Month: July 2020

All Different

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We’re All Different

I know, that’s not really news to us. Though you wouldn’t know it if you just listened your couple-clients, would you? It’s wild to me how much they expect the other to have the same personality, likes/dislikes, perspective, neurobiology, history, motives…well, you get the idea. Or rather, it’s not that I think they really expect that, but they just seem not to give it much thought?
I’d like to share an exercise with you that I use with many couples, to good effect. It asks couples to identify their differences – silly ones, serious ones, big and small – and to identify how they tolerate, accept, or celebrate those differences. (And they do at least tolerate them all, or they wouldn’t be in your office!) It gives you an opportunity to talk about how all of those are ok, and how you can even move up from tolerate to accept, or from acceptance to celebration. And it sets the stage for another important part of coupes work – each choosing to accept the other person fully while making efforts to change themselves, accepting influence from the other person and accommodating when more movement doesn’t feel possible.

 

Note: Couples, even ones who do this very well, need to continually revisit and update this information. Just as we’re different from our partners, we’re different from ourselves from last year, or ten years ago.

Bonus: This works with families, too!

Comment below if you have other techniques you’ve used to help couples or families experience each others’ differences in a gentle way.

 

 

 

 

Blank may be better…

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Blank may be better…

I know there’s some kind of marketing value in having lots of “letters” behind your name and on your business card. 

But please, let’s stop the madness. 

Paying $59.99 to be a “Certified Life Coach” does not actually add anything to your practice. Becoming a “Certified XYZ Therapist” for a few hours of training that doesn’t help you do anger therapy any better than basic counseling training is a bit shameful. Mediation and anger and wellness, oh my! I’m sort of willing to go the distance on this and say that these kinds of credentials are actually unethical and misleading (APA Ethics Code 5.01 & ACA Ethics Code C.4)

Not convinced? Read this article about how a middle schooler can become a “Certified Clinical Trauma Professional” and then come back. Here’s the tl;dr…

Mental health professionals typically represent their competencies by earning a diploma and obtaining a state license to practice. Some practitioners choose to further represent their expertise by acquiring specialty certifications. We review the broader landscape of these certifications and provide a case study of a program that illustrates current problems with specialty certifications. Specifically, we demonstrate that an 8th grader with no prior mental health education or training can pass a test intended to assess expert levels of knowledge obtained from a workshop. Implications of these findings on the validity of specialty credentials and the public’s trust in them are considered.

Rosen, G. M., Washburn, J. J., & Lilienfeld, S. O. (2020). Specialty certifications for mental health practitioners: A cautionary case study. Professional Psychology: Research and Practice. Advance online publication. https://doi.org/10.1037/pro0000324

 

Let’s not chase the appearance of expertise. We don’t need to compete with 8th graders. Own your real credentials; clients will respond to your actual expertise. 

 

 

VERB Your To-Do List

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VERB Your To-Do List

VERB your to-do list

I’d like to share with you a cool and random idea I had with a client that is really working for me personally.

See, I know that a lot of people, when they “can’t get motivated to do what they need to do” have maladaptive ways and reasons. They are perfectionists-who-procrastinate (and it’s worth working on their shame-related core belief), or they have their priorities all out of whack (and it’s worth taking the conversation to values and meaning), or they or maybe have subconscious resistance (and it’s worth discovering it!). Or whatever.

Some people (and I suppose I’m one of them) are just kind of internally inconsistent. I don’t always wake up in the morning with the same kind of “energy” and the kind of energy I have fluctuates during the day. Honestly, it often doesn’t matter. When it’s time to teach, it’s time to teach. When it’s time for therapy, it’s time for therapy. (Those are easy – I have internal access to my teaching and therapy energy almost all the time. I haven’t yet sorted out whether I believe that’s natural, and I just found the right occupational place for myself, or if it’s something that develops with value-oriented-time-and-practice. Or both. Or something else.) When it’s time to turn in grades, or work on a grant proposal, or have a meeting with colleagues I disagree with … I rarely have the right kind of energy, but it doesn’t really matter. It must be done.

But there a lot of things that sort of fall in the middle – writing, cleaning, reading, etc. And there are some times (and I know this is a luxury, but it’s likely that you have at least some measure of it as well) when my day isn’t demandingly structured by an outside authority. And, yet – I’ve spent most of my life trying to demandingly structure my own time! (I sort of understand why, but it’s a long Family of Origin tangent.) Here’s what I do now:

I’ve chosen to group the items on my ongoing to-do list by type of energy. Generally, these are all things that don’t have hard deadlines or involve other people.

My current categories are WRITE, LEARN, CREATE, CLEAN, WORKPREP, THINK, and RUN-AROUND.

Under the WRITE category, I have things like make more blog posts and work on articles and workbooks I have in progress. The LEARN category includes reading one of my stack of not-yet-read psyc books, doing continuing education, etc. The CREATE category has more personal items – my kids’ photo books, hypnosis recordings, painting the bathroom. The CLEAN category literally just has every sub-divided space in my house listed! Under the WORKPREP title, I have things like advocacy research tasks and handouts I want to make for clients. The THINK category is where I put those random thoughts I have that I don’t have time to pursue when they pop in. And the RUN-AROUND category is everything that requires me to get in my car – typical errands.

So, when I have a bit of unstructured time, I can just check in with myself and see what kind of energy I have, then I can go to my list and choose something. I can’t tell you how much more productive I have been since I started this!

As a bonus (and this came up with a client, as well, and then also is now important in my own life…), I added REST and CONNECT categories. 

Comment below: How about you? How do you structure your own productivity when someone isn’t doing it for you? What kind of categories might you have on a verb’d to-do list?

 

 

 

 

 

Undiscovered Self Jung

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Undiscovered Self (Carl Jung)

I love reading. And I’m such a psychology nerd that some of my favorite things to read are the classic texts written by the fathers and mothers of psychology and psychotherapy. So, in case you might want to read some of these – I’ll give you some glorious snippets as I come across them to entice you. (And for those who really don’t want to read these kinds of things, maybe still some good quotes to spice up your consultation meetings and help you feel psychologically erudite.) ?

Carl Jung’s The Undiscovered Self: The Dilemma of the Individual in Modern Society (1957)

This is a tiny, punchy little book! Coming in at just 112 pages, it’s pretty easy to read and fits nicely in a purse or laptop bag! Here’s one of my favorite lessons:

Individual reality can’t be expressed by statistical averages; every therapy client is a completely unique creature and needs to be treated as such.

The more a theory lays claim to universal validity, the less capable it is of doing justice to the individual facts. Any theory based on experience ins necessarily statistical; that is to say, it formulates an ideal average which abolishes all exceptions at either end of the scale and replaces them with an abstract mean. This mean is quite valid, though it need not necessarily occur in reality. … The exceptions at either extreme, though equally factual, do not appear in the final result at all, since they cancel each other out. (p. 7) … While [the average is] reflecting an indisputable aspect of reality, it can falsify the actual truth in a most misleading way. … Not to put too fine a point on it, one could say that the real picture consists of nothing but exceptions to the rule, and that, in consequence, absolute reality has predominantly the character of irregularity. … There is and can be no self-knowledge based on theoretical assumptions, for the object of self-knowledge is an individual – a relative exception and an irregular phenomenon. (p. 8) If I want to understand an individual human being, I must lay aside all scientific knowledge of the average man and discard all theories in order to adopt a completely new and unprejudiced attitude. …If the psychologist wants not only to classify his patient scientifically but also to understand him as a human being, he is threatened with a conflict of duties between the two diametrically opposed and mutually exclusive attitudes of knowledge, on the one hand, and understanding, on the other. This conflict cannot be solved by an either-or but only by a kind of two-way thinking: doing one thing while not losing sight of the other. (pp. 9-10)

That’s all I’ll give you here, but you should read it for these other gems:

  • How communism and capitalism both devalue the individual while purporting to do the opposite
  • How religion really exists through experience only, not dogma
  • The problem with ignoring your shadow and the good that can come from it
  • How art prophesies cultural shifts

 

Yes! All of that in this teensy, tiny book. Enjoy!

Comment below if you’ve read this book, or any Jung, and give your favorite quotes!

 

 

 

Just close your eyes and rest…

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“Just close your eyes and rest.”

This is what we need to tell our kids, and ourselves. Trying to demand that you fall asleep, or that awful thing where you think “if I could just go to sleep NOW, I’d get 5 hours. … if I could just go to sleep NOW, I’d get 4 ½ hours…” NOT HELPFUL. Changing this language is just the beginning of the wide array of strategies we can use to help clients get restful sleep – something that’s associated with pretty much every physical and mental health measure there is! 

 

Sleep hygiene is maybe the thing that’s most applicable to virtually every client – more so even than journaling, I’d say! It’s a shame, I think, that many accessible resources for sleep hygiene are quite poor (even though they’re usually pretty accurate). I’d like to share with you the sleep hygiene handout I made for my clients – feel free to share (but, you know, obviously don’t SELL!).

 

It’s geared toward adults, but could pretty easily be modified. It doesn’t mention sleep meds (which are often antipsychotics or antianxiety meds – BEWARE; also the sleep specific meds like Ambien have some really alarming side effects!) or pharma sleep “helpers” (like antihistamines or melatonin). It also doesn’t mention some of the sleep re-set techniques for when sleep has gotten really out of control, e.g., the 24 hour re-set or the 5.5 CBT-I strategy .

 

 

Comment if you teach sleep hygiene to clients, or if you’ve learned a new sleep hygiene technique you can share! 

 

Frog: A Noble Creature

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Frog: A Noble Creature

I know. Frogs don’t seem that noble. And whether they are or not, or even if the case could be made that they are (and I believe it could), that’s not even remotely the point.

You see, “Frog: A Noble Creature” is just what I title this image when I give it to one half of a couple. “Horse: A Noble Creature” is just what I title this image when I give it to the other half. See why?

…

(If not, tilt your head so your right ear touches your right shoulder)

It usually takes just a moment for the two of them to notice that they have the same picture. Which is good, because the point is to show them that they can’t easily see the other person’s picture the way they see it, unless they come around to the other person’s position and look from where they’re sitting.

It’s just a little introductory exercise to empathy and perspective taking, but it really seems to drive the point home better than a lecture. Here are two of my other favorites.

 

 

Comment, please! How do you explain empathy to clients? Do you know of any other optical illusions to share that would help?

Note: I hate posting images without original sourcing, and I don’t know the original source for any of these. If you do, please share!

 

 

 

 

Living fully in the moment

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“Living Fully in the Moment”

I feel like that’s a thing we say a lot. So I’d like to break it down a little bit. Specifically, I’d like to talk about what living-fully-in-the-moment is NOT, because it’s not really enough to know what something is. We don’t know the shape, the fullness of something, until we find its edges.
 

What living fully in the moment is NOT:

 

  • It’s Not-Living
    • This might be “deadness,” that depressive, withdrawn un-aliveness. It can also be “stillness” or avoidance, not going-forth because of fear. It can be disconnection from the other life (people, activity) in the world through isolation, numbness, or “tuning out.” And it can be the “early death” of an unlived life – a life made too narrow by fear or unwillingness.
  • It’s Part-living (i.e., not living fully)
    • This can be a distorted existence – constricted by too-strong opinions or too-strict beliefs, by an internal critic or demanding internal parent that allows for no exploration. This can be a life lived under pressure, “obligated” in ways that the person even has difficulty articulating. This is a life lived “in bad faith,” as the existentialists say – full of blaming others and circumstances, rather than holding the freedom and responsibility for one’s own life.
  • It’s living in the not-now, not-here
    • This might be living in the future – consumed by anxiety about situations not yet arrived. Or worry for those not immediately present, who you wish you could control or keep safe, but who you don’t and can’t possess. This can be stuckness in the past – regret, guilt, and fear or repeating past mistakes. Missing out on the present and what is becoming because the gaze is focused backwards, or too far out.

Comment: What do you see as the unlived life? How have you helped clients live fully in the present?

 

 

 

 

Therapeutic Apology

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The Therapeutic Apology

If you haven’t said “I’m sorry” to a client this month and meant it, you might want to check in. In real relationships, we blow it sometimes. So, if you’re having authentic, therapeutic relationships with client, apologizing will be a part of the deal. Not only is it an important part of a real relationship, it models something very important for your client. Here are some tips:

 

  • Recognize when to apologize
    • When you have violated part of the explicit or implicit contract
      • Running late, mistaken charges, delays in providing requested documentation, unclear communication, etc.
    • When you haven’t honored them well
      • Made an assumption, not listened well, gotten distracted, interrupted, followed your own agenda, etc.
    • When you made a mistake you shouldn’t have made
      • Forgotten to check their homework and they missed session time to process something that was important to them, started into a metaphor you often use but then realize it’s not well tailored to this particular client, overstepped a boundary, pushed too hard that day
      • Note: When you make a mistake that was reasonable at the time, and not due to a lack of knowledge/ethics/conscientiousness on your part, just explain it without apologizing. This is excellent modeling!

 

  • Only apologize for things you have control over (i.e., your own behavior)
    • Avoid the “habitual apology” (women are especially prone to this). That’s when you say “I’m sorry” when no offense actually occurred.
      • “I’m sorry (for taking up space in the hallway because I have a body and walk at the same time as you which is obviously not my fault)”
      • “I’m sorry (because you were speaking very softly and the air conditioner is loud so I couldn’t hear you which is obviously not my fault”
      • Resist the urge to apologize just because they don’t like something (e.g., for your email/contact policy, for ending session on time, experiencing difficult feelings, referring them appropriately)
    • Apologize for what you DID, not for what happened.
      • NO: “I’m sorry we had a misunderstanding just then.”
      • YES: “I’m sorry I wasn’t listening well just then and assumed incorrectly.”
    • Two exceptions to this rule:
      • Go ahead and say “I’m so sorry to hear that….” when something unfortunate has happened to a client. Even though sorry isn’t exactly the right word, that’s so culturally established that if you don’t say it, the moment will be really weird, and that moment is also usually moment when you need to NOT be weird, and really be attentive and present, and not explaining weird cultural, linguistic idiosyncrasies.
      • Go ahead and apologize if your administrative staff, office management/maintenance people, etc. have done something unpleasant or insensitive. The client often sort of sees them as an extension of you.

 

  • Apologize WELL.
    • No beating around the bush, be specific and own it.
      • “I’m sorry for getting distracted just then.” “I’m sorry for not listening well.” “I’m sorry for running late today.”
    • No passive aggression. Avoid giving your “reasons,” unless you’re sure they’re really reasons (not excuses) and they’re actually important to the process. In that case, be specific.
      • NO: “I’m sorry for getting distracted just then. I have a lot going on personally right now.”
      • YES: “I’m sorry for getting distracted just then. What happened was that what you said really struck a chord with me around grief, and I’m wondering now if or how grief is playing a role for you?”

 

  • Follow up.
    • They’re likely to say something like “oh, no worries” or “it doesn’t matter.” So, follow up on that with something like “thanks for you patience” or “you do matter to me, so I just wanted to let you know.”
    • Add what you’re planning to DO about it.
      • “You have my full attention now.” “Can we go back and you can describe it to me again so that I can understand better?” “I’m going to make sure I adjust your fee for the missed time today.”
      • Oh, and then DO that.

 

Comment with your own “rules” for apologizing, or a time when you have used the therapeutic apology and it’s been important.