Seeing Red on Valentine's Day?

We've all seen the ads, one dozen roses for $19.95. Chocolates, teddy bears, pajama sets and more! Now my wife would gladly receive these gifts and appreciate the sentimentality and display of love for her. And I would certainly appreciate the hugs and kisses I get in return. However, gifts such as these are only external expressions of what is hopefully genuine and lasting love felt for a spouse. Gentlemen, just to let you in on a little secret, your spouse or significant other can spot genuine love from a mile away. She can also spot inconsistencies in a story or series of stories from her man. It is very difficult to keep up appearances if the genuine feelings toward her have cooled off. Sometimes, if left untreated, she will see a different kind of red on Valentine's Day that may become passionate, but not in the way her husband would like.

So what's to be done about a marriage when the romance has cooled or if it never gets started? Almost all marriages go through a honeymoon phase. This period of time could be anywhere from a few months to the resumption of pre-marriage arguments on the honeymoon night! Consistent fighting between the couple that happens during the engagement time should be a red flag warning to the couple that there are major problems between the two that need outside assistance to resolve. The actual wedding ceremony, however beautiful, will not be enough of an emotional commitment to counter-balance deep problems one or both partners may bring to the marriage. This is not to suggest that the marriage vows are meaningless or without power. Such vows are a very powerful commitment to the partner and, for many, to God. However, it is common for future marriage partners to be on their best behavior with their future spouse. Clothes get picked up, kitchens are kept clean, laundry is done, are you hearing me gentlemen? And ladies, women too are mostly inclined to put their best foot forward prior to their wedding day. Both men and women may take better care of themselves, exercise, or show a higher level of concern and affection prior to the wedding day. Many a spouse has found themselves asking, what happened to the man or woman I married? One year into the marriage, most secrets have been revealed. One spouse finds themselves facing the reality of their spouse, which will likely lead to unhappiness and confusion. Without help the reality of this “problem” spouse will begin to wear down the spouse who feels deceived. At worst, the seeds of a future divorce will have been planted, to be nurtured by denial, isolation, lack of communication, and potential aggression. The commitments expressed on the blissful wedding day will be challenged. Hopefully the commitments will hold, often they do not.

Can a marriage be salvaged that was begun on a foundation of deception? Yes! But a lot of very hard work is involved to make that happen. It's not just that the offending spouse has a lot of explaining to do. It is also about what deficiencies were present in the offended spouse where she or he did not see it coming. True, some people are very good liars. Politicians gain a lot of influence by subtly twisting the truth to an unsuspecting public. It has been said that love is blind. Yes, that can be true. But love does not have include a lack of curiosity about a potential marriage partner. Many couples take advantage of online match-making services. These types of services can be simple hook-up sites, an online version of the local bar. Or, some sites offer evaluation methods that help potential partners learn about dimensions of personality functioning in a person that can offer a peek into the internal psychological world of a potential life-mate. What happens in the internal psychological world of people is what eventually gets expressed as maladaptive behaviors toward a spouse or others. If, during courtship, a person is faking it that they are sociable or outgoing when in reality they would rather be alone or do things only with their partner, this reality could come as a difficult surprise when it is realized six months into the marriage. Taking a close look at what a potential partner does with their time or with whom they hang out with can provide clues to the inner world of this person.

A major area for evaluation of a future partner includes attempting to determine the level of self-worth, or ego strength, in the partner. People with a healthy ego strength are people who are appropriately confident but never take themselves too seriously. They are not conceited and they can take it and appropriately respond when a stranger does them wrong. If someone close to them does them wrong, they have enough depth in their character to ask about what they did wrong, rather that simply fire back at the person who did them wrong. They are in-touch with their inner feelings and are not overwhelmed by those feelings. They are also able to provide genuine support to their partner because they are strong enough within themselves to give of themselves. Persons with lesser ego strength are likely inter-personally needy. They may fawn over their partner or shower them with gifts but this is only an outward expression of their neediness. Such fawning has at its heart the strong need for returned fawning by the other. True love gives without expectation of return. True love involves a depth of character that can overlook faults and do the things required to help the other succeed, regardless of whether the love is returned. Spiritual expressions refers to this form of love as agape love.

So how does a couple climb back from the abyss? First, get help. Find a quality couples' therapist or a clergy member who has had adequate training in marriage counseling. It is important that both partners are comfortable with the therapist because, often, there are ancient secrets in the marriage that must be brought into the light. It is okay to fire a therapist if either spouse becomes overly uncomfortable with the therapy process. For counseling to work, trust must be established with the therapist by both partners because the life of the marriage will become very rough before the healing in the marriage arrives. It will arrive, if both partners take the long view and are able to remember the good things about their mate that made the marriage happen in the first place. Remember, there are psychological reasons why a partner found it necessary to hide their dirty laundry from their spouse prior to the marriage. Except in very extreme circumstances it is unlikely that the offending partner deliberately chose to deceive. It is more likely that this partner carried too much psychological baggage that they were unable to or did not know how to clean up prior to the marriage. The love between the couple was real, but so was the baggage. Baggage can be cleaned up, it both partner are committed to honesty, openness, and long suffering in the face of revealed psychological pain. Not only with the offended spouse have to work through her or his pain but the offending spouse will have to be willing to uncover the baggage she or he brought into the marriage. The cleaning process can take some time. A helpful therapist who is committed to the goals of the couple, including saving the marriage, will be able to work through these difficulties at the right pacing and with the necessary support. 

Some basic areas for saving or rebuilding a marriage include developing internal awareness of a person's psychological structure and if that person's ego strength is sufficient to the tasks of making a healthy marriage work. If it is low, that does not mean the marriage should end. Developing ego strength is a core function of quality psychotherapy. A second major area for marriage counseling involves creating or improving interpersonal communications skills. A poor listener or a poor communicator can impede the building of a successful marriage. Also, learning ways to validate the other person's person-hood goes a long way to the functioning of a healthy marriage. Many people have found it useful to learn how their partner expresses love and the ways that their partner wants to receive love. Quality love between a couple is much more than just sex. Other couples have also found it beneficial to review and document their purposes for the marriage; a mission statement for the marriage or similar goals. If the marriage is not 50-50, in most or all areas, such an imbalance could be the beginning of a downward spiral. People like to be heard, they like to feel wanted and needed. Making a healthy marriage work is less about big things in life than about the little things, done for the other out of agape love, that many times no one but the loved spouse will know about.

Dr. Love

Managing emotions and emotional memories

When was the last time you were not able to “manage” your emotions. Yesterday? Last week? A few minutes ago? Managing our emotions is more difficult than one might expect. Our brain has many complex and wonderful structures that allow us to function and to analyze or think through the emotional realities we face everyday. One of the primary groups of brain structures that influences our emotions is the limbic system. The limbic system is a set of individual brain structures including, but not limited to, the hippocampus, the amygdala, dentate gyrus, and relatedly the nucleus accumbens, and the orbitofrontal cortex. Some of these brain structures are directly related to emotional processing such as the amygdala, which helps to let other parts of the brain know of significant stimuli related to reward or fear, or other important considerations such as how to relate to a potential mate. Another important brain structure is the nucleus accumbens, which is often referred to as the pleasure center of the brain. The brain structures in the limbic system and related structures are highly connected to the prefrontal cortex, which is a brain area most associated with problem solving and executive functioning. A map of the brain would locate the limbic system in the center of the brain, roughly between the ears whereas the profrontal cortex is just behind the forehead. The specific functioning of the parts of the limbic system continues to be the subject of significant research. However, for the purposes of this blog, what is highly important is that the functioning of the limbic system is not the functioning of the prefrontal cortex. In simpler terms, our emotions function differently from or problem solving cognitive functioning. Neither brain area is superior to the other, we need both. Without our emotional processing we would be little more that robots, similar to a certain TV character from a very logical distant planet. However, with too much emotional processing it would be difficult to get anything worthwhile accomplished, even if we felt very very very good in the process.

Dr. Marsha Linehan (1993) offers a useful methodology for conceptualizing the co-processing of the emotional brain functioning of the limbic system as it works with the rational brain functioning of the prefrontal cortex to accomplish the daily activities of our lives. Dr. Linehan posits that optimal co-processing of environmental and internal stimuli involves a partnership between emotions and reason, which is considered using our “wise mind.” The use of the wise mind requires one to pay attention to what is occurring in our emotions even as we also pay attention to the rational interpretation of our environment and our role within it. On most occasions we do balanced wise mind processing as part of our normal routine in living a successful life. However, our emotions, like our rational interpretations of our world, involve memories. Memories are stored in various locations throughout the brain and we recall them mostly in a contextual manner, such as when we see someone we think we knew before and then gradually place their face and the context of our prior relationship. Then, suddenly, an onslaught of memories, both good and not-so-good, floods our consciousness bringing both rational and emotional states to our current thinking. If we have good memories of this person this renewed relationship will brighten our day and bring a happy time of reminiscence. Yet, the recollection of difficult emotional memories may throw us off our game, or worse, place us into a difficult or depressive emotional state.

So are we slaves to our emotional memories? I don't think so. When we recall a difficult time in our past we are presented with simultaneous choices. One choice is whether we should pay attention to this memory or attempt to distract our thinking with something else. Another choice is whether we have gained the emotional resources to handle this memory or do we need to seek help from a safe and trusted person to get through the episode. A third choice concerns the use of coping skills to manage the distresses that arose from the recollection of bad memories. A coping skill can be any internal psychological thinking process or external behavioral process, or combination of both, that helps the person to get back on their feet and find their “wise mind.” Many people have found breathing exercises, or topical guided imagery, or meditation practices to be very helpful coping skills. Still others have benefited from the power of music, the reading of a good book, or the access to our inner spirituality through forms of prayer. Each of these coping skills will involve the use of our rational cognitive processes interacting with our emotional cognitive processes toward the goal of balanced thinking that in turn produces balanced living. Yet, what can we do when the negative memories just keep resurfacing?

Recurrent negative memories, such as those associated with interpersonal trauma, are difficult to process. The above mentioned coping skills can be useful but in some cases the trauma was so damaging that the person's self-view was distorted as a consequence of the trauma. Many forms of trauma involve physical pain and physical damage to the body. Other forms of trauma, equally painful, are traumas of the mind, where physical damage to the body never occurred or has long since healed, at least physically. In cases where the person's self-view has become seriously distorted it is important for that person to seek help from a qualified processional who is familiar about working with a trauma survivor as they re-establish the psychological foundations that existed prior to the trauma. It is also very important for the loved ones of the trauma survivor to learn appropriate ways of helping that will benefit the person who suffered the trauma. Telling a person to just “get over it” is not helpful and often further harms the survivor. Recovery from trauma is not a quick process and working through the loss of the trauma is best accomplished in a supportive and structured treatment environment that works through the processes at a pace the survivor can tolerate.

One of the best approaches to help the wounded trauma survivor is through quality, non-judgmental, and empathetic listening. Such listening is often hard to do because the person we love is suffering and we want to do something, anything, to help them get better soon. Yet, by just being a safe person to them, a person to whom they can say anything no matter how difficult or disgusting, this will provide them with a needed outlet to process their painful emotions. We cannot “fix” the survivor, they must navigate the dark places themselves but not necessarily alone; hopefully within the company of supportive loved ones who will provide a source of consistent love and strength on which to rely. Resolving recurrent negative memories is more of a journey rather than a set of conclusions. We cannot avoid the difficult memories from our past but we can choose how we decide to respond to them. Will we be lost in our painful emotions or will we find the courage to engage our rational thinking and find our wise mind. By reaching out to others during such difficult times we improve our chances for finding our wise mind while simultaneously receiving the support from safe loved ones who help our negative emotions to feel better.

Dr. Love

M. Linehan. (1993). Skills Training Manual for Treating Borderline Personality Disorder. The Guilford Press, New York.

Looking forward to Spring

Are you looking forward or looking backward? As simple as this seems it is an important continuum to examine if you are interested in improving your psychological health. Each year as we struggle through the snow and cold of winter we are faced with the limitations of our frail humanity. It IS cold outside and I DON'T like to shovel snow! When my family lived in the upper mid-west we learned to accept that our social contact usually involved going to the shopping mall on some nights and to church on Sunday. In the worst of winter we would find activities to do with our children at home, not likely to brave the elements simply to go to a movie. After a few months of this difficult weather it became a little dreary. Hence, we learned to look forward to spring through multicolored lenses of practical anticipation, NO MORE SNOW, and pleasurable fantasies, won't those roses smell wonderful.

What are the roses in your life? Do you have any? Are they, metaphorically speaking, people, places, or things. Of course roses have thorns, which reminds us that living in reality sometimes brings pain. But, do we take the time to slow down and listen to the beautiful influences of life. Many people find joy in their relationships with others, seeking the best of life while working through the occasional potholes that can throw us off balance. Others I know find beauty and purpose in helping with social causes or going out of their way to meet the needs of others. These pursuits are fantastic and they enhance the overall good of the community. The wonderful thing about roses is their variety.

Have you ever wondered why God created weeds? So have I. Weeds have a way of distracting from roses. In my garden I have weeds. I did not plant them, they just showed up on their own. You gardeners out there may be chuckling a little right now. Modern science has developed many miracle cures-in-a-bottle to combat weeds. Ever notice how you have to keep buying those bottles. Science has developed these marvels that do get rid of weeds. Yet, this fix is only temporary. Weeds are as much a part of life as are roses, they just have a different purpose. Weeding is a job I don't really enjoy if the truth were to be told. I do like it when the weeding is done and the roses can again display their place of prominence in my garden. In our lives we all have weeds. The so-called miracle cures of psychology do help with our weeds but they do not fully remove them. We call this successive approximation, or more simply, gradually sneaking up on a cure to a presenting problem. As humans we learn throughout our lives. We learn to feed, ride a bike, fall in love, and make a career. At every one of these milestones weeds are present. Either an older brother or sister demands our parent's time so we can't get help learning to ride a bike or the boy down the street woos the girl we are interested in and we feel rejected. These experiences are weeds. A question is: do we allow the weed to grow roots?

A weed that has grown roots is a terrible thing. Weed roots grow very quickly, seeking the same nourishment of water that roses do. But weeds, although living, are not wanted in my garden. Do you want weeds in yours? Weeds distract us from our greater purposes in life. Because they grow so quickly they can often overwhelm us, hiding our roses from those we love. That weeds also need nourishment raises the question, why would we want to nourish that which distracts us from what we really want to do in life? Modern culture often validates those who seek to rise to the top, whatever that top may be. However, we have also seen weeds arise in these so-called stars of pop culture. Many stars have had their lives destruct in full view of a once adoring public. My guess is that they did not like having their weeds exposed for the shallowness that weeds really are. But to live in reality, we must be aware of our weeds and take measures to remove, contain, or prevent them.

I am not suggesting that we all sign up for miracle cures from psychology to keep our weeds at bay. So-called miracle cures, like weed killer, are likely to be temporary cures. Remember weeds are as natural part of life as are roses. So what can we do?

• First, seek self-awareness that you do have weeds and that they will need to be managed.
• Second, reach out for knowledge on what has worked for others to manage your particular weeds. I am not suggesting that their management techniques will work for you. On the contrary, their specific healthy practices will not work for you because you are not them. But their good practices can point you in the right direction for healthy living.
• Third, build or strengthen your positive social network, such as family, good friends, or recreational activities. You may notice that I suggested to increase positive influences in your life. If one of your weeds is substance use, or any other potentially addictive behavior, seek positive influences that help to move you away from increased risk for potentially addictive behaviors. No one really likes an addict.
• Fourth, seek assistance for managing your weeds from neutral and confidential resources such as psychotherapists, clergy, and trusted friends. When you are considering additional resources to manage your weeds, consider the skills of your potential helpers. If you have a serious weed infestation you may need more significant help.

To me, stopping to smell the roses is a way for me to look forward. The beautiful smell of roses changes my emotions in a very good way. I am able to renew my inner man, better able to again find that which is important to me; pursuits that ground me in the core of life's goodness. We all have our roses but sometimes our weeds hide our roses from others or even ourselves. Beginning to tackle our weed management can be a daunting task but not beyond reach. Start by working on the most obvious single weed in your life. Read up on it and learn about the details of this specific weed. How does it grow and how can it be managed? Yes, we all have many types of weeds in our life but they can be managed, one at a time. Just like pulling out weeds in a garden you can only pull out one at a time.

Springtime brings the challenge of encouraging and fostering new life after a season of dormancy. It brings both roses in bloom and weeds that like to grow without restraint. The beauty of spring is that we can pursue again the beautiful fragrance of new flowers, the fragrance of life. This is the stuff of human happiness, the fragrance of life. It does not come without significant difficulties but it is worth the effort to gain the pleasure of a job well done. Pursue life well and you will find beautiful fragrances and lasting joy. Look forward!

Dr. Love

Depression in the Christmas Season

Think about it, Mary and Joseph had every reason to be depressed. Both of them were outcasts from their families and local communities, all for believing a story about a virgin birth told to them by an angel. And then there was the issue of Mary becoming pregnant. In today's diagnosis-laden society, such a story would not be believed by anyone and there would be much pressure to have the couple see a psychotherapist and get a prescription from a doctor. Others may have pressured Mary to consider an abortion. Another factor in their risk for depression is that the society of Mary and Joseph's era was a communal society. Everything was done together as a large extended family and everyone knew everything about everybody else as in the movie Fiddler on the Roof. So a once proud and upcoming carpenter now is accused of intimacy with a virgin and a young girl, probably about age 12, is labeled a prostitute by her betrothed. One can only image the pillow talk of Mary and Joseph's parents. Not your happy Christmas family by any means.

The root causes of depression are varied and extensive. Some have suggested that our biology has much to do with the frequency and severity of depressive episodes. Medicines do help to manage the symptoms of depression and offer many a form of freedom from an unbearable burden. The burden of depression can be thought of as a massive weight on the soul. A person who suffers from clinical depression has dark cloudy days, most days, for most if not all of those days. It is as if you can see a brighter place just over the next hill but when you walk toward the hill to the light the hill keeps moving farther away from you. As if relief from depression is always just outside of your reach. It makes no sense because a person should be able to reason their way out of depression, right? It is not easy and to many such a logical process is impossible.

It is useful to examine the process of how people function when it comes to using our reason or our emotions, or both, to resolve depression. Dr. Marsha Linehan (1993) suggested that we use two primary spheres of cognitive functioning in approaching a task presented to us. Such tasks can include the process of experiencing and working through depression. Dr. Linehan offered that humans use a “logical/reasonable mind” and an “emotional mind” to process experiences. She further offered that these spheres overlap and that within the overlap of logic and emotion wisdom can be found. Dr. Linehan is suggesting a balance between emotion and logic is useful to accomplish human tasks. However, conflict can also be found within the overlap of logic and emotions. So what could Mary and Joseph have gained from learning about balancing logic and emotions.

A main problem for Mary and Joseph was that what was happening to them was not logical in any conceivable manner. The couple knew that they had not known each other in a Biblical sense and yet Mary's belly continued to grow. This was illogical. Yet, the emotional realties surrounding the rejection of their story by friends and family caused severe distress and risked the overwhelming onslaught of hopelessness. But Mary and Joseph did have hope, a hope based on the reality of their separate encounters with the angel. Hope, not in their present situation which was difficult and at times depressing, but hope for their future, the future of their soon to be born son, and the future of humanity. The ability to identify future things to hope for or new beginnings to arrive is the stuff through which depression can be fought and potentially defeated.

A mother who loses an infant to Sudden Infant Death Syndrome (SIDS) or a father who loses a teenage child through a tragic car accident will have great difficulty in their ability to find hope. Hope is not on their horizon for likely a long time. However, this does not mean that hope cannot rise from the ashes of what was before. It is logical to assume that after an appropriate period of mourning a person should be able to rise above their grief and reconstruct a life that is forever hobbled by a tragedy. It is not possible to turn back the clock, so what is left. Some would offer that finding purpose in the midst of despair offers a path toward finding hope. Not hope for the past but for the future, as with Mary and Joseph. A challenge that faces a person mired in depression is to find a way to get out of the depressive loop, a loop of repeating remembering of the tragedy or series of events that forced the person into a depressed state. It is illogical to think that a person would choose to remain in a depressed state by continuing to recall depressing events, but this is where the “emotional mind” can take a person suffering from depression. The longing in a depressed person to return to life before the tragedy is real. So to is the risk for blaming oneself for not doing enough to prevent the tragedy. If only the SIDS mother had remained awake through the night the baby would not have died. If only the father of the now dead teenager had driven his child to the football game, his child would not have died. These are not logical thoughts but they are emotionally driven thoughts, feelings of longing for relationship with the child or person they have lost.

It is not useful to denigrate such feelings because they are a present reality to the person and often all that is available to them in the depths of severe depression. It is useful for loving family members or friends to be available to the depressed person, to listen to them without judgment and without trying to “fix” them. There is no official time clock on how long it takes for a person to recovery from a major loss such as a death. What is important is to provide a safe and psychologically healthy environment for a person to work through their grief. Yes, there will be those dark hours of the night where the tears of remembrance are one's only company. Yet, Mary and Joseph's child let us know that He would remember those tears, listening to the grieving without judgment, only understanding. Psalms 56.8 reads that “You [God] keep track of all my sorrows. You have collected all my tears in your bottle. You have recorded each one in your book.” The hope that Mary and Joseph had, their hope for their future, is available to everyone today. The message of Mary and Joseph is that they reached beyond themselves to God through the angel's messages to find hope. So also is it for the person suffering from severe depression. To find a way to reach beyond their private world of grief, to get it out in the open by talking it over with a safe person. To find, over time, a context for their loss that includes both the past and it's happy moments and a future, with its happy moments. Life, sadly, is not always fair. People do experience losses and death will arrive at every person's door. Yet, we do have the ability to choose how we will live. Will we remain focused on our losses or will we try to build upon our losses to make ourselves into stronger and healthier people, able to offer hope to others from the hope we have learned about as we have experienced our own losses.

History is full of people who experienced significant and chronic losses only to persevere and find a new purpose from out of the ashes of great loss. Mahatma Ghandi experienced great personal loss in his effort to pursue a life of non-violence for all. Mother Teresa experienced tragedy and loss every day in her mission of hope and service to the “untouchables” of India. Dr. Martin Luther King experienced great loss being persecuted and eventually killed by racist tormentors fighting against his struggle for racial equality. Each of these beautiful people found a way to look past their personal loss in the moment, past their battles with feelings of depression, to find a purpose that was greater than their current grief. To honor a loved one lost is to find a way to continue the expression of the hopes and dreams of the person now departed. An infant who died had their world before them, a world of discovery, a world of promise and hope. A soldier who died also had their world before them but chose to risk their life so others could live freely. Choosing to find a world outside of the chains of depression is like trying to define the future. There are no guarantees that the future will always be good and without loss. But, if a person makes the choice to not risk looking outside of their depressed world, they may never learn of the possibility that goodness and a better life are just around the corner.

The old proverb, nothing ventured, nothing gained, is a relevant concept for working through depression. Yet, working through and finding freedom from depression requires support and new perspectives on the tragedy, and the context of the loss. I am not suggesting that a quick fix or a magic phrase will bring immediate relief from severe depression. A deep wound takes a long time to heal. And, similar to the healing of a wound of the skin, the healing occurs from the outside downward into the inner recesses of the emotional tear. A grieving widow learns to put on a happy face rather quickly but the inner sorrow remains. This phenomenon of outward to inner healing of depression is where the support of a structured program of psychotherapy can be useful, reaching out to a safe person. The therapist is a neutral third-party, with training to help the person find alternative ways to think about and process the loss. The therapist will also be able to identify the differences between logical and emotional thinking to help the person sort through what are emotional factors and what is reasonable given the situation. One of the most important factors in working through depression is to find a way to find hope. Perhaps hope is only a shadowy mist at first, fleeting and fragile. But given time hope can develop into the substance of things unseen, sufficient to change mountains of grief into pastures of safety and plenty. Mary and Joseph's immediate loss and likely feelings of depression were changed to feelings of joy and feelings of hope through the birth of their child. So to can the suffering of depression be transformed into honor for the lost and hope for the future through reaching out and getting needed help. The sun may come out today rather than tomorrow, but one has to reach out.

Dr. Love

References

Linehan, Marsha M. (1993). Cognitive behavioural Treatment for Borderline Personality Disorder. New York: Guilford Publications. ISBN: 0898621836.

Linehan, Marsha M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Publications. ISBN: 0898620341.

So THEY say you are an addict... now what?

Bob had been a professional stock broker since his early 20's and he always enjoyed seeing the money rolling in. He was good at his craft and he had dozens of clients, each worth more than he would likely make in his lifetime. He was also a devoted family man and a church-goer, with a wonderful wife and two children balancing their way through the struggles and drama of high school. Yet, Bob had a secret, a life-long, carefully managed secret, that he had long since learned to control, or so he thought.

Bob, of course, is a fictitious person but he could also be any man, woman, or child in our neighborhood. Addiction takes many forms, whether alcohol, drugs, food, gambling, sexual, power, or money; the psychological themes behind the functioning of an addiction are similar. With some addictions, such as drugs or alcohol, brain functioning is greatly altered due to the direct chemical processes of the substance used by the person. Other addictions, such as food or pornography, involve psychological and/or physical gratifications that reinforce the psychological need with a powerful physiological sensation that strengthens the belief that a person can have control or feel good if a certain behavior is followed.

Although the starting point of addictions is often debated in the scientific literature one of the root causes of addictive behaviors is psychological neediness. It has been said that addicts often cannot stand being “in their own skin.” What could possibly bring a person to feel so bad about themselves that they may hate themselves or want to be anyone else but them? In many cases, during a person's early to middle childhood is when the seeds of later addictions are sown. It may be that a parent, aunt, uncle, or older sibling is stuck in a pattern of addiction behaviors. A person may also have been the victim of one or many instances of psychological or physical trauma that has left the person emotionally and psychologically damaged, unable to regain the innocence that was theirs before the trauma. Also, severe and tragic loss, such as a family death, may lead a person to “pick up” a substance or poor behavior as a means to escape their psychological pain. These are all scenarios of the tragedy of addictions. Yet, when people who are close to you, believe in you, and hold you in high honor find out you have a dark secret of an addictive lifestyle what should you do?

Returning to our example, Bob has much to lose. He has built his public life as a model of success and he is receiving the just rewards of his hard work. However, his private life of addiction has been gaining ground on him in recent years. He has come to realize that he needs more of his “substance” than he did before to get the same good feelings and the good feelings do not seem to last as long. A common phrase in the recovery community is that an addiction will “take you where you do not want to go.” 12-Step programs describe this risk for using as “one is too many” and “a thousand is never enough.” Bob is experiencing the physiological and psychological symptoms of tolerance. This means that the body or the mind has come a place where more stuff is needed to satisfy the physiological or psychological need. It is as if the cup a person is holding for their coffee keeps getting bigger and they need more coffee to feel good.

When a person craves their “substance” they have a need that they often do not understand. People may eat to feel better or gamble to “have success” believing that through the external process of ritualized behaviors they will feel better and/or have success. The taking of substances or the pursuit of ritualized maladaptive behaviors usually works to make the person feel better, in the short run. Over time, however, tolerance is developed and more is needed. The Internet and newspapers are filled with the carnage of lives ruined by the pursuit of fulfilling painful psychological needs through substances or behaviors.

For our addict Bob, he has three paths to follow, a fourth choice, going “cold turkey” on his own is unlikely to be successful. Based on his new insight that he needs more substance to meet his needs, he could voluntarily check himself into a recovery program and get help. Yet, due to his thinking that he can “manage” his addiction, he is likely to believe that he can manage “just a little more” substance and “no one will know.” 12-Step programs call this “stinkin-thinkin.” Another choice for Bob is to give up and dive head-long into his addiction throwing caution to the wind and seeing how far he can go, it “sure would feel good.” This too is stinkin-thinkin. A quality choice Bob could make is to push back his pride and admit that he has a problem. This will be very hard for Bob to do because over the years he has built strong psychological walls of self-sufficiency. The idea that he has really been a failure all his life and kept it hidden from others will be hard to think about, much less do something about.

Fortunately in Bob's case he married a very intelligent and perceptive woman. Bob's recent changes in behaviors, coming home later, sleeping later, being more secretive than usual, had been noticed by her. She has taken steps to learn about the processes of addictive behaviors and recovery. As the daughter of an addict, she has seen these signs before and knows that they are ignored at great peril. Much to Bob's surprise, when he gets home late around 9:00PM on a Friday night he finds that there are many more cars parked on his street than usual. When he comes in the door he is met by his wife who leads him into the living room full of people. He is asked to sit down as he is met by his boss, his priest, his doctor, his parents, and his siblings, all there to try and interrupt the pattern of his addiction.

The “intervention” attempted by Bob's wife and friends is just one of many methods that are used to help people begin the process of recovery. Bob could bolt from the room but for the love of his family, friends, and supporters that will likely keep him there. A great deception addicts believe is that they could never seek help because they will be forever rejected by those they love. They may believe their life will be ruined without the support of their “drug.” The fact is, an addict's life is ruined, until they begin the process of recovery. Outside of a process of supportive recovery the addict remains adrift and lost on how to find health. I would like to offer 10 recommendations to those who want to recover:

1. If your secret is still secret, come clean now. You will likely have a better outcome in recovery because you initiated the process, confessed it, and recovery was not forced upon you.
2. Take charge of your recovery. Ultimately you will be the one who makes it succeed, not others.
3. Find a psychotherapist who will accept you in your current state and support your process of change. There are no miracle cures for addictions and it will be very painful at first.
4. Work with a psychotherapist on those early unmet psychological needs or losses that led you to “pick up” in the first place.
5. Be open, humble, and honest about EVERYTHING. You were a liar in your addiction and truth is better than lies. Truth may hurt a lot in the short run but over time it feels better and better.
6. Change your current behaviors, change jobs, routes to work, friends, anything that connects you to your lifestyle of addiction.
7. Find safe and supportive people to hang with, this may not always be your family.
8. Let other's guilt and shaming of your former lifestyle go right past you, don't take it in.
9. Find something outside of your self that can be a strong psychological pillar for you to lean on when you are in that lonely isolated place and are most likely to use. Some people find this support in a “higher power” but others find this through activities or by giving of themselves to others in a humble healthy way.
10. Stop thinking about the negatives in your life, focus on the positive. There is good in you and you know you have shown it to others before. Pursue the good and be good.

Dr. Love

Picking a Psychotherapist

“Pick me, pick me” shouts the four-legged jackass jumping high in the air at the back of the crowd in scene in a famous movie about a shy and greatly misunderstood green giant. We all laughed because the scene brought back those uncomfortable memories of our teenage years when popular others were picked while many of us remained in the lineup, unchosen. Why others were chosen over us is a complex topic and maybe will be a topic of a later “Notes.” However, choosing a therapist has some similarities to picking the best possible players for a half-court pickup game, but it is not always about the person with the best free throw shot.

The process of therapy is an intensely personal endeavor. We choose to go to someone for help because we have been unable to figure it out on our own. If we could have fixed it, why spend the time and money to tell another person about our problems? Also, therapy involves personal disclosure in a confidential setting. Even so, it is still telling someone else about how we have been hurt by another, or hurt ourselves. Therapy involves gaining trust in a stranger and keeping that trust. Many people find this very hard if not impossible to do.

So how do you know if a therapist can gain and keep our trust? Many times when we look for a therapist we will turn to trusted friends, a pastor, rabbi, priest, or our doctor for advice. Our friends may know someone who has seen a therapist and had good results who could make a recommendation. But then, both the friend and that other person would know that we need to see a therapist. Of course, we hide our own need by saying, “I have a friend who needs...” when we are the person in need. This is a dilemma because we are hurting and need to talk to someone, but who?

There are many resources that have referral sources including state and national therapist trade associations such as the American Psychological Association, the California Psychological Association, and the California Association of Marriage and Family Therapists. Individuals psychologists and therapists join these organizations for various reasons and one of the benefits they receive is to be placed onto a referral list for the association. This may be a good place to begin looking for a therapist but it is not the only place. Other resources also include mental health service agencies in the local community. These agencies are much closer to the community and they will be able to refer to appropriate providers or they may have their own therapists or service providers. The good thing about working with an agency is that they will usually have several options to help find the right therapist.

Talking with your family doctor is always a good step to take when dealing with a complex problem. Your doctor has your best interest in mind and he or she is not in the therapy business, so there is no conflict of interest. Also, your doctor will be able to tell if the problem is serious enough to require medications to stabilize the behaviors of the person in need. When you talk to your doctor, though, remember to ask them if they think seeing a psychologist or other therapist to work on the problem would be a good idea. Your doctor may be able to help with an anti-depressant or provide some good common-sense advice, but this may not be enough to find lasting relief to your problem. It is good to remember that complex problems do not go away by themselves and are not fixed quickly. Finding quality solutions to complex psychological or interpersonal problems is what professional psychotherapy is all about.

In looking for the right therapist for you, ONE SIZE DOES NOT FIT ALL! If a therapist does not seem right for you, or the “shoe does not fit,” find a new therapist. Psychotherapists can facilitate therapy through over four hundred different styles of therapy. Everyone is different, including psychotherapists. So, be yourself, explain the outlines of your problem to a prospective psychotherapist and see what happens. The right therapist will have the skills to help you feel good about yourself even as you work through the terrible things that have happened to you or the terrible mistakes you have made and now want to resolve. Over 85% of what works in therapy due to the fact that the therapist and their client were able to build a quality trusting therapeutic relationship that provided a secure foundation to heal the deepest hurts.

So ask friends or family for advice about seeing a psychotherapist if you don't mind everyone else knowing your business. Asking your doctor will be confidential and will always be a good resource. Asking a community mental health agency will also be confidential and is also likely a good resource. Remember, at the end of the searching the choice is up to you, not your family or your friends. You will have to live with your choice, but your choice does not have to remain final. If you find that the therapist you chose does not continue to help you to feel safe while in therapy even when working through very painful issues, consider another therapist. You are free to leave therapy at any time and your therapist will provide you with referrals to another therapist. As a psychotherapist, I consider myself but a small part of client's recovery from their problems. You are the major part of your recovery; find a therapist who will cheer you on!

Dr. Love

Starting a Clinical Psychology Practice

Getting people to find you on the web is a difficult thing. Well, here goes...

Dr. Chris Love, PsyD is a California licensed clinical psychology practice serving Crestline, Lake Arrowhead, and the greater San Bernardino mountain communities. Providing professional psychological services including psychological assessment for Personality Functioning, Substance Abuse, Cognitive & Intellectual Functioning, Forensic/Legal Evaluations, and Behavioral issues. Professional psychotherapist services include therapy for Families, Couples, Individuals, Seniors, and Adolescents. Located at the beautiful new Crestline Plaza in downtown Crestline, CA, my office offers full amenities including: ample, close, well lighted free parking, ADA compliant facilities, clean ADA compliant restrooms, a waiting room and receptionist, and a comfortable confidential therapy office. Therapeutic approaches utilized include Client Centered, Cognitive Behavioral, Interpersonal, Family Systems, Dialectic Behavior Therapy, Motivational Interviewing, and time-limited Psychodynamic.

Dr. Love