Magical Thinking

I've started doing some extra work, some initial assessments and outpatient therapy with more children. I was a little apprehensive at first, but I am finding that this work is feeding me spiritually! Now I understand what Paul meant when he said "though outwardly we are wasting away, inwardly we are growing day by day." As always, God knows just what I need and when I need it. Let me tell you this great story about a little boy I saw the other day.

This child is 8 years old and has a history of abuse and neglect. In our second session, he and I are playing, and I am watching for themes to begin to emerge in his play. Being the analytical adult I am, I am watching for themes of aggression, control, or anger. I am watching for re-enactments of abuse scenarios and perhaps bringing his perpetrator into our play. He surprises me, however, and points out that a little monster doll sitting in the corner is another child at school who has been bullying him. I walk my little princess doll over to Woody, the character he has chosen to represent himself, and say, "Hey, go over there and tell him to go away!" This child looks me in the eye terrified and says, "No, you do it." I realize that this child is not looking to exercise control or aggression. He just wants to feel protected by the adults in his life, so I tell him, "No problem. Let me take care of this." I walk my princess doll over to that monster and give him a thrashing of the MOST epic of proportions. He gets beat, kicked, punched, and utterly destroyed. All the while my client is laughing and jumping with glee. His joy is infectious and I begin laughing too. I tell that little monster, "There, take that! And if you ever mess with my friend again, I'll come back and do the same thing again! Now get out of here!" We take that monster and hide him behind a stack of books. I can tell that the mother, who is looking on, doesn't know whether to laugh with us or be horrified.

That was last week, so I was excited to see my little friend again this week. I ask his Mom how things have been and she says she's seeing improvement. I ask my client about the bully and he smiles and says, "Oh, we're friends now." This is the power of a child's magical thinking and the magic of play! It is so refreshing to me, watching the innocence with which children mold their little worlds. They don't need to read a book about bullies or go to the seminar. They don't need to call a meeting or talk it out-- not that there is anything at all wrong with those methods of change. But those are adult methods.

I'm being reminded of the child's methods of change, which require immense faith. Children make magical connections where none seem to exist in the real world. Sometimes this is to their detriment, such as making the erroneous connection that Dad left the home because they (the child) were not smart enough or assuming they are being abused because they are bad children. I am being reminded through these precious little kids, sometimes feeling good is as simple as just believing it to exist. Sometimes feeling powerful is thrashing a stuffed doll or, in my case, defeating a sink full of dishes. Somewhere along the way, we lose some of the magic of thinking, and I'm so grateful to be reminded I can still pick that skill up when I need it. If I want to feel peaceful today, it starts with a little play. When the little girl inside me is laughing with delight, just like my client the other day, you know it's going to be a great day.

Photo above found at:
http://throwing-colors.deviantart.com/art/Monsters-99556578

Selling Myself Short?

I have really had the strangest dreams lately. My husband says to me, "Oh, God, do I really have to hear about your dreams?" The concept of dreams having meaning seems like a foolish one to him. I, however, believe strongly that most of our dreams are not just refuse from the day. They actually are telling us something! I believe our subconscious minds pick up images, words, non-verbal cues, and all sorts of juicy tidbits from the day that the conscious mind is either too busy or too defended to really see. Then at night, the subconscious pieces together the images and clues into a story that often seems nonsensical. Perhaps my husband thinks this is crazy, but I just happen to have generations of brilliant psychoanalysts who agree with me on this... so there. I guess you can imagine what the arguments around my house sound like, poor hubby.

Back to my VERY fascinating dream... so, I dream I am back in the home I grew up in. I'm an adult living back at home with Mom and I'm growing hundreds of tomatoes (FYI, any time you're dreaming about your childhood home or family of origin... pay close attention). I simply grow these hundreds of tomatoes and most of them rot on the vine. I'm doing nothing meaningful with them apart from just growing them. I will occasionally enjoy a few of the tomatoes for myself, but there are just so many of them that most of them go to waste. One day, in the dream, I realize, "Hey, I should really be doing something with all these tomatoes. These are really gorgeous, and there are people who would probably like to have them." So, I decide to sell them to a local woman at a farmer's market. She re-sells the tomatoes and we split the profit. I go into the yard and am struck by how many of these darned tomatoes I actually have. I begin plucking them from the vines and realize they are real gems. Some are fat and deep red, others are smaller and perfect. They vary in shade and size, but they all seem wonderful to me. I gather several bags and go inside the house and declare my intentions to my Mom who says, "Why would you do something like that? You could take those tomatoes straight to people yourself and not have to split the profit! Lots of people would buy those from you." I get very angry at her criticism and reiterate the fact that I WANT to sell them to the lady at the farmer's market.

As I'm gathering the tomatoes, I recognize there is one really exotic kind growing in the yard. In my dream, I call them black cherry tomatoes. They are so deep red they actually look black. They are bursting with flavor and so beautiful. I know they lady at the farmer's market will be excited about the opportunity to sell these. I take her my produce and she is, in fact, very excited at what I've brought. When she sees the black cherry tomatoes, however, she seems a little reluctant and is just examining them. I am marveling at their beauty and say, "They're amazing, aren't they?" She hesitates and just says, "Well... I don't know if anyone will really be interested in these." She estimates her profits and pays me. I leave feeling a little let-down and thinking maybe my Mom was right.

So, that's the dream and it has stuck with me for days. Out of curiosity, I googled black cherry tomatoes this morning and discovered that this is an actual tomato. This is what they look like in reality, beautiful, huh?


I think it's difficult for me to interpret my own dreams, because my own conscious mind will filter out some of the obvious interpretations. On the surface of things though, I think the dream is a reflection of the growth I have done in the past several years. I have actually become productive at work and at home. I have done tons of self-exploration and worked hard to address some character flaws and personal issues. Maybe for the first time in my life, I look around and see real fruit-- enough fruit to actually feed someone other than myself! The only problem is where and how to do that, I guess. I'm not real sure about that black cherry tomato. In the dream, I got the feeling that the tomato was so odd that it actually put people off. Now that I think about it, I can see how that's happening too in my reality! I'm open to your interpretations. I sense this dream is an important one to me.

And should you come to my website and see "Get to the Inside: a psychotherapist's spiritual blend of psychology and agriculture," don't be surprised... I'm just saying.

Top photo found here:
http://bellecatastrophe.deviantart.com/art/Farmer-s-Market-Weekends-117520394

Stuck

I am a slippery oiled fish on
a silver tray
plaster-eyed and glassy
skin gray as stone. I've known
a fish-bowled world and
time like a shiny black bomb ticking
to destruction.
You've got me sizzling orange,
stuck, thoughts thick as glue through
my veins
filled halfway now to alabaster pupil--
I lie here
cold as the fish-hooked lip
limp on this altar slab.

I have lots to say and
you really don't care.

Photo above found at:
http://saldaeanfarmgirl.deviantart.com/art/Fish-64210750

Love

If I speak in the tongues of men and of angels, but have not love, I am only a resounding gong or a clanging cymbal. If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but have not love, I am nothing. If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing.

Love is patient,
love is kind.
It does not envy,
it does not boast,
it is not self-seeking,
it is not easily angered,
it keeps no record of wrongs.
Love does not delight in evil but
rejoices with the truth.
It always protects,
always trusts,
always hopes,
always perseveres.
Love never fails.

The Holy Bible, New International Version
I Corinthians 13: 1-8
Photo above found at:
http://moatasimkhalaf.deviantart.com/art/LOVE-56031932

How About a Little Compassion?

As I was standing in the grocery line this evening, I browsed through this week's notable and highly-esteemed news source, In Touch magazine. I flipped through some photos of plastic women in overpriced dresses and the essential who's cheating on who articles until I reached the REAL news that spills the beans... Kate Gosselin is stressed! The magazine featured a photo of Kate popping one of her little one's in the mouth, reportedly after scolding the youngster. I didn't read the entire article but saw blurbs about how Kate is falling apart; Kate is reaching a boiling point with the kids; Kate is caught again roughing up the kids, etc. I do not regularly write about celebrities or current news, but this issue really needs to be addressed.

Here's what I know-- Kate Gosselin is a single mother of eight children, due to a humiliating, heart-wrenching divorce that dominated television and magazine headlines for months. Even if the divorce had not been a very public one, it was still a divorce. I'm very grateful I have never had to experience divorce and pray to God I never have to, but having watched many friends, family, and clients go through this hellacious struggle, I know it ain't pretty! Divorce is just about one of the toughest events a person can possibly face, even if the divorce is from a cheating, abusive, or just plain obnoxious spouse. It is still an ending of everything you once believed your life was going to be. This is made all the more agonizing when there are young children involved. Can you imagine the agony when there are EIGHT young children involved?

I do not ever want to try to excuse poor or abusive parenting. My point is this-- why is Kate Gosselin being stressed considered news? An article that went something like this would really be news: "After a public and grueling divorce, single mother of eight, Kate Gosselin, demonstrates patience and profound tolerance with her children. While on an outing with the eight children, a frenzy of paparazzi snapped photos of the cheerful, well-rested Kate embracing her children and laughing kindly at their sibling squabbles." Of course this woman is stressed! She is alone, and I would imagine angry, scared, humiliated, and emotionally disoriented! She is a human being. She is not perfect. Her husband is across the country jet-setting with his latest 20-something love affair, while she is trying to manage their children. Before we cast stones, let us consider for one moment what it must feel like to be Kate Gosselin.

We need a kinder, gentler world where we reserve judgement. We are all human and, thus, prone to mistakes. I thank God my mistakes are not broadcast on the evening news. Can you imagine going through some of your most difficult times and having reporters capturing your entire experience? Heaven forbid you show circles under your eyes, take the kids to school without any make-up on, or publicly discipline a child who just publicly acted a fool. How different our world could be if, for even one day, we reported from a place of compassion and understanding, and refrained from reporting intrusively on other people's life-altering and personal moments. I think the best reporter of Kate's demeanor, feelings, and behavior would be Kate herself, if and when she is ever willing to share her story.

When PTSD goes AWOL (PTSD, part 2)

I think the most common and troubling PTSD I tend to see is in teens and/or adults who have experienced trauma (often multiple traumas) and has gone untreated for many years. Over the years they have developed a set of behaviors aimed at relieving their anxiety, which often includes various addictions. I also see that what began as PTSD symptoms (see previous post for a listing) has morphed into a post-traumatic stress personality. There may be minimal PTSD symptoms remaining years after the trauma(s) have occurred and in their place is an anxiety-ridden, angry monster in denial!

This is not to say that everyone who has ever experienced PTSD has his or her personality altered. And I also want to clarify that technically speaking, there is no such thing as post traumatic stress personality. This is just the name I have come up with to describe this type of personality. Typically this is a person who experienced multiple traumas, interwoven/complex traumas, or trauma that occurred repeatedly over a significant period of time. These traumas typically occurred at a young age, probably before age 8, and no one (including the child or adult in question ) has linked these past traumas to present day feelings. Usually these clients will say, "Oh, that happened a long time ago. I'm over it." This client has received no direct support, validation, or treatment related to the traumas they have experienced. The client has likely presented for treatment around age 17 due to frequent assaults on peers and teachers, chronic tension with a caregiver, inability to form attachments, and drug use. Usually these kids have been diagnosed with Attention Deficit Hyperactivity Disorder or possibly even Conduct Disorder (a disturbing diagnosis equivalent to Antisocial Personality Disorder for kids).

It is very common that these children or adults continue to have much chaos and drama in their lives, often at their own doing. Although they may no longer experience some of the acute symptoms of PTSD, the child or adult may engage in daily fights or sexual behavior that staves off the symptoms. The fighting or sexual behavior (or various other "delinquent" behaviors) have become reinforcing in themselves. They work! They keep people at a distance or get the desired attention. They provide immediate relief and maintain a certain level of required chaos. In some cases I see children or adults who seem to repeatedly re-create the original traumas. It is believed that many people do this in the desperate attempt to make right the past trauma. For example, a child who witnessed years of domestic violence may choose a violent partner as an adolescent, believing "my love will change him, this time it will be different, and I will feel BETTER." I also see adults who were victims of physical abuse grow up and have children who are abusive toward them. They have again become the victim within their own home. Another example is the child who was sexually abused who is highly sexualized as an adolescent and highly promiscuous. Particularly with sexual abuse, a child can have their internal sexual thermostat set to "high," and thus be easily aroused or sexually activated. We call this "sexually reactive."

If the adolescent or adult has developed an addiction in an effort to relieve PTSD, then treatment first has to deal with the addiction. This is very common. It is only natural that if you are experiencing intense anxiety, difficulty with relationships, sleep problems, or persistent hostility, you would want relief! Certainly you will get some quick relief from a drink or a hit of mary jane. Perhaps the addiction is one more subtle such as food, video games, relationships, or work. The addiction and the consequences of the addiction become troublesome themselves, wreaking havoc in the life of the addict. It becomes very difficult to address PTSD with someone who is afraid you're trying to take away their drug. Often clients are not open to the possibility of PTSD when the "drug" is keeping them from experiencing any anxiety. It is more likely that behavior and problems related to the increasingly dangerous addiction is what will lead this client into treatment.

Detox can be a piece of cake compared to the hard work of unraveling a PTSD personality. It is essential, however, that the client is willing to do the work of unraveling the knots of their personality if they want to prevent relapse in their addiction. I believe so many people go through drug treatment again and again, returning each time because they have never resolved the core issues of why they NEED to use to begin with. It is also very common that as clients go through drug treatment and "get clean," that they begin to experience years of repressed anxiety, grief, or anger. I'm sure this is probably not very encouraging to anyone who may be considering drug treatment, but wait! If you are at a place where you want to find true sobriety and serenity, the work of cleaning the old toxins from your soul is what will do the trick. We do not have to have our lives forever ruled by past events. We do not have to continue to suffer or engage in behaviors that stave off the pain. We may only be human, but we are strong enough to endure the work. Humans were created to both be hurt and to heal.

Photo above found at:
http://speeddevil141992.deviantart.com/art/Cutting-67927067

Post Traumatic Stress Disorder, Part 1

I've been thinking about the fact that I specialize in treating Post Traumatic Stress Disorder (PTSD) but have never written about it on my blog. I'm not sure why that is exactly. I think partly because I'm afraid that once I get started talking about it, I won't be able to stop! I also worry that I will begin to get long-winded and technical in my discussion of PTSD and lose many of my readers. I think it's important to begin my discussion on this and trust my ability to rein myself in as needed. Thank God for "edit posts" option. Here goes...

What is PTSD?
Well, first of all, for any of you who are unfamiliar with PTSD, let me define it for you. I'm going to define it according to "professional standards," but will put it in everyday terms. A traumatic event is one in which you fear that either yourself or another person is going to be seriously injured or killed. Many people face events like this but do not develop PTSD. Post-Traumatic Stress Disorder develops when, after the traumatic event is over, you continue to feel like you are still experiencing it. You may re-experience it through intrusive memories or flashbacks of the trauma. You may have nightmares of the event or at times literally feel in your body as if the event were happening right now. Also with PTSD you will go to extreme lengths to avoid situations or people that remind you of the trauma. It is common that we sometimes experience these types of symptoms immediately after a traumatic event, such as losing a loved one. The difference between a normal stress reaction and PTSD is that in a normal stress reaction, these symptoms tend to dissipate after one month. Also, in a normal stress reaction, you tend to maintain some level of control over your response and your life is not shattered irreversibly after the event. For example, you may face a horrifying event and be really shaken up about it for weeks afterward. Over the course of the next few months you find that you are able to leave your home, continue with work, and the anxiety does not rule your life. With PTSD, it is not uncommon for people to not experience any symptoms until months or years after the event occurred.

These are the technical criteria for PTSD:

1. A person is exposed to a traumatic event and has a response of intense fear, helplessness, or horror.

2. The traumatic event is persistently re-experienced (i.e., intrusive memories, flashbacks, nightmares, intense distress when exposed to cues or reminders of the trauma, etc.)

3. Persistent avoidance of people/situations related to the event (i.e., unwillingness to discuss the event, inability to recall details of the event or maybe extremely sharp memories of detail, withdrawal from everyday living and people in general)

4. Increased arousal, that is, "hyped-up" behavior-- you may be hyper-alert, on edge, on the watch, difficulty falling asleep or staying asleep, irritable/angry, difficulty concentrating, exaggerated startle response

5. The duration of these symptoms last longer than one month and cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning."

How Does PTSD Happen?
Our brain is an intricate road map of neural pathways. There are happy and pleasant pathways in our brain and then there are some terrifying (though life-saving) pathways as well. An example of this is the fight or flight response. We've all most likely experienced having our fight or flight pathway being activated. Your heart rate accelerates. You go into survival mode. You may freeze up and feel unable to speak. You can feel every hair all over your entire body stand on end. Or you may turn into someone you don't recognize and display tremendous strength or ferocious aggression and fighting back. It's a critical part of our human make-up that we have this response. It keeps us alive in many terrifying situations and has for eons now.

Things go awry if this fight or flight response gets activated when there is not actually any terrifying event occurring. Someone with PTSD who has a history of physical abuse from a parent may be triggered into fight or flight years later when someone in the grocery store bumps into them roughly by accident. A child who was sexually abused in a bathroom may continue to experience intense anxiety about going to the bathroom years later. A war veteran who saw a friend killed in combat may continue to experience a feeling of hypervigilance and anxiety at the sound of loud trucks or booms. When someone has PTSD, their brain continues to categorize many events as "danger," when, in reality, there is no present danger. This categorization is not under control of the person and happens too quickly to be stopped many times. Once the woman in the grocery store was bumped by a stranger, the brain quickly perceived this event as life-threatening and activated a neural pathway of "high alert." Once the neural pathway is activated, it's like a loop with no end. She's driving on this pathway that just goes around and around with no exit.

As you can imagine, this is a miserable way to live. Often people with PTSD are going through their everyday living being triggered by voices, scents, perceived threats or sounds. These people are unaware themselves what is happening within them, not understanding what just triggered intense anger or anxiety. Many people with PTSD have no clue that they symptoms they are experiencing have anything at all to do with a traumatic event that likely occurred years ago. Or, if they do have some suspicion that their present anxiety is related to event(s) from the past, they are not fully aware of the extent to which their very personality is being shaped by fear and a need to avoid.

There Is Hope
PTSD does not have to be a life-long disorder. There are good and effective treatments for PTSD that are backed by research. The most effective treatments for PTSD aim to help people access helpful and positive neural pathways in the brain, when triggered, rather than falling into the fight or flight loop. This is what is being done in narrative and cognitive behavioral therapies that create positive and helpful pathways then, through repetition, link them with the traumatic event and triggers of the event. Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy that literally retrains the brain through the use of eye movements to access helpful networks in the brain. I love EMDR and use it often in my practice. It often brings immediate relief to those suffering with PTSD. I have personally seen countless children and adults suffering with PTSD go bravely through treatment and lose their diagnosis. I have watched these people begin to experience relief from symptoms within weeks and months of treatment. If you have PTSD, you do not have to suffer or self-medicate for relief (this is another blog post!). There is treatment available to help you. I believe the human mind wants to heal itself and sometimes it just gets stuck. It is good to seek the assistance of a trained professional to help the broken record get un-stuck and get you back on the right track.

Photo above found at:
http://m-a-e-e.deviantart.com/art/trauma-125461377