Martin Seligman Video and Podcast

If you are interested in what Martin Seligman has to say about positive psychology and optimism first hand, then check out the following...

I was talking about Seligman in class and one of my SSW students looked him up and sent me this link to his video:
http://www.ted.com/index.php/talks/martin_seligman_on_the_state_of_psychology.html

Here's a link to a podcast/transcript:
https://mail.lausd.net/exchweb/bin/redir.asp?URL=http://www.abc.net.au/rn/allinthemind/stories/2009/2766891.htm%23transcript

More Yalom, the Here-and-Now and Authentic Relationship

Reading Yalom revolutionized my thinking. His unblinking self-awareness and honesty inspired me to be – to discover – who I am as person and professional in the therapeutic relationship. It is very intimate, powerful, rewarding and ultimately, integrating and liberating.

The following passage from the same book quoted in the previous post, Momma and the Meaning of Life, describes his counter-transference notes about a fictional patient. He uses these notes for discussion in a counter-transference group he is in with peers/colleagues. It opened my eyes to hear him say these things out loud to peers, to us (his readers) and due to some unintended high jinx, to his patient. The power of this self-awareness and revelation in his work (grounded in the here-and-now approach) with the patient reminds me of the power of process recordings. Most interns report hating them, but I don’t know any other tool that is as effective in cutting to the core of what we, as therapists, do, say and feel in therapy and why (rationale/purpose based on theoretical orientation or lack thereof). Each step is a skill that takes time. What do I think and feel in the moment that I am in with this client in the here-and-now, no matter how deep, superficial, ugly or beautiful? Most interns tend to report what they think the client is feeling instead or guard against revealing unpleasant thoughts and feelings because they sound “unprofessional.” Then, how can I take this thought or feeling and turn it into an intervention – a statement or question to the client in real time? Finally, (most don’t get here but a few have) daring the genuine exchange and authentic relationship.

“This is Dr. Lash dictating notes for countertransference seminar. Notes on Myrna, Thursday, 28 March. Typical, predictable, frustrating hour. She spent most of the session whining as usual about the lack of single available men. I get more and more impatient…irritable – lost it for a moment and made an inappropriate remark: ‘Do you see Dating Bureau on my T-shirt?’ Really hostile thing for me to do – very unlike me – can’t remember the last time I’ve been so disrespectful to a patient. Am I trying to drive her away? I never say anything supportive or positive to her. I try, but she makes it hard. She gets to me…so boring, rasping, crass, narrow. All she ever thinks about is making her two million in stock options and finding a man. Nothing else…narrow, narrow, narrow…no dreams, no fantasies, no imagination. No depth. Has she ever read a good novel? Ever said something beautiful? Or interesting…just one interesting thought? God, I’d love to see her write a poem – or try to write a poem. Now, that would be therapeutic change. She drains me. I feel like a big tit. Over and over the same material. Over and over hitting me over the head about my fee. Week after week I end up doing the same thing – I bore myself.
Today, as usual, I urged her to examine her role in her predicament, how she contributes to her own isolation. It’s not such a difficult concept, but I might as well be speaking Aramaic. She just can’t get it. Instead she accuses me of not believing that the singles scene is bad for women. And then, as she often does, she threw in a crack about wishing she could date me. But when I try to focus on that, how she feels toward me or how she makes herself lonely right here in this room with me, things get even worse. She refuses to get it; she will not relate to me, and she will not acknowledge that she doesn’t – and insists it’s not relevant anyway. She can’t be stupid. Wellesly graduate – high-level graphics work – huge salary, hell of a lot bigger than mine – half the software companies in Silicon Valley competing for her – but I feel I’m talking to a dumb person. How many goddamn times do I have to explain why it’s important to look at our relationship? And all those cracks about not getting her money’s worth – I feel demeaned. She is a vulgar lady. Does everything possible to eliminate any shred of closeness between us. Nothing I do is good enough for her. Presses so many of my buttons that there’s got to be something of my mother in this. Every time I ask her about our therapy relationship, she gives me that wary look as though I’m coming on to her. Am I? Not a whisper of it when I check into my feelings. Would I if she weren’t my patient? Not a bad-looking woman – I like her hair, gleaming – carries herself well – great-looking chest, popping those buttons – that’s definitely a plus. I worry about staring at those breasts but I don’t think I do – thanks to Alice! In high school once, I was talking to a girl named Alice and hadn’t any idea that I was staring at her tits until she put her hand under my chin and tilted my face up and said, ‘Yoo-hoo, you-hoo, I’m up here!’ I never forgot. That Alice did me a big favor.
Myrna’s hands are too big; that’s a turnoff. But I do like that great slick, sexy swish of her stockings as she crosses her legs. Yeah, I guess there are some sexual feelings there. If I had run into her when I was still single, would I have hit on her? Probably yes, I’d be attracted to her physically, until she opened her mouth and started whining or demanding. Then I’d want to get away fast. There’s no tenderness, no softness to her. She’s too self-focused, all sharp angles – elbows, knees, ungiving – [a click as the tape came to an end]”

Wow. That’s very (sometimes uncomfortably) revealing. Courageous? Pretty or not, it’s the honest-to-goodness truth and it stands between therapist and client whether we choose to look at it or not. If we look at it then we can act consciously. If we don’t look at it – because it is too disturbing – then how does it come out in ways that we are not aware?

Listening & Connecting

Reading Yalom taught me to be a psychotherapist using a humanistic-existentialist approach. Carl Rogers, master therapist and theorist, also described himself as humanistic and existentialist. I learned skills for connecting using his person-centered approach (active listening skills).

When we listen to clients and their stories and witness their pain, we have an urge to change, fix, minimize or deny their feelings (don't feel that way, look on the bright side, don't cry, it's not so bad). Empathic listening is powerful and leaves clients feeling understood - ultimately very healing.

"Listen to your patients; let them teach you. To grow wise you must remain a student." --Professor John Whitehorn from Momma and the Meaning of Life by Irvin Yalom.

Yalom describes the work of his mentor: "Dr. Whitehorn related to the person, rather than the pathology, of that patient. His strategy invariably enhanced both the patient's self-regard and his or her willingness to be self-revealing...There was no duplicity: Dr. Whitehorn genuinely wanted to be taught...'You and your patients both win,' he would say, 'if you let them teach you enough about their lives and interests. Learn about their lives; you will not only be edified but you will ultimately learn all you need to know about their illness.' "

Yalom asks a client at termination: "Tell me, from your perspective, what was the real center, the core of our work?"
Patient responds: "Engagement," she said at once. "You were always there, leaning forward, getting closer."
Yalom: "In your face, you mean?"
Patient: "Right! But in a good way. And not in any fancy metaphysical way. I needed just one thing: for you to stay with me and be willing to expose yourself to the lethal stuff radiating from me. That was your task. Therapists don't generally understand this. No one but you could do this. My friends couldn't stay with me. They themselves were too busy grieving for Jack, or distancing themselves from the ooze, or burying the fear of their own deaths, or demanding - and I do mean demanding - that I feel okay after the first year. That's what you really did best. You had good staying power. You hung in there close to me. More than just staying close, you kept pushing for more and more, urging me to talk about everything, no matter how macabre. And if I didn't, you were likely to guess - pretty accurately, I'll hand it to you - what I was feeling. And your actions were important - words alone wouldn't have done it. That's why one of the best single things you did was to tell me I had to see you an extra session every time I got really engaged with you."
Yalom: Other helpful things?
Patient: "Again simple things. You may not even remember, but at the end of one of our very first sessions, as I was walking out the door, you put your hand on my shoulder and said, 'I'll see this through with you.' I never forgot that statement - it was a mighty staff of support."
Yalom: "I remember, Irene."
Patient: "And it helped a lot when sometimes you'd stop trying to fix or to analyze or interpret me and you'd say something simple and straight like, 'Irene, you're going through a nightmare - one of the worst I can imagine.' And the best thing of all was when you'd add - not often enough - that you admired and respected me for my courage in persevering."

Yalom summarizes his approach using the here-and-now:
"I bridled at such simplification. Surely my approach to therapy was more complex and sophisticated! But the more I thought about it, the more I came to see that Irene had it quite right.

For sure she was right about 'engagement' - the key concept in my psychotherapy. I had decided at the very onset that engagement was the most effective thing I could offer Irene. And that did not simply mean listening well, or encouraging catharsis, or consoling her. It meant rather that I would get as close as I could to her, that I would focus on the 'space between us' (a phrase I used in virtually every hour I saw Irene), on the 'here and now': that is, on the relationship between her and me here (in this office) and now (in the immediate moment.).

Now, it is one thing to focus on the here-and-now with patients who seek therapy because of relationship problems but another matter completely for me to have asked Irene to examine the here-and-now. Think of it: Is it not both absurd and churlish to expect a woman in extremis (a woman whose husband lay dying of a brain tumor, who was also grieving for a mother, a father, a brother, a godson) to turn her attention to the most minute nuances of a relationship with a professional she hardly knows?

Nonetheless, that was just what I did. I began it in the first sessions and never relented. In every session, without fail, I inquired about some aspect of our relationship. 'How lonely do you feel in the room with me?' 'How far from, how close to me do you feel today?' If she said, as she often did, 'I feel miles away,' I was sure to address that feeling directly. 'At what precise point of our session did you first notice that today?' Or, 'What did I say or do to increase the distance?' And most of all, 'What can we do to reduce it?'

Throughout our therapy I was dogged about engagement. I refused to be pushed away. To her, 'I'm numb; I don't want to talk; I don't know why I'm here today,' I responded with some comment such as, 'But you are here. Some part of you wants to be here, and I want to talk to that part today.'

Ordinarily the here-and-now focus in psychotherapy has many advantages. It imparts a sense of immediacy to the therapy session. It provides more accurate data than relying on patients' imperfect and ever-shifting views of the past. Since one's mode of relating in the here-and-now is a social microcosm of one's mode of relating to others, both past and present, one's problems in relating are immediately revealed, in living color, as the relationship with the therapist unfurls. Furthermore, therapy becomes more intense, more electric - no individual or group session focusing on the here-and-now is ever dull. Moreover, the here-and-now provides a laboratory, a safe arena, in which a patient can experiment with new behaviors before trying them in the world outside.

Even more important than all these benefits, the here-and-now approach also accelerated the development of a deep intimacy between us. Irene's outward demeanor - frosty, forbidding, supremely competent and confident - kept others from approaching her. This was precisely what happened when I placed her in a six-month therapy group at the time that her husband was dying. Though Irene quickly won the members' respect and provided considerable support to others, she received little in return. Her air of supreme self-sufficiency told the other group members she needed nothing from them.

Only her husband had cut through her formidable demeanor; only he had challenged her and demanded a deep, intimate encounter. And it was only with him that she could weep and give voice to the young lost girl within her. And with Jack's death she lost that touchstone of intimacy. I knew it was presumptuous, but I wanted to become that touchstone for her...Gradually, very gradually, she was able to acknowledge feelings of helplessness and to turn to me for comfort."

Anxiety & Massage

Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients
TIFFANY FIELD, PH.D., CONNIE MORROW, M.S., CHAD VALDEON, B.S., SANDRA LARSON, PH.D., CYNTHIA KUHN, PH.D., AND SAUL SCHANBERG, M.D., PH.D.

Abstract. A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects. J. Am. Acad. Child Adolesc. Psychiatry, 1992,31,1:125-131. Key Words: massage, child/adolescent psychiatric patients.

Not surprising, I suppose. So if we know it, then why aren't we all doing it more? Massages for everyone! For the kids and for the caring adults who serve the kids!

Reflection

Critical reflection on practice is a requirement of the relationship between theory and practice. Otherwise theory becomes simply “blah, blah, blah,” and practice, pure activism.

-Paulo Freire, Pedagogy of Freedom

Writing is Good for Us

How do we meditate, reflect, look inward when there are so many distractions? How do we hear the sound of our own inner voice among the noise?

I have been wanting to write for a very long time. Writing is good for us. I didn't altogether get it whenever I heard writers say that they write because they must. Now I get it.

In Writing Down the Bones: Freeing the Writer Within, Natalie Goldberg writes:

"I went home with the resolve to write what I knew and to trust my own thoughts and feeling and to not look outside myself...Trust in what you love, continue to do it, and it will take you where you need to go."

"Why do you come to sit meditation? Why don't you make writing your practice? If you go deep enough in writing, it will take you everyplace."

"This book is about writing. It is also about using writing as your practice, as a way to help you penetrate your life and become sane...really say deep down what you need to say."

In Writing as a Way of Healing: How telling our stories transforms our lives, Louise A. DeSalvo writes:

"Writing has helped me heal. Writing has changed my life. Writing has saved my life...And how often have others - acquaintances, friends, students, published writers - told me that writing has helped them heal from loss, grief, or personal tragedy, that writing gave them unimaginably plentiful spiritual and emotional advantages? That writing has changed them, has helped them come to terms with something difficult, that writing has saved their lives. Often."

DeSalvo describes James W. Pennebaker's Opening Up: The Healing Power of Confiding in Others as summarizing "ten years of scientific research into the connection between opening up about deeply troubling, emotionally difficult, or extremely traumatic events and positive changes in brain and immune funtion...Pennebaker's work on the relationship between suppressing our stories and illness, on the one hand, and telling our stories and increased health, on the other is well respected and pathbreaking in the field of psychology..."

At the Evolution of Psychotherapy Conference in Anaheim recently, Bessel van der Kolk quoted the results from Pennebaker's research. He said how important it was to keep track of our internal life and put it into words.

Write it down. Now how does that feel?

Learning

In the parable of the sower and the seeds, a sower scatters seeds on the road, near rocks and among weeds and thorns. Exposed to the sun, the seeds become scorched and die or among weeds become choked and die. When the seeds fall on good earth, they grow yielding thirty, sixty, and a hundredfold.

Are our hearts and minds open to what we can learn? Is our earth good, is the soil tilled? Are universal messages, inspiration, whispers, signs and signposts lost on us? Or are we ready? What fruit will we bear and what will be sown in the spring?