you or manage stress takes the feeling to a whole new level. Yet, that’s just what you do when you enter psychotherapy. Just as you had to put yourself into the hand of your teachers and coaches, in therapy you need to gradually do just that with your therapist to help you through what can be a harrowing adventure. The foundation for therapy is called the therapeutic alliance (1, 2). When it’s there, you know that your therapist is there to help you, no matter how hard the going gets.

The therapeutic alliance might be the most important part of beginning a psychotherapy. In fact, many studies indicate that the therapeutic alliance is the best predictor of treatment outcome (3-5).

See entire article:

http://www.huffingtonpost.com/deborah-l-cabaniss-md/therapeutic-alliance_b_1554007.html

 

Dynamic Opposites

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Girl with grandfather

Girl with grandfather

When I was a young girl, my grandfather and I would go for long walks together. He was a tremendous influence in my life and came from a time when intelligence defined how far a man (or a woman) got in life. Those walks were a major part of my education and they most definitely molded many of my life-long philosophies.
Perhaps one of the most memorable life-lessons my grandfather spoke about during our time walking together was also one of the simplest of concepts. As if it were just yesterday, I remember him telling me that both, too much and too little of something made it no good. Everything , even something that starts out good, can become something hurtful, he explained, when it dwells in extremes.

I didn’t understand it then, but I have lived long enough to understand it now. Finding the balance in things is critical to a happy, healthy, successful life. Everything, including people and all their components, have polar ends. But they also have a center, a place where both of those two extremes are no longer opposing each other or pulling in opposite directions. The center, the neutral point of any two oppositional forces is the place we store our most valuable resources.
Try this simple exercise to serve as an example. Clench your right hand into a tight fist. Then release it. Now do the same with your left hand and release. You have just put fairly equal pressure or tension on both sides of your body, first your right and then your left. But as soon as you complete the action, your body restores itself to balance, and you feel better; centered and more relaxed.

Too Hot - Too Cold

Too Hot – Too Cold

Goldilocks understood this concept perfectly when she rejected both the Pappa bear’s cereal because it was too hot and the Mamma bear’s cereal because it was too cold. She continued her state of discomfort until she continued onto the Baby bear’s bowl of cereal which was ‘just right’ for her. Neither extreme of hot nor cold suited her. And as we all know the rest of the story, she repeated this process again to find her level of comfort for sitting on chairs and finally for being able to rest and fall asleep.

Although we have much in common with each other as human’s we also all have very unique and individual components that make us exactly who we are and each one of us has our own exact location for balance within us. Mine is not where yours is, yours is not where Goldilocks’ is and that is a wonderful thing because it affirms our individuality.

And, our own personal sense of balance is not ever exactly the same in any given moment. Life is dynamic, not static. Energy is dynamic. And because of that, all our components are constantly in motion, changing. So, our sense of balance in one situation shifts when we are in a different situation during the same day. Also, the very same situation at one time, can cause a shift of balance in us the next time we come across the exact same situation.

Dynamics of Life

Dynamics of Life

The key is to understand and accept this dynamic and make a habit of ‘checking in and fine-tuning’ ourselves so that we identify where we are internally on the opposite – balance – opposite spectrum. The more we connect with our perfect sense of center and balance, the more energy, happiness, healthfulness, mindfulness and performance we develop for ourselves.

I had the opportunity to speak with a fascinating man yesterday, and hear what he had to say about all of this. He explained his ideas about how this balance, this center and putting space between our opposites can eliminate the tension and stress from our nervous systems and grant us well-being.

If you drink a cup of caffeine in the morning, it is nothing that can harm you in any way, he stated, if you also partake in having a glass of wine in evening – the stimulant in the coffee in your body is brought back down by the calming effects of the alcohol in the wine and you have returned your system to its pure balance.
This fascinated me and I hope you too. More to come on it all very soon.

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

A mad world A diagnosis of mental illness is more common than ever – did psychiatrists create the problem, or just recognise it?

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Unfortunate Events

When a psychiatrist meets people at a party and reveals what he or she does for a living, two responses are typical. People either say, ‘I’d better be careful what I say around you,’ and then clam up, or they say, ‘I could talk to you for hours,’ and then launch into a litany of complaints and diagnostic questions, usually about one or another family member, in-law, co-worker, or other acquaintance. It seems that people are quick to acknowledge the ubiquity of those who might benefit from a psychiatrist’s attention, while expressing a deep reluctance ever to seek it out themselves…

…While a continuous view of mental illness probably reflects underlying reality, it inevitably results in grey areas where ‘caseness’ (whether someone does or does not have a mental disorder) must be decided based on judgment calls made by experienced clinicians. In psychiatry, those calls usually depend on whether a patient’s complaints are associated with significant distress or impaired functioning. Unlike medical disorders where morbidity is often determined by physical limitations or the threat of impending death, the distress and disruption of social functioning associated with mental illness can be fairly subjective. Even those on the softer, less severe end of the mental illness spectrum can experience considerable suffering and impairment. For example, someone with mild depression might not be on the verge of suicide, but could really be struggling with work due to anxiety and poor concentration. Many people might experience sub-clinical conditions that fall short of the threshold for a mental disorder, but still might benefit from intervention.

See link for interesting article on psychiatry…and bits about the importance of psychotherapeutic intervention…

http://aeon.co/magazine/being-human/have-psychiatrists-lost-perspective-on-mental-illness/

Does abuse define a career path?

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DOES ABUSE DEFINE A CAREER PATH?


DEPRESSION

Does abuse define a career path?

One of the enduring questions of human development and behaviour is why we take the paths that we do. What influences us in our choice of partner, profession, lifestyle and other things that make us who we are? This is a deep and complicated question even if a “good enough” upbringinghas been experienced but even more so when a history of abuse and/or dysfunctional parenting has prevailed. In this case, whenlackingthe foundation of security, how do abused children make their way in the world, seemingly dragging a ball and chain with them? A book I recently reviewed may offer some clues and answers to this.The book in question is  “Strong at Broken Places” by Linda TSandford.The basis of the book are the stories of twenty child abuse survivors who figured that “the best revenge is living well”. Prevailing over a childhood of sexual and physical abuse, neglect, parental substance abuse and witnessing domestic violence, Linda Sanford asked them to look back and help us all understand how they fared so well. One of the first popular books on resiliency, Strong at the Broken Placeswas written for every survivor, friend, family member, mentor or helping professional who seeks the path towards self-forgiveness and healing. 

Linda T Sandford spent most of time while writing her book explaining why she believes that abuse does not necessarily jump generations and the patterns of the past can be broken by survivors. This is often not the case when survivors of abuse choose a career path. It can be said that some abuse victims find their way in the working world because of the abuse and not in spite of it. Sandford eloquently uses a quote from Freud to start her reasoning: “there are two pillars of healthy life, love and work” It appears from Sandford’s research that many who could not find love, threw themselves into the other, making work the focus of their life.

In a normal family, parents are considerate and understanding with their children. They allow a child to be happy, responsible, creative and love is given and accepted by both sides. The child does not need to prove anything or work hard for the parent to love them and love is unconditional. In troubled families, abusive parents expect children to “do” for them in a spirit of “you are not good enough to love, you have to earn it”. Children, often thinking that this conditional love is better than none, “do” for their parents, becoming little “mothers, fathers, husbands or wives”.  This lead Sandford to the following conclusion: in contrast to the stereotype painted by society that abuse victims are “underachievers”, many excel at work, maybe because this work ethic is instilled in them through the abuse itself. This success in the workplace is usually not turned into the self-esteem that one would imagine. Many survivors point to the fact that work gives them a place “to belong”, either mirroring early family life helping siblings or parents or giving them something that they had never experienced before. Sandford states clearly that for many abuse victims, work is a manifestation of her theory of “looking good on the outside”.

It is then not surprising that abuse survivors often choose careers that have some relation to the abuse they suffered. Concerning this point, there is a widely held prejudice that due to the abuse, abuse victims careers are somewhat chosen for them through the conditioning experienced by the abusive parent. For example, if an abused child finds comfort in the animals or plants, many believe that this would drive them to be vets or horticulturalists. Sandford’s research did find, however, that many abuse victims end up in the helping professions, ranging from nurses to therapists. Through abuse and neglect, many survivors had to take on responsibility for the care of siblings and indeed parents from a young age and also have an ability to anticipate inappropriate behavior. Characteristics needed in abundance when helping others.

Jen • 1 year ago

Have you experienced abuse?
YesNoDon`t want to sayEmotional AbusePhysical abuseSexual abuseOther:

For many survivors, the world of work is a meaningful place. Many abuse victims were brought up in poverty and working hard is a way of providing financial security. Many of the sample interviewed were self-employed in some way to avoid working “for” someone and many saw work as a way “offering social contact but without the need to show vulnerabilities or bare one’s soul”. Many survivors were by their own admission, workaholics, stating that this addiction was “more socially acceptable” and is “rewarded by society” bringing a sense of “self worth” to what they are doing. Sandford states clearly that balance in life is vital. What worked as a child, that is working hard to achieve, rarely works as an adult and many survivors use this “busyness” as a shield for depression. Sandford finishes by saying that she believes that “being should stand proudly next to doing and working”.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals, couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here ……

Milton H Erickson

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On the bus yesterday, I listened to an audiobook about a man I found very interesting. I would love to reproduce everything I heard, but this will be some facts that I found especially interesting

I had the nickname in grade school and high school, “Dictionary,” because I spent so much time reading the dictionary. One noon, just after the noon dismissal bell rang, I was in my usual chair reading the dictionary in the back of the room. Suddenly a blinding, dazzling flash of light occurred because I just learned how to use the dictionary. Up to that moment in looking up a word, I started at the first page and went through every column, page after page until I reached the word. In that blinding flash of light I realized that you use the alphabet as an ordered system for looking up a word…I don’t know why it took me so long. Did my unconscious purposely withhold that knowledge because of the immense amount of education I got from reading the dictionary?

Milton H. Erickson – Wikipedia

His story is impressive, and even more so when one considers his background: He was color blind, deaf and dyslexic. He learned hypnosis, and worked as a psychiatrist first. He married, got 5 children with his wife (he had three from previous relationships). He founded the American Society of Hypnosis. He died in 1980, and his ashes were strewn over a mountain top that many of his clients reached.

I had polio, and I was totally paralyzed, and the inflammation was so great that I had a sensory paralysis too. I could move my eyes and my hearing was undisturbed. I got very lonesome lying in bed, unable to move anything except my eyeballs. I was quarantined on the farm with seven sisters, one brother, two parents, and a practical nurse. And how could I entertain myself? I started watching people and my environment. I soon learned that my sisters could say “no” when they meant “yes.” And they could say “yes” and mean “no” at the same time. They could offer another sister an apple and hold it back. And I began studying nonverbal language and body language.
I had a baby sister who had begun to learn to creep. I would have to learn to stand up and walk. And you can imagine the intensity with which I watched as my baby sister grew from creeping to learning how to stand up.
– My Voice Will Go With You

He was recognized for his hypnotherapy, were he integrated his extensive knowledge collected from experience and intelligence. An example of his insights: “One day a horse wandered into his home place. He let the horse take him where he wanted, and he stopped where he came from. When the farmer asked how he knew where the horse came from, he said: I didn`t, the horse did”. By relying on the force of the unconscious, he could help both people and animals

Milton Erickson was an interesting therapist and scientist: With creativity he tailored therapy to each client so that it fitted perfectly. He was the perfect ”mirror” for others, so much that he actually could “talk” exactly like the client in front of him. He strongly believed in the unconscious, and in letting people find their own insights. He could tell little anecdotes that were completely right for the client. An example was an alcoholic that lived in a family where everyone drank (even his own wife) and drunk for several years. He was considered a hopeless case. Milton gave him a task: He should go to a park and sit down to watch a cactus for several minutes. Erickson told him this cactus could live without water ericksonfor three years. 5 years later his sister called Erickson and told him both he and his wife had stopped drinking. He also used Reframing, mirroring and the paradox intervention. And example of the first, is when he sent a rootless client to Flagstaff so that she created new positive associated to a place that just seemed negative before. An example of the second is when he met a patient that tore things apart. She tore and threw everything she saw: Clothes, curtains, wallpaper. Generally, she was acting out. Erickson stood beside her and did the same thing, he tore up pieces of the wallpapers and threw things here and there. He exclaimed: “This was fun! Let`s go somewhere else and do more of it”. They came to a hospital, where he ripped the clothes off a nurse.

After this event, the girl became an angel, not knowing that the nurse in on the whole thing. An example of the paradox intervention was telling a woman who had severe problems with her weight. Erickson told her to try a new method where she first would gain a certain weight before she started with dieting. When she no longer had to restrain herself, she suddenly lost the weight she needed.

BUCHis theories have been developed further after he died, and one of the results is NLP (Neuro-linguistic programming ). I actually know very little about NLP, but I have thought several times that I`ll have to check into it, since I`m very interested in theories integrating what we know about our brain, with psychology.

  1.  Milton H. Erickson | History of Hypnosis

    Milton H. Erickson (1901-1980) graduated from the University of Wisconsin in 1

    Milton Erickson, Founder of Conversational Hypnosis | Business NLP

  2. Ericksonian Hypnosis: Breaking Habits with Tasks — NLP 

    PICTURES:  http://www.pinterest.com/pin/391391023837204618/
     http://ww2.odu.edu/~eneukrug/therapists/Erickson.html

The sound of living like a psychological millionaire

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The art of living as a psycholgical millionaire: To use your energy in a way that gives you a result you need.

A person with the possibility of becoming a psychological millionaire does just this. For this to happen, certain principles must be satisfied. Efficient mental energy has four caracteristic features. Its:

– Adaptive

– Goal-oriented

– Successful

and

– Devoid of waste

Examples of non-efficient living:

Certain diagnostic groups can have enough mental energy, but low mental efficiency. This can for example be clients with AD/HD or Borderline personality disorder. They might do a lot of things, like walking around in a room restlessly or having an emotional outburst. Their problem is using the energy in a good way: They can`t regulate it in a way that makes it able to live a good life. Some groups have too low energy to be efficient, like with depressed or fatigued clients.

When working with dissociation, parts have different levels of mental energy and efficiency. EP`s can actually be the most energetic parts in the system, but have very low efficiency, since they repeat behoviors in a dysfunctional way. It is possible to have a dissociative disorder like DID and borderline PF at the same time. In this case most parts will have borderline features, that is: High levels of mental energy but low efficiency.

Energy and efficiency in trauma

“Looking in a cupboard that is empty, will not work no matter how good the torch is”. Nijenhuis, 2013

Trauma can also be understood by using the concept of energy and efficiency. Trauma can be either too much or too little energy or efficiency. For example, an EP can feel stuck, with high levels of energy, but low levels of efficiency. The EP can`t “get out of it”. There is no symbolization of the event, since it “feels like” the trauma is still going on. The part or the EP is “stuck” in what was. To connect the then with the now, it`s necessary to reach the reach the higher level of language, and that is easier when an empathic therapist helps the EP. Empathy is necessary to tune in to the EP`s experience. If the EP is afraid, the voice of the therapist must be soothing and calm. The therapist must tune in so that the EP is seen and validated. When the therapist tries to understand the EP, the ANP of the patient might learn that it`s possible to collaborate and help EP`s.

Example of working with an EP with enough mental energy

Imagine a claustrophobic EP (picture 1). The EP has trouble breathing because her throat feels constricted. The therapist might observe this, and tune in to this with a low, empathic voice “It looks like you have trouble breathing ?” The therapist observes that the EP tries to nod. The therapist continues: “I see you tried to nod, but it looks like its hard to move?”. The therapist explores the EP`s experience, thereby respecting and validating her.

The therapist can also ask the EP to try to broaden her field of consciousness, by asking if they can try to breathe slower or by asking of if the EP could look at something around her that is comforting. He can also try to tell the EP that she is safe, that boundaries will be respected, or say that everything will be okay. Moreover, the therapits can make it clear that the EP decides what happens next, and that everything will be predictable and safe. The therapist watches the EP and helps her, where she is, there and then.


Working with a non-verbal EP

If the EP is young and can`t talk, one has to communicate non-verbally. For example, if the EP is in “freeze-mode”, the therapist can ask questions about the inner experiences of the EP: “Can you find a place in yourself where you have some ability to move?” If the EP moves the ANP`s finger just a tiny bit, the therapist might say: “Is it possible to move your finger a little bit more?” Gradually, the EP is exposed to new experiences that will be healing in time.

If the frozen EP is able to move, either by actually walking around in the room, the EP learns what it couldn`t when abuse happened. When the therapist is able to intone and be there for the EP`s, magic can happen. I`ve experiences this myself, and every time it feels so meaningful. To see a afraid little EP starting to feel stronger, feels like I`ve been able to lift a heavy weight together with them. Therapy is heavy work. The EP must shred the cloak of repression that weigh down on them, and that cost a lot of mental energy. This means that the client must have enough mental energy available.

If he is tired, starved, physicially unfit or doesn`t do anything inspiring that gives joy or energy, it might be best to wait until more energy is available. Trauma-therapy is hard work, and cost both physical and mental energy. Going into trauma-material before the client has filled up her batteries, is not recommended.