Swedish Therapy Cabs: Therapy on the Go

http://www.ngvglobal.com/images/stories/vehicles/Volvo_tri-fuel_Stockholm_Taxi_(2009).jpg

Sweden has the highest number of one-person households in the EU — 47% of Swedish households are comprised of persons living alone. Living alone can increase loneliness and other symptoms of depression especially during long Swedish winters where there is very little daylight.

In an attempt to introduce therapy to riders who may be experiencing depression and/or other issues, Taxi Stockholm, a private taxi service, has hired three therapists to provide counseling in the back seat of its taxis to passengers. The idea is to normalize therapy and even help passenger/client with a pressing issue. No matter how short the ride, bringing therapy to the rider can expose and normalize the idea of therapy so they are more likely to seek it out themselves after they leave the taxi.

What a great idea! I am all for it — especially in large cities where personal connections are difficult to make and maintain and time is short. This could be one very clever idea to destigmatize therapy for the general public.

Peaches Update: Death from Heroin OD

This is a follow up post to an earlier post on the tragic death of Peaches Geldof at age 25 with her young child next to her. I had played celebrity death sleuth but was incorrect in my assessment.

Legacy of addiction gets handed down like family estates and jewelry. Her mother overdosed at age 41 with a child at her side, and our Peaches recreates the scene 14 years later, except she was only 25.

Do we all become our parents? I think not.
Are we helpless to go on repeating the past, whether it is an addiction or a pattern of thinking and behaving?

This is why therapy needs to be part of every recovery process. Addiction isn't just the physical and psychological dependence. There exists a core conflict, our defining wound which originates in childhood. The resulting pain, whether psychological or spiritual or both, is what we attempt to dull with our substance(s) of choice.

Through therapy and/or spiritual reflection, we can become more aware, more in tune with our subconscious, so that we are less likely to act out, or behave unconsciously, and repeat what we know or become the parents whom we feel let us down.

http://www.thefix.com/content/peaches-geldof-reportedly-died-heroin-overdose

The Importance of Addiction Counseling in Staying Sober

flickr commons

One of my favorite bloggers writing on the subject of sobriety, the Drunky Drunk Girl, recently posted a piece about why counseling should be part of living sober. She does not downplay the importance of AA and other types of mutual support groups to maintaining sobriety.

But, she says, professionals are needed to help "unravel the core issues" hidden under the addiction.

I've been doing this work for a few years, and I glimpsed some of these core issues. I mean glimpses because even the those in therapy are not completely invested in the process. It could take years of work and courage to digging, and for many this is too daunting.

Whether a client has had the most horrific childhood, suffered abuse and neglect, witnessed addiction and violence, and subjected to immeasurable harms caused by poverty; or the client comes from old money and had access to all the educational and vocational opportunities afforded by money, the underlying issues are very much similar — unresolved, unprocessed emotional pain originating in childhood. It can be parental neglect, enmeshment, a traumatic event, or even a habit (modeling) — if your parents drank fine wines with every meal, it wouldn't seem abnormal that you consume over 5 or 6 drinks during an evening out, which becomes the norm.

My job is to ask question, then listen, ask more questions and listen some more. And what comes to the surface is magical thinking, habitual (mindless) behavior, projection, distorted negative self-image, lack of a support network, anxiety and depression, etc. And they all intersect at one point or another.

It's possible to work through all this. However, you have to be willing to work at it and learn to be okay with the discomfort. There is just no other way.

https://drunkydrunkgirl.wordpress.com/2014/03/30/the-importance-of-professional-counseling/

Blogging for Sobriety

I am a big proponent of journaling as a way to keep things honest between you and yourself. It's an invaluable tool that deepens self-awareness, whether or not you are in therapy.

And, there is blogging, not blogging as marketing, but personal blogging. It is a form of journaling, but it's not the lock-and-key, Dear Diary variety. Personal blogging is like keeping a journal that's meant to be read by whomever. It's personal and public at the same time.


It's therapeutic because making a declaration, which isn't exactly shouting, blogger reminds herself of who she is and what she aspires to become. It's writing for self-reflection and inviting others to witness the process, which CAN be an act of courage and commitment, or just a form of narcissism. It's much like "Hi, I am so and so, and I am an alcoholic" part of AA. 

Which brings me back to sober blogging. I like this blog very much for the reasons cited above and more. I hope it can inspire others to rethink their relationship to alcohol.

http://drunkydrunkgirl.wordpress.com/2013/09/02/inspiration-to-others/

The Examined Life

Some books are to be tasted, others to be swallowed,
and some few to be chewed and digested.
Francis Bacon, the philosopher, not the painter.

Sometimes a book can come along and make your life better. Reading it feels as though it was meant to enter your life at that exact time.
And isn’t this why we have a life-long love affair with books?

Books can help us answer questions we haven’t yet to formulate. At their best, they rouse us to carry on an inner dialogue and deepen our self-awareness. And awareness is the first step in the process of change.
Yes, change is possible. It’s a slow-going, subtle shifting of your attitude, first to your self, and, over time, it will manifest outwardly in your interactions with the world.

Stephen Grosz’s The Examined Life is one such book. Grosz is an American psychoanalyst based in London. I love this book because the writing is superb; language is simple and precise, without psychological jargons to showcase the author’s expertise. He writes for an audience interested in living a deeper, more authentic life (don’t we all?). Though I am not a book reviewer, if you are interested the literati love his book!

My clinician self found important lessons in how to be a better therapist, both in technique and in philosophy. And as a general reader, I very much appreciate the clinical cases he presents, because I identify with many of the enduring “issues” that had brought people to his office. Some of these universal themes are: the search for and keeping of loving relationships, forgiveness, resolving the hurts from our imperfect childhoods, loneliness, sexuality, raising children, facing death.

If there were to be a syllabus for therapy The Examined Life would be a required reading. 

Quick note about psychoanalysis: It is a type of psychotherapy I DO NOT practice. However, I hope to start training in it in the near future. Its aim is to affect or change the personality structure of the client over an unspecified period of time. Usually a client brings in a complaint of a non-urgent nature, something that nags her but does not interfere with her overall functioning. Free association is the primary technique used in analysis; it means that the client is encouraged to think out loud, to say whatever comes to her mind. The analyst then interprets what was said, noting patterns or other significant content to which the client was unaware. There is little advice giving, and progress or insights are made by the client on their own.

The work I do is more hands on and goal directed. The issues I deal with tend to exist on the surface of day-to-day life, whereas psychoanalysis deals with issues that are more deeply imbedded.

Fatherless on Father's Day

Fatherless on Father's Day. Some thoughts.

Holidays, even Hallmark holidays like Mother’s Day and Father’s Day, can be difficult for those of us with atypical childhoods. Rather than a celebration these "holidays" can, if not downright depressing, be a reminder that you are missing out on something, that you aren’t quite normal. This is how it feels. However, if you look at statistics, father-absent households in the US are quite common (one in three children). Still, if you have lost your father or never had a father to begin with statistics will not soothe how you feel.

Loss is part of everyone’s experience. At times, especially like today, Father’s Day, your loss can feel significant. You feel life has treated you unjustly. You may even feel resentment towards others who appear to have it all (like a loving, caring and strong father). 

The following are some points to reflect on to gain some perspective.

1. Be grateful for what you have. 

This may be difficult, if you’ve had a very difficult history with your father or with your family. There are many of us who have suffered sexual, emotional or physical abuse by our fathers, and the scars will forever haunt us. But the fact is you have survived it, and there is help to undo some of the damage. Remind yourself that you are not alone, and many of us have overcome our traumatic histories. Also, the miracle of being alive means accepting its unpredictability and our humanity – we are capable of great love, but we also have the potential to cause great pain to others, even our children. 

2. Acknowledge the feelings of loss, sadness, anger and pain.

Emotions, like energy, is in a state of entropy. This means unconsciously we are trying to achieve a state of equilibrium, a state of emotional balance. Physical pain is avoidable and something we can manage. But psychic or emotional pain – a defining feature of human experience and therefore unavoidable – must be felt and accepted. It cannot be stuffed away. This would upset the natural course of emotions. Unprocessed emotions will surface down the road, and often it will be more troublesome.

Practically, it means reaching out to someone on a difficult day (Father’s Day, anniversaries, etc.) and talking about how you feel. You will still feel blue afterwards, but you will find comfort. And if your history contains significant loss or trauma, psychotherapy or talk therapy is something you should seriously consider. Avoidance and denial can contain our pain only to a point. Pain needs to have light shined upon it so that it can’t fester in the darkness of memory.

3. Step back from yourself. 

If you are reading this chances are you live in the “developed” world. When we become absorbed in our pain and confuse it with physical pain, the primacy of our feelings can skew our perspective. The fact that you are reading this on a computer (whether it’s your own or shared) you are part of the fortunate minority. We have in common a standard of life and freedoms that most people in the globe can’t take for granted. We can bitch about our own lives, the politics of our imperfect countries, but the fact is our lives could be intensely more difficult. This does not mean your private sorrows, losses, and painful biographical facts are meaningless. But, it means recognizing that you are not alone in the world who is suffering. Emotional pain is one thing, but consider what it might be like to lack adequate shelter, access to health care and education, and food and water.

Practically, this might mean paying more attention to world affairs, for instance getting a more global perspective from news sources that are more international in scope, reading books on public health,  volunteering, and donating money to organizations. 

What We Don't Talk About When We Talk About Love

Rather than roses, chocolates and glittering jewels, I’d like to discuss, today being Valentine’s Day, the other side of contemporary dating life: blisters, warts, shame and embarrassment. In a culture that glamorizes sexuality at every opportunity, the unpleasant outcomes of active sexuality do not receive the necessary attention it deserves. Sexually transmitted diseases (STD) and infections (STI), which are solely medical conditions, suggest promiscuity, immorality, uncleanness and other equally unsavory connotations. Because of these culturally objectionable associations, many people newly diagnosed with a STI or STD, confine it to themselves after a hasty conversation with their doctor. And, of course, there is the Internet, the vast public forum for both pertinent medical information, and misinformation and opinions that perpetuate the stigma around sexual illness and sexuality. 

Shame and guilt, when not named and brought out to air, fester and gain momentum and significance. Repression and denial may be effective for a short time, but, eventually, the emotional impact requires processing; otherwise, the original shame and guilt will seep into other parts of life. As difficult as it may seem, what it means to have a STD or STI needs to be talked about. Exploring your feelings now will be better for your emotional and physical health in the long run. You can talk about it with someone in your life who is nonjudgmental, mature and caring, such as a close friend, parents, confidant, partner or a therapist. In addition, it is also very important to understand it from the medical perspective; this is necessary to protect your health in the future.

This topic brings up so many issues, I will make sure to write more on this very soon. 

Thank you for reading.

Sort of a Film Review: Silver Linings Playbook

http://www.kentuckytheater.com

Initially, I was skeptical about Silver Linings Playbook, but it disabused me of the misconception that all rom-coms are silly affairs in which an attractive young woman and man fall in love after overcoming a series of obstacles. SLP, like other movies of the genre, shows us that the quest for love is universal. Its two protagonists, played by Bradley Cooper and Jennifer Lawrence, are very pretty, as you would expect. I had dismissed Bradley Cooper as an exceptionally good-looking comic actor, and I wasn't familiar with Jennifer Lawrence. However, she won me over as the wounded yet feisty and self-aware young woman; I found her character so intriguing I forgave her being so young, talented and beautiful. And, I gained an appreciation for Bradley Cooper as a man with bipolar disorder just released from a long stay in a psychiatric hospital. His performance did not embarrass; he didn’t simply play “crazy.” Instead, he played a man whose capacity for suffering emotional pain was monumentally greater than most people’s because of the illness. 

As a mental health professional, I appreciated how the film treated mental illness with depth, humour and fairness; I am hoping that it can lift the some of the stigma that keeps people from accessing mental health services. 

These are some of the reasons why I recommend Silver Linings Playbook:

1. By no means should Cooper’s character be mistaken for a clinical case study of bipolar disorder, but it portrayed BD's main features in a believable way. Also, his father's (played by Robert DeNiro) compulsive and superstitious dependence on numbers was a lighthearted look at OCD-like behavior, perhaps to suggest that predisposition to mental illness can be hereditary. 

2. The movie shows that character's bizarre behavior of Bradley Cooper's character did not come about in a vacuum (it's important to note that he did not have delusions or hallucinations, symptoms of psychosis). The distress of catching his wife with another man had triggered his hypersensitivity to a full-blown episode of mania and depression (although we did not see his depressive symptoms). His reaction went above and beyond the "functional range" of emotional response, and, as a result, he was hospitalized. Symptoms of mental illness, especially mood disorders, are extreme (pathological) reactions to life’s inevitable ups and downs, and they are disruptive and upsetting to the sufferer and their family and friends. But, the point is that everyone of us have experienced these symptoms to some degree, because this is what it means to be human. 

3. Medication works. It does not “cure” but, under the care of an able psychiatrist, it can manage and control the symptoms and improve the quality of life for the patient and their family. It enables the patient to work, be in relationships and seek talk therapy to complement the pharmacotherapy, which only addresses brain chemistry. The most effective treatment for mental illness is drug therapy with concurrent psychotherapy. 

4. People diagnosed with mental illness have unique personalities and real lives, and they are capable of great achievements. They are more than their symptoms or diagnosis. One can LIVE with mental illness.

5. Mental health professionals are real people. We have real lives that are sometime messy and have interests outside work that may seem incongruent with what we do professionally. However, I am not a fanatical fan of any sports team.