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Pain is Inevitable; Suffering is Optional

The goal of Acceptance and Commitment Therapy (ACT) is to create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. This is done by changing one’s relationship to their symptoms in order to live a more value-driven life. Further, the goal is to accept what is outsideof one’s control, and commit to taking action to enrich one’s life. It can be summed up in one basic premise: pain is inevitable, but suffering is optional.

Oftentimes, trying to get rid of symptoms actually results in being more bothered by the symptoms. For example, try to not picture a pink elephant in your mind’s eye. What happened? You saw a pink elephant. This is just what happens when we try NOT to focus on any particular thing!

Being too focused on symptoms impacts our ability to life a value-driven life. We’re too busy and using all our energy on “symptom-reduction” rather than choosing to focus on what is meaningful in our lives, such as family, friends, relationships, advancing career, rest, self-care, and so forth. When we instead focus on our values, our symptoms can drift to the background, rather than take center stage.

ACT asserts that problems are essentially caused by two things: cognitive fusion and experiential avoidance. Cognitive fusion is when we become inseparable from our thoughts, and then our thoughts dominate our behavior. Experiential avoidance happens when we attempt to avoid, get rid of, suppress, or escape unwanted experiences (thoughts, feelings, memories, sensations, etc.).

Trying too hard to control how we feel simply gets in the way of a rich, full life. We can’t do important, value-driven things if we are always trying to get rid of symptoms. Control is the problem, not the solution.

What can we do about this? Practice defusion to get stuck from our thoughts and gain distance from them. Defusion is taking a step back and seeing our thoughts for what they are: nothing more or less than words and pictures. As I like to say, look AT your thoughts, rather than FROM your thoughts.
Thought Defusion PICTURE for blog post - Copy

Here are some ways you can attempt to defuse from your thoughts:

  • Say “I’m having the thought that…”
  • Use a silly voice to say the thought
  • Sing the thought like a song
  • Repeat the thought nonstop for 30 seconds until it sounds like gibberish

Another way to defuse from unhelpful thoughts is to practice mindfulness. What is mindfulnessMindfulness means paying attention with flexibility, openness, and curiosity. It allows you to be aware of your experience in the moment as opposed to being “caught up” in your thoughts. Mindfulness involves an attitude of openness; being curious about your experience rather than fighting with it. This is helpful because often times the more we try to fight the way we feel, the more we end up feeling it.
hexagon-4
 
The goal of ACT is referred to as psychological flexibility, which entails being present, opening up, and doing what matters. An important facet of psychological flexibility is acceptanceallowing thoughts and feelings to be present, regardless of whether they are pleasant or painful.

The fun part of ACT (in my humble opinion) is valued living: doing what we want to be doing with our lives. What’s important to us? What do we want to stand for? How do we want to behave and act on a daily basis? Our values are our compass; they guide our decisions and behavior. A good way to figure out what your values are is to imagine your retirement party or funeral — Who would you want to speak about your life and what would you want to hear them say?

Once you have figured out what your values are, then final step is to take committed action (effective action motivated by your values). One helpful way to do this are to make a public commitment; tell someone about it. This will create some level of accountability for you. Another thing you can do is create an action plan worksheet. Last, but not least, simply take the first, tiniest step. The first step is often the hardest, but if you can manage to get started, the rest will follow.

For more on Acceptance and Commitment Therapy, click here and here!

3 Core Conditions for Therapeutic Change

The person-centered counseling approach was established in the 1940’s by humanistic psychologist, Carl Rogers. The goal of a person-centered therapy is to create the necessary conditions for clients to engage in meaningful self-exploration of their feelings, beliefs, behavior, and worldview, and to assist clients in their growth process, enabling them to cope with current and future problems.

A major concept of this approach is that people are generally trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Another key concept is that the attitudes and characteristics of the therapist, and the quality of the client-therapist relationship are prime determinants of the outcome of the therapeutic process.

Rogers maintains that therapists must have three attributes to create a growth-promoting climate in which individuals can move forward and become capable of becoming their true self: (1) congruence (genuineness or realness), (2) unconditional positive regard (acceptance and caring), and (3) accurate empathic understanding (an ability to deeply grasp the subjective world of another person).

1. CONGRUENCE (GENUINENESS)
Congruence refers to the therapist being real, authentic, and genuine with their clients. It’s called congruence because their inner experience and outward expression match. In being authentic, the therapist shows they are trustworthy, which helps in building a good therapeutic relationship with the client. It also serves as a model for clients, encouraging them to be their true selves, expressing their thoughts and feelings, without any sort of false front.

2. UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE
Unconditional positive regard means the therapist genuinely cares for their clients and does not evaluate or judge their thoughts, feelings, or behaviors as good or bad. Each client is accepted and valued for who they are, as they are, without stipulation. Clients need not fear judgment or rejection from the therapist.

3. ACCURATE EMPATHIC UNDERSTANDING
Accurate empathic understanding means that the therapist understands their client’s experience and feelings in an accurate and compassionate way. The therapist recognizes that each client’s experience is subjective and therefore strives to see things from the client’s unique perspective. An important part of accurate empathic understanding is for the therapist to convey that they “get it” by reflecting the client’s experience back to them. This encourages clients to become more reflective with themselves, which allows for greater understanding of themselves.

If you’ve ever had an experience where you felt like someone just really got you…they completely understood where you were coming from, or could truly relate to the way you felt – that’s accurate empathic understanding.

Rogers asserts that empathy helps clients (1) pay attention and value their experiencing; (2) see earlier experiences in new ways; (3) modify their perceptions of themselves, others, and the world; and (4) increase their confidence in making choices and pursuing a course of action. Jeanne Watson (2002) states that 60 years of research has consistently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts it this way:

“Therapists need to be able to be responsively attuned to their clients and to understand them emotionally as well as cognitively. When empathy is operating on all three levels – interpersonal, cognitive, and affective – it is one of the most powerful tools therapists have at their disposal.”

 

References:
1. Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). American Psychological Association, Washington, DC.
2. Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

Raised by an Addict [Part I]

In her memoir, There was a Little Girl: The Real Story of My Mother and Me, Brooke Shields paints an honest and vivid picture depicting her experience of being raised by an alcoholic mother.

Much of her childhood was filled with chaos, and a lack of structure and stability, which is quite common in families with addiction.

She speaks about the enmeshed, codependent relationship she shared with her mother for many years:

    I never thought I could live without you. I knew and understood you better than anyone else in your life. I became the meaning in your life when it would have served you to find the meaning from within. Your approval meant the world to me, as did your happiness. That was the hard part, because I wanted your approval for my growing up independently of you, yet I feared my independence was the root of your unhappiness. But if I had not fought to differentiate myself from you and from our tight bond, I would not have been able to survive.

There are many themes in her life story that are shared by others who have lived with an addicted or mentally ill family member:

Being constantly afraid and worried for their safety and well-being
Feeling like it’s your responsibility to keep them sober and alive
Becoming panic-stricken when you haven’t heard from them in a while
Desperately trying to control their addiction…AND NOT BEING ABLE TO.

Brooke lacked a sense of confidence and security, despite becoming famous at such a young age. She never felt good enough. How could she, when she wasn’t enough to keep her mother from drinking?

She was not her own person. Her existence and purpose were for her mother, not for herself. How can you be your own person, when you spend all of your energy trying to please someone else? There’s no room for you to discover who you are. Her job was to intuit the moods and needs of her mom: “She was my barometer for joy. If she was happy, I was happy.”

Like many children of addicts, Brooke became parentified, taking care of her mother, instead of getting to be a kid. It affected her as she got older, as well. While others her age were going out and dating, she was afraid to intimately connect with another person, for fear of mom feeling abandoned. As if by loving someone else, she would somehow love her mother less. There wasn’t enough space for anyone else.

[Story Continues in Part II]