O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

Archives for May 2013

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How Anger Hurts Relationships

Getting angry…is easy and everyone can do it; but doing it . . . in the right amount, at the right time, and for the right end, and in the right way is no longer easy, nor can everyone do it. —Aristotle, Nicomachean Ethics (II.9, 1109a2

Managing Conflict Rather than Eliminating Conflict

Conflict is inevitable in any long-term relationship. In the Gottman approach to couples counseling, we help clients understand that conflict is normal. Rather than eliminating conflict, we help them learn to manage it. Why can’t all conflicts be resolved? Because backgrounds and personalities don’t match exactly. Couples will always have some areas of disagreement: neat/tidy, disorganized/scheduled, emotionally expressive/keeps feelings inside, to name a few. Even two tidy people may disagree on who does more work around the house or, perhaps, what cleaning routine to follow.

By the time couples come to counseling, they have often been having the same argument in different forms for many years. The issue has become gridlocked—and just as drivers stuck in traffic feel angry and frustrated, partners who can’t move beyond an issue start having negative feelings about each other and the relationship.

Learning to Listen Without Anger

Anger is often the result of feeling misunderstood. When one partner feels like they are not being heard on a particular issue, and they likewise have trouble listening to their partner’s point of view, anger simmers, sometimes for years—finally coming to a roaring boil.

Jim and Joan came to counseling because she felt he stopped participating in the family years ago. Meanwhile, Jim felt disenfranchised. His views and opinions on how they were raising the kids were ignored and he felt he was “just a paycheck.” Joan felt he had checked out and was uninterested in her, the kids, or their home. They were both angry; they both felt the other was wrong. When they tried to discuss this problem it always escalated to screaming and yelling, often within earshot of the kids.

When they started couples counseling, they had had this same fight many, many times. Jim would withdraw; Joan would become more focused on her friends and the women in the neighborhood, whom she confided in and got support from. Joan and Jim were emotionally estranged. Not surprisingly, intimacy, both emotional and physical, had come to a grinding halt.

Gridlocked Problems: Begining to Compromise

When I listened to them discussing a variation of this gridlocked problem, I saw that each became angry quickly, and the result was they stopped listening to the other. Joan would lecture and Jim would face the other way, clamming up. People have many ways of expressing anger: he was seething inside quietly, and she was ranting loudly, but both were angry.

I stopped them when this happened and had them take just a few minutes to calm themselves. To go from anger to calm by learning to self-soothe is an important skill in all relationships, but especially in marriage. It can take just a few minutes to do this. This isn’t about swallowing or denying anger; the trick is to then re-engage in the conflict discussion with a more receptive and less defensive tone.

Staying angry is much easier, but “doing it in the right amount, at the right time, and for the right end, and in the right way” (as Aristotle said) produces quite different results when dealing with a perpetual problem. It is okay to be angry. But understanding why you are angry, and learning to express your feelings in a way that is clear and void of the four horsemen will lead to a very different conversation with a different outcome. Once Joan and Jim learned to talk about their conflicts without getting flooded, they listened to each other with deeper respect for the other’s feelings. This is the first step in learning to compromise.

Practicing self-soothing is something you can do at any age, and at just about any time. Listen to this simple three-minute ”breathing space” to feel the difference in your thoughts, feelings, and physical sensations when you take just a few minutes out of a difficult situation. For it is not just the repeated, unmanaged fights that damage the relationship, but the skewed and distorted perceptions that keep you stuck in gridlock, stewing, for years—over the same issue.

Try this brief relaxation exercise:  Three Minute Mindfulness

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Finding Happiness: You Can’t Always Get What You Want

 Those only are happy who have their minds fixed on some object other than their own happiness. – Mill

Grasping for Happiness may Lead to Depression

Judging by the huge number of psychological and self-help books claiming to know the secret to happiness and how people can increase it, we have become a nation obsessed with happiness. Happiness is important to well-being and for physical and emotional health, but research has shown that the more we value happiness, the more likely we will feel disappointed. These studies suggest that encouraging a goal of maximizing happiness (as many “self-help” books do) may be counterproductive.

Happiness is not an achievable goal in the same way academic success is, through working hard and studying. Happiness is more slippery than that. By making happiness a goal to be achieved, we set difficult-to-obtain standards that can be easily frustrated. Frustration leads to disappointment and discontent and, paradoxically, decreasing happiness.

When we expect to feel happy and instead end up feeling blah, bored, or bothered, our experience is incompatible with our goal of happiness. When people put too much emphasis and value on seeking happiness, they become vulnerable to paradoxical effects.

Unhappiness (though not depression) is often attributable to a particular circumstance, such as hearing that a close friend had an accident. So in positive circumstances, people have every reason to feel happy. You might, for instance, plan a special occasion like a party or a night out, fully expecting happiness as a result. Yet you might feel let down instead if the occasion couldn’t live up to your expectations for it. So the more you desire happiness, the less likely you may be to obtain it, especially when happiness appears within reach.

Accepting the Good, and the Difficult Emotions

It makes sense to follow John Stuart Mill’s suggestion not to have your mind fixed on personal happiness. Eliminating happiness as a goal to be achieved helps people better accept negative emotional experiences, improving overall emotional health.

In psychotherapy, we work on accepting that not all experience will be positive or happy. It is by accepting both our difficult experiences along with the more favorable ones that we begin to live life more fully. And in living fully, with ups, downs, and the in-between experience, we may be surprised to find happiness is often just around the corner—obtainable—if we’re not grasping for it.

In mindfulness-based cognitive therapy and stress reduction, we teach non-judgmental acceptance of all of our thoughts, feelings, and physical sensations. And, paradoxically by practicing this acceptance, those moments of happiness sneak up on us, and we can be surprised to find ourselves feeling happy for no apparent reason.

Iris B. Mauss, Maya Tamir, Craig L. Anderson, and Nicole S. Savino. (2011). Can Seeking Happiness Make People Happy? Paradoxical Effects of Valuing Happiness. Emotion.

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How Lifestyle Changes Can Be Therapeutic—And What To Do When They’re Just Too Hard

The October 2011 issue of American Psychologist featured an article on how mental health professionals significantly underestimate how unhealthy or missing lifestyle factors—for instance, nutrition and diet, or service to others— contribute to many emotional health problems. It also discussed how immensely helpful improving these factors was in treating many mental and physical health problems. Researchers have termed these improvements TLCs, or therapeutic lifestyle changes.

The eight lifestyle factors include exercise, nutrition and diet, time in nature, relationships, recreation, relaxation and stress management, religious or spiritual involvement, and service to others. Plentiful research supports the importance of these eight TLCs—as does plain common sense. And each lifestyle factor contributes to the others. Exercise and diet affect mood, and recreation (inscribed in the word itself: re-creation) will help instill a sense of well-being. In a virtuous cycle, when people feel physically comfortable with their bodies, when they feel vital and energetic, they will have the energy to engage in activities such as service to others and feel inspired to spend time in nature and contribute by giving to others.

Many folks today are facing challenges in obtaining the most basic and fundamental needs, such as food and shelter and financial and physical safety. These must be met before additional needs can be addressed. Yet by addressing lifestyle factors with the means at your disposal, it may be possible to shore up your resilience, your ability to withstand hard times. Certainly, it is difficult to think about exercise in times of financial stress, but it could be possible to carve out time to participate in a softball league or to make time to walk in nature, or the public park. Cutting out the cable channels can make for creative ways to spend that time. Some of the poorest people are the most active in service to others, because of what giving gives back to them.

It seems obvious that TLCs have to potential to help people lead better lives. When we’re healthy and we know something is good for us, we usually do it. But how do we implement these when depression or anxiety are present? In that case, those TLCs begin to feel like burdensome “shoulds”—and most everyone has resisted doing something just because we should, even if not depressed.

Depression & Anxiety Make Implementing Healthy Behavior Difficult

Depression and anxiety make change feel impossible to achieve. A well-meaning partner will say, “Just get up an hour earlier and go for a walk.” But to a depressed person, that’s a monumental effort. Getting up and exercising when you are feeling fatigued and lethargic is no simple thing. Sleep, as well as energy, is affected by depression; bouts of insomnia, for example, can lead to too much daytime sleeping, making sufferers look lazy to their families. ”Just get up and go,” the non-depressed person might say; “don’t lie around all day.” And while this may be absolutely the right thing to do, the depressed person has no “get up and go.”

Likewise, someone with social anxiety has trouble engaging in activities that will bring social connection. Avoiding people becomes the norm, thereby limiting potential rewards that come with socializing. For the depressed or anxious, not doing what they know they should be doing leads to self-incrimination and shame, worsening both conditions.

How Psychotherapy Can Help

Psychotherapy can help. During the first appointment, psychologists take a history that includes past and current relationships, educational and employment history, and family background. We also ask about current and past medical problems, medications, and use of substances. It is imperative to take this history to understand how the various life factors are impacting the current or “presenting” problem, as we call it.

Of course, while psychotherapy can begin the dialogue, the difficult part for many is implementing TLCs. What gets in the way of exercise, eating well, and taking time for you? If relationships are difficult, how are you contributing to that? Are you engaging in retail therapy or overindulging in drugs, alcohol, or other substances? An important component to any therapy is to look at what is working and what is not—and then taking responsibility for making changes in your life. Good therapy is not just about saying “Uh huh, you poor thing.”

Including the eight lifestyle behaviors in your life will undoubtedly help you feel better, use fewer psychiatric medications, and live life more fully, but if getting there from where you now feel like climbing Mt. Everest, then consider finding a good psychologist to help you.

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Being Playful Gives Freedom from the Restrictions we Put on Ourselves

Finding your playfulness again
Learning to Play

Gerald Heard visited Georgia O’Keeffe at Ghost Ranch in 1937. He had an interest in Eastern religions and metaphysics. One morning, O’Keeffe found Heard’s footprints around the tree where he had been dancing as well as a cryptic inscription he had etched into the earth at the base of the tree. “Gerald’s Tree was one of many dead cedars out in the bare, red hills of Ghost Ranch. From the footmarks around the tree, I guessed he must have been dancing around the tree before I started to paint it. So I always thought of it as Gerald’s Tree. “ Georgia O’Keeffe.

O’Keeffe painted two versions of the tree, indicating its importance to her. On a visit to Ghost Ranch, I heard this story and was captivated.

David took this photograph in 2008. The tree has not changed in the years since O’Keefe painted it. That this twisted tree, would be the subject of several paintings fascinates me. To see color in dirt takes a willing eye. It is easier to see beauty in vivid flowers or lush forests. The desert makes you work to see it’s unique beauty.

Over the years, I have made many trips to theSouthwestt. One of my favorite pieces of writing is from the novel, Song of the Lark by Willa Cather. This takes place after an intense period of her life as an opera star. She goes to the desert to rest and recuperate.

I sat down in the middle of the garden, where snakes could scarcely approach unseen, and leaned my back against a warm yellow pumpkin. There were some ground-cherry bushes growing along the furrows, full of fruit. I turned back the papery triangular sheaths that protected the berries and ate a few. All about me giant grasshoppers, twice as big as any I had ever seen, were doing acrobatic feats among the dried vines. The gophers scurried up and down the ploughed ground. There in the sheltered draw-bottom the wind did not blow very hard, but I could hear it singing its humming tune up on the level, and I could see the tall grasses wave. The earth was warm under me, and warm as I crumbled it through my fingers. Queer little red bugs came out and moved in slow squadrons around me. Their backs were polished vermilion, with black spots. I kept as still as I could. Nothing happened. I did not expect anything to happen. I was something that lay under the sun and felt it, like the pumpkins, and I did not want to be anything more. I was entirely happy. Perhaps we feel like that when we die and become a part of something entire, whether it is sun and air, or goodness and knowledge. At any rate, that is happiness; to be dissolved into something complete and great. When it comes to one, it comes as naturally as sleep. 1918

Sitting down in the dirt, or the grass, and letting the sounds and small movements of the tiniest creatures catch your attention is a way to play. Play comes naturally to children. They can play by dancing round the mulberry bush, or by laying down in the tall grass and watching the clouds move across the sky, creating castles and animals in their mind. Or watching a line of ants as they carry their burdens along their well-worn tiny paths, letting imagination carry them away.

Think of the ways you play

Wake up early, dance around the base of a tree and find a communion with nature. Being spontaneous, playful, and indeed silly gives freedom from the restrictions we put on ourselves. Think of the ways you play. Write down the most vivid times you played in the last five years. What do they have in common? What do you feel as you remember them? Then think back on some of your earliest memories of playing when you were small. Do these experiences have anything in common?

Being mindful and playing are ways to find the ever-elusive joy we often let slide by for more routine tasks of life. Give in to the urge to dance in the early morning, or in the starlight and watch as you come alive again.

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140 Characters or Less: The Three-Sentence Rule in Communication

 

Couples frequently come to therapy complaining of communication problems. Conflicts don’t get resolved. Intimacy has left the relationship. They lead parallel lives. The focus is on the kids, or their work or friends, but not each other.

During the first session of couples counseling, I take a history of the relationship and ask them to talk about a current problem for ten minutes. Invariably one partner will dominate the discussion. In subsequent sessions, I see the same thing.

For instance, Jody and Tom came to couples therapy because Jody feels Tom never listens to her. She is upset because he tunes her out and doesn’t open up about his thoughts and feelings. Observing Jody and Tom for a few minutes gives an important clue to why they have come to this place in their relationship: Jody talks a lot. In fact, she talks in paragraphs—even pages. She is animated, eager to express herself. Tom sinks into the sofa, shoulders hunched in resignation as Jody takes over the conversation. There is no doubt that she has important points to make and makes them well, but Tom doesn’t get a chance to speak. When I prompt Jody to let Tom speak, he gets a couple of sentences out, and then Jody interrupts, speaking for him.

Who Talks More in Your Relationship?

I have seen this scenario over and over again in my work with couples. Do women talk more than men? This is a controversial issue and many factors come into play. American neuropsychiatrist Louann Brizendine reported that the average man speaks about 7,000 words a day, while the average woman clocks in at 20,000. My observations would bear that out, although admittedly, I see a skewed sample. However, I don’t think it is a genetic or neurological issue so much as a relationship one.

The very thing that Jody wants from Tom is closeness, but she doesn’t give him a chance to talk. The pattern gets further entrenched as Tom’s unexpressed resentment grows and he retreats into his own thoughts, which often see Jody in a negative light. This perpetuates the cycle, with Jody seeing him in turn as distant and aloof. Furthering the pattern is a subtle dynamic at play: as Jody sees Tom’s discomfort and reluctance, she talks for him—letting him off the hook, so to speak.

They each have a role to play in this dynamic but are not aware of their roles.
Using a variety of interventions, I have Jody and Tom change the way they talk and listen. I frequently invoke what I call the “three-sentence rule” for the partner who dominates the conversation. When they come to see the pattern, this rule is met with chuckles and relief. Jody doesn’t really want to do all the talking, and Tom wants a chance to be listened to.

Reciprocity is Essential to Good Communication

Lately, because of the popularity of Twitter, I suggest a rule of 140 characters or less. Tech-savvy couples know this means to limit talk to the most pertinent points, usually in three sentences. Pause. Give your partner a chance to respond. Resume. Reciprocity is essential to good communication. As Tom expresses himself more, Jody can relax and feel less need to control the conversation. In this way, couples learn more about each other, bringing closeness and, in time, greater intimacy. Couples are often surprised to see their patterns of communication are changeable.

So if you catch yourself speaking in paragraphs abounding with run-on sentences, stop and let your partner have a chance to speak. You may be surprised by what you learn from each other.