Writings/Blog

A House United

I have been investigating “state model” or “parts of self” theories of personality. According to these theories, the different parts or “states of mind” that make up who we are have their own personal memory systems. These parts expand from our very earliest infant states and grow up mostly together, if we’re lucky, or fragmented, if our earliest “true self” expressions are discouraged and stymied. It’s as if our inner children had been forced to grow up in different parts of the house.

Parts can for example, be social personae, defenses, emotionally isolated or disavowed and can be triggered by context. The more rigid they are, and less they flow, the more problematic. So, what are some ways we can get these parts into harmony? To possibly bridge the gap between them, so that they flow, or transition more easily?

The great clinician Carl Rogers’ focus was to unite the self into a harmony he called “congruence”. Rogers and his Humanistic approach to therapy begins from the point of view that the patient has a “true” self. This self is expressed organically with a felt sense of congruence that arises when what we think, say and do mostly align with each other.

Carl Rogers c. 1964 in the famous “Gloria” sessions. Wouldn’t you like him as a therapist?

This is quite different from saying something in one state of mind, and doing the polar opposite in another. This dynamic of parts can result in perplexing actions or hypocrisy. Since they sometimes seem to have a mind of their own, we might not trust ourselves, or be ashamed of certain “bad” parts when they are triggered and express themselves.

This what we want to get a handle on in therapy, for the patient to know and experience all their states consciously and fully; to be able to trust themselves.

Carl Rogers began with relationship. In fact, Rogers was the among the first major clinicians to emphasize the human relationship element of therapy as the most healing factor.

Rogers would begin with what he termed “unconditional positive regard”. While it appears this statement describes a Buddha-like radical acceptance, it really means that the therapist is present with the patient and attempts to immerse herself into the patient’s subjective experience with responsiveness, restatement, and clarification. This means that the therapist does not try to educate the patient or modify his behavior, rather it means that the therapist and patient engage in dialog to collaborate in articulating the patient’s feelings and thoughts as they unfold during the therapy hour.

Some parts are more acceptable to the patient than others. But the fact is, all of them exist within the patient. Roger’s therapeutic method gives the acceptance for each part to express itself fully, as it arises, and even the more distrusting parts come to see the consistency and acceptance of the therapist, who herself behaves in a congruent manner.

Through the therapist’s empathetic listening and mirroring – reiterating and exploring what the patient says until the patient has the felt experience of being understood – all parts that can express what was held back and defended against, and the social personae can let down their masks and become more genuine.

As all parts grow, they feel increasingly confident to join the group; become integrated. The patient gradually feels more “real” and less fearful of retribution and ashamed by the expression of a “bad” part. This integration mirrors Roger’s “congruence”, in which the states flow naturally and smoothly the entire self can think, feel and act as a whole. As therapy progresses,  all the members of the family are increasingly able to sit down together and appreciate each other’s conversation in harmony.

 

 

 

 

 

 

Hypocrisy and our “Parts”

An embarrassing confession. I stick to a perfect diet, until I don’t! I am proud of the fact that I avoid certain foods, and I often say in a restaurant, “no thanks, I don’t want dessert, I don’t eat sugar”, while giving a look of righteous judgment to my dinner partner. Yet, before I know it, another part of me is triggered, and I’m helping myself to “just a bit” of their delicious chocolate mousse cake. Then I rationalize it, “well, I don’t want to be a killjoy…and you can’t always be too strict!”

We see hypocrisy as a character flaw. In our minds, it’s a willingness to appear morally virtuous, while being able to do what the hell you want. “Do as I say, not as I do”, the old saying goes. We assume a conscious self interest, of “having your cake and eating it too”.

Yet science may have a different explanation.

There is an interesting concept in psychology that is so cool, I have a hard time wrapping my mind around it. It is called “State Dependent Learning and Memory” (SDLM) This means something like, what you remember in one state of mind, you may not in another. Remembering something works best when you are in the same state as when you learned it. For example, you may determine you are going into the living room to get, say, your glasses, but once you are in there, be at a complete loss as to what you went in there for. You go back outside, and of course, you remember the keys! The change of venue triggers a different “state”.

Multiple-Personality-Disorder

So what does this have to do with hypocrisy?

Many people, in fact most of us, seem to have different “parts”. We could characterize this parts as, for example, a serious side, being flirtatious, fear of strangers, loving humanity, or dark thoughts. Sometimes, we need to be in a “mode”, to navigate the demands of society: professional, wife, friend, mother.

Typically, most of us can transition from one “self” to the other with relative ease, as there is a uniting memory of “self” undergirding our personality. But, thanks in part to SDLM, we can also can compartmentalize our parts, so that they seem to run on different memory systems. What we perceive to be negative parts of ourselves (often that are quite entrenched) that hold painful memories (such as traumatized parts), that we are ashamed of (such as phobic parts), or parts that cope with negative emotion (such as addicted parts) can more easily be disavowed and “dis-remembered”.

In these cases, SDLM can make our awareness of our inconsistencies “fuzzy”, so that we may feel perfectly righteous about our philosophy of high value characterizing one part of ourselves; one of our mental states, and then go ahead and completely violate that value in another state. That is the essence of hypocrisy. When we perhaps rail against some vice, be it substance related, sex oriented, or inclined towards a negative personality trait, such as judgement of others appearance.

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Once someone makes us aware our inconsistencies, we often deal with our bafflement, then shame with some type of rationalization. It’s an awful lot easier than the scary realization that we don’t really know ourselves that well! Take my “sugar” self. My dietary rigor is a fairly new “part”, and one that I have been able to sustain with relative success and with pride. However, there’s another part of me that’s been around a lot longer – the one that is a kid, that loves the dopamine rush of that delicious, velvety chocolate! That part can usurp my “good” part before I even know what happened.

As I am inclined, I will direct this back to the spiritual realm, with a quote from local trauma expert, Dr. Frank W. Putnam, whose book The Way We Are – How States of Mind Influence our Identities, Personality and Potential for Change (2016) I am getting some of this inspiration to write about our “parts”:

“We are all prime to this process to a greater or lesser extent. It is the rare person who can achieve the psychological distance work which to carefully examine the contradictions in his or her behavior. Indeed, it is just such a dispassionate self-awareness and self-reflective equanimity that is sought in the quest to achieve a state of spiritual enlightenment”

So perhaps it is only the enlightened soul who is never hypocritical!

 

Sugar – Obesity, Addiction, Depression

“…the war on drugs has taken a back seat, but not because it has been won. Rather, because a different war has cluttered the headlines — the war on obesity. And a substance even more insidious, I would argue, has supplanted cocaine and heroin. The object of our current affliction is sugar.” – Robert Lustig

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Remember a few years ago when high fructose corn syrup (HFCS) was implicated in childhood obesity? That was the research of neuroendocrinologist Robert Lustig. As described in his book Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease (2013), added sugar was implicated in not only obesity, but metabolic syndrome which can include any or all: obesity, high blood pressure, diabetes, and heart disease. Why?

Too much sugar causes a surge in insulin. Insulin blocks the effect of leptin, the hormone that signals that you have had enough to eat. This leads to obesity, which is linked to a host of other diseases.

Now Lustig is back on the scene with a new book, The Hacking of the American Mind: The Science Behind the Corporate Takover of our Brains and Bodies, which proposes another more sinister effect of sugar: depression. Sweet is evolutionarily delightful; it gives us pleasure. Excess sugar consumption floods the brain with dopamine, the pleasure neurotransmitter. And similarly (for our purposes) as insulin blocks the benefits of leptin, so does dopamine block serotonin, the contentment neurotransmitter.

Therefore, sugar behaves simarlarly as all substances of abuse – it is addictive. It fuels short-term pleasure, while dampening a long-term sense of well-being. Without the substance, and with lowered serotonin, in absence of the drug of choice, the world is grey and depressing. Another “fix” of pleasure can temporarily increase positive emotion. With decreased seratonin, only a rush of dopamine can take an addict out of the colorless funk that invariably occurs when the substance is not longer in the body.

The FDA, the USDA don’t adequately acknowledge the extent of the ill effects of sugar. And why should they? Legislators are often unduly influenced by big money; in this case the Sugar Association’s powerful lobby. Sound like a conspiracy? Well, maybe it is. That very same lobby paid off Harvard researchers decades ago to point the finger toward fat rather than sugar as the key to the dietary cause of heart disease.

This unfortunate influence yields to this day an OK from the FDA of a carbohydrate-heavy food pyramid, and still little acknowledgment that sugar is the enemy. Therefore, it is very difficult to persuade people to believe that sugar is really that harmful.

But it certainly can be, especially in excess. And it is correlated with depression, and as a therapist, I say that is bad news.

To be continued….

Yanni and Laurel, The Romance that Will Improve Therapy (and may save the world…)

I make no bones about the fact that I am a huge fan of Jonathan Haidt, the moral psychologist who is now tenured at NYU in the business school to help improve ethics in business.

Therefore, I would like to take this topic up again in light of a new romance that I am following on the web – The Romance of Yanni and Laurel.

For those of you who don’t know of this blossoming love story, I deposit here a video for your consideration. Please look at the video before you read any further.

OK, now take a moment to think about what this means. What did you hear? Did you hear Yanni? Laurel? You will only hear one.

As a therapist, It’s my duty to understand the world through a patient’s subjective experience, to the best of my ability. That means, I must begin treatment by accepting the way they see the world, even if this view is causing them suffering, which it often is. It also means I must understand their belief systems, to the best of my ability, whether moral, religious, political, sexual or otherwise.

This is one of the reasons I love why Jonathan Haidt. A meticulous scientist, he devoted years to his “Moral Foundations Theory”.  Haidt, in The Righteous Mind (2012) demonstrates that human morality is based on these five foundations: Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, and Sanctity/Degradation. Here it is in a Ted Talk, where Haidt explains the concept:

What Haidt discovered is that the moral systems of people with different political and temperamental inclinations vary. This theory states that, the more left of the spectrum one is inclined, the more the moral domains of Care and Fairness dominate a person’s moral system. The more to the right, the more Loyalty, Authority and Sanctity. Towards the center and on the center right, all 5 domains are distributed more or less equally.

This means that good people can see the world through entirely different moral lends. This also means that the other side might seem, unfortunately, to possess an inferior morality.

When I met the seperate singles, Yanni and Laurel, my first thought gravitated to Haidt in that if we are ensconced in a moral system, whatever that may be, that is the filter through which we understand the world. And these filters can be entirely different, yet what we perceive through these filters is what we absolutely believe to be true. We either hear Yanni or Laurel.

So, now we see that people have different moral systems. Each thinks they are moral beings and the other, as demonstrated by our divided world, less moral, or even immoral. You hear Yanni or you hear Laurel, and ne’er the twain shall meet. Or shall they? Two lovers passing like ships in the night. What can bring them into the daylight so they can see each other?

Ok, now take what you thought you were hearing and decide to hear the opposite. If you hear Yanni, try to hear Laurel. Keep trying. Leave the computer and go back. It took me about 30 times. Come on, make an effort! Keep doing it until…Aha! You heard Laurel!

If you make a decision to look at the world through a different filter, suddenly your subjective reality changes. Suddenly, you hear things in a different way, as someone else does.

So, here’s the amazing thing. Once you train yourself to hear the other name, you will be able to cycle back and forth at will. You can hear both sides of the story!

Now, you try to imagine what it is like to be in the opposite moral system? If you are more liberal, try to imagine valuing Loyalty as much as Fairness? Or, if you are on the right side of the spectrum, on the other side, valuing Fairness as much as Sanctity? Try it. Take some time. It will be worth it. Do the same exercise with envisioning an alternate moral system. Practice until it feels real. Honing this skill allows you to see the world in your way and your opposite’s way at will.

Doesn’t mean you have to change, but this exercise may yield some insight. Can you imagine how healing it would be to understand the experience of your “opponent”? To see the world through their eyes?

Sometimes a therapist sitting with a patient and hearing Yanni when the patient is saying Laurel takes some time to reconcile. Dedication to this task makes for good therapy.

Dedication to the task of envisioning another person’s moral system might heal our divide.

Now, let’s play matchmaker!!

 

Postscript:

If you need to practice, here is an easier one to get you started:

Shame, Guilt and Self Loathing.

Shame. We all know what it feels like. That devastating moment when you realize somehow you’ve crossed the line from “good person” to “bad person”. At least, with that visceral feeling of a knife in your heart, that is certainly what it seems.

Shame is contingent on a desire to belong. When we do or say something that causes a breach in our relationships with others. Sociologically speaking, we fear being ousted from society. Evolutionarily speaking, this shame is hardwired to keep us alive by restricting our behavior to fall within the parameters of what has evolved as best for the tribe.

But let’s look at shame. There are two kinds. One is the shame of knowing you have harmed someone, inadvertently or worse, purposely – through anger or resentment. The other is the shame you feel about your self; that something is essentially wrong with you.

The first kind of shame is useful, it tells us when we have betrayed the social contract. We could call this guilt.The second kind is not useful. It is based on early patterns that carry over into adulthood. It manifests in self-loathing. We could call this a maladaptive defense.

The good news is, both have a remedy. The remedy for the first is simple, make amends. The remedy for the second is not so simple. It will require a psychological and, for some people, spiritual intervention.

Naturally, since I am a therapist, I will focus more on the second, but I want to say something about the first before I go there, as there are certainly psychological difficulties implied by “making amends” as well. While the solution of making amends, of apologizing, of mending a relationship rupture as an antidote to guilt is self evident, it can be challenging. This is a time where we must take a good look at our action, assess it, and determine the best course of action to repair the damage.

Logically, your thoughtless action is not you. You must use your higher self, your “observer” to separate your self from the action in order to chart the best course of repair. Look at the action itself. How can you remedy it? Did you call someone “stupid” in the heat of an argument? Your apology might be: “I’m sorry, I was just so overcome with anger that I misspoke. I don’t think you’re stupid, I have respect for you, and I was wrong to say what I said. I hope you will accept my apology, and I value you as a person”

That sounds easy enough. And it should be. And it is an excellent mindful practice to make it a point to do so. It’s obvious to most of us that discrete, often momentary actions do not necessarily define us.

However, let’s look at this situation from the standpoint of self-loathing; an attribute many of us may possess, to varying degrees. For some reason, even though we know our bad action is separate from who we really are, it certainly doesn’t feel that way. Why? What happens when, even after we apologize, we go home and ruminate over what we did and how bad we are, even with the offended party might have accepted the apology and may never even think about it again?

The answer to this can be complicated, and of course will vary greatly from person to person. What happens essentially, is a misstep triggers inherent shame about oneself. This is a deep shame whose roots may be very early. This is the shame of self-attack and self-loathing.

So how does this kind of shame develop?

We are hardwired to attach to our parents/caregivers. This is so critical a truth that there is not even any reason for me to provide evidence. We know this. Therefore, a small child will do anything and everything to maintain that bond. Optimally, this bond is reciprocal. The parent and child are attuned, and each bonds to the other as the relationship develops and thrives.

Of course, the real situation is not always optimal. Parents are subject to all manner of stressors, problems, mental health issues. At the far end of the spectrum, some parents are downright abusive, and some worse than that….

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From these sub-optimal parenting situations come varying degrees that the child must hide, as D.W. Winnicott phrased it, her “true self”. This natural and authentic expression of the child’s selfhood often gets the message that some or all of it must go into hiding in order to appease or please the parent. These early mechanisms to hide or stifle are formed with the inchoate worldview of a child, who can only determine, by her parent’s rejection, that she is bad and the parent is good.

So where does shame come in? Again, shame is an evolutionarily hard-wired behavior inhibitor. Give a child the message often enough, and a pattern develops where the shame shuts down the true expression of self. As the child grows, these early patterns of stifling the true self remain embedded as patterns of relating. This maladaptive defense continues to serve to keep relationships intact.

Trauma expert Dr Janina Fisher sees the young shamed self as a separate entity that “hijacks” the adult with shame when triggered by something in the adult relationship that reminds us, consciously or unconsciously, of that early bond rupture.

In the adult, this shame that once served a valuable purpose to the child carries on in the adult as self-loathing as in, “I am bad for my tendency to upset others”. This self-loathing in turn contributes to depression, anxiety and other psychological problems.

The remedy for this is therapy. In psychodynamic therapy, we go back to these early parts and unravel their pull on the adult, often by exploring unconscious expressions, so that they can be resolved and integrated. Using Fisher’s parts work as a tool, we open a dialog with the younger parts, and in doing so, become more acquainted with the part of the “true self” that the child had to hide.

How long will this take? I wish I could say. Often, resolution is rapid…but this work, especially in the case of significant childhood trauma, can be ongoing. However, clients frequently find that even discovering the origin of this self-loathing shame is freeing and hopeful. This kind of insight can release that shame from being tied so tightly to sense of self.

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Spiritual intervention can be a useful tool as well. For people who are inclined to be spiritual; who have contact with their, as Frankl puts it, “Noetic” dimension, spirituality can help ease the burden of self-loathing.

Inherent in most spiritual practices is a sense of unity with something larger, which puts us in connection with a Goodness that we are part. And, if we are part of that, how innately bad can we really be?

Also, spiritual practices encourages mindfulness and contemplation. The practice of mindfulness strengthens our “observer”, so we can indeed learn to separate our self from the triggering situation, which is why it is an integral aspect of Fisher’s work.

Guilt, shame, and self-loathing – indeed they are painful. But the pain of these very human states, when they emerge, are a call to action – whether it be making amends, or the deep work of resolving maladaptive defenses. Thankfully, we have the tools to, if not resolve them, to ease the burden in which they influence our lives, and in doing the work in therapy, discover how much more of our “true selves” we really possess available to relate to others and feel comfortable in our own skin.

Tao de Ching #10 – Use the Emptiness

We join spokes together in a wheel,
but it is the center hole
that makes the wagon move.
We shape clay into a pot,
but it is the emptiness inside that holds whatever we want.
We hammer wood for a house, but it is the inner space
that makes it livable.
We work with being,
but non-being is what we use.

 

What is Tao is the void. It can be “used any way you want”. So with emptiness, to contain it properly, as enclosed by the shape of a bowl, is to find it’s optimal use. That is somewhat of the nature of Tao – how can it be used well, not wastefully. It is always present and always has been. We cannot relate to the universe without it, as it is the silent “way” that we connect. We can connect badly, with force, and in this way Tao is elusive. We get what we want, but lose and waste much and by obtaining what we want in this way, many lose ends remain. Tao is never too much, never too little. To work with Tao, to to some extent, let things happen and act on what happens rather than the reverse – this increases fluidity and decreases resistance.

Transforming Psychic Pain and Isolation through Transcendence and Connection

There is something about the notion of spiritual transformation in psychotherapy that really appeals to me, and I think this is partially based on my respect for the work of one man in particular – William James. James is considered the father of psychology, and his best known work – Varieties of Religious Experience – extracted from a series of lectures over 100 years ago (1911), is still a classic.

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Throughout the book is the ongoing theme of spiritual transformation, or to put it more concretely, a change, sudden or gradual, in the way we relate to the entirety of our being. In terms of spiritual transformation, this can mean feeling closer to God, or more connected to the Universe – but optimally for the purposes of therapy – to humanity. Ultimately, spiritual transformation allows a person to connect with some universal truth, and the essence of themselves that remains pure despite misfortune, trauma, depression etc.

Detriments to therapeutic progress can often be characterized as a feeling of isolation from or inferiority to others. But in terms of our collective humanity, this doesn’t make sense. We are all in this together. We know this, but this knowledge does not change what someone who is suffering from depression and anxiety actually feels. To feel a sense of separateness from others can be both a symptom and a cause of psychic distress.

What if we were able to see beyond that, to the truth of our connectedness? This may require some kind of transformation in our worldview. However, to have some insight into the totality of being can be a powerful experience. But how can this be achieved? I have a few ideas based on experience and on research that might be helpful.

 

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Meditation is often regarded as the most accessible way to achieve this connection. Not only does this put us in touch with the spiritual dimension through contemplation and silence, but  importantly, ongoing practice increases grey matter in the prefrontal cortex, the part of the brain that maneuvers social relationships, in terms of decreasing fear responses and increasing connectedness.

 

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Ritualistic practice of other sorts have always been prescribed for the existential issue of mortality, limitation and misfortune. Even if one is not religious – and by no means does one have to be to have a spiritual practice – the ritual of practicing being connected to something greater can the “true self” at the core of us all. Practicing a ritual, whether within the context of organized religion or more secular forms of practice such as yoga, meditation, being in nature, a regular volunteer gig, or other personal rituals can be invaluable in providing the sort of connection to transcendence that allows us to see a way beyond our material and psychological limitations.

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Read the spiritual masters. There is a plethora of spiritual and transformational literature out there to help you make sense of things.  Go for the classics, and use YouTube to help you along. Some of my personal favorites: Buddhist Dharma, the Bible, Carl Jung – Modern Man in Search of A Soul, Plato, of course William James – Varieties of Religious Experience. Two fantastic books that really get to the bottom of it: Viktor Frankl – Man’s Search for Meaning and the great Tao de Ching, of which I am slowly blogging away. These books contain wisdom for the ages, and in the case of some of the ancient texts, the collective wisdom of generations.

 

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While still somewhat controversial and of course illegal, the use of hallucinogens to achieve this is not a method that should be disregarded. James himself reported powerful feelings of connectedness through his own experimentation. The MAPS (Multidisciplinary Association for Psychedelic Studies) has taken the transcendental hallucinatory experience seriously for therapy of substance abuse, PTSD and depression. In the throes of a hallucinogenic state, many report connecting to the totality of being and can emerge from the experience with a new sense of connection and of feeling that one’s place in the universe is solid and that one’s being is valuable. MAPS ongoing research that continues to yield promising results will likely change the illegal status of certain substances in the near future.

 

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Above is the great Carl Rogers, whose method was to cultivate “congruence” – to enable us to line up what we really are with what we feel we are and how we act.

Last, but far from least, transcendence is something that can be accomplished through therapy, no doubt – and as a therapist I truly believe this. Therapy itself, through connecting with an attuned and welcoming therapist allows a patient to explore themselves and their totality with encouragement and without judgment of their “true selves”. Ongoing exposure to the therapeutic relationship in which one discovers and gives voice to parts of the self that were stunted through a variety of developmental and environmental factors are allowed to blossom, and old defenses that are not longer needed can diminish and can cease “hijacking” the patient. As the “true self” strengthens, so does the capacity to tolerate others flaws and to empathize, and ultimately feel connected.