Mental Health Notes

Envy

2012-02-02T13:06:00.005-05:00

I don’t think I’veever known anyone who didn’t feel envious. Not you, of course. Youare a very kind, generous, loving person, and you are very content with whatyou have, very grateful, not boastful, all that good stuff. I even know that you are aware that even themost glamorous, successful, seemingly happy people have their troubles andwoes, that the grass may always seem greener but really it isn’t, and allthat. I know you remind yourself of thisas much as possible, and you really try not to succumb. But face it – you feel envy, I know youdo. We all do.

So look, a littleenvy – not a big deal. This one’s house,that one’s garden, car, job, clothes, kids, money, pool, friends, hair, abs,boobs, waist, golf handicap, biceps, all the other body parts, someone else’s spouse,someone else’s unmarried status. . . Don’t try to tell me that one of those things didn’t ring a bell. You know what I envy? People who don’t like sweets. In fact, I hate people who don’t likesweets. Not really… but sort of.

Why envy matters,and it really does, is that for some people, envy is what spoils everything. It’s as though they’ve got a Hank Williams-inspiredbucket with their self-esteem in it – and their bucket’s got a hole in it. Nothing that goes in stays in – it’s empty theminute it gets filled. For this kind ofperson, it’s hard not to envy everyone and everything. What’s sad is that often, these people areadmirable – competent, talented, generous. They can have so many good qualities, and even be recognized, praisedand admired – and still, none of that stays with them. It’s almost as though their preferredself-state, their default, is the one that says I’m small, you’re big; I’mnothing, you’re something.

When someone hasthis kind of envy problem, it’s usually more complicated, because lurkingbehind the self-deprecation and envy, there is often a hidden sense ofsuperiority and contempt of those they envy And when those people they envy crash and burn, oh, the schadenfreude! “See?” we say? “All that money and beauty, and look whathappened! Tsk tsk tsk. I’m glad we’re poor and homely looking, aren’tyou?” Yeah, right.

Well, as Abe Lincoln once said, "It has been my experience that folks who have no vices have very few virtues." We all have to work on dealing with envy. It's good to realize how corrosive it can get, if you let it. The only cure for it, when it gets chronic, is to recognize that there is a conflict going on, one that isn't clear. I see this quite often, in so many of the people I work with in therapy. The conflict is this: One part of you knows you are worth paying attention to, caring about, worthy of being respected, loved and cherished. Another part, that feels inadequate and without power, perhaps representing experiences of being belittled, is unfortunately working overtime to disagree, to hold on to feelings of worthlessness and shame.

It's that second part that throws a wrench in the works, a stealth saboteur voice in your head that contradicts every good thought you ever have about yourself. If that inner conflict between the voices in your head - where one says "I'm good" and the other says "No, you're not" - is not made conscious, envy is bound to become obsessive. It's like you are forever straddling a fence - and we all know what that feels like. Aside from not choosing which side to stand on - are you worthy of love, care and respect, or not? - sitting on top of a fence hurts like the dickens. And that pain is what it feels like when the feeling is envy.

Is Anybody Happy?

2011-11-08T19:01:00.000-05:00

I am much too young, and so, undoubtedly, are you, to actually remember Ted Lewis, the band leader whose catch phrase, "Is everybody happy?," spoken in his high-pitched madcap-ecstatic voice, furnishes me with the ironic title of this month's essay. Be that as it may, the conversations I have these days, socially and professionally, range in mood from, oh, say Shostakovitch's 8th Symphony, to Chaplin's "Smile, though your heart is breaking...". Happy days are not here again, yet, and they seem like they are more likely to be somewhere over the rainbow than to be just around the corner. (If you want the citations for all these song phrases, email me. And if you don't feel depressed enough yet, listen to Shostakovitch's 8th.)

At the low end of the spectrum, there are those who have lost or are losing a job. The more over 35 you are, the more this hurts, in every way - it's demoralizing. Then there are those who worked hard, saved well, and are seeing their retirement funds go down the tubes while their health costs, even with Medicare, go up up up. I am going to stop talking about financial matters here because it's too depressing.

But before I stop, I have to mention obsessive watching of cable news shows and political talk radio. That's another thing that seems to be angsting up the zeitgeist, big time. It seemed like it might finally be balanced, maybe even fair, when MSNBC came on the air to challenge Fox News. Now, whether you are on the left or the right, watching this stuff is like taking daily doses of terror and rage pills, which gradually accumulate in our brain cells until we are all walking around like we're in a Freddy Krueger movie crossed with a weather disaster movie, waiting for someone to say something on the left or the right or about the weather that will send us screaming in terror as we wend our way through floods, tornadoes, hurricanes, monsoons... and then droughts. Good times!

Well, for people whose lives were already pretty traumatic, you can imagine how keeping things together could be harder than ever right now. It's hard for most people today. Our government is like two bitterly divorcing parents, Republican Dad and Democrat Mom, fighting constantly, making the kids (us) feel torn in half, like nothing is secure, nothing is safe. I won't say which one I think is less guilty, and which one has lost its mind, but the former starts with a D, and the latter starts with an R.

So how do I finish this up with a ray of sunshine and a gleam of hope? Well, this is a good time, if you have friends and family, to repair damaged bonds and ties, as much as you can, and find time for fun, for connection. It's a good time, if you are alone, to reach out for support where you can find it - maybe through some religious or spiritual affiliation, or from a mental health professional. It's a good time, if you are able, to pitch in to some constructive effort that might help a cause you care about, or maybe the less fortunate; or if you're out of work, in between looking for a job, take care of all the organizing and repairing you never had time for while you were working. It's a good time to turn off the radio and the television and read, play a game, cook a meal.

It's getting darker and it will be getting colder soon. If you can find some warmth and some light, take it in, and spread it where you can.

Ups and Downs

2011-09-02T16:38:00.002-04:00

I had a great vacation this summer. My whole family did. We relaxed, we had fun, we had a great change of scenery, great activities, great food, great people to be with. It was perfect.

And then we got back to JFK on a Sunday evening, and only Dante could do justice to the infernal torment that ensued for the next 5 or 6 hours. I will spare you the gruesome details. Suffice it to say, we finally got to home sweet home early Monday morning.

“Let’s pretend we’re still on vacation,” I suggested to my wife later in the week, as we confronted the bills, the schedules, the yard project, the lack of enough sleep, the suddenly not working refrigerator and the possibly not working dishwasher, the bills … did I mention the bills?

But that’s the thing – vacations are great when they are very different from the rest of your life. Hopefully, it doesn’t mean that life=miserable, vacation=wonderful. But vacation, when it’s good, is good because it’s somewhere around 180° different from your normal routine.

There are people I’ve worked with who have had it very hard growing up – suffering extreme abuse of various kinds. And some of these people have a fantasy that, given what they have been through, life should now be a bed of roses. And they are extremely angry when it isn’t, which is, oh, pretty much every other day, more or less. A big part of living well for these people is accepting that they have to work at creating and maintaining a good life – it doesn’t just happen, it isn’t automatically the reward you get for surviving a terrible childhood. And when you’re doing your best, and hurts and disappointments still happen – it doesn’t prove that life really isn’t worth living, or that the world and all its people are cruel, and you are doomed. It just means that life has its ups and downs, and it is up to us to do the best we can and make the most of what we’ve got.

At the same time, I notice that one need not have had a terrible childhood to unconsciously entertain this fantasy – that life is supposed to be and actually can be wonderful all the time, that we can always be at our best. Many of us with happier childhoods have this fantasy too – and it is being sold to us constantly, in commercials, seminars, retreats, health food stores, plastic surgeons’ offices, and the endless stream of self-help books and tapes that relentlessly identify yet another seven steps to this, that or the other.

It’s true that we are living with a bad economy these days, and it looks like we may be living with it for a while. There are many more people out there now who are busy just figuring out how to survive, let alone live well. But I’ve had the opportunity to work with people who have nothing, and with people who have everything, and I’ve seen both these kinds of people have the same amount of anguish about solving the same puzzle – how to be happy, how to feel good, how to have a good life.

Long ago, Freud said with a touch of irony that the goal of psychotherapy was to convert neurotic misery into ordinary unhappiness. But most psychotherapists today would agree, I think, that we are aiming for more. We want to help people find the strength and resilience to get through hardships; and to find the desire and the willingness to work at building a good life. The two go hand in hand – there can be no lasting good in life unless one has the strength and the resilience to endure and get through hardships, whether they be material or spiritual.

Another famous psychoanalyst, Frieda Fromm-Reichman, treated a young severely schizophrenic woman some years ago. As the young woman began to regain her health and sanity, she became terrified of leaving the hospital and being without the therapist. As the time for the girl’s discharge came closer, in response to the girl’s worries about life beyond therapy, Fromm-Reichman was honest with her: “I never promised you a rose garden,” she said, which became the title of the memoir the woman later wrote, under the pen name Hannah Green. Fromm-Reichman had already been through a great deal herself: escaping the Holocaust and starting a new life in a strange land, divorce, and loneliness. At the same time, she loved her work, and nurtured many patients and students. She was loved and respected by all who knew her. A good life.

Most people can’t always be on vacation, and none of us can always dwell in a garden of roses. It may seem like some people have everything come easily to them, but I’m certain that most people with good, happy lives are people who have worked hard, with persistence, to build and maintain that happiness.

Mourning

2011-06-03T18:58:00.000-04:00

Back in 1915, Sigmund Freud wrote one of his best known papers, “Mourning and Melancholia,” and he introduced an idea that has since become common knowledge: that if a grave loss is mourned well, one can expect, in a reasonable amount of time, to get on with one’s life. But if mourning never ends, and a loss becomes a source of unending grief, then melancholia, or depression, results.

Most of us adults are mourning, at some level, for something lost. Lost opportunities and lost youth might be the most commonly mourned experiences. Though we may not brood openly or excessively, we probably all know someone who has never stopped being bitter, or regretful. There are some great examples of mourning turned to melancholy in literature – Dickens’ Miss Havisham, still in her wedding dress though she was cruelly jilted many years before; Scrooge, endlessly bitter because his one true love betrayed him; Tennessee Williams’ Blanche DuBois, who has had to bury every one of her relatives, has lost her family home, and is fast losing her youth. Fragile and frazzled, the loss of her sister to the brutish Stanley - her sister being her last family tie and the last person she had any control over -finally drives her insane.

Adults who as children were abused and neglected, often find mourning challenging. The Scottish psychoanalyst Ronald Fairbairn put it this way: he said that for a child who depends entirely on his parents, it would be better to feel like a sinner in a world ruled by God, then to have to realize that one is an innocent living in a world ruled by the Devil. In other words, children would rather believe that they are bad than have to believe that their own parents would abuse them. Many adults, in therapy years later, have great difficulty mourning these kind of losses – the loss of security and safety they suffered as children; the loss of ever feeling loved and cherished by a truly caring parent.

Defending against their grief and their desolation, these patients often go through life dismissing the pain of their wounds. “Yeah, so my father was a raging drunk and my mother didn’t do anything to protect us. So what? I don’t want to go through life blaming them for my problems.” I’ve heard this kind of remark many times, and I marvel at how people who take this attitude seem to be trapped in endless self- loathing and self-reproach. Not wanting to “blame” their parents, they have no problem relentlessly blaming themselves. Some will even go so far as to claim that they should have been stronger, at the age of 5, and not been so selfish, such a cry-baby. At 5, with a raging drunken father smashing dishes, screaming at a depressed, crushed mother, this child, according to his adult self, was supposed to have behaved in a way that would have made his mother happy and avoided triggering his father’s rage.

Somehow, it is easier for this adult child to loathe himself, than it is to acknowledge how profoundly his parents failed to function as parents – how unable to give and to love they really were. He cannot bear to know the depth of terror he must have felt all through childhood. He cannot bear to face the facts, because then he will feel the sting of grief so deeply that it will pierce him through and through. And he fears that once he opens up this grief, it will never stop, he will be drowned in it. He doesn’t know that this grief, if allowed to be released, can be a part of the mourning process, the process that allows us to bury the dead, to let them be at rest, and eventually to go on with being alive, and free.

Instead, the adult who was abused as a child, by holding a deep, sometimes unconscious belief in his own badness, keeps his tie to the abusers alive. Instead of denying his parents the right to define him as the bad one, and bearing the grief of having been unloved, he blames himself, as the abusers did, and keeps the abusers alive, internalized as his own self-attacking voice.

Very few people go through life without having some grief to bear, some terrible loss to mourn. Whether we mourn the loss of something beautiful, or of something terrible, our mourning is meant to restore and renew us, to allow for a letting go, to prepare us to value and cherish the life we have, to do our best to make the most of our time here. Depression can have many causes, and can be treated in many different, effective ways. For some, it will be the acknowledgment of loss, and the discovery of what it means to truly mourn, that will be the path out of depression, toward life.

The Control Paradox

2011-04-24T07:48:00.002-04:00

Humans start needing to have some measure of control fairly early in life - possibly from about the time we draw our first breath. It is ironic, then, that uniquely among all living creatures, we alone are aware of the inevitability of our eventual death, and completely without any control whatsoever over when that will happen. This may explain to some extent why control issues loom large in the human psyche. No matter how easy going we may want to imagine ourselves to be, control issues are inescapable. Our unexamined needs for control can paradoxically put us in prisons of our own making.

Negotiations with significant others around issues of control and power can often be baffling, frustrating and exhausting. For example, pretty much every parent is familiar with the seemingly endless struggles one has with one's kids. Are the most successful parents the ones who exert the most control? We probably all know kids who grew up under extremely strict conditions, for whom things did not turn out so well - unlike the apparently perfect prodigies born to and raised by Amy Chua, the "Tiger Mother" who is all over the news these days. I certainly talk to quite a few people professionally for whom an authoritarian upbringing was not the way to get to Carnegie Hall, but rather contributed heavily to their addiction problems, impotence, divorce, alienation from family, depression and anxiety - and so on.

In my work with people affected by authoritarian groups (sometimes such groups are thought of as cults, or as cult-like), I've talked to scores of people who joined such a group searching for freedom of one kind or another: from ego, from inhibition and fear, emptiness, meaninglessness, etc. Where they ended up instead was spending some of the best years or decades of their lives living like slaves, allowing a charismatic leader to dictate every move they made, everything they wore, ate, said and did. In all those years before they finally left their group, they thought they were on the road to liberation. Michael Wright's superb recent piece in the New Yorker about how the screenwriter Paul Haggis got into Scientology, what he put up with to stay in it, and why he finally left, is a great illustration of how one can allow oneself to be controlled by others - all the while deceiving oneself into believing that the subjugation and exploitation one accepts is all in the name of self-realization, freedom, and making the world a better place.

For many who are struggling to find the right intimate partner, control issues can be a stealth killer. One strong, highly accomplished woman I worked with whom I'll call Sonia easily attracted men who showed intense interest in her. These were men who seemed masterfully in control - of their careers, their wealth, their bodies and their sexual performance. Sonia would eventually become dismayed to discover that these men also expected to be able to control her. When she resisted the controlling behaviors, the man in question would quickly turn from seductive pursuit to belittling rejection. In spite of the repetitive disappointments she experienced with men of this type, she found herself turned off by and made herself unavailable to men who were less dominating. Catch-22.

Like Sonia, we all have unconscious, complicated relational patterns that are impacting our way of managing our control needs, especially with our most significant others. If we believe that it is a basic human right to be free - and today, more and more people all over the world are beginning to assert that it is - then it behooves us to understand more about the need for control. There is a world of difference between control as a destructive, rigidifying tool for domination; and control, built on trust, compassion and respect, that creates stability, allows for flexibility, and encourages freedom.

Feelings

2011-01-10T05:25:00.000-05:00

Two of my patients some time ago were men in their 40’s, married faithfully, each with a couple of adored children. Both men were coming to therapy because of panic attacks – terrifying moments of helplessness and confusion, feelings so painful that neither man could really find the words to describe what happened to them at these times.

Each of these men were up against extremely stressful circumstances: one man was facing serious financial troubles with his business; the other had learned that his wife had a difficult health issue that she would need to address. It wasn’t hard to understand their fear, their dismay. Yet at first glance, these men seemed to have all the strength they might need to face their challenges: intelligence, the love and support of significant others, considerable talents, and many previous achievements and successes. Both men were going ahead and doing what they needed to do. But neither could stop the force with which they would suddenly, with little warning, find themselves in the grip of panic episodes so intense that they feared they might be losing their mind.

What these men, and many other men and women I’ve known, had in common was that they were taught, pretty much starting in the cradle, that feelings of distress, of any kind, were not worth having. They were taught, by the way they were responded to by their parents, that to be afraid, or sad, disappointed, hurt – feelings like that were just a waste of time. Don’t feel sorry for yourself, it’s nothing, don’t be ridiculous – cheer up, forget about it; those were the more benign kinds of responses they got when they were seeking comfort and understanding. Others I’ve talked to tell me that they would get yelled at, or hit, if they were upset. One man recalled that every childhood picture showing him smiling was taken just after his father had smacked him in the face, for not smiling.

Obviously, parents want their children to learn to be strong, have a thick skin, be able to handle themselves, because parents want their children to grow up to succeed in the competitive adult world. But too often, parents want to dismiss the difficult, painful feelings their children have, because many parents are overworked, too stressed, and too tired to have the patience and take the time to calmly and sensitively tune in to what their children are feeling.

If we as parents are not dealing with our own troubles – avoiding them by drinking too much, for example, or zoning out in front of the television night after night - then we are not teaching our children how to understand and express their feelings, because we are finding it preferable to be numb. In essence, we end up telling our children that we love them when they don’t bother us with their troubles – and that they can expect withdrawal from us if they aren’t burying their feelings and making things easy for us.

When you learn to minimize your own feelings and needs, and to adopt a stance of always being “fine,” because that’s what your parents rewarded, or because it made you feel superior to your whiney sister, or because it made your anxious, depressed parent feel better, you have learned not to take care of yourself. The contempt and dismissiveness you’ve learned to feel toward your own vulnerability keeps you from tuning in to what you feel, what you really need and want. When all the suppressed and warded off feelings reach a boiling point, they break through the walls of denial, and hit the fan, wreaking panicky havoc.

Life is always going to be presenting us with problems, including some that are frightening and overwhelming. We will, every one of us, have to face painful situations, no matter how much you may think you’ve got it all under control. Contempt and impatience for your own feelings, and for those of your spouse and children, are not effective coping mechanisms. What that’s really about is fear – fear of feelings. Feelings are what make us alive – and being able to stay open to the full range of our feelings is a way toward realizing the fullness of the human potential – for growth, for health, for life.

© Daniel Shaw, LCSW 2011

Internalized Misogyny

2010-11-17T02:11:00.000-05:00

Misogyny – hatred, dislike or mistrust of women . You could think of it as femi-phobia, similar to the way we use the word homophobia. Women have fought hard throughout the previous century, and are still fighting, to leave behind their status as chattel, and enjoy the same rights that men (not including slaves) have always taken for granted. As that awful old cigarette ad used to say, women have “come a long way.”

But in my work as a therapist with women from every walk of life, I often encounter a subtle, sometimes very unconscious kind of gender-based self-denigration. I have come to think of it as internalized misogyny. It takes many forms, and here’s just one example.

A patient of mine, Erika, of whom I am tremendously fond and admiring, is an artist, with Ivy League higher education degrees, a terrific résumé, a great intellect, and a funny, warm, down to earth personality. She anticipated the arrival of her first baby, whom she knew would be a boy, with tremendous excitement, and in his first year, was thrilled with what a great baby he was. Two years later, she learned she was pregnant again, this time with a girl. The pregnancy was nothing like the first – she was miserable the whole time. She had nightmares and day-mares, unable to stop herself from imagining that her daughter would be an impossible baby, and an even worse adolescent.

Some time after her daughter arrived, she came back to therapy and told me about her younger brother’s wedding. Unlike Erika, whose every move as a child was monitored by her adoring but very demanding parents, Tom, her brother, was left alone to develop his own style. Never a great student like his sister Erika, he did his own thing, travelled the world after high school, lived on a boat with his girlfriend, and eventually, following his own timeline, became successful developing a computer business.

What moved Erika deeply about her brother’s wedding was the way he and his bride created the wedding they truly wanted – a joyful, thoroughly original and beautiful wedding like no one else’s. Erika’s wedding, by contrast, had been all about what her mother had wanted.

Erika realized that she had spent too much of her energy growing up preoccupied with trying to figure out what her mother needed and wanted, trying to please mother, guilty and anxious about her impact on her mother. Her efforts to create a mother who could be happy always failed. Her brother was the opposite. He didn’t assume responsibility for his mother’s feelings, and his mother seemed to be content to just let him do his own thing.

My point is that many women pass on a subtle or not so subtle message to their children: if you’re my daughter, you must make me happy; but if you’re my son, all you have to do is make yourself happy. These daughters grow up feeling guilty and conflicted about their own desires, their own self-interest; while their brothers grow up free to become their own man. If this daughter isn’t subjugating herself, she’s a royal pain; but if this son goes out and does his own thing, well, boys will be boys. Erika was able to realize that even with her own child in utero, she was beginning the cycle all over again, imagining her daughter as a royal pain that she wouldn’t be able to control.

Early in my work with Erika, I realized she was incredibly inhibited about imagining what kind of life she really desired. She’d found a great husband and had yet to have kids. But she was terribly stuck in her work as an artist. I asked her to bring in a drawing that would represent her deepest desires. What she brought in, with much shame and embarrassment, was a drawing of herself sitting by a house where she was sipping coffee on a sunny patio. I was kind of stunned to realize that it was excruciating for her to feel entitled even to having a home where she could sip coffee on a patio.

Now, after her brother’s wedding, something had clicked. Now she knew where she wanted to live, how she wanted to live, and what she wanted to do as an artist. She knew what she wanted, and she felt entitled to work toward creating it – and her husband was thrilled. Most poignantly, Erika knew that she would have the chance to raise her daughter in the same way she wanted to raise her son: to become a person who could be free from guilt and shame about desire and self-interest; a person who knows who they are, what they want, and is able to figure out how to create a good life. Finally, Erika believes that that is the model she herself can provide for her children. I’m so happy to be able to say, you’ve come a long way, Erika.

Addictions

2010-09-25T07:06:00.000-04:00

Like so many other puzzling weaknesses in the design of humans – knees come to mind – addiction is a weakness we can all become susceptible to under the right (i.e., wrong) conditions. Addiction is ubiquitous: there are over thirty different twelve step programs, each addressing a different addiction – the original, of course – alcoholism; but also gambling, debting, narcotics, marijuana, sex, and many others. Just in terms of dollars and cents, government estimates of the total overall costs of substance abuse in the United States—including health and crime-related costs as well as losses in productivity—exceed half a trillion dollars annually. And that’s just addiction to substances – not shopping, food, or “love,” just to name a few others.

How do so many of us get into the addiction mess? Poverty, mental illness, childhood trauma – these are commonly recognized predictors of addiction. On the other hand, there are more than a few addicted millionaires, from what I’ve seen and heard. My own experience of working with addicted people is that in every case, no matter what the addiction, no matter what the demographic, an addicted person is someone who has great difficulty with healthy needs – knowing what they are, knowing how they can be met, and believing that they can be met.

For example, Marty is a successful high level executive, handsome and healthy, a church going man who loves his wife and kids very much. When his wife discovered a trail of internet porn sites on his computer, she was horrified and he agreed to give up his habit and go to therapy. She didn’t understand why, when they were sexually active, Marty was still looking elsewhere.

I soon learned that when he was in high school and his older brother died in a drug-induced accident, Marty started drinking heavily until he too almost had a fatal car accident. His parents were hard working people who weren’t talkers, especially where feelings were concerned. Once his brother was buried, no one really talked any more about him. Marty straightened out after his own brush with death, did well in school, and worked his way up.

Marty got very good at pleasing others, his bosses and clients, and he’s a good provider, a good husband and father. His own needs and feelings are the last things he thinks about, if at all. So at night, when he was done being terrific at work, and his wife and kids were in bed, he would feel restless, exhausted and hyper at the same time, and the lonely, guilty pleasure of viewing porn would help him end the day and get to bed.

Porn was a quick substitute for meeting needs that he couldn’t identify, let alone articulate. It had just gotten easier, more reliable, to get a quick fix that didn’t involve having to give anything, or making actual connection with anyone. It didn’t occur to him that his real needs - the underlying needs all humans have, for intimate connection, for affirmation and support, for recognition and encouragement from the ones we are closest to – could be acknowledged, verbalized, and met – and not by his computer. The marital therapy work Marty and his wife eventually did helped consolidate his understanding, and helped his wife feel closer, too.

Addictions are tough to kick, and sometimes medical solutions, such as detox and rehab for alcohol and drug dependence, are necessary. But for most addicts, once the habit is kicked, the hard part really begins. Many recovered addicts can get good at meeting the needs of others – and some may stay sober by trying to deny their own needs altogether. The harder part is learning to acknowledge your own needs, letting people get close, and letting people love you. As a member of the human race, you’re allowed to have needs, and not be held down by shame. Feeling worthy enough, being able to be vulnerable enough to invite others to meet your needs is a big part of recovering from addiction – and recovering the capacity to love and be loved.

Safe

2010-06-02T11:09:00.002-04:00

Safe
~~~~~

One of my favorite Norman Rockwell paintings is of a mother and father tucking their two small children into bed. It's a perfectly typical scene, except that when you look closely at the banner headline on the newspaper in the father's hand, you see the words "BOMBINGS" and "HORROR."

I was born 11 years after the bombing of Pearl Harbor, and the subsequent war which Rockwell is referencing in that headline, but my son was born just a couple of years before the attack on the Twin Towers. In terms of capturing the depths of concern a parent feels for their child's safety, Rockwell's painting could not be more heart-stopping or more eloquent.

Yet it's not just in troubled times - like those we seem to always be living in these days, now that our televisions bring us everything that happens everywhere 24/7 - that we worry about our safety and the safety of our loved ones. If a child is lucky, her parents worry from the moment she is conceived - will she be healthy; will the birth go well; will we be able to afford all that she needs and all that we want to give; will she grow up well; will no tragedy befall her or us... The list of worries is endless, from cradle to grave.

But it won't help our children if they come to know us as endlessly worried, fearful, anxious people. If we model fear, mistrust and suspicion of anything that lies beyond the tight little circle of what we can control, we could grossly limit the sense of possibility and wonder that life on earth can still offer, battered and torn as our planet and its peoples may be.

One of the things I have learned from being a psychotherapist and working with people who have been traumatized in various ways, is how devastating the absence or the loss of the sense of safety can be. Whether this breach of safety occurred early in childhood, through neglect and abuse - in which case the very people the child most needed for safety are the ones who have most endangered and betrayed him ; or whether it has occurred later in life - divorce, loss of employment, unexpected loss of a loved one - safety becomes for a traumatized person something that can feel eternally out of reach.

Helping a traumatized person means helping them feel safe enough to open up, to trust and to feel, so that a healing process can take place, so that hope and desire can be revived. But if things are too safe - if they are not asked to challenge themselves, to learn to open up to new perspectives and new possibilities, then a traumatized person cannot move out of that narrow, crampled circle consisting only of what seems controllable.

Let's face it - control is just an illusion. Some of the wealthiest people I've met live in a constant simmer of fear and distrust. Much of what we call health - confidence and strength - is based on the ability to lightly compartmentalize and maintain a modicum of denial.

Whatever successes we do or don't achieve, however much control of our survival needs we have or don't have, in the end, I believe that being able to love, to love and be loved, is the most essential ingredient in the sense of safety. It's in connection, human and for some divine, it's in learning to trust and to love, that our only real safety lies.

Some weeks after the World Trade Center attack, singer-songwriter Lucy Kaplansky was riding the subway in Brooklyn, and she took note of the way that people and children were behaving much as they had done before the attack - people just being people, all part of the human community. She ends her song, "Brooklyn Train," with these lines:

"Williamsburg bridge,
Sun hits the train as
It rises over the city again.
Nobody speaks,
Everyone stares.
Remembering all that
Used to be there.
And only the living
Know what loss means,
Riding together on this
Morning train.

Down below on iron veins,
Rolling waves of subway trains.
Rails of mercy
Cross the lives of men,
Safe in the body of
New York again.
Safe in the body of
New York again."

© Daniel Shaw 2010

Jealousy and Envy

2010-04-01T07:39:00.000-04:00

I worked with a man who finally, after years of what seemed like an endless cavalcade of failed romances, found the love of his life. She was different from all the others – she was more mature, thoughtful, patient, and had no penchant for histrionics. At every therapy session he reported another week of steady gains in bliss.

I knew there would be a shoe dropping soon, and sure enough, one week, with sadness, anxiety and shame, Joe told me that he’d gotten jealous. Anne had not texted that day for a number of hours, and when she did call him, she made it brief because she was with a friend having coffee. Joe had spent many lonely hours that day obsessing, spinning elaborate, twisted explanations for what it was she was doing and why she wasn’t calling. By the time they talked later that night, he was spewing out angry accusations.

Joe is smart, handsome, hard working, responsible, artistic, sensitive. But he spent most of his childhood and adolescence with parents who repeatedly told him what a bitter disappointment he was to them. No amount of success in his adult life has erased the impact of trying to grow up while enduring his parents’ harsh, angry attacks. Convinced that a woman he loves is betraying him, he forgets that his greatest fear, mostly unconscious, is of being what he felt like as a child: unlovable. His jealous accusations and mistrust could push a less determined woman than Anne out of his life. But Joe worked hard to deal with his fears and insecurities, and not project them, not turn them into paranoid jealousy and fantasies of betrayal. Joe and Anne are working things out.

Envy is something else altogether. I worked with an extraordinarily creative woman who ran a very successful design business. She had a wonderfully rich life in many ways, was well liked by friends and employees, enjoyed a great marriage. It looked like she had it all… so why was she never excited, happy or proud about her work? Why was there only a painful emptiness about it all; why was she unable to feel as if she wanted any of it or found any of it enjoyable?

Sandra’s father was a very successful man in a highly creative field. He spared her the brutal belittling he repeatedly gave her brothers and her mother. The one or two times in her life that he said something admiring of her are etched in her memory; otherwise he was silent and absent. Her dreamy mother, obsessed with every New Age philosophy and therapy, was a beautiful woman who never left home without looking like a page out of Vogue. Mother seemed to encourage Sandra’s talents, but fundamentally, it was always about mother. Sandra was chiefly meant to be her mother’s admiring mirror.

Bursting with every kind of talent, Sandra was exhibiting her first drawings in major shows as a teenager. But instead of pursuing an art career that would put her in the spotlight, she worked out a way of hiding in plain sight. She designed all kinds of things that sold with great success, but which almost no one knew she had designed. Unconsciously, she could not risk any kind of show of fulfillment, because bringing attention to herself would be too reminiscent of her mother’s vanity and self-absorption. Further, she couldn’t resolve the guilt she felt about her brothers and her mother. Why did father abuse them and spare her? It was as though being successful made her too much like her abusive father; and made her the object of the others’ envy and resentment. So she allowed herself success – but not fulfillment, not happiness.

Sandra hadn’t made any of these connections from the past to the present – her unhappiness seemed like an inexplicable punishment. Once she began to make sense of how she lived in fear of the envy of others, and in guilt about surpassing others, she could begin to see a way toward being able to enjoy and take pride in what was rightfully hers.

We are all challenged to recognize the impact of jealousy and envy in our lives – those feelings are within us and all around us, and not always in ways that are obvious. We’re all susceptible to these feelings, but for some, freedom to enjoy life – or in Freud’s famous phrase, work and love - can only come when the roots and meanings of our envy and jealousy experiences can be illuminated.

Dating Without Drama

2010-02-04T07:51:00.000-05:00

Over the years, I have counseled many people who were going out of their minds because they kept getting into bad relationships and not getting into good ones. Some people are confused about the difference between being in love, on the one hand, and hysterical, chaotic, sadomasochistic drama, on the other - although there usually is some overlap. Here are some common errors and some more productive alternatives.

You are miserable, lonely, hurt, frustrated and frightened. You are alone again; or you have been with someone for ‘x’ number of weeks, months, years, and you’ve been unhappy just about the whole time. Your fights are repetitive, no one has discussed marriage or it keeps getting postponed, your sperm is slowing down or your eggs are drying up, you’re not having sex, or you’re having great sex but fighting bitterly in between every short-lived reconciliation. You try to travel together and one of you ends up flying back early, alone. You invite your girl/boyfriend to meet your parents and she/he decides not to show up at the last minute. You blame everything on your partner, and vice versa. You talk about going to couples counseling, but it never happens.

This is not a great place from which to start having that great relationship you say you want. You - yes, that’s spelled Y-O-U -- have to change. You have to get clear that you are a worthy, valuable human being, entitled to love and be loved. Your sense of unworthiness may be so deep and so unconscious that you don’t even know it’s there - but it’s why you’re lonely, or why your relationship is lousy. Get your self-esteem together, start working on repairing the relationship you are in and commit to it, get into that couples counseling already – or get out of it and start fresh.

So let’s say you are starting fresh, ready for a new relationship. Having followed the advice above, you now believe in yourself, you have fully worked through your hidden self-doubt and self-loathing, you have reinforced your belief in your strengths, your goodness, and your worth, and you are not unduly focused on your flaws and weaknesses. And you are crystal clear: you want to get into a great, healthy, strong, happy, successful, intimate relationship. If you aren’t really crystal clear about that - you haven’t changed enough yet. If you experience repeated frustration and disappointment in getting to this healthier place, consider consulting a mental health professional for some deeper self-understanding.

But let’s say you are in fact clear. Good, now start dating. You have to tell everyone you know that you are looking to meet someone. If you are 30 or over, you probably need to use the online dating sites. You might need to use online dating even if you’re younger, but the older you are, the more useful those sites tend to be. Forget bars, for the most part. They’re more for hook-ups than relationships, and you need not to confuse the two.

Next, you have to be a smart shopper. Yes, you are being chosen, or not - but you are also choosing. Be the chooser, and be picky. If someone turns you down, keep moving. And if someone is into you, it doesn’t mean you have to be into them. You either are or you aren’t - and if you aren’t that into them, the sooner you decide to keep looking elsewhere, the better. You can spend 6 months trying to figure out if you really want to be with someone or not - but if you’re honest with yourself, you probably knew it wasn’t a go from day one, and you let fear and guilt stop you from saying “no thanks.” And then you spent 6 months with the wrong person, when you could have had 25 dates during that time, one of which might have yielded someone you would have been crazy about. And now that person is no longer available, because you were wasting your time not breaking up with Mr./Ms. Wrong!

Yes, you need to be really attracted to the person you fall in love with - but maybe some of your requirements - like no back hair, or extra large breasts, or a minimum of $3 million in conservative investments, and other overly-specific demands - maybe you need to be a little flex on some of those things. And bear in mind, you’ve probably already had horrible relationships with people you were intensely attracted to, or people who seemed to be able to provide you with everything you wanted, so physical attraction or plenty of dough, by themselves are not enough. Is this person kind, supportive, excited about you and your dreams and goals - and vice versa? Do you share common tastes, preferences, interests? Do you imagine enjoying the same kinds of activities and lifestyle together?

Keep looking for the right person, don’t give up. Don’t get entangled in relationships that are either lifeless, or full of drama from the get-go. Believe in yourself and the goodness of the love you want to give. Good luck in your search - and vive l’amour!

Anxiety

2009-11-08T11:24:00.000-05:00

Being human, we naturally all have quite a bit to worry about. For starters, we may be the only species that has to deal with knowing for sure that we are mortal. Back when existential humanism was mainstream, Ernest Becker wrote a book worth reading called “The Denial of Death.” He noted our difficulties with the hard cold fact that we really have zero control over how and when the grim reaper arrives. Becker felt that denial of our impotence, when it comes to mortality, could bring out either the best, or the worst, in us. This impotence in the face of death could lead us to delusions of omnipotence (think dictators, charismatic cult leaders), on the one hand – or to benign uses of power, such as the empowerment of others (think, say, civil rights).

This was what the Buddha, centuries ago, was trying to work out: how do you live if you’re not wearing blinders? if you actually see the suffering all around you, and the impermanence of everything – how do you bear the pain, why do you even bother? The Buddha’s solution was the attainment of equanimity – the opposite of anxiousness - and countless volumes of elaborations on that idea, including countless workshops and seminars, have mushroomed ever since.

Controlling anxiety is not just a matter of philosophy and faith, though; it’s biological and it’s psychological, too. It’s built in to the most ancient part of the human psyche-soma, a survival mechanism meant to alert us and heighten our responsiveness to danger. In other words, it’s in our nature, and it’s not always a bad thing.

For some, anxiety is all over the place, they know it and everyone around them knows it. For others, anxiety is more subtle, and may be disguised as irritability, anger, moodiness. Obsessive anxiety can be persistent and highly resistant to being explained away. Often, there are deeper reasons for obsessive anxiety, rooted in the ways we were brought up, the things we learned about anxiety from our parents. This kind of anxiety is depressive, and can lead to panic; the feeling of never being able to have enough control. If it’s really chronic, and not just about this or that situation, it’s a good idea to talk to a mental health professional to get some help with understanding and managing it better.

One thing that may be good to bear in mind as you try to deal with your anxiety, whether it’s mild and occasional, or persistent and debilitating, is that you are not the only one. It’s something that challenges all of us, and something we can spend a lifetime learning to understand and regulate.

These days, there is climate change and economic downturn, not to mention that old standby, nuclear proliferation; they are just no help at all when it comes to anxiety. It’s probably easier to go ahead and sweat the small stuff, than to fully confront the big stuff that really makes us feel helpless. But even with huge things that are worth worrying about, we somehow have to go on living, as creatively, as lovingly as we can, don’t we? It’s a conundrum – there are some things we should actually be worrying about more, not less. But then what about everyday life, family, friends – shouldn’t we be trying to make the most of what we have? If you have this all figured out, let me know.

The mid-century Protestant theologian, Paul Tillich, wrote a fine book called “The Courage to Be,” in which he referenced a medieval drawing by Albrecht Durer, titled “The Knight, Death and the Devil.” When I read about this drawing, I got a print and hung it in my office. There’s the knight in his armor, on his horse, looking straight ahead, resolute, determined to reach his goal. To his right is Death, an ancient man holding an hour glass, following the Knight, not letting him forget the dark, terrible fears that the future might hold; a constant reminder of the ultimate annihilation. And behind him, a horned beast, the Devil. I think of the Devil as metaphorical for the demons, all the guilt and shame, that so many of us drag around behind us; the feeling of never being good enough, worthy enough . With fear of what’s ahead, guilt about what’s behind, shame about what is - it’s hard to go anywhere.

Death, the Devil, fear, guilt – that’s life. They follow the Knight every step of the way. But he just keeps looking forward, eyes on the goal, unswerving, committed, determined. He’s an ideal, the Knight - quixotic, mythically possible - but maybe not humanly possible. Nevertheless, he certainly can be an inspiration.

Dependency

2009-09-18T08:21:00.002-04:00

Many people seek therapy to try to understand why they cannot form healthy, enduring intimate relationships. Often, their conflicts around dependency are undermining their efforts.

The word “dependency” is used, frequently with contempt, to describe infantile neediness. This contempt for neediness makes us ashamed of having needs. So, for fear of being seen as needy, we hide our needs from others, and from ourselves. But then we feel hurt when a significant other doesn’t recognize our needs without our having to tell them what we want. Or we wish someone would need us more - but when they do, we feel turned off. There are a lot of mixed signals about dependency flying around, and most of us are sending and receiving them all the time.

Dependency is not a dirty word. Whether we’re comfortable about it or not, the fact is, we are born dependent. Throughout the most important years of human development, from infancy through adolescence, what children need most for healthy development is to have the secure feeling that the adults in charge are dependably there for them - caring, interested, empathetic, loving.

This kind of caregiver really takes the time to see and hear the child, and this child is then supported to feel that she matters; having needs and desires doesn’t end up making her feel hopeless and powerless. These children develop faith in the possibility of getting their needs met. They also develop concern about the needs of others – not from being shamed into caring, or being told they are selfish, but from the model of care and concern their parents present.

Children do need to learn to become more independent over time. But the development of healthy dependency can be thwarted when impatient, self-absorbed parents resent the child’s dependency. This leaves the child little choice but to become overly dependent; or else to shut down her own sense of need, and pay attention only to the needs of the parents. Neither situation bodes well. For these people, developing healthy interdependence – relationships characterized by mutuality and reciprocity - can become a lifelong challenge. The classic film The Heiress is a great illustration of this unhealthy kind of parent/child situation – and Ingmar Bergman’s last film, Saraband, is an extraordinarily deep and brilliant exploration of this theme as well.

Some parents keep their children dependent, covertly or overtly, with the aim of maintaining control over the child so that the child will stay and take care of the parent, rather than go off to build their own separate life. These parents are dependent on their children for needs they should be looking to other adults to meet. Classic films like The Barretts of Wimpole Street and Now, Voyager dramatized this kind of parent child relationship to great effect (don’t you wish Rick’s Video store was still around?). And Alice Miller’s seminal book, The Drama of the Gifted Child, has been popular for decades for the way it illuminates these kind of relationships.

We depend on the kindness, the care, the recognition and the understanding of others, from the beginning to the end of life. Finding a partner and sustaining a healthy relationship, where each of you are supported to grow and mature over time, works best when both partners are committed to validating and meeting each other’s needs. If you have been discouraged about building and sustaining a healthy, intimate relationship, you may need help to better understand your needs - especially your fears and conflicts about dependency.

Up To Date

2009-09-13T19:16:00.000-04:00

To any current and any future readers:

This is the point at which all the old pieces I've already written are now on the blog. From here on, all the pieces will be up to date.

Thanks for reading -

Best wishes,
Dan Shaw

D-I-V-O-R-C-E

2009-09-13T19:15:00.000-04:00

In Tammy Wynette’s country classic, the “D” word gets spelled out, not spoken aloud, to protect the divorcing couple’s young child. Yet the lump in the singer’s throat suggests that it is she who can’t bear to confront the brutal finality of the word.

Many of the couples I see in my psychotherapy practice, and many 0f the married individuals, report that they feel so stuck, discouraged, hurt and enraged about their relationship that they don’t know if they can keep going. Still, many who are hopeless about their marriage can and do find a way back, even from what seems like total ruin.

Typically, each member of the couple will have bitter complaints that go something like this: “I hate when you do such and such to me.” “Well I hate when you do such and such to me.” “ I only do such and such because you do such and such.” “Well I only do such and such because you do such and such.” Etc.

If both partners can put their own hurts aside long enough to see how they themselves have been hurtful, the marriage has a real chance. But in many cases, one of the partners becomes more and more adamant, insisting that all the couples’ problems stem from the other person. Of course there are cases when one of the individuals is indeed so derailed – for example, from drug addiction, or chronic infidelity – that there can be no progress unless those issues are addressed. More typical, though, is a situation where there is fault on both sides – even when the fault of one is initially more apparent than the fault of the other.

Sometimes, in cases where one partner refuses to accept any responsibility, the other partner will repeatedly back down and take the blame to keep the marriage going. The backing-down partner often develops “mysterious” chronic illnesses, like headaches, gastrointestinal problems, or muscular-skeletal symptoms, and may spend a good deal of time looking to doctors and healers for sympathy. On the other hand, the partner who never accepts any responsibility for the marital problems may also have a host of illnesses, which serve as a further blockade to the kind of searching self-honesty that would allow them to see their own part in the problem.

If one of you does all the accusing and the other has to do all the apologizing, eventually there will be, if not Divorce, then Deadlock. Divorce is one way out of deadlock, and sometimes it’s the right way. Staying in a dead marriage and being depressed, or finding distractions (affairs, for example) are other, less constructive ways of dealing with marital deadlock.

Most marriages arrive at deadlock at some point, and often not just once. And most good marriages that last are ones in which both partners have worked hard, repeatedly, to take responsibility, repair damages, apologize and forgive. We humans will never be perfect, but we can keep on growing as people, right to the end. If you’re not growing as a person – learning to develop more meaningful connection with others, overcoming the shame of acknowledging and addressing the destructive tendencies in yourself that prevent intimacy from deepening - your marriage isn’t growing, either, and it’s probably time to get some help.

Depression

2009-09-13T19:14:00.001-04:00

No, not the economic one - the other kind. Depression, once an illness that dared not speak its name, is now familiar to most Americans. It effects men and women, young and old, and plenty of us. Depression can be minor or major – that is, less or more seriously afflicting. It can come in a single episode, or it can be recurrent or chronic.

Andrew Solomon , the brilliant author of a comprehensive work on depression entitled “The Noonday Demon,” described it as “the aloneness within us made manifest.” “The only feeling left in this loveless state,” Solomon wrote, “is insignificance.” Another great poet of depression, William Styron, likened it to “darkness visible.”

To those who have not known clinical depression, the powerful, poisonous grip of it can be hard to understand. The depressed person, instead of eliciting our compassion, can seem like someone who just wants pity; who isn’t trying; who wants everyone else to be as miserable as he is. Those who love a depressed person are deserving of compassion themselves: the depressed person is often very hard to live with. He cannot feel loved, no matter how sincerely and with how much devotion others try to love him. He clings to his loved ones, even as he pushes them away. His self-loathing is often turned on those who love him, who then feel the brunt of his profound disappointment in himself, his discouragement and self-contempt. The more he hurts those who love him, the more he sinks into shame, guilt and despair.

Depressed people need help but often are too afraid, discouraged or ashamed to seek it. Those who love them need to push, insist, or demand, if need be, that they get help. Two things help: medication and psychotherapy.

The SSRI medications (Selective Serotonin Reuptake Inhibitor), such as Prozac and its many successors, have been the most effective medical treatment to date. With relatively few side effects for most people, they have helped relieve the worst symptoms of most kinds of minor depression, and they are very often successful in controlling recurrent major depression. However, these medications do not turn sorrow into joy – an SSRI is not a panacea. Rather, SSRIs help to diminish obsessive rumination. For the depressed person, this can mean that the compulsion to obsess over an endless litany of cruel judgments against himself can be controlled and eventually even stopped.

But these habits of self-loathing run deep and have not sprung out of thin air. The terrible thoughts and feelings of the depressive have meaning – and therapy is the means by which the traumatic origins of depression can become known. People typically think of “trauma” as a terrible incident of some kind of violent assault. But trauma can also be developmental. Developing as a child in a family led by caregivers who are ill – for example, with alcoholism and other addictions; mental illness; personality disorders and mood disorders - can be a significantly traumatic experience.
For those who have grown up under these conditions - where trauma is cumulative, and rooted in childhood dependence on unstable caregivers - the sense of utter, desolate aloneness can become a lifelong, haunting presence, like a curse one is helpless to dispel. Too often, depressives blame only themselves for their difficulties, not realizing that their upbringing all but guaranteed they would eventually fall prey to depression.   Therapy not only illuminates the origins of depression, but helps to create a path toward healing, growth and change.

If you have healed your depression through exercise, through spirituality, through service to others or meaningful, inspiring work, or through a loving relationship – you are among the lucky. If you’ve tried it all and still suffer, seek the help of a licensed mental health professional. It is never too late to get help for depression, and to claim the right to a life of meaning and possibility - a life in which it is possible to love and be loved.

A New Year

2009-09-13T19:13:00.002-04:00

My sister-in-law Juliet told me that one year she decided to only make New Year’s resolutions that she could actually keep. After much deliberation, she resolved to take better care of her shoes. And in fact, she has kept this resolution for many years now (except for the one pair of boots the new puppy got a hold of). It was a matter of being realistic, she told me, and not setting herself up for failure with some unattainable goal.

Which made me think about ambition, aspiration, desire.

George, a young 29 year old man who could still pass for a teenager, was going to be setting up a hedge fund. He had already made a tremendous success as a Wall Street trader, with a system he had worked out that had led to tremendous gains for his company’s clients. Now he wanted to branch out on his own.

George was driven. He didn’t really date; he’d hook up now and then, but most of his companionship came from the guys at the high stakes poker games he frequented. And when he couldn’t wind down, there was one particular pill that would take the edge off for him.

George’s father had divorced his mother when he was about twelve years old, and the father proceeded to do everything he could to ruin his mother. Though very wealthy, the father had schemed so that his wife couldn’t get at his money, and Ralph saw his mother reduced to near poverty. He decided that earning hundreds of millions of dollars would be his guarantee that his mother, his brothers, and he would never lose control of their lives again.

I believe George will succeed, and I’m sure I will both admire and envy his success. But it looks like he will spend his thirties on telephones, in front of computers, living on adrenaline, popping pills, using money as a fortress that could end up locking him up from the inside. George thinks it will all be worth it when he is 40. I hope he’s right.

Is it possible to have grandiose ambitions without being obsessed? The constant stream of celebrity meltdowns the media bombard us with suggests that it isn’t easy. And then there’s that little matter of the collapse of the global economy – oops! Hopefully we all now recognize that the glamour and hype of the celebrity culture and of the financial world is often undergirded by pharmaceuticals, rehabs, prisons and divorce lawyers. And that many seeming successes are actually just bubbles.

George had a moment recently - while high - of perfect peace, looking out at the view from his penthouse windows, feeling really good about what he’s accomplished. George is a great guy; I hope someday he can feel good about himself even when he isn’t high, and that he can open up and share his life, his amazing accomplishments, with someone who loves him.

It’s great to set goals in the New Year. I’m not saying don’t aim high. Go for it! But it’s also important to stop and recognize and appreciate what you’ve achieved, and what you’ve got. We can tend to focus on what isn’t enough, and lose sight of what is, what is good enough. So here’s an idea: resolve to relax more, to connect more with others, and to enjoy living while you can, as much as you can. And maybe take better care of your shoes, while you’re at it. Happy New Year!

Parenting

2009-09-13T19:12:00.000-04:00

A friend, and the mother of 2 lovely children, recently told me, her voice crescendoing with frustration, “You should write about what to do when your child is being so impossible that, as much as you love him, YOU ACTUALLY FEEL LIKE YOU COULD BECOME A CHARACTER IN A GREEK TRAGEDY!” Greek tragedies - you know, those ancient dramas where the parents murder their children, or each other, or all of the above?

Full disclosure: I am currently a parent of a 10 year old boy and a 7 year old girl, and all too often I know just how that mom feels. Like you, I struggle with putting good parenting intentions into action. There’s obviously far more to say about parenting than I can do justice to here – and always more to learn - but here are a few suggestions.

• Aim to stay calm as much as you possibly can. Your anxiety, resentment, losing your cool, flying off the handle, shaming and blaming – it just serves as a bad model for your child to mimic, feel hurt and rejected by, and throw back in your face. Being calm when your child is being impossible models to the child that problems, conflicts, and moods are normal human experiences that can be addressed constructively. And it shows that you are dependably in charge – not by force, but with strength.

• Do others tell you your kids are terrific, and you’re wondering why they are often so impossible at home? For kids, growing up, going to school, dealing with the social world and ever-increasing responsibilities is a constantly challenging process. Kids are doing all they can do to hold it together out there. Maybe they need to be able to fall apart a little at home, and maybe we need a little more empathy.

• Kids are super-sensitive, and they easily pick up on your bad moods. Transitions are often tough for them. Does your own moodiness lead you to focus on all their flaws and forget to notice their strengths, their efforts? Try cutting them some slack when they act out – it often helps them calm down and get themselves together more quickly.

• If your partner is a calmer parent than you, stop resenting her (or him), and resenting the kids for favoring him (or her). Instead, ask for her (or his) support to help you become a more relaxed parent.

• Work on your connection to your partner/spouse. Get your power struggles and other disconnection issues cleaned up. Your kids need unified, mutually respectful and loving parents, not embattled and embittered rivals. What kids learn about relational behavior and what they act out is often exactly what you model to them in your own relationship to your partner.

• You are not perfect, you never will be, and no one else will be either. If you can’t admit that, you are officially a control freak, which is to say that you need to get yourself under control. When you dispel all illusions about perfection being a possibility, it will be easier to be accountable for your mistakes and easier not to be expecting perfection from your kid, or from your partner/spouse. When you make a mistake and lose it with your kid, honestly apologizing is a highly effective way of reconnecting and healing. Don’t forget to model forgiveness, too, when the apology is aimed at you.

Finally, find people you can vent to about parenting who aren’t condescending and judgmental. You want to love, care for, support and encourage your kids? Make sure you’re getting all those things, too – from friends and family who appreciate how much you love your kids, how hard you try, and all the good you’re doing.

Gotta Be This or That

2009-09-13T19:11:00.000-04:00

Without even realizing it, we are constantly making choices, from one second to the next. Yet for some, choosing is an agonizing process. Unlike the mandate in the title of the 40’s swing tune – gotta be this or that - some people cannot ever decide between this or that, and they and those around them suffer a good deal as a result.

At worst, such indecisiveness may be a sign of Obsessive Compulsive Disorder (OCD), a mental illness that runs in families. The classic symptoms, such as hoarding, fear of contamination, checking repeatedly, and ordering symmetrically, are considered pathological when the compulsive need to ritualistically perform these actions becomes overwhelming, depressing and disabling.

I’ve seen a number of people for psychotherapy who were never diagnosed with OCD, because their symptoms were not obvious.

For example, there’s the man who repeatedly stays in romantic relationships with women he won’t marry, because he fears he is making a mistake and should be with someone else. He fears the woman he is with will become controlling, demanding, overweight, and that he will lose too much money if she divorces him. He’s also turned down job offers because he felt he didn’t have enough information, only later to realize he had missed tremendous opportunities.

There’s the woman who puts intense pressure on herself to be extremely nice to others, for fear that she will say something cruel and unkind that will hurt them. As a result, she agonizes over any decision involving interpersonal transactions; and obsesses constantly over how she has been offended, or how or if she has offended others.

And there’s the woman who has to exhaustively research any choice about anything – from buying a toaster to moving out of an apartment with an abusive landlord - and as a result, feels unbearably backlogged because of all that she hasn’t been able to get done. When she isn’t utterly exhausted, she’s feverishly busy researching, and obsessing constantly about what and how much she is eating.

The common obsessive-compulsive theme for these people is the fear they have of doing the wrong thing, a fear of making choices which will have both morally and concretely disastrous consequences. They can never fully trust themselves or others, but are nevertheless always unconsciously debating: am I the bad one that cannot be trusted? or are you the bad one that should not be trusted? Is this world safe for me, or am I constantly in danger? No matter how they deliberate, they never get a satisfactory answer.

In therapy, it became clear that each of these people had difficult developmental experiences and certain family problems that seem to have triggered the OCD symptoms. But in each case there was also a history of anxiety disorder in previous family members – a good reason to consider medication.

Today, “SSRI” medications that regulate serotonin levels in the brain are successfully prescribed for OCD, resulting in the relaxing of obsessional rumination. But as with all mental health concerns, talking things out in psychotherapy is also important. For OCD sufferers, medication and psychotherapy can help uncover the underlying psychological structure of the problem, and can aid the development of hope and determination – both of which are needed to gain control of the symptoms.

Choices are often hard to make, but with OCD, choosing becomes a nightmare. If you or someone you know suffers from OCD, the best choice you can make is to consult a licensed mental health practitioner and get you or your loved one some professional help.

Dependency

2009-09-04T05:49:00.000-04:00

When The Boss is A Bully

2009-08-30T12:37:00.003-04:00

I was once seeing two young women for therapy during roughly the same time period, and the differences in how they each handled very difficult bosses were instructive.

Carla could tell a good, amusing, entertaining story about the boss she assisted and how insane he was. Eventually, Carla stopped entertaining me and exposed how deeply resentful she really felt. But Carla was so good at being perfectly accommodating that her boss considered her indispensable, and came to depend on her more and more. While Carla was complaining bitterly to me in therapy, at her office she was smiling and entertaining and placating her boss without any setting of limits.

Carla also had a boyfriend whom she complained about, yet she couldn’t stand up to him, even though we agreed he seemed to endlessly avoid real commitment. As we explored further, the pattern and its history became more visible. Carla had been daddy’s girl until Carla was a young teen, at which point her father stopped being interested in his family and found a young girlfriend, bought a motorcycle, copped out of paying for Carla’s college expenses, and so on. It seemed that Carla was used to being in relationships where she gave her all, but ended up not getting much in return, especially if she tried to get her needs recognized. She kept working harder at being the perfect daughter, the perfect girlfriend, the perfect assistant. She had become used to being the one who did all the giving, and couldn’t see that she repeatedly got stuck in involvements with people who responded to her ambivalently, as her father had, and balked if she asked anything of them. Luckily for Carla, a friend gave her name to another company, and she left her underpaying job for a much better situation. But Carla still needed to learn to believe in herself enough to form healthier, more mutual relationships. As confident as she was in her talents, she lacked confidence in her sense of authority and entitlement in relationships.

Another patient I’ll call Andrea had grown up feeling that her parents had her back at all times; and that they trusted and admired her. Andrea was working on important issues in therapy, but confidence in what she deserved in her relationships wasn’t one of them. After an initial good year at her job, Andrea’s boss began playing her off against a co-worker. The boss was always demanding more of her, but would make himself unavailable to Andrea when he knew she wanted anything from him, and wouldn’t go to bat for her with the higher ups when it would have been appropriate to do so. In her second year, after a holiday bonus that fell short of what Andrea knew she deserved, she started looking for work and quickly found a far better paying job. She was careful to communicate with her new potential employers what her salary requirements and expectations would be, and what her hopes were in terms of office environment. Andrea and the company heads who interviewed her hit it off beautifully. She started her new job full of excitement and hope.

Angry, selfish, demanding, sadistic – whatever flavor of craziness a boss might come in, it’s likely that anyone who works will encounter a bad boss sooner or later. If you are constantly frustrated about your boss, and you’re not finding ways to make your situation better, you may be part of the problem, and professional help may be advisable. When so much of life is our work life, doing whatever it takes to make work better should be a no-brainer.

Bipolar

2009-08-30T12:33:00.002-04:00

I met Lauren, an attractive middle-aged woman with warm, deep blue eyes, for a perfect cappuccino at Didier Dumas’ in Nyack the other day. She had called to tell me about the support groups at the Mental Health Association in Valley Cottage, for people with bipolar disorder and for their friends and family. I asked her to tell me how she got involved, and here is what she said:

She met Josh, her second husband, after being introduced through a dating service. They talked on the phone and he seemed very interesting, very well-mannered. She had divorced at a fairly young age, and raised her now-grown children as a single mom. Josh had raised four children, all Ivy League grads, now with families of their own. He was divorced after a 27 year marriage, and he continued to work in the highly specialized medical field in which he had been quite successful. Lauren and Josh began dating, and soon Lauren learned that Josh’s career had been marked by a series of repetitive conflicts with colleagues; that he needed a lot of attention; that he could at times be inappropriate and demonstrate poor judgment. Lauren continued to date him because in spite of the “issues,” he was also sincere, kind, loving, generous, adventurous, and fun.

Lauren and Josh were married for about a year, when Josh’s strange behaviors escalated. Lauren needed to tend to her ailing elderly father, and as she became less available, Josh became increasingly resentful. He made big messes in the house and didn’t clean up; he’d be banging around working on projects in the middle of the night; he’d easily get angry to the point of screaming. It escalated to the point where Josh seemed completely out of control. Lauren laid down the law and got him to see a psychiatrist; the psychiatrist arranged for an inpatient hospital stay. Bipolar disorder, which should have been diagnosed when Josh was in his 20’s, was at long last identified, and medications were prescribed. Josh started acting like himself again.

Getting the medications right took about six months. Lauren stood by Josh even though she was wounded, feeling self-protective as Josh recovered. At the same time, she learned everything she could about bipolar disorders, she became a walking encyclopedia on the subject. She learned about the mood swings, from manic highs to dark, depressive lows. The highs involve distorted and dangerous thinking, and self-destructive behavior – extreme irritability and anxiety are common; as are grandiose, euphoric states. The depressions are dark, deep, agonizing. These moods can be mixed, they can alternate, they can be separated by relatively normal periods. Lauren had seen it all with Josh.

Lauren made it clear she wouldn’t be Josh’s nurse or his mother – he would have to be responsible for his medications, for monitoring his behavior, for staying in therapy. And he would need to take responsibility for his impact on her and on the others around them.

Josh and Lauren (not their real names) attend both the Bipolar Group and the group for Friends and Family of people with Bipolar disorder, at the Mental Health Association of Rockland in Valley Cottage. For information on the Bipolar group that meets on Tuesday nights please call Leslie Davis at (845) 638-2576; for the Friends and Family group please call Donna Davidson at (845) 613-7086.

As I left Lauren and told her I would tell her story in this column, she couldn’t help becoming tearful. “I’m so grateful,” she told me. “People need to know about this illness, how to treat it, how to get support.” Lauren, thank you for having the generosity and the courage to share your story; I know it will be greatly appreciated.

© Daniel Shaw 2008

Singles

2009-08-30T12:32:00.002-04:00

If you were the one without a partner at your family gatherings this season and you weren’t happy about that, you are not alone. A lot of people I talk to are despairing because they have tried and tried, and they still haven’t found a partner. They wonder what they are doing wrong; they wonder if all men/women are just like the last disappointing, unreliable person they dated.

Of course there are many factors that might cause someone difficulty in finding a partner. One problem I encounter quite frequently is unconscious ambivalence – deeply conflicted feelings that are not fully recognized.

I often get astonished stares from people when, after lots of listening and exploring about what is going on with their unsuccessful dating, I question if perhaps they might be more ambivalent about wanting intimacy than they realize. I’ll point out that they have a history of choosing ambivalent, passive, commitment-phobic partners; they have a history of staying with someone too long, even when it didn’t seem right from the get-go; and that they display many other behaviors that suggest that without realizing it, they are making the same bad choices again and again. Then there are the relationships in which both people continually feel like the victim of the other – I’ll save that one for another column.

Working through ambivalence, I will typically explore three areas:

1. Desire. Do you really want intimacy? What were your parents like with each other? What were you like with each of them? Based on your parental models, does intimate relating evoke fears of being smothered? being dominated? being neglected? being expected to be perfect? being constantly on the defensive? Even though you truly want a committed, intimate relationship, there can be another more hidden part of you that fearfully anticipates repeated hurts and disappointment. When these kinds of fears are not conscious, they have an undermining effect on the fulfillment of our desires.

2. Entitlement. If you believe we are all born deserving love as our natural birthright, are you sure you still believe you have that right? If not, what changed? Was your love and affection for your parents welcomed with tenderness, or was it ignored, even rejected? Was love given to you conditionally, begrudgingly, stingily? Were you led to believe that you were never good enough, and therefore didn’t deserve love? Were you expected to meet all your parent’s needs for love, but made to feel guilty about wanting anything for yourself? Now as an adult, when dating, do you make yourself like a commodity, an object to be chosen or rejected? Why aren’t you entitled to choose?

In order to exercise your right to choose, and not remain stuck in the helpless, passive position of waiting to be chosen, you need to flush out the old negative messages and work on internalizing new ones - mesages that support you to believe deeply that you are good enough to have the right to love and be loved. If that reminds you of Al Franken’s Stuart Smalley character, so be it: Stuart Smalley had the right idea (“I’m good enough, I’m smart enough, and doggone it, people like me!”).

3. Hope. Do you feel hopeful, confident and optimistic that you will find love? Can you find a way out of discouragement and disappointment, out of fear and anxiety? I recommend you stop thinking that you are being singled out by unseen powers for endless punishment – you’ll never prove it. You are better off working toward developing patience, and the hopeful, optimistic conviction that you have as much right as anyone else to find happiness.

If you are stuck in repetitive, discouraging relationship patterns, don’t give up. I’ve seen again and again that people who are willing to work hard at clarifying their desires, overcoming fears, and building a healthy sense of entitlement and hope, can succeed in finding and sustaining love that lasts.

Rx for Parents With Children

2009-08-30T12:31:00.000-04:00

If you are married or partnered with children, answer this: when was the last time you went out on a date with your partner, without your kids? If you have to think about it for more than fifteen seconds, you may just have identified one of your biggest problems as a couple.

When two people make a life together and include having children, they take on innumerable responsibilities. In our commendable efforts to be good, loving, responsible parents, we often forget to plan ahead – to the time when those kids will grow up, start their own lives, and fly the coop. I’ve noticed that many people whose partnerships are hitting the rocks are just at the point of approaching or having to adjust to an empty nest. Again and again, I hear that their life was all about the kids. With the kids gone, they don’t know who they are as people, or as a couple.

The big joke you always hear about married couples and life partners is that their wedding rings have cut off all sensation to their genitals (rim shot sound effect, please). But let’s be honest: happy unions aren’t just about having more sex. You can’t rely on sex alone to create the sense of being recognized, seen, heard, acknowledged and appreciated. Those are the things aside from sex that most partners crave, whether they admit to it or not. What does create the sense of being deeply known and appreciated is the time that a couple puts aside for each other, through the years, to be alone together, to open up to each other, to depend on each other and trust each other.

That is why it is so important to stop making excuses for not hiring a sitter, or having appropriate friends or relatives take the kids for a night or two on a regular basis. Using children as an excuse to avoid deeper connection with a partner is an easy trap to fall into, and a hard one to get out of. If you haven’t been dating your partner; if dating your partner feels like cheating on your kids; if you’re avoiding acknowledging pent-up frustrations or resentments; if you’re having arguments or important discussions on the fly, by e-mail, or when you’re half asleep; if you’re not finding the time to speak and show your love and appreciation because you’re assuming that it’s understood – don’t be surprised that you feel disconnected.

The best way to draw closer and stay closer to your partner is to regularly take time for just the two of you, out of the house, without the kids – at least once a month, but preferably more. You don’t have to dress up, you don’t have to put any pressure on yourselves. Yes, now and then, plan something wildly romantic and special. But for your regular, recurring dates, keep it simple. Don’t always make it a movie or a show, where you barely get to talk. Just go someplace casual where you can hear each other. Maybe you’ll have an argument that you needed to have to clear the air; maybe you’ll be quiet because you’re just calming down and relaxing; maybe you’ll stop worrying about the kids for a minute and take care of each other a little. In whatever way it happens, you can tell each other all about yourselves, and just be the two of you again -- the same two people, more tired, older but still recognizable, who were once so wildly, crazily in love with each other.

It Ain't Over 'til It's Over

2009-08-27T17:04:00.002-04:00

In my experience, people these days are in too much of a hurry to "move on" and "let go." It seems that most of us have a natural tendency to minimize the importance of experiences that have been emotionally difficult. We want to stop hurting quickly, and we don't want to feel embarrassed or stigmatized by difficult aspects of our past or present. What happens when we think we've reached closure, and we really haven't?

Not too long ago, I asked a woman who was having some marital problems about the most significant events she could tell me from her life story. She mentioned several things, including a teenage car accident; but for the most part, she was at a loss. Everything had been quite normal, she told me; her family was intact and there was nothing unusual to report.
When we spoke the next week, she told me with considerable surprise that when she told her husband about the session, he asked her if she had remembered to discuss the sudden, premature death of her younger brother when she was in her teens. How, she wondered, could she have left something so significant completely out of the story?

She and I have come to understand that her parents' mute, unbearable grief was so intense that after her brother's funeral, no one in the family tended to say much about it – almost as though they were ashamed. Everyone tried to go on about their business, and dropped the subject. Did her subsequent heavy drinking in high school, and the car accident that followed, perhaps have something to do with how quickly everyone in her family had tried to "move on" and "let go?" And her marital problems now, the distance she feels from her husband - could it have anything to do with her old habit of pushing feelings down, avoiding thinking or talking about what's painful?

"What's the use of getting into all that now?," I'm often asked. "That was 30 years ago. What good will it do to bring up all those feelings?" For the people who ask these kind of questions, "those feelings" too often never had a chance to be known, articulated, expressed – and thereby processed, digested, made bearable. Buried feelings about painful experiences reverberate in people's lives, and when unprocessed, come back to haunt in ways that are not always obvious. Rushing by the painful times, pushing the painful feelings away, doesn't really work out in the long run. As one of my favorite sages – Yogi Berra - once said, "it ain't over 'til it's over."

Wise advice can also be found in the words of Ecclesiastes: "There is a time to weep, and a time to laugh; a time to mourn, and a time to dance; a time to rend, and a time to sew; a time to keep silence, and a time to speak." These different times that the Prophet speaks of are the times of our lives. Moving on and letting go doesn't have to mean pushing feelings away, keeping things on the surface. Moving on happens when we are living fully, awake and filled with feeling, through all the different times, up or down, that the unfolding of our lives will bring.

© Daniel Shaw 2007

dan@danielshawlcsw.com
http://www.danielshawlcsw.com

The Joy of Imperfection

2009-08-27T17:01:00.001-04:00

It's summertime – is the living easy yet? Stress all gone? Not yet? Not surprising. As the Buddhists say (pardon my paraphrase): if you're born a human, then you've got stress – no exceptions. Luckily, many folks manage life's normal level of stressful ups and downs with some measure of acceptance.

There is a particular kind of stress, though, which many people experience, that can be subtle and which often goes unidentified: the stress of having to be Perfect. That's Perfect with a capital P.We can all be a bit perfectionistic at times, but "capital P" Perfectionists are more extreme. It's not just that they are unduly frustrated by flaws, weaknesses, vulnerabilities, and - heaven forbid - mistakes. It's that good isn't good enough, great isn't good enough, and even excellent isn't good enough. Nothing is good enough, and someone always has to be blamed for that.

Perfectionists have a rigid expectation of their own Perfection, and a tendency to devalue their own achievements, no matter how considerable. They alternate between being judgmental of others, and of themselves. For the Perfectionist, being "good enough" is a cop-out, a lazy person's excuse for not trying hard enough. The result of this attitude is not greater productivity: it's exhaustion. Like Sisyphus, they feel like they're always pushing a boulder up a hill – or they make the people around them feel that way.

Perfectionists can't stop judging, and it is always the same verdict: "Guilty of not being good enough." In my view, unless you're being paid to be a judge, or unless you're a criminal, then you should not be living in a courtroom, where someone is always being accused, put on trial, condemned, sentenced and punished. Contrary to the Perfectionist's beliefs, conscious or unconscious, imperfection is not a crime, and neither is it a sin.

For some who drink or drug too much, their substance abuse can be a way of shutting up the accusatory voice of their inner slave driver - the inner task master that never stops judging. Their drug of choice provides some relief, but only temporarily, of course, and at much too great a cost.

I once worked with a gifted and intelligent man, whose life seemed charmed to those who knew him socially, but who was grinding himself down with his relentless self-criticism. I asked him, even though I knew what his answer would be, "What if you won the Nobel Prize? Then would you be good enough?" We both agreed that, Nobel in hand, he'd still find a way to trash himself. I am pretty convinced that, in spite of our imperfections, we all have the right to feel that we are basically good enough – to live, to love and be loved. I hope he came to feel that way, too.

So it's summer. Time to bask in the joy of imperfection. If you're having a summer vacation this year, see if you can make it a break from the constant stress of Perfectionism. Appreciating and enjoying what is good enough, in one's self and in others, while knowing that nothing is ever Perfect, is actually a vacation from stress that you can take any time, any place.

© Daniel Shaw 2007

dan@danielshawlcsw.comhttp://www.danielshawlcsw.com

April Showers Bring May Flowers

2009-08-27T16:57:00.001-04:00

“Though April showers may come your way, they bring the flowers that bloom in May…”

So goes the ‘20s Al Jolson tune that became a theme song of the Depression era. My mother, who grew up during the Depression, would sing it to herself in our Bronx apartment kitchen at times when she was down. Mom sounded a lot like her favorite singer, Mildred Bailey. In our house, singing tended to lift the spirits.

April showers bring May flowers: so corny, and so true. We don’t know joy in life without also knowing sorrow. Joy and sorrow go hand in hand, like night and day, shadow and sun, showers and flowers. Yet I’ve noticed that some people persist in thinking that there is something wrong with them because they aren’t constantly happy. The truth is that no one’s life - rich, poor or in between - is without some measure of painful disappointment.

I’ve had a beef for a long time with all those different large group seminars that promise so much success and fulfillment as long as you keep coming back and paying for more and more seminars. Yes, we can all use more support, more motivation, more encouragement. But we can’t live in a state of hyper positivity all the time. At least I can’t – can you? Post-Jolson, the Rolling Stones put it well: you can’t always get what you want – no matter how positive your thinking.

It seems to me that part of leading a healthy life is developing the capacity to bear disappointment – in life, in ourselves and in others. To bear – it’s the opposite of collapsing under the weight of something. To bear disappointment, sorrow, guilt, means to be able to go on living productively and creatively – to affirm life, even while bearing the knowledge that life is hard, nothing is perfect, and our time is short.

If we accept that life will always bring disappointments, sorrows and regrets, then it really makes sense to invest in developing the habits of appreciation and perseverance. As the pre-Jolson poet so wisely put it, “gather ye rose buds while ye may.”

It was uplifting to read recently of the 96 year old writer, Harry Bernstein, whose first novel was recently published to tremendous critical acclain. The book was rejected dozens of times, and then lay on a publisher’s desk for a year before someone picked it up and decided to give it a shot. Talk about never giving up!

We probably all know how hard it is to experience a crushing disappointment, at a personal level, or even at the global level – the world can sometimes seem, especially these days, awfully rotten. It’s not always easy to resist the temptation to crawl into bed and pull up the covers. Maybe sometimes, at our darkest times, crawling into bed is the best we can do.
But then come those spring flowers – first there’s crocus and daffodil, then forsythia , then the lilacs, magnolia, apple, cherry - the annual succession more and more fragrant as the summer draws closer. It’s worth getting out of bed for, every time. Winter will always come back - but faithfully, undeniably, thankfully - so will spring.

Spring Cleaning

2009-08-27T16:55:00.001-04:00

Well, we made it through January and February, and for many of us, the hope of spring does at last begin to stir the heart. For others, though, hope barely flutters, because the winter months have been painfully SAD - which stands for Seasonal Affective Disorder. For some, this time of year is excruciating. Rather than bringing hope, the end of winter is marked by shutdown, numbness, irritability, a sense of disconnection, apathy, and worst, despair.

Depression, seasonal, situational, or chronic, is a grim illness, because it convinces you that you are not ill, but rather that you are simply weak, lazy, and unworthy. If that's the cruel way that you've been thinking of yourself, then that is the depressed part of you talking. Depression is not a moral failure - though it does lead one to feel self-loathing. Most of us can get somewhat depressed from time to time, but chrnic depression is a powerful disease that eats at the soul and sucks the joy out of life.

The late writer William Styron used the phrase "darkness visible" to refer to his lifelong episodes of depression (it was also the title of his extraordinary memoir on the subject of depression). Styron, and many other highly accomplished, productive people who have spoken publicly of their struggles with depression, have shown exceptional courage to do so. Even in this confessional age of Oprah, many people consider their depression, or the depression of a loved one, as something to be hidden, a secret shame they hope will go away if it is ignored.

More recently, people go to their family doctor and ask for Prozac, or the latest anti-depressant they've heard of. Sometimes with medication, they experience enough relief from the worst of their depressive symptoms so that they carry on. But to attempt to get rid of depression solely in this way is an error, in my view. Yes, depression can be biological, but rarely is it purely a matter of genes. In all my years of practicing psychotherapy, I have never met a depressed person who didn't have significant cause for depression - usually, unrecognized, untreated trauma of one kind or another. Trauma can ensue from a discrete episode, such as an assault, a rape, the witnessing of a horror. But trauma can also be cumulative - examples might be growing up feeling unseen and unloved; or feeling that one never lives up to others' expectations, no matter how unreasonable those expectations may be; or being systematically dominated, controlled or belittled in a relationship. Untreated trauma, discrete or cumulative, is at the heart of depressive illness, and there is still no better way of treating it than through talk therapy, or therapy combined with medication prescribed by a qualified mental health professional.

With good psychotherapy, the root causes of depression can be unearthed. A therapist can be a compassionate witness to your personal history, a history that you may have tried to forget, or get rid of, or render meaningless. Therapy can help you put your history in perspective; learn to live with and bear the losses you need to mourn; and find the courage to make new choices, seek new opportunities. Many people know this, and yet refuse to seek help, believing they can change themselves. Certainly some can, but on the other hand, I've known people who bounced in and out of depression for 50 years before they really got serious and sought help.

Victor Frankl survived the Nazi concentration camps, and went on to become a renowned psychoanalyst. He wrote: "When we are no longer able to change a situation - we are challenged to change ourselves." For those who make good use of it, psychotherapy is still one of the most effective ways of changing oneself. If this has been one more depressed winter for you, begin your spring cleaning by getting help from a licensed mental health professional. If someone you know is depressed, tell them to get help. Getting help is a sign of strength, not of weakness; the decision to get help for depression is a sign that you can find the strength to overcome it.Daniel Shaw, LCSW, practices psychotherapy in Nyack, New York, and in New York City. He can be reached at in Nyack at (845) 548-256; and in New York City at (212) 581-6658.www.danielshawlcsw.com shawdan@aol.com© Daniel Shaw, LCSW, 2007

You Say You Want a Resolution

2009-08-27T16:50:00.002-04:00

Another New Year is here, and it’s time to make those resolutions. Lose weight, exercise more, eat healthier, be less irritable, spend more time with the kids, get out of debt, have more fun, more sex, more vacation… Self-disclosure: If I actually remember half my resolutions the day after I make them - let alone eventually achieve them - I’m lucky.

It’s been my experience, both personally and with the people I work with in my psychotherapy practice, that making a resolution to achieve something, to change something in yourself, can be quite challenging for many of us. Rather than being resolute, many people disappoint themselves and others because they are chronically irresolute - the condition famously, tragically suffered by Shakespeare’s Hamlet.

How can we understand ambivalence, the tendency to obsess, to ruminate endlessly about a decision only to find ourselves repeatedly stuck in the same place? I’ll present two very brief examples:

Ted is 33, smart, handsome, and on the partner track in a good law firm. He dates, meets someone he likes, and gets involved in an exlusive relationship. After two years, the girl makes it clear that if he doesn’t want to marry her, she will break up with him. This is the third relationship he’s had like this - in a row. He thinks he can’t move forward because he can’t decide if he’s settling rather than finding someone he is absolutely sure about. When we get down deeper, he realizes that he fears that in any intimate relationship that he commits to, he will be forced into a submissive role, as he was all through childhood by his intimidating, highly controlling father.

Sally is a successful photographer for a magazine. The young intern assigned to help her is driving her crazy - he does sloppy work, he is defensive, feels inappropriately entitled, and acts like he is doing her a big favor. Sally values being respectful and helpful to subordinates, and can’t bring herself to handle the intern. Instead she agonizes in therapy sessions about what the right thing to do would be, all the while continuing to put up with the Intern from Hell. I eventually hear about Sally’s mom, a child-like woman that Sally was always more like a parent to than a daughter. If Sally ever had a protest or a complaint about her mother, and she had good reason to have many, her mom would burst into tears, feeling so hurt and victimized by Sally. For Sally to assert herself always meant that she would end up feeling profoundly guilty, as though it were selfish of her to consider her own needs rather than everyone else’s.

What’s next for Ted and Sally? They have to use the insights they’ve gained in therapy to act, to force themselves past their fear and their guilt, to stop repeating the same patterns they got stuck with and are stuck in. They need to resolve to be resolute. Encouragement and support in therapy and from others will only go as far as their own openness to growth and change, to making an internal shift, a resolution.

And perhaps what needs to be recognized is that whenever we make any choice, we gain the thing we choose, but we also lose what we did not choose. There is no way around that one - it’s a fact of life. If you’re waiting to know what the perfect choice is, you’ll be waiting indefinitely. We can make good choices, but not perfect ones.

So another New Year is here. There are only so many new years any of us will live to see. My New Year’s resolution is to answer Hamlet’s question. To be or not to be? To Be! Yes! To Be.

Happy New Year!

Daniel Shaw, LCSW practices psychotherapy and psychoanalysis in Nyack, New York and in New York City.
Nyack: (845) 548-2561; New York: (212) 581-6658

Shawdan@aol.com
www.danielshawlcsw.com

Family Functions and Dysfunctions

2009-08-22T14:41:00.003-04:00

‘Tis the season for families to gather together, and for some, these will be warm, happy times, filled with glowing Norman Rockwell tableaux and plenty of lovin’ from the oven. If that unambiguously describes your holiday season, count your blessings, and read no further.

For the many people still reading: don’t be embarrassed, you’re not alone. The holiday season is stressful, and not just because of the ever-looming threat of weight gain. Many families, even the most together ones, get increasingly anxious as the time for holiday gatherings draws near. Perhaps you worry about some of the following questions:

- who will drink too much and get mean or inappropriate this year?;
- which sibling will be scapegoated?; which siblings will fight and will it come to blows?; who will mom and dad defend and who will they blame?;
- how much criticism will you have to take? how much being ignored can you stand?;
- are mom and dad going to snap and bite at each other the whole time? will they finally get divorced this year?;
- is this the year you’ll finally come out of the closet? Or is it better just to go on deflecting the questions?
- which of your divorced parents gets what time from you?; which of your kids will be with you? which ones, if any, will be speaking to you?

I could go on. If I left you out in the above, I’m sure you can fill in the blanks.

I suggest that instead of greeting the holidays by going unconscious and numb - and then coming back to your regular life and getting depressed and having fights with your friends and loved ones and wondering why - that you instead take some time to consider what you need to do for yourself to stay sane and healthy over the holidays.

It might seem wrong and not nice, when you’re supposed to be spontaneously creating all those Hallmark/Kodak moments, to be using prescription anti-anxiety medication; or sneaking calls to your therapist or 12-step sponsor; or looking over the plane and train schedules you brought with you in case of the need for an emergency premature departure. You’re right. Reality is not always pretty.

So if you know that Day 5 is always when it hits the fan, then plan in advance to leave on Day 4. If drink 4 is when you start losing control, stop at drink 3. If you need to stay home this year, then by all means take a year off, and give yourself some time to sort things out. Any of the options above make more sense than allowing yourself to be pulled, yet again, into a destructive group regression, turned into a child again, assigned a role to play that you long ago outgrew. As the poet wrote, “good fences make good neighbors,” and similarly, good boundaries, not too loose, not too rigid, but just right, are at least one element of what makes good families.

Remember, nobody’s perfect, including you, and no one’s family is perfect. How do you balance your love and your anger, your need to connect and your need to be your own person? No easy answers. Use the support you have from those you trust, and make the best of your particular imperfect situation. Find warmth and make warmth wherever you can this season. Happy Holidays, and see you in the New Year!
© Daniel Shaw, 2009

Daniel Shaw, LCSW, practices psychotherapy in Nyack and in NY City.
Reach him at (845) 548-2561 in Nyack,
at (212) 581-6658 NewYork City
by e-mail: shawdan@aol.com
website: www.danielshawlcsw.com
and now blogging at: http://danshawmentalhealthnotes.blogspot.com/

Making Up Is Hard To Do

2009-08-20T18:51:00.003-04:00

Most of us have had - and some of us still have - the fantasy that if someone really knocks your socks off, and if they are a scintillating, fantastic person with no problems, then they will make a constantly delightful, always exciting mate, and life will be one big high, all free and easy, for evermore.

Sorry to break the news, but it just doesn’t happen like that, at least not to members of the human race. The fact is, we're all - emphasis on the all, including men, women, straights, gays, and others - fallible, sensitive, vulnerable people, with blind spots and weaknesses. It's exciting to meet someone and feel that old sexual chemistry; but when you get really close, sooner or later the other chemistry inevitably kicks in - the chemistry of buttons getting pushed.

Nobody pushes buttons like those we come closest to. It's a fact of life. When we're born, we start pushing our parents' buttons, and they push ours, and from there on, you can be assured that later in life, anyone you become intimate with will eventually push your buttons, and vice versa. And that especially includes the one person you were most sure was in no way like either of your parents.

That's because, in any couple, both parties bring their relationship history with them - meaning that how we saw our own parents relate to each other, and how we related to our parents, is deeply rooted in our psyches. Once the initial potency of the chemistry between new lovers begins to cool down, our buried relationship history will usually turn up like a bad penny and get acted out, in one way or another.

That is the point where the real work of intimacy begins. Intimacy is not about never having fights and always having good times. Intimacy is about recognizing that we are always vulnerable to each other, always needing one another, and always capable of hurting one another. It's about learning to respect that vulnerability while being more and more honest with each other. It's about making it through hard times, each other's hard times. And it's about learning how to have fights that end - not somewhere in the middle with nothing resolved, but all the way to a point of better understanding and deeper connection, with real apologies and forgiveness.

That's how intimate trust and mutual appreciation deepen and grow. When human beings get close, we inevitably come into conflict. Personal growth for couples comes through struggling, over time, to learn how to negotiate conflicts. Repetitive arguments are signals that each member of the couple - not just one, but both - needs to grow, change, bend. Couples who get really good at repairing the disruptions that inevitably arise between them become able to breathe clearer emotional air. When a couple has learned well how to make up, how to apologize and to forgive, they have more than just fun - they have love.

You're A Narcissist - In A Good Way

2009-08-19T21:00:00.006-04:00

by Daniel Shaw, LCSW

These days I hear the term “narcissist” thrown around quite casually, and what I think people usually mean by it is “it’s always all about him,” or “she’s so vain,” or “he’s selfish.” Psychoanalysts since Freud have been referring, for the last 100 years or so, to the Greek myth about the beautiful boy named Narcissus, to try to describe certain traits of human nature. The story goes like this. Narcissus was cruel and cold to Echo, a nymph who loved him. He hurt her so much, she withered away until only her voice remained. You can still hear her ghostly “echo” when you call out while hiking in the hills. One day, Narcissus saw his face in a pool of water and got stuck gazing at his own awesome beauty. He got so enchanted with his exquisite reflection that he stared at himself until he wasted away and died. The pretty, fragrant spring flower we call Narcissus grew up from where he decomposed.

Readers of “He’s Just Not That Into You” would no doubt have been delighted by the bad news about Narcissus. “Serves him right, that bastard!” Which, undoubtedly, is a healthier reaction than the nymph’s, a woman who loved too much, evaporated, and became nothing more than a mournful echo.

The truth is, while we’re usually not as bad as Narcissus, we all have some of the narcissist in us. Sure, we do our best not to obsess too much about our hair, our waistline, our wrinkles, and so on - but we end up spending a lot of money anyway, on products that promise to confer youth, vigor and beauty on our too, too solid flesh. And beyond the usual vanity most of us would confess to, we all enjoy, or perhaps only long for, admiration of one kind or another. We all spend at least some time, energy and money on self-promotion, on our “narcissism.” How could anyone ever get anything done if they didn’t have some kind of belief in themselves?

The Narcissus myth, though, points to something darker and more cruel than just the foibles of everyday human vanity, or the very human needs we all have for the maintenance of healthy self-esteem. In some cases, narcissism can be pathological. Such people are abusers, people who need to prove and assert their sense of superiority and entitlement again and again, by persuading others that they are inferior. These abusive narcissists love themselves unconditionally, but others are always unworthy in their eyes, always falling short, always not good enough. Maybe it was a boss, or a teacher; it might even have been a religious leader, or a therapist. It might have been one or both of your parents, or a sibling. If you’ve been around at all, you’ve probably known an abusive narcissist. They are the people who proclaim their own perfection, and according to them, they are never, ever wrong. So if there has been any problem, or disagreement, or mistake, or failure - according to the abusive narcissist, it’s all YOUR fault. With this kind of person, you can never win. And because so often they are charming, seductive, persuasive and charismatic, we want their approval, and we keep trying, over and over, to win it. But according to them, we never seem to be good enough.

Abusive narcissists inflate themselves by sucking the self-esteem out of others - and the most powerful ones can make us feel so intimidated and dependent, we might even find ourselves persuaded that their abuse is for our own good. Abuse from a narcissist family member can be the most difficult abuse from which to recover. When the abuser is a parent or sibling, a spouse or partner – someone whom we depend on and have deep bonds to – their repeated attacks on our self-esteem get under our skin more readily and deeply. All the Greek tragedies are stories of the terrible destructiveness and cruelty family members can inflict on one another. This pain is especially acute, because it is caused by someone one has loved and trusted deeply.

But not all cruelty is the same as abuse. If you’ve ever loved anyone, you know that, at times, it’s possible to be terribly cruel to those you love; in fact, it’s almost impossible not to be cruel, sometimes, to those you love the most. If you’re healthy, you can apologize, atone, forgive. Both of you in the relationship can learn to become increasingly less destructive, more and more loving. But an abusive narcissist will never offer a truly heartfelt apology. The real distinguishing sign of an abusive narcissist is that they cannot and will not admit they ever do anything wrong.

If you are trapped in a relationship with an abuser, and you want to get out, you’ll have to learn to stop believing the abuser’s accusations - that you and only you are the wrong one and the bad one. For some people long used to taking it from an abuser -- even, and often especially, if that abuse happened in childhood long ago – shame, fear, guilt and poor self-esteem can be tenacious. It can take a lot of hard work and support to gain enough faith and confidence in yourself to successfully navigate the rough shoals of life, love and work. Healthy narcissism, enough self-love, can help us learn some of life’s hardest lessons about relationships: with some people, we can experience mutual growth, and constructive, creative collaborations; and with others, no matter how hard we try, we’re always left at the bottom of the win-lose seesaw. A healthy narcissism can keep our self-esteem balanced, and give us enough confidence to pursue our dreams and ambitions, to feel worthy of love and to be loving. And it can help us learn to break free from and steer clear of abusive relationships.

Daniel Shaw, L.C.S.W. Upper Nyack, NY shawdan@aol.com http://www.danielshawlcsw.com/

Introduction

2009-08-19T20:14:00.005-04:00

The following posts are short pieces I have written over the last several years for publication in The Nyack Villager, a little monthly magazine that everyone here in Nyack, where I live, gets in the mail. I cover a range of topics, mostly regarding things that are relevant to the people with whom I work. I hope you will find these pieces relevant too.