The Trauma of Being Alive

In a recent New York Times editorial, Mark Epstein talks about a personal conversation with his mother, over four years after his father died from a brain tumor. As he points out, our grief doesn’t immediately go away. And sometimes, it doesn’t ever go away. It doesn’t hurt less. It just hurts less often.

Epstein’s approach to suffering, grief, and therapy is influenced heavily by his Buddhist practice, and he highlights the fact that suffering and potential suffering are universal human experiences. “There is no way to be alive without being conscious of the potential for disaster… Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific achievement, outside our ability to control it.”

One of the most important tasks of human existence is our ability to make meaning from suffering, and to come to terms with the reality that things end, break, hurt, and disappoint us. Learning to face these realities with hope and courage gives us the capacity for joy.

In 1968, Kent Keith wrote the Paradoxical Commandments as part of a booklet for student leaders at Harvard. The Paradoxical Commandments acknowledged the reality of risk and loss, but encourage us to “do it anyway” despite the unpredictability and turbulence of our lives.

People are illogical, unreasonable, and self-centered.
Love them anyway.

If you do good, people will accuse you of selfish ulterior motives.
Do good anyway.

If you are successful, you will win false friends and true enemies.
Succeed anyway.

The good you do today will be forgotten tomorrow.
Do good anyway.

Honesty and frankness make you vulnerable.
Be honest and frank anyway.

The biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds.
Think big anyway.

People favor underdogs but follow only top dogs.
Fight for a few underdogs anyway.

What you spend years building may be destroyed overnight.
Build anyway.

People really need help but may attack you if you do help them.
Help people anyway.

Give the world the best you have and you’ll get kicked in the teeth.
Give the world the best you have anyway.

Confidence and Humility

“We have to keep looking both ways to remain humble and confident, humorous and serious, playful and responsible.”
– Henri Nouwen

Henri Nouwen was the unofficial patron saint of my graduate program at Wheaton College. His deep affirming love for humanity and his honesty about his own struggles to live a faithful life made him a key figure whose influence continued after his death in 1996. Through his writings, I have been challenged to accept the paradox of my humanity as a wounded healer.

Too much humility results in self-assassination. Too much confidence leads to foolishness and hubris.

Humility puts a check on our stubborn pride and opens us up to new experiences. Confidence allows us to take risks that promote our growth.

Soren Kierkegaard once described two kinds of despair that lead to existential anxiety. The first is wanting in despair not to be oneself. The second is wanting in despair to be oneself. Both kinds of despair lead to fear, doubt, shame, and guilt. Kierkegaard’s antidote to this despair, which he called “the sickness unto death,” is for the self to “rest transparently in the power that established it.”

Humility and confidence make way for a kind of radical self-acceptance that allows us to acknowledge the truth of who we are, but also to outlive our life and become more fully ourselves.

Christian teaching affirms that human beings carry the spark of divinity, but at the same time are prone to death and disease. Part of the process of therapy is restoring the balance to rediscover our infinite worth and our finite existence. As the old creation myth in Genesis teaches, we are made from dust, but we’re brought to life by the very breath of God. We might be dirt, but we’re inspired dirt.

What is an emotion?

As an emotionally-focused therapist, I spend a lot of time thinking about the complex nature of human emotions and the way they work. I was delighted to see that a recent issue of Psychotherapy Networker magazine was dedicated to understanding emotions and how they factor into the therapy process. Susan Johnson, a pioneer in emotionally-focused couples therapy, wrote an article on “The Power of Emotion in Therapy” which brought together insights from her couples work and research by cognitive neuroscientists who have studied the brain and how emotions work in our central nervous system.

It’s not easy to explain what an emotion is. Part of that stems from the fact that emotions are whole-person experiences. Part of it also comes from the fact that we have emotional responses to so many different stimuli – both external and internal. Looking at the literature on emotions, we see some of the following ideas expressed:

Feelings… nothing more than feelings

This approach to understanding emotions stems from the fact that our emotions are so fickle, unreliable, and illogical. In this view, emotions are just feelings and something to be avoided. We shouldn’t make important decisions based on emotions, since they are always changing and often misleading. Emotions, in this view, change like the tides and we shouldn’t pay attention to them. We need logic to overcome our emotions and help us to make objective, rational decisions based on facts, not feelings.

A universal sign language

In this view, supported by anthropologists and popularized by the work of Paul Ekman, emotions are a universal means of nonverbal communication that has developed through human evolution. We can understand what a person’s emotions are by observing his facial expressions, measuring his vital signs, and checking his eye contact. This is a powerful view that is echoed by Susan Johnson and other emotionally-focused therapists, and it’s useful in understanding the power of nonverbal communication. It isn’t what we say. It’s what we express emotionally that matters. And as we are learning in the study of mirror neurons, human beings are exquisitely capable of paying attention to the emotions of others and pick up on these emotions in an unconscious way.

A motivational response to stimuli

In this view of emotions, an emotion is a physiological response that prepares us to act. In the classic example, when we see a snake, we might immediately and reflexively respond with fear. Fear triggers our limbic system, causing an automatic flood of neurotransmitters that activate our sympathetic nervous system. The sympathetic nervous system response increases heart rate, opens blood vessels, and causes our pupils to dilate. The body’s “fight or flight” system is in gear as muscles clench and we are ready to move. Moments later, we realize that the snake is a non-poisonous garden snake and our parasympathetic nervous system sends out an “All Clear” signal, telling us it’s safe to rest.

Nico Frijda and others have studied extensively the motivational component of emotions. Anger, fear, disgust, surprise, and other emotions have a motivational component, and understanding how these emotions get us ready for action can help us to pay attention to the messages they’re transmitting through our bodies and minds. Once you understand the message, you can evaluate whether you need to react or not.

All of these views of emotion are reductionistic in one way or another. The “nothing more than feelings” view suggests that emotions are divorced from reason and logic. Much of neuroscientific research focuses on the evolutionary value of emotions to help us survive. In these views, emotions are pre-rational and pre-cognitive.

Thoughts and emotions

Adding thoughts to the equation increases the complexity of understanding emotions. The fact is that emotions aren’t just feelings or motivations. We have thoughts about feelings, and create a snap judgment about what the feelings mean. For example, if my stomach hurts and I feel tension in my lower back, I might be feeling indigestion. On the other hand, I might be feeling anxious about the presentation I’m about to give. How are we to know what is really going on? We begin to tell ourselves stories about the feelings and motivations.

Part of what makes therapy work is the fact that we are able to talk ourselves into and out of emotional states. Our reasoning can help us make sense of the feelings and emotions, analyzing where they’ve come from and whether or not they are useful. Depending on the stories we tell ourselves about the world, our relationships, and ourselves, we are set up to feel certain emotional states more readily. Our beliefs affect our emotions and prepare us to feel certain emotions more readily. For instance, if our core belief is, “The world is an unsafe place and you cannot trust anyone,” it is likely that we will be more ready to feel fear and anger because we have already prepared ourselves to be threatened.

Emotions and core values

Emotions are affected by our core values. We don’t get emotional about things unless we feel some concern about them. We get emotional about things that are relevant to our goals. As Mark Twain said about getting older, “Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” If, on the other hand, we are worried about items that haven’t been checked off our bucket list, or we feel that we’re being cheated by mortality, we are going to mind a great deal.

Theorists like Anthony Demasio have made a distinction between “basic” or “primary” emotions (the six basic emotions are fear, anger, disgust, surprise, happiness, and sadness) and secondary emotions such as shame. The fact that we can have emotions about our emotions points to the complexity. Secondary emotions, in Demasio’s view, are highly individualized based on our life experiences. They are not innate and they are affected by the culture, our religious and moral beliefs, and our families.

Emotions help us learn. The positive and negative feelings associated with emotions help us to learn what is desirable and undesirable, safe and unsafe. Emotions help us make decisions quickly, and when we learn to trust our feelings, we generally make better decisions. At the same time, because emotions bias our thinking, our judgment can be skewed. And since our thinking affects our emotions, it is easy to create a self-fulfilling prophecy that keeps us stuck.

Understanding emotions helps us understand ourselves deeply. Learning to pay attention to our primary emotions, and to the messages that they are giving us, can help us make wise decisions. And when we identify where we learned to feel secondary emotions (and the judgments and core beliefs that drive those emotions), we regain some of our freedom, confidence, and clarity. We begin to realize that we have choices and that we don’t have to be victims of our emotions. We can choose to think, feel, and act differently.

A Poem for Independence Day

The Journey

Mary Oliver

One day you finally knew
what you had to do, and begun,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late enough,
and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.

Facing Challenges Is How We Grow

In 1990, Mihaly Csikszentmihalyi of the University of Chicago wrote Flow: The Psychology of Optimal Experience. The book provides a phenomenology of optimal experience and happiness based on research and interviews with individuals who had found great happiness and fulfillment, sometimes in spite of extraordinary challenges.

The book is a result of over 25 years of research and reflection by a leading psychologist (and he hasn’t stopped there!), and it’s based on a simple discovery:

Happiness is not something that happens. It is not the result of good fortune or random chance. It is not something that money can buy or power command. It does not depend on outside events, but, rather, on how we interpret them. Happiness, in fact, is a condition that must be prepared for, cultivated, and defended privately by each person.

The key insight of the book is that happiness is more than simply the passive experience of pleasurable sensations. The feeling of optimal experience, or flow, is derived from achieving mastery over our own experiences as we face increasingly complex challenges. There must be the proper balance of challenges and resources to meet those challenges. When our attention is focused by our intentions, and we move toward unique solutions to life’s problems, we grow. Overcoming these challenges leads to a feeling of confidence, a loss of self-consciousness, and a deep focus that makes us feel connected to ourselves, the world, and others.

If only there was a way for us to run a program, like in the movie, The Matrix, to create this sense of calm and focus!

The avoidance of pain and risk inhibits our growth. This is not to say that we actively seek out painful or high-risk situations. But as we maintain our focus on achieving self-mastery in the midst of life’s challenges, we develop habits of character (courage, patience, persistence, confidence, calm, creativity) that open us up to new experiences and create a deep sense of fulfillment.

Csikszentmihalyi notes that flow experiences are autotelic: that is to say, they are good in themselves and do not have some future goal or benefit in mind. That’s not to say that every flow experience is sought out initially. Sometimes, we discover flow in the midst of activities that we were forced to do.

As a child, my parents made me take piano lessons. I didn’t always enjoy the discipline of practicing for a half-hour each day, particularly when the passive activity of watching television seemed so much more enjoyable at the time. Nevertheless, as an adult, I find that playing music is one of my greatest delights.

We don’t get to choose the hand that life has dealt us. We do, however, get to choose the ways we will respond to the challenges and setbacks of life. We can, as the apostle Paul said, “find the secret of being content no matter the circumstances, whether well-fed or hungry, whether living in plenty or in want” (Philippians 4:12-13). In fact, there is research that suggests that hormones that make us feel hungry also relieve stress.

We don’t need to fulfill every desire in order to be happy. It is true that optimal experience occurs when we have clear goals, a likelihood of completing the task, and a sense of control over our actions and decisions. But the joy of flow is not simply in the completion of the task. We experience flow in the midst of the struggle.

Happy people find enjoyment through facing and overcoming challenges. That simple attitude is the difference between happiness and misery.

A Word on Impermanence

This TED talk by Julian Baggini is a wonderful discussion about how we think of ourselves, and how our beliefs can affect our openness to change.

Baggini, who is author of the book, The Ego Trick, notes that Western philosophy has traditionally thought of “the real you” in terms of some core essence that is permanent and unchanging. People who follow horoscopes or use trait psychology to define personality adhere to this view. We like to be diagnosed because it feels good to have an authority who tells us the truth about who we are, what’s wrong, and how to make it right. The experience of going to therapy is powerful and affirming because a licensed, trained specialist provides some clarity for you about what it takes to be made well.

But Baggini argues that maybe our memories, desires, temptations, and sensations exist only in the moment. It is the task of thinking to tell us, “This is me” and, “This is not me.” We develop a narrative about ourselves that defines us.

It’s the shift between thinking of yourself as a thing which has all the experiences of life, and thinking of yourself as simply that collection of all the experiences of life. You are the sum of your parts.

There is something therapeutic about the ability to reinvent yourself. Your past is part of who you are, but your past doesn’t have to define you. The future can be different. And no matter how intolerable the present moment might be, the pain of the moment will pass.

The challenge of growth is deciding which experiences and desires we will accept and remember, and which ones we will reject and forget. We frequently experience anxiety, anger, and frustration about our lack of control as circumstances change. It is easy to forget that we are not simply victims of our experiences, but active participants in the process of paying attention.

Gooseberry Falls Minnesota

Baggini’s metaphor is that the self is like a waterfall. The water flowing over the waterfall is the collection of experiences, desires, and sensations from moment to moment. But there is also a channel that allows the water to flow, and as the water flows over the channel, the water gradually changes the channel through erosion and motion.

The constant flow of experiences, desires, and sensations can occasionally be overwhelming for us. At the same time, there is some comfort in knowing that these experiences are affecting who we are. We have some choice about what we choose to hold onto, and where we pay attention in the moment. We can fear the loss of our selves, or we can welcome the changes as they happen.

Do you want to get well?

When Jesus saw him lying there and learned that he had been in this condition for a long time, he asked him, “Do you want to get well?” – John 5:6

This has to be one of my favorite Bible stories of all. Jesus sees a man who has been paralyzed for nearly 40 years, sitting by a healing pool, and asks the man what appears to be a really stupid question. But when the man replies by lamenting his victimhood (“I have no one to help me!”), Jesus says, “Go, take up your mat and walk.” And that is when the miracle happens.

I’ve been in discussions with a number of professional people helpers, policymakers, and others who have a keen interest in seeing a return on investment for efforts to provide healing and hope to hurting people. In my work with the Lazarus Project, we are currently in serious discussions about outcome research, measures of success, and quantifiable results. In my work with Safe Haven Family Shelter, we are in the midst of major discussions about ways to end family homelessness and empower families in poverty to achieve lasting self-sufficiency. In my work with family members who could be identified as “codependent” in one way or another, it is a constant struggle to determine how to help a relationship where someone doesn’t seem ready to get well.

I don’t want to reach any psychological conclusions from the Bible story in John’s gospel, but I do find it encouraging to see how Jesus the healer asks the motivational question, ignores the victim stance, and invites his “patient” to make a move toward hope and wellness. The miracle happens when the paralyzed man takes the risk and makes his move.

No matter what the paralysis is in your life, and no matter how long it has been, it’s not too late for a new beginning.

Pool at Bethesda
Photo: Christ Healing at the Pool of Bethesda, Carl Bloch, 1883

NPR: Depression is More Than a Serotonin Imbalance

I was very pleased to see this article from NPR over the past week, because it highlights something I’ve been saying for about 20 years regarding depression and mood disorders.

Here’s a quote from Alan Fraser at the UT-San Antonio School of Pharmacology:

I don’t think there’s any convincing body of data that anybody has ever found that depression is associated to a significant extent with a loss of serotonin.

The thing about SSRIs (Selective Serotonin Reuptake Inhibitors) like Prozac and Zoloft is that they do seem to have some positive impact when it comes to treating depressed mood. I explain to my clients that these SSRIs are a bit like a lifejacket. On the one hand, these medications help to buoy up your mood and allow you to float on top of the turbulent seas of depression. On the other hand, the medications can often feel like a hindrance or impediment when it comes to moving forward in the ways you might need to get out of the situation. It’s hard to swim while you’re wearing a lifejacket. But you’re a lot less likely to drown if you have one.

As the NPR story explains, one reason why drugs like Prozac have such a pull on our imagination is that we want to help people understand that depression is a type of sickness, and that medication can help treat the symptoms of that sickness. Because serotonin is your body’s “Mission Accomplished” neurochemical, having more serotonin in your system gives you a greater sense of peace and calm. But there is more to depression than simply feeling uneasy. Lack of pleasure (anhedonia) is another hallmark symptom of depression and makes it more difficult for those in its grip to shake themselves free. “Nothing tastes good” is a common complaint from people who are in the midst of a depressed episode. There are also existential issues for many people with depressed mood. Why should I bother trying? What’s the point of my life? Where am I going? Will this ever get better?

The answers to these existential questions are extremely important. Dispensers of conventional wisdom and friendly advice might try to offer helpful solutions, but those suggestions often ring hollow when you’re in the throes of depression. To find your way out of the depression, you have to find solutions that work for you. And because of the lack of desire, pleasure, and energy, it’s difficult to believe that anything will really help.

It’s one reason why the professional help of a trained outside observer can be so valuable. While medication can be very beneficial, so can talk therapy. A therapist can help you to use your support system in appropriate ways, tackle the “stinking thinking” that keeps you stuck, and take action in ways that move you out of the maze of negativity and frustration.

For more on depression and treatment, I recommend these blogs:

Beyond Blue

The Happiness Project

Mindfulness and Psychotherapy

Where’s Ben?

As we head into 2012, I have a few new schedule updates to share. I’m pleased to announce that I will be working 2 days a week with The Lazarus Project at Austin Peay State University in Clarksville, serving veterans, active duty military servicemen and women, and their families. The Lazarus Project has partnered with Soldiers and Families Embraced (SAFE) to offer free counseling services, and I will be helping with the intake and referral process.

So, my schedule for the New Year looks something like this:

Monday: Brentwood/Maryland Farms at my main office location.

Tuesday: Wesley Foundation, Austin Peay State University, Clarksville from 9-2, occasional appointments available in the evenings in Brentwood

Wednesday: Wesley Foundation from 9-2, occasional evening appointments available in Brentwood

Thursday: Pleasant View United Methodist Church in the afternoons, appointments available from 2-10 PM, occasional evening appointments available in Brentwood

Friday: Brentwood/Maryland Farms

In addition, I continue my project work with Safe Haven Family Shelter, as I will be developing their family mentoring program and supporting the program staff with addressing the needs of homeless families.

I have openings for new clients at the Pleasant View location starting immediately, and also have room for five or six new clients in Brentwood. To schedule an appointment, use my contact page or call (615)301-1839.

New Years Resolutions

As we say goodbye to 2011 and look ahead to a new year, I wanted to take a minute to talk about why bad habits can be so addictive, and how to keep your New Years resolutions in 2012.

The force of habit is pre-conscious and pre-cognitive. We do without thinking, and before we know it, the intention is in our head and we’ve already begun to entertain the idea of doing what we tell ourselves we don’t want to do. Whether it’s the tendency to light up a cigarette or the tendency to play World of Warcraft (after we’ve told our spouse we promise to cut back), addictive patterns are hard to fight with mind control or talk therapy. Part of the disease of addiction is that it tells you that you don’t have a disease!

The other thing that makes New Years resolutions hard to keep is that we give up after we make a slip or two. Resolutions tend to be iron clad, abstinence-based rules that we try to impose on ourselves. As a result, the first day we don’t exercise, or overindulge, or sneak a quick smoke while no one’s watching, we stop trying altogether. What if, instead of resolving to stop an unwanted behavior, you resolved to start being more mindful and less compulsive about it?

What we know about trauma and the brain is that our fears and resentments have a way of lighting up our limbic system, the “fight or flight” part of the brain that reacts to pain and warns us about impending dangers. “I will never let that happen again,” we tell ourselves. The autonomic nervous system response is like a reflex that happens before our rational mind has time to think about it. The rational mind is hijacked by our survival instincts, but our survival instincts don’t always give us accurate messages or help us to take the appropriate action in response to the perceived threat.

But when it comes to our resolutions to stop addictive behavior, we punish ourselves when the instinctive, mindless parts of ourselves overwhelm the more rational, intentional parts. We judge ourselves, heap shame and guilt on top of the fear and hurt, and a negative spiral of messages begins to play like a song that’s stuck on repeat. With this experience, is it any wonder that people stop making resolutions altogether?

There is a better way.

You don’t have to get stuck. You don’t have to get into a power struggle with your limbic system. You don’t have to give up.

New Years resolutions don’t need to be compulsive and you don’t need to beat yourself up over them. Instead, you can let go of the old tapes in your head, the old shameful messages, and the old disappointments and failures. Why not end 2011 with something like a Burning Bowl ceremony, where you gather with others to release the burdens on your mind and look forward to a fresh start in the New Year?

You can do your own Burning Bowl at home. It’s an easy process. All you need is some paper, matches, a pen (I’m a fan of crayons, personally!), and a bowl to contain the paper. Write down the resentments, losses, broken dreams, fears, and other burdens that you’re carrying. I suggest that you take multiple slips of paper and write down a simple word or phrase to remind you. If you like, you can draw a picture to symbolize the burden you’re releasing. What’s important is what it means to you.

Once you’ve written down the list of things you’re releasing, take a moment to consider what you’ve learned from the experience of the past year. Decide what you’d like to hold onto, and what you need to let go. Stop wishing for a better past. Then take the paper, crumple it in the bowl, and light the matches. The purifying force of the fire will create light and warmth, and release the energy from the paper. Allow that experience to release the positive energy from your unburdening process.

When you’re done, and the fire has faded, it’s up to you what you do next. Some people bury the ashes or scatter them in a garden. Others save the ashes for Ash Wednesday, and a time of further purification during the season of Lent. Whatever you do, remember that nothing is wasted. Out of the ashes, new life will arise in 2012.

Burning Bowl

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