Relationships Depression Anxiety Mental Health Information

What I'm Reading Now -- Richard Rohr's Breathing Under Water

6/29/2017

Recently a lovely friend of mine, Margaret Martin, gave me this book as a gift. Margaret knows that I am an advocate of many 12-step programs and thought I might like Richard Rohr's take on it. Like any good friend she knows me well and I really loved this book!

First of all Mr. Rohr is a wonderful writer. His prose is beautiful and captivating. He weaves religious writings into his own thoughts in reference to each of the original 12 steps of Alcoholic's Anonymous. For those of you who are not familiar with 12-step programs, most other 12-step groups take their "steps" from AA so this book also applies to other "fellowships" such as Al-Anon, Sex Addicts Anonymous, Emotions Anonymous, Adult Children Anonymous, Over-eaters Anonymous and so on. While the spiritual aspect of 12-step is sometimes a thorny issue for people Rorh has a wonderful way of not preaching or evangelizing but rather speaking as a religious scholar familiar with many religious texts and traditions. He opens the 12-steps up in a way that I found to be very rich and thought provoking.

Let me take a moment to clarify that while I enjoy reading religious texts from various traditions (Jewish, Christian and Islamic to name a few... as well as Buddhist, but that's not really a religion...) I am not dogmatic about religion with clients. Research does suggest that spirituality is helpful to folks and as a psychologist I often encourage people to consider that fact. However I am not of the mindset that a psychologist should be pointing people in any particular spiritual or religious direction.

That said I do think that if you are not adverse to religious writings and furthermore if you are open to the 12-step approach to things you may enjoy this book. One of the first things that Rohr points out is that, to him, one of Jesus's central messages was to become enlightened in such a way that one can enjoy the wonders of this life while still in it. In Rohr's opinion, sometimes that message gets changed to putting off the joy until the life hereafter. Rohr equates this with the recovering alcoholic who focuses simply on not drinking (abstinence) while failing to fully "live a life of recovery". In this sense, truly living "in recovery" opens one to the daily joys and miracles of life without blunting oneself to the pains of life through addictive behaviors or thought patterns. In AA language this is the difference between a "dry drunk" (i.e. abstinent) and someone practicing recovery.

While Freud once said that the goal of psychotherapy was to turn neurotic sufferings into ordinary sufferings, I also feel that the goal of therapy can be to open us up to the daily miracles and even ecstasies of the human existence. I have seen many people find this through the 12- steps and also through spiritual practices such as prayer, mindfulness, loving kindness (metta) meditations, yoga and psychotherapy. In my opinion as a mental health provider, however you get there it is a great gift to give oneself. To be fully present in the moments of life and to fully participate in the joy (and yes, the grief and pain as well) is to live life to the fullest. Which calls to mind the quote by Shaw:

Another profound comparison that Rohr makes between the teachings of Jesus and the 12 steps is the idea that only once a person has "hit bottom" spiritually, emotionally or physically (or all of the above!) can they experience true transformation. He references a conversation Jesus had with one of his disciples in which he talks about needing to be "ground like wheat" and then recovered before one can be useful to another human being to help in his or her healing. Rohr goes on to say that "Those who have passed over [had a profound and transformative experience] eventually find a much bigger world of endurance, meaning, hope, self-esteem, deeper and true desire, but most especially, a bottomless pool of love both within and without." (p. 124-5).

I am a person who loves contrast, who loves unexpected parallels between seemingly unrelated things. So for me this book was a treasure trove of similarities between two traditions that, on the surface, don't seem to have much in common. While spirituality has always been an important part of the 12-step programs, I have not seen direct comparisons of the 12-steps to the words of Jesus as written in the bible. So I enjoyed seeing Rohr sew these two traditions together along the points where they truly do seem to be saying the same thing.

If you have had painful or distressing experiences with organized religion, or find it a concept that is simply not useful to you I completely respect that. Each person's life is their own journey. But I do think that looking for the deeper meaning in things, whether that is along traditional religious lines or more spiritual or metaphysical lines, can provide a source of inspiration, empowerment, hope and peace in those times where life breaks you open.

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Wishing you peace, health and happiness in all of your relationships, including the one with yourself!

Best,

Dr. Jordan

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How Do We Learn Shame ?

5/26/2017

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I have written about shame before but wanted to expand on my earlier blog with some new information on how exactly we learn to be shame prone.

James Harper has written about this subject and explains that families that promote shame lack certain fundamental qualities that protect against shame. These qualities are accountability, intimacy and dependency. If these qualities are present in sufficient amounts in a family system children can grown up without undue amounts of shame. To break these
qualities down:

"accountability" is the sense that "family members feel and act responsibly towards each other and meet each other's basic emotional needs"

"intimacy" is when family members are "able to share physical touch, be nurturing to each other, and share emotional experiences" in a way that feels supportive and comforting

"dependency" is the "ability of family members to rely on each other emotionally for basic needs". This includes parents not being annoyed by the natural dependency of young children and being willing to continue "scaffolding" children well into adolescence as they learn to become more autonomous.

Again if these qualities are not present enough kids will end up feeling toxic amounts of shame. When kids experience shame a lot they naturally begin to internalize it. That emotional state gains preference in the nervous system and is more easily accessed. I compare this to driving down a dirt road every day for several week. Over time you will notice grooves getting established in the dirt so that it gets harder to deviate from the path you have been taking each time. This is similar to the way our brains respond-- the more we feel something (or think something, or do something) the more that pathway is reinforced and becomes easier for the brain to find the next time. So numerous experiences with shame as a child make is "shame prone" in adulthood.

“Children are especially vulnerable to shame." commented Sarah MacLaughlin, LSW in this article in Huffington Post. "Self-centered and dependent, young humans will easily translate, “You did something bad,” into, “You ARE bad.” We need to be aware and careful about the messages we send.

One potent quote I heard about shame was this --

Shame is a lie someone told you about yourself
(that you believed).

Whether it is intentional or not we need to be careful about the messages that we transmit to kids. That they are frustrating, that they are "too much", too needy, too demanding, incompetent, embarrassing or not measuring up to our standards. They may believe these falsities many, many years into the future.

Perhaps one of the reasons that shame is such a persisting emotion and so hard to "un-learn" is that it is tied to our very survival. Shame is centered in the autonomic nervous system. Unfortunately the human brain, in some ways, is pretty dumb. It cannot distinguish between physical threat and emotional threat, just like on a brain level it does not distinguish between physical pain and emotional pain (see my earlier blog on this). When the brain perceives any kind of threat it responds by booting up "crisis mode"-- the autonomic nervous system. This is the response of the brain to shame, probably because shame implies a threat to important relationships. Especially in childhood our relationships with caregivers are life and death matters. If we are being shamed by our caregivers we respond as if our survival has been threatened-- because it has. Just like being attacked by a bear we have the urge to hide or flee. If that does not work we resort to attack. Shame is hard-wired in to these deep areas of the brain (the ANS) that are designed to protect us from actual annihilation. So once these areas have been reprogrammed to feel shame it can be very hard to root out.

Shame proneness in kids is sadly predictive of numerous problems in adulthood, including alcohol abuse, high risk sexual behavior, legal problems, suicide attempts and social isolation. Shame proneness, while not associated with age or socioeconomic level, is also associated with low self-esteem and PTSD as well as the problems mentioned above (Ashby et al. 2006, Crossley & Rockett 2005, Feiring & Taska 2005, Stuewig & McCloskey 2005). Shame-proneness assessed in the fifth grade predicted later risky driving behavior, earlier initiation of drug and alcohol use, and a lower likelihood of practicing safe sex (Tangney & Dearing 2002). Similarly, proneness to problematic feelings of shame has been positively linked to substance use and abuse in adulthood (Dearing et al. 2005, Meehan et al. 1996, O’Connor et al. 1994, Tangney et al. 2006). For people who are HIV positive, having persistent feelings of shame predicted t-cell decline, showing compromised immune function (Weitzman et al. 2004).

Shame-prone people also engage in aggressive acts more than those who are not shame-prone. For example they tend to verbally attack, blame and externalize as well as the more passive-aggressive option of simply talking badly about someone behind their back. Shame-prone folks are also more aggressive physically, either interpersonally or by attacking objects/possessions important to the person they are angry at (think keying someone's car). Sadly the shame-prone person may also harm themselves or simply ruminate in their unexpressed anger. Interestingly these individuals admit that their anger gets them into trouble and is destructive of relationships but they seem to have trouble not being triggered into these negative behaviors.

Brene Brown has written and talked extensively about shame and how to become less shame-prone. She suggests the following steps to help recover from a shame-prone upbringing:

Recognize shame and it's triggers. Know how shame feels in your body, what thoughts are associated with it. Learn to predict situations in which you are likely to feel ashamed.
Give yourself a reality check. Ask yourself where these expectations came from. Are they realistic? Do you even agree with those values? Is what is being asked of you even possible?
Reach out. When we talk to compassionate others who can hear about our shame and not turn away, who can sometimes even utter "me too", we diminish the grip of shame on our psyches. Shame exists only in isolation. It is the myth that we are somehow less than, somehow untouchable to others. Experiencing the opposite is a powerful antidote.
Tell others when you feel shamed by them. Many of us are so self-loathing that when someone says something unkind or hurtful, provoking that familiar feeling of shame, we don't say anything. Instead we pull into our shell and begin the narrative of self-recrimination. In order to learn not to be shame prone we must speak up and tell others how their words or actions have made us feel.

For more help with shame I recommend Brene Brown's Ted Talk or her book on shame. She also has other resources available on her website.

Therapy can also be a wonderful tool to work on deep feelings of shame or surviving a shaming childhood. People can heal from toxic shame and learn to more fully love themselves and live the lives they truly deserve.

Wishing you happiness and peace,

Dr. Jordan

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The Course of Love -- by Alain de Botton

4/23/2017

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This is, by far, the most accurate account of marriage I have ever read. Alain de Botton's most recent novel is not for those who want to maintain a fairy-tale version of marriage. It is certainly not for anyone who wants to cling to the idea of a soul mate, someone born to understand your every wish without you even uttering it. It is for those of us who seek to understand why so many marriages fail. Who seek to understand what marriage is really, truly about. (I say here marriage but really I am talking about any kind of long-term coupling). It is not a sad story by any means. It is a realistic story of two flawed people who build a life together. That life includes romance, but also children, mess, affairs, work and heartache. But in the end they continue to "choose each other" as Bruce Feiler would say in his recent book.

The book follows two characters as they meet and fall in love and continues on through their lives for the first few decades of their union. During this time they struggle, sometimes together and sometimes privately, with just what to expect of marriage. In the end they come to understand that with all its flaws marriage offers us something unique and valuable-- the opportunity to truly put another's needs first, over and over, which can only be done by growing as a person.

Of course like the rest of us the characters in de Botton's book had no idea what marriage was at first. The soon to be husband reflects on his desire to propose and concludes that "He hopes through the act of marring to make an ecstatic sensation [falling in love] perpetual." (p. 40) Not to be cynical here, I have been happily married for nearly two decades, but to think that by marrying as an act itself you can seal in that feeling of falling in love would be quite misguided. One has to work at continuing to fall in love like one has to work at staying in shape. Sadly if not properly guided many of us will eat too much cake, go to the gym too infrequently and then not recognize that person in the pictures from our 20 year high school reunion. Marriage is much the same. Many of us come to the institution poorly trained and somehow expect that following our instincts will lead us to the habits that build and sustain this marvelous partnership. Years or decades later when the union is on its last breath we wonder what happened.

The main characters also find that being coupled sheds light into areas of our lives that previously we had happily been spared. As de Botton puts it "The single state has a habit of promoting a mistaken self-image of normalcy...[our] tendency to tidy obsessively when ...feel[ing] chaotic inside, [the] habit of using work to ward off...anxieties, the difficulty...in articulating what's on [our] mind when...worried, [the] flurry when [we] can't find a favorite T-shirt---these eccentricities are all neatly obscured so long as there is no one else around to see [them]." (p. 42) How beautifully this captures our own self-serving bias-- that how we are, what we think, what we feel, what we prefer, how we operate, is normal. Forgetting all the while that we are just as weird, conflicted, inconsistent, hypocritical, defensive or even downright crazy as the next person. This self-serving bias leads us to the problem that "Without witnesses, [we] can operate under the benign illusion that [we] may just, with the right person, prove no particular challenge to be around." (p. 42) Ah, the illusion that we are right and our partner SO wrong! That if only they would come to their senses and agree with us! Be like us!

De Botton also touches on the potentially tragic tendency of humans to move towards familiarity. We think we are searching for that perfect person who will complete us, who will overlook our bad habit of leaving the milk out or staying up until 3am on Facebook only to be obscenely grumpy the next day. But alas what we are actually searching for is a relationship "that it will be reassuringly familiar in its pattern of frustration." (p. 44) He muses that when we do, accidentally, run into a person who is healthy and not inclined to replicate our painful childhood wounds we find ourselves "rejecting [them] not because they are wrong but because they are a little too right-- in the sense of seeming somehow excessively balanced, mature, understanding and reliable-- given that, in our hearts, such rightness feels foreign and unearnt." (p. 44)

This is where in working with couples I think it is important to point out the opportunities of what might seem like an unfortunate union. For when we partner with this person who is inclined to hurt us in ways that are similar to our original caregivers we also open up the possibility that these new attachment figures (our partners) can HEAL those old wounds. This is the type of work promoted by Dr. Stan Tatkin in PACT. Dr. Tatkin explains why relationships are so "hard" in his brief Ted Talk and helps us to understand how the things we bring to our relationships-- our childhood wounds, our attachment styles, our nervous systems, can undermine our hopes for a perfect union. In working with couples using the PACT style I try to help partners heal each other's wounds from childhood, which has the nifty benefit of not only freeing up more resources in the now-healed-person but also creates immense gratitude, love and appreciation for the partner-who-healed. It's a beautiful gift that pays forward.

The characters of de Botton's book also experience the sad phenomenon pithily described as "if it's hysterical it's historical". Meaning, when you partner reacts hysterically (i.e. going WAY overboard) they are probably "triggered" into some childhood feeling being brought up by the present situation. This has the misfortune of causing a person to react like a lunatic given the current circumstances. When triggered by our spouse, de Botton says "we lose the ability to give people and things the benefit of the doubt; we swiftly and anxiously move towards the worst conclusions that the past once mandated." (p. 84) The spouse that is 20 minutes late is confused with the father who abandoned us; the wife who circles the room chatting with everyone while her husband is left at the punch bowl becomes the mother who never had time for him. And on and on. These are the circumstances that, if misunderstood, can tank a marriage. But often it takes a professional to help the two lost souls embroiled in these patterns to see what is really going on.

And much to my surprise in reading de Botton's book, his couple actually finds themselves in the office of an attachment-based couples therapist! I swear de Botton did not consult with me on this. Although if he had it's certainly what I would have recommended. And as has been my experience for the past decade of using PACT, de Botton's couple is able to heal what had previously been fodder for battles enumerable. They learn to see the wounded child inside of each other and minister to it. And their love grows immeasurably. It would sound like a fairy tale if I did not see this exact narrative play out so many times in my own practice. His couple learns that "Everyone is always impossible. We are a demented species." (p. 182) De Botton goes on to show us how "The Romantic vision of marriage stresses the importance of finding the 'right' person, which is taken to mean someone in sympathy with the raft of our interests and values. There is no such person over the long term. We are too varied and peculiar. There cannot be lasting congruence. The partner truly best suited to us is not the one who miraculously happens to share every taste but the one who can negotiate differences in taste with intelligence and good grace. Rather than some notional idea of perfect complementarity, it is the capacity to tolerate dissimilarity that is the true marker of the 'right' person. Compatibility is an achievement of love; it shouldn't be its pre-condition. " (p. 216).

It's a beautiful book with a real and honest look at marriage, warts and all. Some people ask me how you know if you are ready for marriage. My usual response is that no one can be ready for marriage because it calls you to be someone you are not yet ready to be. Your fullest, highest, most evolved self. But perhaps from now on I will recommend as an alternate answer that you are ready for marriage if you can read this book and still believe in love. If you can see it not as a tragedy but as a testament to the power of two people's desire to overcome who they were and become better people within the bonds of a partnership that will push their every button. If you can see that as love, then maybe you are ready.

Wishing you health and happiness in all of your connections,

Dr. Jordan

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Helping Your Child Get Through Anxiety

4/16/2017

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Occasionally I get requests from writers to post on my blog. I find this flattering of course and am pleased to share a platform with anyone who is trying to help others. A while back Noah Smith reached out to me asking to share his writing on helping children with anxiety. As a mom of a son with OCD and social anxiety this issue is particularly close to my heart. I appreciate Noah taking time to write about it and am pleased to share his words here:

With the world in the state it’s in, it’s no wonder that children and teens are having a hard time coping with anxiety. Violent incidents captured on camera and shared on television and social media, cyber bullying, and the pressures (including peer pressure to use popular drugs) that come with school and relationships are just a few of the things kids deal with these days. No matter how hard you try as a parent to give your child a loving environment to grow in, sometimes there are things that are simply out of your control when it comes to their wellbeing.

For this reason, it’s important to help your child learn ways to work around feelings of anxiety and focus on positive thinking. This can help both of you when those feelings surface. Here are some of the best ways to help your child cope with anxiety and the stress that comes with it.

Don’t avoid situations

It might seem like the best idea is to have your child avoid situations that trigger his anxiety, but that might actually make things worse. Facing his fears is often the best way to learn how to cope with them, and the best way to do this is to be prepared. Help him picture the scenario that’s giving him worry and ask him to think of two ways he can handle it. For instance, if he’s anxious about being separated from you in a public place or missing the bus at school, have him come up with solutions so that if those things ever did happen, he’d have a plan.

Empathize

No parent wants their child to worry or stress, but it’s important to validate your child’s feelings rather than simply telling him not to worry or be afraid. Let him know that it’s okay to have those worries sometimes and that no matter what happens, everything will be okay. It may also help to talk to your child about what you were afraid of when you were his age.

Educate

It might be helpful to do some research on anxiety and stress together. Talk about how being anxious makes your child feel and whether it affects him physically, as it can sometimes do. Feeling jittery, nauseous, or distracted are symptoms of anxiety but might not always be associated with it, and these things can affect your child’s performance at school or his ability to be social.

Learn coping techniques

There’s no one right way to deal with anxiety or negative thoughts, so it’s important to work through a few different techniques to see what works for your child. These can be anything from positive visualization to breathing exercises; if it helps your loved one get through those tough moments, encourage it. Remind him that those thoughts will come and go…”go” being the operative word.

If your child is having difficulty with eating or sleeping because of anxiety, help him find ways to relax. This might include taking a hot bath before bed, or finding different ways to eat meals rather than sticking to a routine. For instance, you might have a fun “carpet picnic” for dinner one night. Lay out a tablecloth or blanket in the living room and have a movie night, eat pizza or finger foods, and create a low-key atmosphere for the family.

Remember that anxiety is simply a feeling that can affect how we feel mentally and physically; it is not who we are. Help your child learn the best ways to cope with his own feelings of anxiety by keeping in mind that he is in control.

Author: Noah Smith

PLEASE REMEMBER IF YOU FEEL LIKE NOAH'S WRITING HAS BEEN HELPFUL TO "LIKE" THIS POST ON FACEBOOK OR TWEET IT. ALSO FEEL FREE TO SHARE IT WITH ANYONE THAT YOU THINK COULD BENEFIT FROM KNOWING MORE ABOUT ANXIETY AND CHILDREN.
-- Dr. Jordan

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Adam and Eve as the First Love Story-- What Can We Learn from Biblical Love?

3/27/2017

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With divorce rates in some social strata continuing to rise and many of us bemoaning the loss of true intimacy in an age of Snapchat and Facebook, Bruce Feiler has found an unlikely source of inspiration to help us navigate the modern waters of love-- the bible. Yes, folks, that ancient text with all of the "begat"s and such. Feiler writes quite convincingly that Adam and Eve may have had it right from the very beginning. Stay together, even when the proverbial applesauce hits the fan. Even when it might look like one of you has made an uber-big mistake and put both of you in jeopardy. Even when one of you outpaces the other in knowledge, life experience or situation. Even when you get evicted from the only home you have ever known. Even when one of your offspring kills the other. Stay together. Learn, grow and circle your wagons when necessary. Don't give up on each other. Don't turn on one another in times of strife. Forgive each other.

Feiler makes some startling points. He says that the message of the story is not "disobeying God", it's "about obeying the larger message [of God], which is making the relationship work". God made these two to be companions for life. God calls upon them to "succeed...Go forth and multiply" according to Feiler. He argues that the only way Adam and Eve can do that is to continue to turn towards each other in hardship and, unlike so many of us in our baser moments, not vilify one's partner. To forgive the shortcomings of one's partner and re-commit to the relationship. He states that love is "not a choice we make once; it's a choice we make multiple times." Eve chooses to return to Adam after eating the fruit and Adam chooses not to reject her. They chose to make a new life together. They chose to stay together even after one of their children kills the other. They even chose to recommit to the marriage by having another child-- a sure sign that each believes in the relationship.

Feiler calls love "an act of imagination, an act of commitment and ultimately an act of love to re-choose someone after a difficult time." He adds, "That choice is much harder than the first." I can't think of a more poetic way to describe what it takes to succeed in marriage. To continue to re-choose at every turn. To doggedly, even when one's own hope is waning, re-choose to be "all in." This is what we mean when we talk about putting one's partner first in PACT. Protecting the "couple bubble" and nurturing it.

Many years ago I met an older couple who had been married several decades. As is my practice I asked "what's the secret?". The man replied "my wife is not the same person that I married all those years ago. She has changed many times, and each time I fall in love with the new version of herself." He smiled as though he were the luckiest man alive-- to have been able to love different versions of the same woman for nearly half of his life. I think most of us would hope to be so lucky. He continued to choose her. That's love. Not the easy kind of love you see in Hollywood or that we grew up with in our princess and prince charming fantasies. The real kind where you double down and recommit, knowing that come what may you have each other.

Wishing you health, happiness and connection in all of your relationships,

Dr. Jordan

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Forgiveness -- Do I Have To?

2/11/2017

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One of the first things I try to establish with people who have been deeply hurt is that there is no "right" answer to forgiveness. Each person and each situation is different and no one can know what ultimately is going to be right for you. There are different types of forgiveness and sometimes it can help to learn the distinctions. What follows is a summary of a wonderful 3-minute video on the topic, along with some of my own ideas.

In this video by UCLA psychiatrist Dr. Stephen Marmer delineates 3 different types of forgiveness. These are:

1) Exoneration-- what we typically think of as forgiveness. Wiping the slate clean as though the hurt never happened. This restores the relationship to the state of innocence that existed prior to the injury. This is appropriate in the following instances:

when the injury/hurt occurred due to a true accident. The person did not do the harm intentionally. Like if I borrow your car and someone rear-ends me, or if I trip and spill a glass of red wine on your brand-new white sofa.
when the person who hurt you is a child or someone who, for a legitimate reason, could not understand the harm that was being committed (such as an acutely mentally ill person) AND towards whom you have loving feelings.
when the person who has hurt you is truly sorry, takes full responsibility without excuses for what they did , asks for forgiveness and assures you they will not knowingly repeat their bad action.

Dr. Marmer goes so far as to say that in these situations if you are not able to offer forgiveness it may suggest that there is more wrong with you than the person who harmed you. I tend to be a more "case by case basis" person rather than make such a sweeping proclamation. But I can see his point. If your 5 year old accidentally breaks your favorite vase and falls into tears and apologizes there might be something very wrong with you if you cannot forgive him or her.

2) Forbearance-- this is when the offender:

makes a partial apology
mingles their acceptance of responsibility and sorrow with blame that you somehow YOU caused them to behave badly
the apology that is offered is therefore not really authentic

Dr. Marmer goes on to say that even if you have no responsibility in how you were harmed you should practice forbearance if the relationship really matters. He goes on to say that you should
(I would say you "may want to consider", I am not a fan of the word "SHOULD"):

cease dwelling on the particular offense
do away with grudges and fantasies of revenge
BUT retain a degree of "watchfulness"

Dr. Marmer states that forbearance allows us to maintain ties to people that are important to us but are far from perfect. I would argue that many of our families of origin may fit into this category. In this case establishing healthy boundaries that can keep us from being further injured while still maintaining some connection can be a good compromise. He goes on to state, and I agree, that after a sufficient period of "good behavior" forbearance can rise to exoneration. I would say that this is probably a reasonable idea to try the first few times someone is not able to offer a sincere apology. But if the trend continues, or if the injury is simply too grievous, you may not ever want to drop your guard with this sort of person. Again, it's probably best dealt with on a case by case basis.

But what do you do if the person who has harmed you never acknowledges that they have done anything wrong or gives an obviously insincere apology making no effort towards reparations whatsoever? Dr. Marmer gives examples of adult survivors of child abuse, business people who have been cheated by their partners or family members who have betrayed one another.

This is where Dr. Marmer offers an third option:

3) Release -- this does NOT exonerate the offender, nor does it require forbearance. It also does not demand that you continue the relationship. He suggests that what is required for release is to stop defining yourself by the hurts that have been done to you and release bad feelings and preoccupations with the negative things that have happened to you. He contests that if you do not release the pain and anger from old hurts and betrayals you will, in effect, allow the people who hurt you to continue to influence you on a daily basis. He asserts that you are allowing these people to "live rent free in your mind" while you suffer from their occupancy.

What Dr. Marmer implies but does not talk about is something that I refer to as a "trauma bond". The original use of this term was for Stockholm Syndrome, or feeling positively towards one's captors. I use it a little differently. To me a trauma bond does not have to feel positive. You don't need to idolize your abusive partner or join the militia that captured you and held you prisoner. To me it can represent the broader idea of a tie to a person with whom you share emotional pain. Many times the trauma bond is from a victim to a perpetrator, or from the "harmer" to the "harmee". I think broadening the construct to include any tie, positive or negative, to a person you have been in pain over, is perhaps more applicable to most people's lives. Most of us have never been prisoners of war or help captive by a psychopath. More commonly we have histories of being emotionally neglected or abused in childhood by our own parents. Even if we have decided not to ever talk to them again and have completely cut them out of our lives, that bond remains unless certain steps are taken to "release" it. This release is NOT done to repair the relationship or restore it in any way. It is done to cut the psychic tethers that keep us anchored to that person and that old pain. Releasing a trauma bond is for the person who has been hurt. It is a gift one gives oneself. It is not an absolution of the wrongness of the act or actions. It is not an absolving of the person who has done it. It comes closest to how I once heard Maya Angelou describe forgiveness. She said forgiveness to her was saying to herself "I am done with you" and moving on with her life. Breaking the trauma bond. Releasing ones own self from the pain of the past. There does not need to be any regard for what happens to the person(s) that hurt you. They may thrive or perish. It does not matter. The release is for you alone.

Recently I listened to a wonderful audio book by Harriet Lerner, Why Won't You Apologize? This is the woman who wrote a series of "The Dance of..." books starting in the 1980's. The most well-known of which is probably The Dance of Anger. This is one of the most well-read self-help books about anger and I find it entirely refreshing that the author of this book is NOT promoting forgiveness across the board. In fact she says that it is inappropriate and not at all helpful to think about forgiving someone who has NOT APOLOGIZED. As a therapist who often works with people who are from dysfunctional families in which the abusive, neglectful or inept parents still don't realize that they injured their now adult children I think this message is vital. Most of my clients actually never get apologies from their parents and often choose to not even talk to their parents about the hurts they sustained in childhood. And some of my clients decide not to work on forgiveness of those parents. And that does not impede their emotional progress one bit in my estimation. Our culture seems to be obsessed with forgiveness as if it is the only legitimate route to personal growth. I disagree. For those who want to forgive, for those who are reaching for it, I think it can be an amazing journey. However it is not the only way to grow as a person and I hardly think it is necessary. In my opinion there are things that, put simply, cannot be forgiven. However, I DO think that breaking a trauma bond and releasing oneself from the ties that have bound us to a person who has hurt us can be a very important experience and can free up emotional resources for other endeavors.

If you find yourself challenged with the prospect of forgiveness and are not sure how to move forward I encourage you to realize that there are many different options. Dr. Marmer has outlined the 3 options he finds useful. Dr. Lerner's book offers additional approaches. Maya Angelou has her method. Deepak Chopra has a process that he outlines here. Whatever route you take I hope you find a way to break any trauma bonds that you have and liberate yourself to focus on building the life you deserve.

Wishing you peace and release from past hurts,

Dr. Jordan

PS If you have found this blog or the resources embedded in it helpful PLEASE consider sharing it with someone! You can "like" it on fb or "tweet" it or just forward the blog link to a friend. Also feel free to leave a comment and I will be happy to respond. Or you can email me via this website if you prefer a private conversation. Thanks for your support!

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Interview with Dr. Stan Tatkin on Shrinkrap Radio-- Great Explanation of His Roots

2/5/2017

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For anyone who has wondered how Dr. Tatkin came to develop his theories this is an old interview on Shrinkrap Radio from 2008 in which he talks at some length about his early training experiences. As always Dr. Tatkin is clear, coherent and incredibly articulate. He explains his circuitous route to becoming a relationship expert, starting as a professional musician (drummer!) and weaving through inpatient psychiatric hospitals with John Bradshaw where he learned Gestalt therapy and psychodrama, to working in addiction treatment, on to studying American Object Relations with Dr. James Masterson, to training in the Adult Attachment Interview with Drs. Mary Main and Erik Hesse and finally to studying infant brain development with Dr. Alan Schore. Once in private practice Dr. Tatkin realized a strong interest in working with some of the more severe personality disorders such as narcissism which lead to his epiphany that prevention was where he wanted to put his focus. This lead him into looking at infant attachment and eventually to adult attachment in romantic relationships. In working with couples we not only help the adult dyad we also increase the security of the system in which any children are reared. This pays forward in building more relational security in the children as well.

For anyone wanting a brief and very understandable explanation of the Avoidant attachment style he does so right around minute 40. And of course if you want to get the major download of all of Dr. Tatkin's wisdom I recommend Your Brain on Love, his audio program in which he explains to lay people how his theories explain why relationships go awry in the short and long term.

In this interview Dr. Tatkin also references a film about infant attachment called When the Bow Breaks which drew him in to the field of infant attachment and lead him to the work of Dr. Allan Schore. He also mentions several of Dr. Schore's books, including Affect Dysregulation and Disorders of the Self if you want to get deeper into some of his "source" material. All in all it's a great 50-minute interview with someone who I feel is at the leading edge of relationship science.

Wishing you the best in your relationships and connections,

Dr. Jordan

PS If you have enjoyed this blog/link to Dr.Tatkin's interview please consider "liking" it on fb and/or tweeting this post. That helps other people find my blog and connect to these topics. Thanks!

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The Meaning of Flowers and the Languages of Love

1/19/2017

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I realize that a psychology blog doesn't have much to do with botany, or flowers, or the purchasing or delivery of such goods. However, I often blog about relationships and there happens to be a certain holiday approaching that strikes fear into the hearts of many folks....Valentines Day. If you are coupled, or hoping to be coupled, you may be sweating about the best way to impress your sweetie. While everyone can certainly be different, in my experience many folks appreciate a delivery of flowers. This tends to score the most points if they are delivered ON Valentine's Day and AT their work in plenty of time for all of their co-workers to see how loved they are.

I was recently solicited by a company that does reviews about posting on this blog. I've never before received such solicitation and would typically not be interested. But I have to admit that after going to their site I was very impressed at the level of research they conducted. Anyone who reads my blogs knows I LOVE research. So I decided to give them some free advertising, which hopefully wont' offend any of you. I am not getting any kick-backs from them nor did they pay me. I just happen to appreciate the leg work they did and I do agree that sending flowers can be a great way to show someone that you are thinking of them.

They kindly provided this information about the meaning of flowers per the custom in Victorian times, when sending flowers was a way to covertly express sentiments:

Flowers have symbolic meanings.

Since ancient times, flowers have acted as meaningful symbols. The meanings of particular flowers vary wildly, but there are some standards that most flower dictionaries and guides, like Old Farmer’s Almanac, seem to agree on.

Chrysanthemum: Cheerfulness
Daisy: Innocence, Hope
Iris: A message
Lavender: Devotion, Virtue
Lilac: Joy of youth
Poppy: Consolation
Red Rose: Love, Desire
Violet: Loyalty, Faithfulness

If you are in the market for delivering flowers this Valentines Day and want a company that does same-day service and has been road-tested you may want to consider reading the reviews on this web site: http://www.reviews.com/online-flower-delivery/

If you aren't sure what's the best way to reach your beloved you might consider their "love language". You can take an online test here to determine your love language, and you can always email it to your honey as well to find out theirs. Once you know their love language it can be a lot easier to impress them! Learning my partner's love language answered my decades-long mystery of why my husband acted so proud when he would change the oil in my car. This is something that, prior to meeting him, I was fully capable of doing. When we met he decided it was going to be his thing. I thought it was just because he enjoys working on cars. Fast forward 10 years when I finally read the "love languages" book and I finally realized that it was because "acts of service" were his love language! I cringe to think of all of the times he was let down because I did not gush over his changing of my car's oil or his overhauling my bicycle. I just took these to be normal kindnesses but to him it was as if he was writing me a love poem or serenading me with a love song. Who knew! And especially since my love language is "words of affirmation". It also explained why when I did give him a card with a thoughtfully written passage he never saved it, but his eyes nearly glazed over with tears of gratitude when I made him a special meal. While I am not often much for "pop" psychology books this one, in my opinion, is worth reading.

So go forth and do something special for your beloved this Valentine's Day. Relationships need care and feeding to flourish so make it a habit to speak your partner's love language frequently.

Wishing you happiness and health in your connections,

Dr. Jordan

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Is Anger Healthy?

12/19/2016

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I have previously posted a blog titled "Anger versus Abuse". Since writing that blog I have come across additional information about anger and decided to re-visit the topic. What follows is the original blog post with some additional insights included. I hope you find it helpful.

In considering whether or not anger is healthy we need to think of what it's purpose is. Anger is a signal, like the warning lights on your car dashboard. Anger calls our attention to something about the situation and says "Houston, we have a problem!". So in and of itself anger is not positive or negative. It is simply a "signal" emotion, like fear. It tells us that we need to take a look at what is going on or things might get dicey.

Where I think most people go awry is how they express anger. Contrary to what many of us thought growing up expressing anger is not the same as yelling, breaking things or slamming doors. In fact if the person you are interacting with is doing things that trigger your fight or flight system (raise your blood pressure, increase your heart beat, make you sweat, shake, want to retreat) then you are not witnessing someone's anger, you are in the presence of abuse. Yep, that's right! And the normal human response to being abused is to want to hurt the other person back. So we yell, stomp our feet, throw things or say mean hurtful stuff back. Now WE are being abusive as well. Take a look at the two pictures at the top of the page. The woman on the left is angry but is not doing anything abusive. The woman on the right is also angry but she is clearly letting someone have it. You can quickly see how your body responds differently to these two pictures. The woman on the left you would probably not mind being in a room with. If you found yourself in a room with the one on the right you would probably run out of the room as fast as possible! And therin lies the difference...

I think this is a very important distinction to make. Anger is actually NOT a damaging emotion. Abuse is damaging treatment. I repeat, anger and abuse are NOT the same. I can sit down calmly and tell you that I am angry because you borrowed my car and ran it out of gas. If you feel embarrassed, guilty, sad or contrite but NOT fearful, nervous, threatened or like you need to yell at me then I have NOT been abusive. I have just been angry. Anger is an indication that our boundaries have been violated. I don't like it when people do not show appropriate respect for my things and so if you use my car and don't put gas in it I am going to be angry. But that's OK. By conveying that I am upset it shows you that you have crossed a boundary and so you will try not to do that in the future.

Many of us who grew up in dysfunctional homes confuse anger and abuse. We think that if someone is red-faced, yelling, shaking mad, throwing things or hurling awful accusations at us they are "angry". I would argue it is much more useful to see this as abuse. That way both people can see how unhelpful and inappropriate this behavior is. Abuse never leads to anything good. Anger, when expressed without turning in to abuse, should ALWAYS lead to something good. It is a communication about what you need to feel respected, cared for and even loved. It is essential for you to communicate this so that you are taking care of yourself and protecting the bond you have with that person. It is important for them to hear this message clearly and take corrective action. That is the purpose of anger. Anger, when used correctly, should actually bring people together through pointing out areas of the relationship that need work. The purpose of abuse is to discharge physical energy and to hurt the other person. That is not anger. The expression of anger is about trying to identify and solve a problem. Dumping, which many people mistake for the expression of anger, is about hurting the other person in an effort to make yourself feel better without any regard for the other. Abuse and dumping push others farther away. Appropriately expressing anger should in fact ultimately bring people together because it brings important feedback to the offending person. In it's best form anger is used in service of the relationship.

One of the most well-known authors on anger is Harriet Learner, who wrote The Dance of Anger. In an interview on the Relationship Alive podcast Ms. Learner suggested that the worst time to communicate your anger is when you are angry! She recommends calming down first and then discussing your anger. What? Yes! Talk about your anger when you are NOT angry. I know, mind-blowing. It makes me think of when a toddler has a temper tantrum and we tell them to go calm down. Then we ask them to use their words to talk about why they were upset. The same applies to us. When you are activated and angry you need to NOT talk but rather step away briefly and do some deep breathing or other things to get your nervous system regulated. Then you can calmly engage the person who made you angry and explain what they did that was so offensive.

In thinking about positive expressions of anger that are clearly not abuse think about the sit-ins of the civil rights movement in the US. There was plenty of anger on the parts of the protestors who saw the racial oppression and abuses going on. However the play-book of those sit-ins was literally that "not a hair on the head of [the oppressors] would be disturbed". The protestors wanted to convey their anger appropriately and NOT allow it to turn into abuse, which would have spurred an abusive reaction on the part of the authorities. Abuse begets abuse. Anger, if expressed appropriately and without abuse, should beget positive results and heightened mutual understanding.

Anger can teach us things about ourselves and reveal things about our partners or other loved ones. If the anger seems out of proportion to the event (you bring my car back with no gas and I calmly tell you we can no longer be friends) then there is likely some "unfinished business" being triggered from the past. In this example perhaps I had parents who used my property, resources or accomplishments for their own selfish purposes and I felt used and mistreated. I am, therefore, naturally sensitive to feeling that others don't care how they treat me and are going to take advantage of me. So my anger in this situation, if I can see that it is out of proportion, will direct me to look at areas of my past where maybe I have some unresolved wounds. That in turn provides an opportunity for healing.

Understanding the purpose of anger can help us to not suppress or deny it. Understanding the difference between anger and abuse can help us learn to express anger in an appropriate way that can lead to increased knowledge, understanding and harmony for ourselves and in our relationships.

If you find yourself confused about or uncomfortable with anger I encourage you to think about tackling that problem. Anger turned inward/suppressed can lead to depression, loss of motivation, difficulties in achievement, addictions, poor self-care, physical illness and even self-attack or self-abuse. I have heard the expression that depression is simply "anger that you don't feel that you have the right to have". Anger expressed as abuse can lead to shame, loss of relationships and/or jobs and even legal problems. Therapy can be an excellent tool for learning more about anger and how to comfortably express as well as witness it, as can the 12-step group Adult Children Anonymous (which focuses on people from any type of dysfunctional childhood) or books such as The Dance of Anger. Regular exercise and/or mindfulness mediation can help stabilize the nervous system so that when you feel angry you are better able to prevent it from veering into abuse. Proper sleep and not over-using stimulants like caffeine and energy drinks can also be helpful in keeping one's nervous system stable. Classes on anger management can help you learn the physiological signs of anger and how to manage the feeling when it arises and stay grounded when you see it in others. There are many options for working on this problem and I hope you consider trying some of them.

Wishing you health and happiness,

Dr. Jordan

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How We Learn To Be Ashamed

11/30/2016

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I have written about shame before but wanted to expand on my earlier blog with some new information on how exactly we learn to be shame prone.

James Harper has written about this subject and explains that there are types of families that tend to be shaming. Harper, along with a colleague Hoopes (1990) says that healthy families all contain the following essential qualities to promote optimal emotional development in children-- "accountability"-- the sense that "family members feel and act responsibly towards each other and meet each other's basic emotional needs"; "intimacy"-- family members are "able to share physical touch, be nurturing to each other, and share emotional experiences" in a way that feels supportive and comforting; and "dependency"-- the "ability of family members to rely on each other emotionally for basic needs". This includes parents not being annoyed by the natural dependency of young children and being willing to continue "scaffolding" children well into adolescence as they learn to become more autonomous. Parents who fail to provide enough of these essential qualities inadvertently create shame experiences in children. If repeated often enough this can become part of the child's self-concept and identity. They feel that they are inconvenient to their parents, that their basic feelings are not acceptable, that their world is unpredictable. They learn to despise their natural needs to be dependent and also their normal failures and struggles as they grow and develop. They assume that if only they were "good enough" they would be loved and, therefor, their feeling unloved is somehow their own fault.

When kids experience shame a lot they naturally begin to internalize it. That emotional state gains preference in the nervous system and is more easily accessed. I compare this to driving down a dirt road every day for several week. Over time you will notice grooves getting established in the dirt so that it gets harder to deviate from the path you have been taking each time. This is similar to the way our brains respond-- the more we feel something (or think something, or do something) the more that pathway is reinforced and becomes easier for the brain to find the next time. So numerous experiences with shame as a child make is "shame prone" in adulthood. Research shows that people who are "shame prone" or have "trait shame" learn to expect to be shamed and they learn to hide their flaws from others. This impairs their ability to feel intimately connected with others and can even cause these people to lash out and shame others before they can be shamed themselves. According to studies people high in "trait" shame tend to also be more pessimistic, narcissistic, dependent, emotionally labile, feel victimized and be introverted. In an effort to cope with chronic shame people often turn to substance abuse, addictive behaviors (sex, gambling, eating, work, exercise) and/or chronic interpersonal conflict in an effort to ward off the collapsing into shame they so fear. Mills, Imm, Walling and Weiler (2008) found that children with higher shame experiences also had higher cortisol in their bloodstream, a sign of physiological stress. Remember that the brain does not distinguish emotional versus physical pain in where the information is processed or how the body responds. So shame provokes a stress response in the body that, over time, can lead to chronic stress-related illnesses including more trouble returning to physiological baseline after feeling shamed.

Relationally shame-prone partners tend to have insecure attachment styles (Karos, 2006; Wells & Hansen, 2003) and distressed romantic relationships (Greenberg, 2008). Their sex lives also tend to be problematic/unfulfilling. I am often fond of telling couples that anger and shame are two tried and true arousal killers. Shame-prone partners have trouble communicating in their relationships because they are so guarded and are constantly trying to defend themselves against having shameful parts of themselves discovered. They may perceive attempts to be close as intrusive and an attempt to uncover things that they feel shame about. They may also be aggressive and try to push others away, especially as that person is trying to get closer to them. Sadly in this way shame-prone people often create the situation they are fearing-- being seen as "bad" or "unlovable", which reinforces their feelings of shame.

While all of this is no doubt frustrating to those who are trying to love and be with a shame-prone person it is important to remember that shame-prone people, like all of us, have earned their scars and defenses. Research shows that people who are chronically struggling with shame tend to have histories of abuse, be it sexual (Feinauer, Hilton & Callahan, 2003), physical (Kim, Talbot & Cicchetti, 2009) or other traumas (Lee, Scragg & Turner, 2001). They also are more frequently abandoned by their spouses (Claesson & Sohlert 2002). So they have plenty of reasons to feel vulnerable, victimized and exposed. Empathy and emotional validation are keys to helping a shame-prone person feel more comfortable. Essentially acknowledging their shame and giving it words can be a great weight off of the shame-prone person's shoulders. Of course since those who are shame prone tend to see judgement at every turn it's important to phrase things carefully and let the person know that it makes sense that they feel shame based on their history. It can also be very powerful to share some of your own shame feelings in an effort to normalize their response.

Chronic shame can rob a person of adequate self-worth, goal achievement, fulfilling relationships and feelings of love, joy and satisfaction. If you or someone you love struggles with chronic or intense feelings of shame I recommend that you reach out to a mental health professional to discuss treatment. Psychotherapy, whether it is individual, in groups or as a couple can be a powerful way of healing this toxic emotion.

Wishing you health and happiness,

Dr. Jordan

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The Course of Love -- by Alain de Botton

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Helping Your Child Get Through Anxiety

Adam and Eve as the First Love Story-- What Can We Learn from Biblical Love?

Forgiveness -- Do I Have To?

Interview with Dr. Stan Tatkin on Shrinkrap Radio-- Great Explanation of His Roots

The Meaning of Flowers and the Languages of Love

Is Anger Healthy?

How We Learn To Be Ashamed

Krista Jordan, Ph.D.

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