"She stood in the storm and when the wind did not blow her away, she adjusted her sails." ~Elizabeth Edwards Charles Krauthammer, who was a Pulitzer Prize winning columnist for the Washington Post, died earlier this summer. He was by no means a political kindred spirit of mine, but I was drawn to read more about his life. I didn't know until recently that he was paralyzed in a diving accident when he was a first year medical student. With the help of many, but one professor in particular, he graduated from medical school and became a psychiatrist. He later became a political columnist. The Washington Post opened their archives and I read some of his columns. One he wrote about resilience. In it, he talks about Roy Hobbs, the hero of Bernard Malamud’s “The Natural,” a baseball prodigy who tries to return to the game after being shot. “No one knows why Hobbs is shot,” he wrote. “It is fate, destiny, nemesis. Perhaps the dawning of knowledge, the coming of sin. Or more prosaically, the catastrophe that awaits everyone from a single false move, wrong turn, fatal encounter. Every life has such a moment. What distinguishes us is whether — and how — we ever come back.” I have been thinking more about trauma and how it changes lives. As Dr. Krauthammer says, "every life has such a moment.". I have had mine. You have had yours. I feel comfort knowing that, as Robin Roberts' mother told her when she was diagnosed with cancer, "everybody's got something". Knowing that bad things happen to all of us, that it is part of the human condition, somehow feels better than isolating with the idea that it only happened to me. And I've been thinking about resilience too. Here's a simple definition. Resilience is being able to become strong, healthy or successful again after something bad happens. Bouncing back. Getting back up and moving forward. Resilience is understanding that the future will not be like the past. Learning from what's happened. Perspective taking. Staying flexible. Adapting to the reality in front of you. Remembering what matters to you and moving towards it. Connecting with others, we are not alone. And at the risk of being a Pollyanna, life can be better on the other side of trauma. While it can seem so bleak in the vortex of the emotions that swirl around a traumatic event, I have seen how the very awfulness of the event, how when everything you thought you could count on was suddenly not there, that upending of what feels like everything, can become the very thing that allows you to start again. New and yet more you than you've ever been. Fresh but not naive. Wiser but not cynical. Allowing experience to make us more of who we already are, that's resilience. :-) “You can’t fix what you don’t acknowledge.”
~Dr. Phil I was talking in an earlier post about radical acceptance, about how it’s not about liking or not liking what’s in front of you, it’s about seeing the reality of what’s in front of you so you can make the most effective plan for how to deal with it. Starting with what is, not what we wish it to be, sets us on a path to a better outcome. Let’s consider an example here. Your doctor tells you that your test results show an unusual pattern that needs further investigation. Of course, you do not want this to be true, you want to have normal test results. You don’t want it to be true that something could be really wrong. Now I’m giving my opinion here, but I think even though you (and I) do not want these fears to be true, getting the facts about what is true needs to be the next step here. Maybe something isn’t wrong. Or maybe something is wrong. If that’s true, you need to know so you can plan your most effective next steps, e.g., finding out about treatment options, or getting treatment or changing your habits. How about a more everyday example? How about getting caught in an unexpected traffic jam on I-40 when you’re on your way to an important meeting with your boss? You haven’t allowed for the extra time it is going to take to get moving again. There’s no exit nearby and you are boxed in by all the other cars. Your only choice is to wait it out. But you’re late! But this meeting is really important! “I can’t be late!” What are your choices? Getting angry? Getting nervous about being late? Getting angry with yourself for not leaving sooner or taking a different route? Yes, all options :-) But effective? Make any difference to getting the traffic moving again? Not so much. So, how about just observing your reaction (“wow, I can really get myself worked up here, can’t I?”) and try to just be in the experience (“well, I’m stuck here for I don’t know how long. Is there anything I can do? Maybe call my boss and let her know I’m going to be late.”). The truth is that the traffic will start flowing again when it does, and your reaction to it will have no influence whatsoever on getting those cars moving again. I think about the Serenity Prayer here, wisdom is about knowing the difference between what we can control (leaving early for an important meeting) and what we can’t (getting stuck in traffic). Acceptance is being in the flow of life as it reveals itself, as it unfolds, not putting undue energy into opposing or resisting the flow of life. I know, I know, easier to say than to live. But aspire to it, set your intention to accept. Notice when you resist, invite yourself to pause and let life be what it is. ♥ “A greater intelligence is available to you when you no longer reject, deny, or “don’t want” what is.” ~Eckhart Tolle Accepting what is. I think this is such a powerful and life changing idea that sounds deceptively simple. What is acceptance? One generally understood definition of acceptance is through the lens of a judgment, that accepting something is the opposite of rejecting something. So with this definition, acceptance is like approval “I accept this because I approve of it, or I’m OK with it.” “She was accepted into her first choice of school”, which would obviously mean the school approved of her. With this definition of accepting as akin to approving, accepting means welcoming something, bringing it closer to you, while rejecting would mean pushing away, denying, not wanting something, in this example being rejected from her first choice of school would not be the outcome she would want. This other (and I believe ultimately more powerful) way to think about acceptance is without the lens of judgement/approval/evaluating. True acceptance means stepping away from the liking/disliking paradigm altogether. Another term for this form of acceptance is radical acceptance, a description used in DBT, radical acceptance means allowing your experience to be just what it is, flowing with the rhythm of life, not trying to control what is beyond your control, just observing what is. Now, this does not mean you don’t have feelings or an opinion about what’s in front of you. What it does mean is that you don’t conflate the two, that seeing what’s in front of you and what you believe about what’s in front of you are distinct. Being able to hold the facts and the feelings about the facts as separate gives you so many advantages. The one most obvious benefit is that you can plan your action based on what is, not on what you wish to be true. Your actions are more likely to be effective the closer they take reality into account. I’ll talk more about radical acceptance in my next post. Stay tuned :-) Hello All! I’m posting this video that is available on youtube that captures one of the main concepts of ACT in a humorous way. The video is just over 4 minutes long. Making room for all of us, even the parts of ourselves we’re not so keen on, and moving forward with what matters to us, that’s the key. What do you think? Acceptance and Commitment Therapy (ACT) is the newest addition to how I think about my work. As with Dialectical Behavior Therapy (DBT), I am learning how powerful this approach is through my work with clients and also with myself.
In a similar way to Bowen’s family systems theory, ACT believes that there is much to be gained by establishing some degree of objectivity of self, that is, being able to stand beside yourself and observe, of seeing your thoughts, feelings and behaviors with some neutral stance. In ACT language, this is known as defusion, that is, recognizing that you are not your thoughts and feelings. ACT uses metaphors a lot and I like that. One metaphor to illustrate defusion is that you are the sky and your moods/thoughts/feelings are the clouds. Even on the cloudiest day, we know that there is sky behind the clouds. Translating that metaphor, no matter what your mood is in the moment, your self is constant. We get into trouble when we fuse our thoughts/feelings/moods with our sense of self. In ACT terms, “I am a bad person” would be “I am having the thought that I am a bad person”. Read those out loud, can you feel the difference? Now I know that the second sentence sounds clumsy and not natural. And that’s the point! The ACT way of describing the experience creates just a bit of space between you and the thought. That space creates enough objectivity that you have room to work on decreasing the power of those negative thoughts, to be reminded that you are not your thoughts. Another defining feature of ACT is the idea of psychological flexibility. ACT believes that suffering is created by inflexibility, of thoughts, actions, beliefs. Like in DBT, ACT theory is based on the idea that resisting the world as it is creates unnecessary suffering. ACT principles and techniques offer a different way of thinking, a different way to approach what life puts in front of us. If you want to read more about ACT, I would suggest “The Happiness Trap: How to Stop Struggling and Start Living” by Russ Harris and Steven Hayes. Or see this article that summarizes ACT from the Association for Contextual Behavioral Science website. Dialectical Behavior Therapy, DBT, is another theory that serves as a part of the foundation of how I approach my work.
First things first, what’s dialectical? How I think of dialectic is the ability to hold the tension of both sides of something, opposing thoughts, opposing feelings. For example, to hold the tension of seeing an event as being both positive and negative, of a relationship that feels both satisfying and dissatisfying, of being able to accept yourself at the same time you are asking yourself to change. Related to this idea in DBT is the working towards acceptance, of self, of the present moment, of reality, of life. Acceptance doesn’t mean agreement, it does mean you start with what is. DBT training is divided into several modules, including mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. Threaded throughout the skills is an emphasis on regulation, of feelings, of thoughts, of behaviors. It seems to me that so much of human suffering is based in dis-regulation. Dysregulation of thinking, feeling and behaving. At the risk of sounding like I’m exaggerating (I’m not), DBT changed my life, personally and professionally. For me, DBT was a missing link in my approach to my work and to my own life. DBT provided me with a rich framework for teaching clients tools and strategies to learn to better manage their thoughts, feelings, behaviors and relationships. Learning to take into account what DBT calls “reason mind” and “emotion mind” to come to “wise mind”, meaning making the choices and decisions that are not right for everyone but are right for me is such a simplifying framework for how to approach life. Once you identify your core values, your primary goals, what you like and don’t like, what works for you and what doesn’t, figuring out the next steps come more smoothly. If you want to read more about DBT, Google it. The first articles listed are going to give you a nice overview. One thing before you read, remember that while it was originally developed to treat borderline personality disorder, DBT principles are applicable to a wide range of behaviors. I teach them to my clients and I personally use these skills every single day! I thought I’d write the first few posts telling you about a few of the more important influences in how I approach my work as a psychologist. While I (like most therapists) describe my style as “eclectic”, there are several layers of theory that I primarily rely on.
The theory that I think of as the foundation of how I view human behavior and relationships is Murray Bowen’s Structural Family Systems Theory. According to Bowen, the family, not the individual, is the basic emotional unit. Each family system tends to have its’ own baseline of anxiety. Anxiety is seen as being triggered by external events or internal states. One example of an external trigger might be the job loss of a family member. The anxiety of the person that lost the job gets added to the collective emotional field. In addition, each family member reacts to this news in some way, adding their own anxiety to the mix. For the internal state, almost like a set point of anxiety, each person and the entire family system can be influenced by temperament, genetic or biological influences or from events that happened in past generations. Intense emotions, like anxiety, are highly contagious within the family unit and are also passed down through the generations. The more anxious the system, the more individual family members rely on ineffective ways to manage anxiety, e.g., conflict, cutoffs and triangulating. What to do? The general approach from Bowen’s theory is to step back and cultivate objectivity from the system before you plan your action. The first step is to observe what’s going on, what you’ve gotten tangled up in, therefore gaining objectivity from the emotional field, stepping just enough outside the intensity to allow thoughtfulness to mesh with the emotions to take a more measured position while maintaining the connection to the family unit. This process can be done by any individual in the family system on their own. The goal is to learn to manage your own anxiety by stepping back a bit from the anxiety field, all the while maintaining the vibrant connection to the rest of the family system. If you’re interested in reading more about systems theory, check out wikipedia’s entry on Murray Bowen. I would also highly recommend anything written by Harriet Lerner. She starts with Bowen’s framework and, writing in an accepting, nonjudgmental (and female) voice, makes it easy to see how these ideas can work in real relationships. And stay tuned! I’ll write more in future posts about how I apply this way of thinking to systems in general, not just family systems, but other systems you are a part of, such as your relationship with your partner, your workplace, and other groups you belong to. |
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