How to Love Almost Anybody

Think that somebody who you really don’t like, but you need to spend an awful lot of time with that person. Is there any way possible to get to actually like him or her?

Or maybe there’s somebody in your life who you used to love her very much but that love is faded and that saddens you. Do you wonder if there’s any way to reconstruct the love and build a new edifice?

I was thinking about these questions last week while teaching humanistic psychology and the concepts taught by Carl Rogers as part of his client centered psychotherapy. It disturbs me to think that although the tools that Carl Rogers taught and made available to the counseling or psychotherapeutic community are really very efficient tools, are they available and/or appropriate for the average person? Somehow I knew that they had to be, but I didn’t get an answer until Saturday afternoon when I read the words written 2000 years ago by the sages of the Mishnah. I will explain that later.

There are three conditions necessary for building a really good relationship. The first one is called, “unconditional positive regard.” This means that you will accept the other person as a human being with unique values and unique goals. As professionals we are taught not to impose our own world views, perspectives, or values on the people we are working with. Ken lay people do that? I certainly believe so. The big question is: what practical steps are needed to achieve it?

The second condition is called, “empathy.” I think it goes without saying that any human being can cultivate empathy. The challenge for most people is to understand the difference between empathy and sympathy. If a person shares with you his or her hard times or difficult feelings that may make you feel bad. You will then be sympathetic. That sympathy comes because you feel bad about what that other person has gone through. It derives from your own feelings and not from the feelings of the other person. So let’s say, for instance, you see a young woman with two-year-old twins and an infant all eligible stroller struggling to get her children into her car just as it is starting to rain and she has bags of groceries along with her. You look at her and you feel bad for her. You feel sympathy for her. You go over to her and tell her how big you feel for her predicament. Is it your feelings or her feelings you’re feeling? She turns to you tells you that she doesn’t feel bad at all, on the contrary, she is quite overjoyed. She says that she had a long and hard struggle to have children and it is times like these when she realizes how small the effort really is compared to the struggle it was for to actually have the children. Empathy means that you share the feelings that the other person has. In order to cultivate empathy one must first cultivate the ability to get to know other people. Is this possible for the ordinary layperson to achieve? I certainly believe so. The big question is: what practical steps are needed to achieve it?

The third condition is called, “genuineness.” This means that the person can be open and honest with the other person in the relationship. At first glance this might seem much more basic than the previous two conditions. But in reality I think that this is much more difficult to achieve. But it is far from impossible. In my experience I have seen many nonprofessional people cultivate the quality of genuineness. The big question is: what practical steps are needed in order to achieve it?

There is an ancient book written by the Jewish sages of about 2000 years ago called, “Ethics of the Fathers.” This is a collection of moral statements brought together to teach proper ethical behavior. In the first chapter there is a statement by one of the sages which seems so obvious that one would think it’s completely unnecessary and superfluous to be included in this collection. He says, “and judge every person favorably.” When you look at this statement in its original language, Hebrew, something very curious becomes apparent. The word for “every person” does not actually mean every person but it means, “all of the person.” What this sage is telling us is that if you are able to judge all of the person, you would certainly judge that person favorably. Aha! This gave me the insight into the practical steps one needs to take in order to achieve the ability to absolutely accept and possibly love any particular person.

As you strive to get to know another person on a deeper and deeper level you get to appreciate that person to a greater and greater extent. When you ask your friend, lover, or acquaintance why he or she did something or how they were feeling about something you get to know the person on a level that was not previously experienced. The more you learn about your friends’ reasons, feelings, and motivations the more you will appreciate that person for who he or she is.

Be genuinely concerned and curious about your friends’ reasons, feelings, then motivations and your relationship will surely be able to get to that level that can make everybody feel good.

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Why Psychiatric Medication is Confusing

“Hey Doc, why are you using me as a guinea pig? I am not taking these meds!”

Anybody who has been around people who need psychotropic medications (drugs for mental illness) has heard this complaint. Psychiatrists can never be sure if the prescription they write will do the “magic” that is sought. It is normal practice for a physician to give a trail of one medicine for a few weeks (or months) and if it is not working, try something very different. Or even begin a “cocktail” of medicines that might just do the trick.

It seems unusually cruel that people who have issues trusting people are given medicine that is so unreliable.  In American culture physicians are the most trusted of people. But when some of us feel so bad that we can’t even think straight, and we can’t trust anybody, we often go to a doctor who will write something on that special pad that might help, but might even harm! Why is the system so cruel?

To understand this, we need to understand a little bit about psychiatric diagnosis, and then a little bit about the medicines themselves.

Psychiatric diagnoses or the types and categories of mental illness is defined in a book called DSM (Diagnostic and Statistical Manual) published by the American Psychiatric Association (APA). This book is periodically updated and is currently in the fourth edition. The APA is an association for physicians who specialize in psychiatry. So they are interested in having their particular specialty be as similar to other medical specialties as possible. But there is a major, essential difference. Mental illness is not like most other medical illnesses. Most illnesses are defined by what causes them. Mental illness is defined by symptoms.

In most fields of medicine a disease is defined by the pathogen (the “bug”- virus, bacteria, etc.) that causes it. You have a sore throat so you go to the doctor to find out what you have. She takes a culture and tells you that you have strep throat. And she writes out a prescription for a medicine that will kill the strep.

The sore throat is a symptom. Before you went to the doctor you knew you had a sore throat. You did not know if it was strep throat or post nasal drip. Any symptom can have multiple or various causes. It is the doctor’s job to figure out the cause in order to prescribe a cure. Otherwise, you could just go and but some Cepacol.

But the DSM does not define mental illness according to cause. That because we generally do not have much of a clue about the causes of mental illness. (Except for one case, I will mention later.) So all of the categories in the DSM are defined by symptoms. A person has bipolar disorder because he or she acts like a person with bipolar disorder. A person is labeled schizophrenic because he or she has two or more of one set of symptoms and a certain amount of other symptoms. But nowhere is there a diagnostic test that is similar to a blood test, MRI, or throat culture. (This is also why people with major mental disorders usually have multiple diagnoses or the diagnoses change over time.)

All of the symptoms are behavioral. That means, we can look at the way a person is acting and apply the label that fits best. Of a seven year old has six or more features of inattention for at least six months, then he has ADHD. But do we know (or care) if it is caused by a malfunction of the brain or because the home is so unorganized that the kid rarely gets enough sleep? (Try staying focused on 4 hours a night of sleep.) Or some other reason?

Since psychiatric illness is defined by symptoms and not causes, the medicines are also given to address the symptoms and not the causes. That can be very good. If you need to control the symptom of hallucinations, it is fine to give anything that will work. If you need some immediate relief for your sore throat there is nothing wrong with a Cepacol. But it might not work, if the cause remains and can overpower the symptom. So if it doesn’t work, we can’t be sure why not. So the next best thing is to try the next best thing. Try a different medicine that might attack the symptom a bit more efficiently.

There is one category of psychiatric illness where we do know the cause. That is Post Traumatic Stress Disorder, and the related diagnoses. We know that there is a clear environmental cause. But that just makes the problem of prescribing medication even more complex. You cannot prescribe a retroactive anti-trauma medicine. (It would be wonderful, wouldn’t it?) Which is why there is no medical intervention for ex-abused people or people who have survived trauma. And when medicine is helpful, it is very difficult to apply that helpful experience from one person to another.

So if symptom relief is the best we can get, go for it. It can be much better than being with the symptoms. Without a cure, I’ll go get a Cepacol.

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Anger Management is stupid. Better to Avoid Anger

Anger and Stress. Most of us suffer from these two maladies, especially if we are blessed with families that struggle with special challenges like mental illness of a member that is an ex-abused person. Last week I attended a family support group. One member shared a list of 100 ways of coping with stress and anger.  I looked over it and it was quite impressive. Many of the items we would think of without the list, and many were very clever. It included things like taking a bath, deep breathing, taking a walk, singing a song, dancing in the living room, etc. I’ve used some of those strategies, and some work really well for me. Bubble baths don’t help me at all, but dancing like a teenager (as long as nobody it there to laugh at me) works really well.

But when you get these suggestions you realize that they are all useful only after you are stressed out or angry. They can help you manage the stress or anger, but do little to help you prevent losing it in the first place. If your spouse had a hard day and complained about you for no good reason, you might just flip. If he or she was really bent out of shape and insulted you or worse, it is possible that the stress and anger can become unmanageable. After you are ready to strangle somebody it can you really turn on the music and just dance?

What we need is some antidote to reduce the stress and anger before it gets too much. Some way that we can feel that it really is not so bad to begin with.

Impossible, you say. I would think the same way. But my eldest daughter is in this matter almost opposite from me. She never seems stressed out. She takes everything easy. I have not seen her act angry since she was a teenager. If she were not my own daughter I would be terribly jealous. But instead I realize that I need to learn from her.

But I am not like her. So I researched and learned from others also. I found that there is actually ways to reduce the anger before it happens.  No guarantees. Not always. But ways to make a significant change in your life and the lives of the people around you.

First let’s understand what anger is. Anger occurs when somebody or something either harms us, threatens to harm us, or prevent us from getting something we need or want. When the car in front of us keeps cutting us off many of us get angry. On the other hand, if we’ve had a hard day and come home to the 7 year old’s shoes in the living room, and we trip on them, we can get angry. Why? Because we feel like that behavior almost hurt us. Or if we are a bit more sensitive, we feel like we are losing control of our seven year old, or of the way we want our home to be. No matter how you cut it, though, we feel somehow threatened by the other person, either physically or psychologically.

The next step (which happens all too fast) is that we think something negative about the person who is threatening us. “That no- good SOB, why does he always DO THAT” “Jimmy, how many times do I have to tell you to put away your shoes? Can’t you learn that simple thing?” These thoughts are what solidifies and crystallizes the emotion into real anger. It takes about 1/3 of a second to move from the feeling to the thought. If we can hijack this process in less than 1/3 of a second, we can avoid the anger.

In order to do that we need to identify an emotion that can replace the anger. What is the opposite of anger? It is not calmness. That is just the disappearance of anger. The one emotion that is absolutely incompatible with anger is compassion. If a person feels compassion for another then it is impossible to feel anger.

Compassion and anger are not really so different. When you are angry at somebody you focus on that person’s faults. “She is so stupid, I can’t stand her! If she comes here again I will tell her to leave.” With compassion we also focus on the person’s faults. “She is so stupid, I feel sorry for her. If she comes here again I will make sure she feels better.”

What about other situations? That ridiculous driver? “That guy really has a problem. I can’t get involved in his problems, so I’ll steer clear of him.” “Jimmy is just a seven year old.  He can’t remember to put his shoes away. I can’t hurt him by yelling at him, poor kid.”

Training yourself is conceptually easy, but it takes a lot of practice. You need to practice coming up with compassionate explanations for other people’s bad behavior on a regular basis. Keep a compassion journal. Set ten minutes every day to think of those stupid things that bothered you during the day and write down how you can feel sorry for the person who displayed the stupidity or bad behavior. It may not be easy at first, but it is the practice that will reap the rewards.

If you keep it up for about two weeks (or less) you will begin to try to think compassionately about people as soon as they do things that are hurtful. Soon after that you will find that you can begin to feel sorry for the other person within that 1/3 window and the anger that was harming yourself will not be there to manage.

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The most basic ingredient for great relationships. Proven scientifically, endorsed by God.

In Martin Selgiman’s new book, Flourish, he writes of a wonderful paradigm to increase well being. In my other blog I am summarizing and commenting on each chapter. But in chapter four there is a concept that is fantastically applicable and useful for every person on this planet. So I am copying much of that posting here.

While most of this chapter outlines the Masters in Applied Positive Psychology program at Penn State there are a few really important concepts and ideas that both practical and enlightening. The first has been a favorite of mine for about 25 years. That, in spite of the fact that in psychology it has not been around for more than a few short years. I’ll explain in a bit.

Seligman calls it the “Losada ratio” named after the fellow named Marcel Losada who “discovered” it. Losada looked at communications in companies and found that those firms that had a ratio of better than 2.9:1 of positive to negative statement flourished and those with less withered. Also above 13:1 faltered since the positive seemed more like fluff than substance. Seligman cites that well known (at least amongst marriage counselors) study by John Gottman that a strong marriage is reliably measured by the ratio of positive interaction to negative ones. Generally, if you want to voice any criticism in a relationship you need to have at least five times the amount of positives to each negative.

I have been using this idea for decades in my practice. I’ve often cited Gottman but I learned it when I was first married. One Rabbi told me that I should not consider my wife as more loving than G-d. “Well, OK,” I replied, “What lesson are you trying to tell me now?” “In the Jewish prayer we ask for all sorts of things. But we don’t ask until we first give at least three prayers of praise, and don’t leave until we give at least three prayers of thanks. Wouldn’t one be enough? No. It is to teach us that if you even want to ask or criticize, you must first give at least three times as much praise and thanks, even to people, especially your wife.”

If you think about it, universal human wisdom did not start with psychology. Psychology is just quantifying it.

So the Losada ratio is one great concept that we can apply today. And he tells us stories about people applying it.

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Should I send my bi-polar kid to camp?

“John wants to go to sleep away camp. With bi-polar disorder how can he go?” Joan, his mother, asked me one day after a few months of coaching.  She knew what was coming in the session, but we had to go through the whole process.

John has been suffering from bi-polar disorder from early childhood. It wasn’t too long ago that it was believed that such a malady could not effect children. Today we know that even children from stable families can suffer from extreme and violent mood swings. Many adults who have this diagnosis have mood swings for many other reasons and they are very difficult to live with. But somewhere along the line it was a choice if you live with an adult who suffers like this. But if it your child you have no choice.

If you are a parent of a bi-polar child you are constantly faced with heart breaking dilemmas. You cannot expect people to understand you or your child. You are always concerned about how they will treat you, your child and your family if you have to tell them about your child’s condition. You know that there is no right answer and no wrong answer, but that only makes the struggle worse. Your experience has shown that even intelligent, understanding people can suddenly view your entire family as “damaged” in some way because of this illness.

So do we send John to sleep away? I ask her, “What have you done to explore this?” She answers that she has talked to other people who have “been there, done that.” She is getting more scared about if something happens than the stigma problem. Joan’s friends, mostly on-line friends, have shared with her their experiences. One friend told her about when she sent her son on an overnight trip with his school and when all the boys went to sleep in the same room it was too much for her son. He “freaked out” and needed to be hospitalized. The mother said that it wasn’t even so bad, but the chaperone wasn’t taking any chances. “That was only an overnight. How can I send John away for a week?” Joan asked.

I explored with her why she wanted John to go away to sleep away. She wanted him to feel normal. She thought it was important for his social development. She needed a break herself.

She thought it might be time since John had been stable for over a year, and seemed to be accepting his illness. We celebrated how far they had come in the past two years. The whole family was doing a great job.

We then tried to look at it from John’s perspective. Did he really want to go? How would he deal with the medication issue and the possible stigma? How did that fit in with their educational goals? Was he mature enough to deal with these issues.

Joan did not have all the answers. Nobody ever does. But she was able to make a plan decide how to make a decision. She has few issues with the stigma question, which is unusual. She and her husband have been working on building an atmosphere of acceptance of the illness and that John will not see it as “who he is” but rather something he needs to deal with. She decided to clarify a few question with her husband and with John and get back to me in a few days.

They decided to send John after discussing it with the director of the camp and building a safety net that included the camp nurse and the head counselor. I am not sure that I would have made the same decision, but I am sure it was the best for them.

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Tapping into the Daydreaming Scene

Do you day dream too much? Or maybe even not enough? How much do people daydream anyway?

Daydreaming has been terribly maligned. In grade school the teachers would call my best friend “the wonder boy” meaning he always seems to wondering about things and not paying attention. If we are caught daydreaming often at work we can get into deep ____.

But daydreaming is actually very helpful. Some research has noted that we should be daydreaming up to 30% of our waking hours. That seems like quite a lot. I suppose it is more important when and where you do it. We do spend a lot of time in places and situations that we are not in close communications with others. So why not? Go for it.

Day dreaming serves a number of purposes. First, as a pleasant “mini-vacation.” We can place ourselves in any situation and in any location. As you probably know, that not only sounds like fun, but it can really be fun.  But fun is not necessarily the only benefit. Actually there are some real value we can reap from our daydreaming. If we keep it realistic we can develop tentative plans that are slightly beyond creative. It can enable us to achieve way more than our rational minds would ever let us. For some of us that idea of staying somewhat realistic can take practice, but it is still fun. And for some of us that pushing the envelope is very entertaining.

We often daydream about our own character. We think of who we are and who we would really like to be. This is like a wonderful positive psychology exercise.  This is actually a way of constructively tapping into your daydreaming skills.

Let you mind wander to focus on who you could really be if you had the power to change yourself over the next 5 or 10 years. Don’t think about what you Momma told you, but focus on who you can become and be closer to your real self. As you think about it, start to imagine real life situations and how you would want to deal with them if you only could do it in your best way possible. You can convince yourself in these daydreams that you have the power to become your ideal self.

But the fact is that you do have the power to change yourself. It takes a bit of concentrated thought of how you can be the best person you are inside. After the daydreaming, if you can write down as much as possible of that possible, ideal self it will become an actual living work in progress.  – No. You will become that actual living work in progress.

If you are a coach you can do this with your clients and help them focus on their positive and ideal selves. Help them write down as much details of their ideal lives and to judge how much of that ideal life is influenced by internal values or something they are picking up from someone else’s values. Discuss it. I’m sure you can do the job well.

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Depression and Anxiety vs. Sorrow and Fear What is means to us.

In a recent discussion with Dr. Steven Brownlow (http://sgbrownlow.com) we discussed the difference between depression vs. sorrow and anxiety vs. fear. The thoughts were important and worthwhile sharing. The distinctions are not really clear to many folk, and can be really important when dealing with these emotions either in yourself or in loved ones.
The distinction can be especially important when you seek to set emotional goals for yourself. The type of work you need to do and what you can expect to achieve can be significantly different depending on what type of emotion you are actually experiencing.

While I have already blogged about the different types of depression and how one might deal with a non-clinical depression in a positive manner, in this blog I will use the term in a technical manner and not as the popular term. That will help us to see some characteristics of the clinical state that is not in the popular usage of the word “Depression.”

Depression and anxiety are the subjects of psychotherapy. One way of defining psychotherapy is that the therapist attempts to have the client’s subjective view of reality coincide with the objective view. When a person is clinically depressed (for purposes of this blog at least) one can say that the person feels sad, lacks motivation, etc., and attributes those feelings to circumstances that are not based in reality. He or she sees the world as a hostile or grim place and feels hopeless and helpless as a result.

Clinical anxiety has a similar dynamic. A person feels anxious because of a subjective perception that does not reflect the objective reality. One is afraid of spiders even though the spiders one sees are not dangerous. A person can suffer from overwhelming anxiety due to a trauma that happened in the past, even though it cannot happen in present circumstance. Such is the dynamic in PTSD, for example. A soldier will play out his or her anxiety at home far from the battlefield. And the anxiety might pervade his or her whole world-view. Now, you will argue that there is a real fear here and the behavior is caused by a real fear. That is true. But the fear is fueled and constructed from an anxiety that is based in an unrealistic, subjective perception and not objective reality.

Sorrow and fear might feel bad but they are positive emotions. Just like pain is not something we like, but without pain we would be in much greater trouble. We would not know when there is some damage to our bodies if we did not feel pain.

Sorrow is the real emotional pain that results from loss. Not a threatened loss. Real loss. Loss of anything can cause sorrow, and that is a natural and positive emotion. It tells us that we need to reevaluate our relationship with the object of the loss and refine our perspective. It could be the loss of a loved one, loss of a job, or loss of an ability. We still need to go on living and learn how to live without that thing we lost. This is the realm of coaching. It is not a pathology. It is not illness. It is a healthy process that we sometimes need help in order to redefine ourselves and set new goals for new levels of fulfillment, accomplishment and flourishing.

Fear, when it is based in reality, is also positive. It tells us that we need to prepare ourselves for possible impending danger. We need to muster up our innate strengths, set strategies and use our skills to deal with whatever it is that poses a threat. It is obviously very important, although it should not overpower the rest of our abilities. In our society we are not to be afraid, but it makes more sense to embrace the fear and the power it gives us to find extra strength to initiative to meet the oncoming challenge. Positive psychology coaching can give us the tools to meet such challenges by focusing on global strengths or higher values, or inner commitment. These are the tools that every healthy person who finds the power to meet scary situations uses, but many of us are not able to consistently muster up these potentials.

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