Living Life 2 the Fullest

Borderline Personality Disorder: Definition

2012-01-21T10:56:00.000-08:00

We have just wrapped up a briefexploration of Narcissistic Personality Disorder, and now are going to shiftgears slightly and address another psychological condition, BorderlinePersonality Disorder.

In 1987, there was a popularmovie, Fatal Attraction, which drewthe public’s attention to Borderline Personality Disorder. The main character,Alex Forrest (Glenn Close), portrayed an individual suffering with a seriousform of this disorder. To quickly recap the plot of Fatal Attraction, Alex meets Dan Gallagher (played by MichaelDouglas), a married business man, and has a weekend affair. Dan sees theirrelationship as a brief fling and attempts to break it off. Alex, however,views their relationship much differently. She becomes obsessed with Dan and isthreatened by his desire to discontinue their relationship. She makesincreasingly bizarre efforts, such as stalking Dan and killing his daughter’spet rabbit, to keep him connected to her. When all these attempts fail, Alex’srage escalates, and she attacks Dan and his family. It is important to notethat Alex displayed an extreme and rare example of BPD. This disorder has manydifferent clinical presentations with varying degrees of severity. According to American Psychiatric Association (2000), approximately one to two percent of the population meets the diagnostic criteria for BPD.

What is Borderline PersonalityDisorder (BPD)?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)identifies nine different criteria for BPD, and requires five of the nine to bepresent for diagnosis. They are:

Frantic efforts to avoidreal or imagine abandonment
A pattern of intense andunstable interpersonal relationships characterized by alternating betweenextremes of idealization and devaluation
Identity disturbance:markedly and persistently unstable self-image or sense of self
Impulsivity in at leasttwo areas that is potentially self-damaging
Recurrent suicidalbehavior, gestures, or threats, or self-mutilating behavior
Affective instabilitydue to marked reactivity of mood
Chronic feelings ofemptiness
Inappropriate, intenseanger or difficulty controlling anger
Transient,stress-related paranoid ideation or severe dissociative symptoms

Dr. Marsha Linehan, whodeveloped Dialectical Behavior Therapy, proposes that the nine symptoms fallinto five main categories: (1) emotion dysregulation, (2) interpersonal dysregulation,(3) behavioral dysregulation, (4) identity or self dysregulation, and (5) cognitivedysregulation. The key word is “dysregulation” or not having it under control.People with BPD have trouble controlling various arenas of their psychologicaland interpersonal life. Theseindividuals tend to struggle with interpersonal relationships, have an erraticemotional life, and often behave impulsively and rashly.

What causes BorderlinePersonality Disorder? In the next article we will review the current understandingof BPD, including possible causes and characteristics.

Movies & Personality Disorders

2012-01-07T11:29:00.000-08:00

Ithought I would take a brief break from exploring the serious side of psychopathologyand review movies which best portray mental illness, with a special emphasis onpersonality disorders.

Hereis a brief list–

Narcissistic PersonalityDisorder

*Black Swan (2010) - Erica Sayers, mother

*MorningGlory(2010) - Mike Pomeroy and Becky Fuller, to a lesser degree

*Wall Street: Money Never Sleeps (2010) - Gordon Gekko

*Wall Street (1987) - Gordon Gekko

*Gaslight (1944) - Gregory Anton,husband

Borderline PersonalityDisorder
Monster (2003) - Aileen
The Hours (2002) - Virginia Woolf
*Single White Female (1992) - Hedy Carlson
*Girl, Interrupted (1999) - Lisa Rowe and Susanna Kaysen, to a lesser degree

*FatalAttraction(1987) - Alex Forrest

Mommie Dearest (1981) - Joan Crawford

*AStreetcar Named Desire (1951) - Blanche, see also Histrionic Personality Disorder

Obsessive-CompulsiveDisorder

*The Aviator (2004) - Howard Hughes

*AsGood As It Gets(1997) - Melvin Udall

*WhatAbout Bob?(1991) - Bobby Wiley

Antisocial PersonalityDisorder

*Girl with the Dragon Tattoo (2011) - Lisbeth Salander

*Dark Knight (2008) - Joker

Dr.Jekyll and Mr. Hyde(2008) - Mr. Hyde

*RachelGetting Married(2008) - Kym

*TheSilence of the Lambs(1991) - Dr. Hannibal Lecter

Histrionic PersonalityDisorder

*AStreetcar Named Desire (1951) - Blanche

Gone with the Wind (1939 ) - ScarlettO'Hara

Depression

*Twilight, New Moon (2009) - Bella Swan

*Revolutionary Road (2008) - April Wheeler

*House of Sand and Fog (2003) - Kathy

*Girl,Interrupted(1999) - Susanna Kaysen

*OrdinaryPeople(1980) - Conrad Jarrett

Post-Traumatic StressDisorder

Fearless (1993) - Max Klein

*TheFisher King(1991) - Jack

*Platoon (1986) - many of thecharacters

Schizophrenia

*The Soloist (2009) - Nathaniel Ayers

*Bennyand Joon(2003) - Joon

*A Beautiful Mind (2001) - John Nash

*Movieswith an asterisk are those I have watched

Hereare several other websites which include either more categories or othersuggestions.

Top10 Films Featuring Mental Illness

http://listverse.com/2009/09/08/top-10-films-featuring-mental-illness/

Psychopathology& the Cinema-Film List (a very comprehensive list)

http://www.neiu.edu/~mecondon/cinfilm.htm

Wikipedia'sList of Films Featuring Mental Illness

http://en.wikipedia.org/wiki/List_of_films_featuring_mental_illness

Whichmovies would you have suggested?

Narcissism: Reading Resources

2011-12-17T12:30:00.000-08:00

This fall I have been exploring the personality characteristics andinterpersonal dynamics of Narcissistic Personality Disorder. There have beenseveral excellent references I have used in the writing of these articles. Here is a list of those resources; please notethat it is not alphabetical, but rather in order of my favorites.

· You Might Be a Narcissist If . . .: How to Identify Narcissism in Ourselves and Others and what We Can Do About It. Meier, Paul M.D., Charlebois, Lisa L.C.S.W., Munz, Cynthia L.M.F.T. Langdon Street Press, 2009.

Dr. Meier’s book contains a helpful questionnaire to aid in theidentification of narcissistic personality tendencies. He also discusses the rolenarcissism plays in parenting and marital relationships.

· Why is it Always About You? The Seven Deadly Sins of Narcissism. Hotchkiss, Sandy LCSW, Free Press, 2002.

Ms. Hotchkiss spends some timedescribing the development of narcissism. She suggests four helpful strategies whendealing with narcissists. There are also several chapters on specialrelationships, such as coping with a narcissistic boss, a substance-abusingloved one, and an aging parent, which addresses those four strategies ingreater detail.

· Children of the Self-Absorbed: A Grown-up’s Guide to Getting over Narcissistic Parents. Brown, Nina EdD, LPC, New Harbinger Publications, Inc.; 2nd Edition, 2008.

Dr. Brown’s book is helpful inidentifying destructive narcissism. She has many practical suggestions on developingand maintaining healthier boundaries with parents who are demanding andcontrolling.

· Loving the Self-Absorbed: How to Create a More Satisfying Relationship with a Narcissistic Partner. Brown, Nina Ed.D. LPC, NCC, New Harbinger Publications, Inc., 2003.

Dr. Brown addresses unique boundariesand expectations that occur in love relationships with narcissistic partners.

· Personality Disorders (Diseases &Disorders). Marcovitz, Hal, Lucent Books, 2009.

Marcovitz provides a nice overviewof personality disorders, including Narcissistic Personality Disorder. Thisbook is written for clients and their families, and contains plenty of everydayexamples of personality disorders.

Please join me in the new year when I start the next series of articles on Borderline Personality Disorder.

Have a wonderful holiday season!

Narcissists in Love—Brief Examination of Narcissism in Marriage, Part 2

2011-12-09T10:06:00.000-08:00

The last article ended with the question: Why do some individualsmarry narcissists?

Narcissistically wounded people seem larger than life. Due to their tendency to idealize their experiences,everything is a grand adventure. They often are the most charismatic individualsin the room. Others are drawn to their grandiosity and spontaneity.

Once people enter the orbit of a narcissist, they arerequired to submit to the narcissistic person’s control. This control unfortunatelyis initially attractive to those who are used to regular self-effacement andself-abasement. Also, some individuals lack the self-confidence to takechances. Narcissists solve this problem by allowing others to live vicariouslythrough their adventures.

However, marriage to narcissists is extremely difficult. Narcissistsare insensitive to the needs of their spouse. They are dismissive of theirpartner’s opinions and thoughts. They have trouble empathizing with others and seem emotionallydistant.

Since getting help requires each member of the relationshipto address their individual contribution to the marital difficulty, thesemarriages often end in divorce. Narcissists rarely see themselves as part ofthe problem and tend to resist the therapeutic process. They are filled withshame, and the fear of being perceived as a failure makes them resistant tochange.

In such circumstances it can be helpful for the narcissist’sspouse to seek individual counseling. Through the support of a trainedprofessional, the spouse can learn to define and maintain healthierinterpersonal boundaries. The spouse can also carefully assess whether stayingin the marriage is possible for his or her psychological well-being.

The next article will be a list of reading resources aboutnarcissism. It will be the last article in the series exploring theNarcissistic Personality Disorder.

In the new year, we will begin to address another difficultpersonality disorder, Borderline Personality Disorder.

Narcissists in Love—Brief Examination of Narcissism in Marriage, Part 1

2011-12-02T09:51:00.001-08:00

In healthy marriages, couples easily move in and out of intimacy.There are periods of time when the two individuals allow themselves to merge physicallyand psychologically, and other periods of time when the two people areencouraged to be separate, autonomous individuals. No one person controls theother partner, but rather there is mutual support. The couple values each other’s differencesand tolerates each other’s shortcomings. There is an implicit understandingthat the marriage becomes richer when the membersʼ individuality is nurtured.

Marriage to narcissists is much different. Control is thekey component in these relationships. Narcissists need their partners toadmire and pump up their fragile self-esteem. They long for a completemerger with their spouse. Their partner’s autonomy and individuality isconsumed by the narcissist’s need. Only the narcissist’s goals and desires arepursued.

The person who marries a narcissist learns to submit. Thisperson is under scrutiny and is frequently criticized. There is constantpressure to please the narcissist. This individual’s purpose is to bringadmiration to the narcissist by behaving in an acceptable manner. The spouseexists for the narcissist’s pleasure. After all, narcissists do not choose theirspouse because they love this person, but because narcissists love the way thisperson makes them feel. This is not a mutually reciprocalrelationship.

Narcissists’ sex life is often in trouble. They are poorlovers, since they are inattentive and inpatient. Real sexual intimacy often istoo risky, making masturbation and pornography an attractive option. The narcissist’sspouse, however, interprets this preference as personal rejection. After aperiod of time, these relationships can become platonic. Trying to pursue sexualintimacy feels too painful and wrought with psychological landmines.

Why would people submit themselves to such a difficultsituation, such as marrying a narcissistic individual? In the next article, wewill briefly explore the attraction to narcissistic people. We will alsoaddress how to get help if you think you are married to a narcissist.

Narcissism: Understanding the Effects of Narcissistic Parenting

2011-11-18T08:51:00.001-08:00

Since Freud, researchers havestudied various environmental effects on maturing personalities, and it hasbeen well documented that parenting styles are profoundly involved in theshaping of children’s developing psyches. It is hard enough working with anarcissistic boss or living with a narcissistic spouse, but being raised bynarcissistic parents has several serious emotional consequences.

What are some of these effects? Dr.Paul Meier in his book, You Might Be a Narcissist If . . . How to Identify Narcissism in Ourselves and Others and what We Can Do About It, identifiesfour consequences of narcissistic parenting. They are: 1) the development of a false self; 2) the desire tobehave with perfectionism; 3) chronic habits of passivity; and 4) increasedvulnerability to addictive behaviors.

The Development of a False Self

Since narcissistic parentsunconsciously need others to help soothe their fragile sense of self, theynaturally turn to any available relationships for this support, including theirchildren. Other people are not seen as whole, separate individuals, but ratheras objects to exploit. As a result, children of narcissistic parents quickly cometo understand that their role is to take care of their needy parents. Theylearn to take cues from their environment on how to act. They become who theirparents need them to be, instead of being true to themselves. Theseexpectations cause these children to develop a false self. They become proficientat looking good which requires them to become disconnected from their owninternal world. By learning to tune out their emotional needs and desires, theyeventually don’t even know how they feel. They become perpetual actors and seemas if they are fine, even when they are not.

Behaving with Perfectionism

Children of narcissistic parentsalso learn it is very important to live up to their parents’ high expectations.Their performance brings pride and glory to their parents, and their parentsoften take credit for their successes. Children of narcissistic parents beginto pressure themselves to perform well. They drive themselves to be the best,whether it is at sports, getting all A’s, or making first chair in the school’sband. This drive is not motivated by their own interest, but rather to wintheir parents’ approval. They learn early that failing to perform brings shameto their parents, so they work hard to avoid this painful consequence.

Habits of Passivity

Since children of narcissisticparents are regularly working to meet their parents’ psychological demands,they must constantly delay or deny their own interpersonal and intrapersonalneeds. They learn to tune out and ignore their own opinions, thoughts, anddesires, and to behave compliantly and easy-going. After all, they havediscovered disagreeing with their narcissistic parents has severe consequences.These parents often retaliate in some manner that punishes outspoken ordemanding children, such as emotionally withdrawing from their child orbecoming enraged when challenged. Children of narcissistic parents learn thatpassive compliance keeps the peace with their dysfunctional parent.

Vulnerable to Addictions

It is not surprising with all thecompromises that children of narcissistic parents make that they becomeextremely vulnerable to addictions. This includes eating disorders, sexualacting out, alcohol or drug abuse, and overeating. These children have learneda long-term practice of suppressing their emotions. They go to excessivelengths to please others and frequently are made to feel like a failure whentheir parents are unhappy. Addictive behaviors become a convenient way todistract themselves from their internal distress or pain.

Children of narcissistic parentsoften benefit from counseling. Through the support of a trained professional, theycan learn to listen and respect their own psychological and interpersonalneeds. They can also get the necessary support to begin to define and maintainhealthier interpersonal boundaries with their narcissistic parent(s).

For more information on finding amental health specialist, please visit How to Find a Good Therapist . It also might behelpful to read more about narcissistic parenting in Dr. Meier’s book, YouMight Be a Narcissist If. . . How to Identify Narcissism in Ourselves andOthers and What We Can Do About It. ( Paul Meier, PhD, Lisa Charlebois,L.C.S.W., Cynthia Munz, L.M.F. T., Langdon Street Press, 2009)

Narcissism: Getting Help

2011-11-03T15:40:00.000-07:00

Recognizing the need for help isalways challenging. It is especially difficult when dysfunctional narcissism ispresent. The nature of the disorder leads sufferers to believe their problemsresult from circumstances outside themselves and not from their poor choices orbad behavior. This occurs for two main reasons.

First, narcissists rarely acceptresponsibility for their situation. Being responsible means accepting blame. Sincefeeling at fault is intolerable, they project blame on to other people or the environment around them. Forexample, if narcissists aren’t punctual to an important business meeting, itisn’t because they left home too late, it is because of the slow drivers who delayed them as they traveled towork.

The second reason narcissists don’tsee themselves as the cause of their problems is because they tend to believethey are better than others. The rules that apply to others, don’t apply tothem. This isn’t real confidence or healthy self-esteem, rather it is aninflated, insecure, and fragile self-perspective.

Both maneuvers (deflected blame andexaggerated sense of self) are psychological defensive efforts to protectnarcissists from their chronic sense of shame. They fear appearing weak, andsince seeking help is a vulnerable act, they tend to resist the need fortreatment. Seeking help says that there are situations too big to handle on theirown. To narcissists, this is extremely risky to their fragile sense of self.

So, do individuals withnarcissistic traits ever initiate counseling? Sometimes, but they are rarelymotivated to seek help on their own. Therapy is usually pursued when they haveencountered severe interpersonal or occupational difficulties. Outsideinfluences often push narcissistic people into psychological treatment. Forinstance, they might be threatened with divorce or have had too many run-inswith their boss. In my experience, these individuals rarely stay long incounseling. Since their motivation to address their contribution to theirproblems is very low, they usually leave treatment as soon as the situationimproves.

Narcissists also seek treatment whenthey have a strong psychological reaction, such as the development ofdepressive or anxiety symptoms, to an external difficulty. The emotional painoften propels them to seek help. It is especially helpful when their supportsystem also encourages the use of counseling. These individuals often are moremotivated to address their personal issues and have a better treatment response.

Since narcissists tend to avoid takingpersonal responsibility for their difficulties, they do not respond quickly totherapy. Counseling takes a long time with regularly scheduled sessions to seesmall improvements. Successful treatment also requires a strong bond of trustbetween the client and therapist before suffering narcissists feel safe enoughto look at their own interpersonal fears and weaknesses.

The next article will address the effectsof narcissistic parenting.

Narcissism Questionnaire: You Might be a Narcissist If . . .

2011-10-20T14:59:00.000-07:00

Since the development of narcissism is due to childhoodstresses, and no one has a perfect childhood, all of us have varying degrees ofthis dysfunction. Although a brief list of narcissistic traits andcharacteristics was provided in the last article, it still might be hard todetermine if we display these characteristics on a day-to-day basis. I thinkDr. Paul Meier’s wonderful questionnairein his book, You Might Be a Narcissist If, might be able to help us identify the daily presentation ofnarcissism. The questionnaire does nothaving a scoring system, however we can evaluate how frequently weunconsciously and/or accidently behave in the manner described in eachquestion.

Narcissism Questionnaire

1. Do I have a humble heart? Do I realize I’m not perfect andhave both strengths as well as weaknesses---and don’t feel overly threatened toacknowledge either of them?

2. Do I have empathy for others? Can I put myself in theirshoes and imagine how my behavior has impacted them? For example, do I slowdown my driving when passengers say they are frightened?

3. Can I admit when I’m wrong? Can I apologize with a caringheart, and do I seek to make things right to help repair the rift in the relationship?

4. Do I think I deserve special favors and preferentialtreatment and should be treated as having special status? For example, do I askfor things that aren’t on the restaurant menu or talk to the server in ahaughty tone of voice that makes him feel inferior to me?

5. Do I tend to think in terms that categorize people in myhead as superior or inferior to myself, rather than believe we are all equal?

6. Do I tend to talk about others behind their backs in a toneof voice or in a manner that puts them down or makes them seem inferior?

7. Am I able to share my strengths and weaknesses with others,or do I tend to brag about my accomplishments, but hide my weaknesses?

8. Am I shocked or do I become angry when others have anopinion that is different from my own?

9. Do I try to exert extensive control over my family membersso they dress or act in certain ways so they don’t tarnish my image to others?For example, do I try to get my kids to pursue sports or careers that I wantthem to do rather than honor what they want?

10. Do I often feel envious of others or believe they areenvious of me?

11. Do I take advantage of others or use others to achieve myown ends without enough regard for their feelings or needs?

12. Do I believe I am special or unique and can only beunderstood by others who are also are special or unique?

13. Do I expect others to automatically comply with my wishes,and do I become shocked and outraged when they don’t?

14. Do I feel an increase in my self-worth when I associate withothers who possess beauty, wealth, high status, or power?

15. Do I tend to needexcessive admiration from others, and do I seek this attention fromothers---even in subtle ways? For example, do I talk to strangers in a restaurantto get their attention?

16. Do I get energized by thoughts of myself possessing moreintelligence, attractiveness, wealth, status, or power than others?

17. Do I take pride in being able to do things without the helpof others, and do I believe that to need others or need help from others makesa person weak or pathetic?

18. Do I feel safest psychologically when I feel alone?

19. Do I feel threatened psychologically when I feel I ambecoming attached to an emotionally dependent upon another person?

20. Do I verbally attack or withdraw from a person who has pointedout my failure, and do I devalue them (put them down) as a way to inflate myown self-worth?

21. When I experience failure (as all people do), do I eitherbecome grandiose in my head (wherein I increase my self-worth by believing Inever fail), or do I experience strong feelings of self-loathing or self-contemptbecause of my failure or mistake (self-devaluation) and shame, humiliation,rage, inferiority, or emptiness?

What should we do if we see ourselves in too many of thenarcissism questions? Or, what if we recognize these traits in a loved one? Howdo we get help? The next article will address how to help ourselves or ourloved ones when dysfunctional narcissism is present.

I want to give a special “thank you” to Dr. Meier for givingpermission to reprint the Narcissism Questionnaire from his book You Might Be aNarcissist If. . . How to Identify Narcissism in Ourselves and Others and WhatWe Can Do About It. ( Paul Meier, PhD, Lisa Charlebois, L.C.S.W., Cynthia Munz,L.M.F. T., Langdon Street Press, 2009)

Narcissism: Characteristics and Development of Narcissistic Personality Disorder

2011-10-07T06:45:00.000-07:00

What is narcissism?

Narcissists have these common characteristics:

Exaggerates their abilities or personal value

Are unable to empathize with others’ needs and concerns

Tend to use others to meet their own emotional and physical needs

Are unable to accept failure

Fear intimacy because they are afraid to be found out or exposed as a fraud or failure

Deny personal responsibility and shift blame to others

Keep others at arm’s length to prevent from being known

Are controlling and need things to go their way

Tend to devalue and/or abandon others when they feel out of control

See people as “good” or “bad” or in other words, tend to idealize some people while demonizing others

Determine a person’s goodness or badness by this individual’s ability to please them

Treat others as objects or tools

Struggle to recognize that other people have their own individual needs and concerns

And when they are parents, they tend to use their children as a reflection of their personal success. These children are expected to perform well. When the child is successful, the narcissistic parent tends to take credit for the child’s accomplishments.

(You Might Be a Narcissist If. . . How to IdentifyNarcissism in Ourselves and Others and What We Can Do About It, Paul Meier,PhD, Lisa Charlebois, L.C.S.W., Cynthia Munz, L.M.F. T., Langdon Street Press,2009)

It is important to remember that most of us present with afew narcissistic traits from time to time. Also, the severity of each narcissisticcharacteristic may range from mild to severe. A person is only considered tohave a Narcissistic Personality Disorder when these traits occur in theirextreme form.

So, how does narcissism develop?

Some theorists think every child is born with thehardwiring to become a narcissist. We understand, however, that there aredevelopmental stages during which increased narcissism is appropriate. Forexample, toddlers tire us with their demands to do every thing themselves. Theytantrum when life doesn’t go their way. Adolescence is another time whennarcissism is apparent. Teenagers often take risks without thinking of theconsequences to themselves or others.

Individuals during such developmental periods are expectedto be more narcissistic. This excessive focus on self is a necessary part ofthe “separation-individuation” process. During this stage each of us learns whereour separate “self” ends and another person begins. We also are exploring our capabilitiesand forming our identity. We come to understand our innate goodness, but alsoour capacity to be bad. We work to contain our impulses, to process our strongemotions, and to regulate our needs. Narcissism is a very normal part of thisprocess.

Pathological narcissism occurs when this process goes wrong.Most psychologists think environmental factors play a large factor in thedevelopment of narcissism. There are several thoughts about how this happens. Itis believed that either excessive attention and love, or emotional neglect canresult in narcissistic tendencies.

When excessive parental focus and love occurs, the childbegins to feel extra special and different from others. He (or she) starts tosee himself as outside normal constraints. It isn’t necessary to follow therules as others do. This child fails to learn that everyone has weaknesses,vulnerabilities, and imperfections. Instead he learns to think others exist to admire his greatness andto meet his needs. He doesn’t know how to delay the gratifications of hisdesires and impulses. He only sees himself and what he wants. He doesn’tunderstand he lives with other people who also have needs. In his world,only he exists.

When emotional neglect during toddlerhood happens, thechild's sense of self can be negatively affected. During this psychological stagethere are two critical needs: to feel loved, safe and special to the parent,and to be emotionally understood. No parent can perfectly address these needs,but consistent, repetitive emotional errors can result in the child developinga fragile self-esteem. When this occurs the emotionally injured person will goto excessive lengths to protect himself against interpersonal rejection. He isextra sensitive to feelings of personal inadequacy and failure. Any situationor relationship which stirs up feelings of embarrassment or shame will cause him to react defensively.

How does one know if he or she is a narcissist?

In the next article we will use Paul Meier’s wonderfulquestionnaire to identify typical narcissistic behaviors.

Personality Disorders: What is Narcissistic Personality Disorder?

2011-09-23T07:47:00.000-07:00

I enjoyed watching arecently released DVD this weekend, called Morning Glory. One of the main characters was Mike Pomeroy (Harrison Ford), a veteran TVjournalist who loved to list his famous interviews and numerous awards. Otherco-workers frequently referred to him as the “third worst person in theworld.” He treated his colleagues with casual disregard and at times sabotagedothers to get his way. He was divorced, had lost touch with his children, andlived in an apartment which looked like a museum. The movie was a comedy, and Mike was fun to watch because he was easy to hate. Yet,there was something very sad about him. Mike Pomeroy is a great example of aclassic narcissist.

Narcissists are usually charming, attractive people. They often are successful in theirchosen careers. We find them interesting and make them the center of attention.Life around them feels exciting and spontaneous. We ignore the fact that they becomedisinterested when the conversation drifts away from their favorite topics. Weexcuse their thoughtlessness and selfishness. We don't mind doing theirfavorite activities or going to their favorite restaurants because they areendearing. We are drawn to them. We feel special when they choose to hang outwith us. Their successfulness and good looks seem to rub off on us. We aresomehow “more” when we are with them.

Life is good with people who have narcissisticpersonality traits until the relationship becomes serious. A developingrelationship begins to emphasis reciprocity and mutuality. It is no longerabout what one gets from being with the other person, but also what one givesto nurture the relationship. Narcissists cannot do this well, if at all. Therelationship always must be on their terms, allowing them to maintain control.They avoid true intimacy by keeping everyone at arm's length. Instead, theytend to use people to meet their constant need to be idealized and idolized.When things go wrong, they are never to blame. They rigorously defendthemselves and attack others when problems occur. Once the relationship movesbeyond the admiration stage, it is no longer fun to live with narcissisticindividuals.

What causes thisdisorder? Is it environmental factors or genetics? In the next article we willdefine the characteristics of narcissistic personality disorder and exploresome theories about how this condition develops.

Personality Disorders: Introduction

2011-09-08T14:32:00.000-07:00

Most of us have had an experiencedealing with an extremely difficult person. We may have initially found thisindividual attractive. He (or she) seemed sincere and had interpersonalcharisma. But once we began to trust this person, we discovered that he was notwho he first appeared to be. We ended up being treated rudely or feltmanipulated. Our interests were betrayed, leaving us feeling ripped off anddeceived. This is a common scenario that happens when we encounter individualswho has some characteristics of a personality disorder.

What is a personality disorder? The AmericanPsychiatric Association in the Diagnostic and Statistical Manual of MentalDisorders (DSM-IV-TR) classifies ten distinct personality disorders. Thismanual is the primary guide mental health professionals use to identify variousmental health conditions. The DSM-IV-TR defines personality disorders as“an enduring pattern of inner experience and behavior that deviates markedlyfrom the expectations of the individual’s culture, is pervasive and inflexible,has an onset in adolescence or early adulthood, is stable over time, and leadsto distress and impairment.” In other words, personality disorders are a set ofinterpersonal habits and behaviors that develop by adulthood and are strikinglydifferent from cultural norms.

Not all characteristics ofpersonality disorders are problematic. Extremely shy people might have sometendencies of an avoidant personality. Graduate students who meticulously studyfor exams might be somewhat obsessive-compulsive. Most of us have a couple oftraits of one of the identified personality disorders. Some of thesecharacteristics help to make us uniquely ourselves. The critical factor indetermining if the personality disorder tendency is problematic is whetherthese characteristics negatively impact our quality of life. For example, doesour spontaneous nature result in unwanted credit card debt? Do we find itdifficult to listen to others and to care about their concerns? Do we findourselves easily fearful and are unable to try new things or visit new places?When our lifestyle and interpersonal relationships are affected, then ourpersonality quirks are no longer cute, but have become a problem.

Over the next nine months I wouldlike to spend some time on the topic of personality disorders. I hope thesearticles will be helpful in identifying general characteristics of the mosttroublesome personality disorders. I also want to provide suggestions on how todeal with mildly to moderately dysfunctional individuals. Should we risk havinga relationship with someone who is struggling with a personality disorder? Whatdo we do when this impaired person is our parent, sibling, spouse, or boss?Hopefully at the end of these articles we will have a better sense of how toprotect ourselves while we continue to support our struggling loved ones.

In the next article we will beginto explore the dynamics and characteristics of the Narcissistic Personality Disorder.

Bible Studies Backstory: Jesus, The Ultimate Therapist

2011-06-05T12:47:00.000-07:00

To purchase the eBooks, go here.

Several years ago I began to seriously look at my spiritual walk. What was the main reason for my faith? Was it to go to heaven? Or to rid myself of guilt and remorse? Was to have an easy life? I realized that despite growing up in the church, my relationship with Jesus Christ felt shallow and two-dimensional. What did I actually know about him? Who was he to me?

As I considered this, I began to connect my professional life to these spiritual questions. I understand that as a psychologist it is my purpose to help clients achieve a greater sense of harmony within their community and within themselves. This usually is achieved through some form of emotional or psychological healing. I also know from my practical experience and clinical research that the most effective tool to achieve this goal is the therapeutic relationship. It has been consistently found that psychological healing occurs over time when a client feels unconditionally accepted and safe to discuss his or her most painful issues.

If human therapists can reasonably achieve the goal of emotional healing through the context of an accepting, supportive clinical relationship, then how much more success will Jesus have in bringing psychological healing to you and me. It was this inspiration that encouraged me to write these studies.

Each studies looks at six unique types of relationships Jesus has with each of us. The first study addresses roles therapists have with clients, but how Jesus uses these relationships to perfectly meet our needs. The second book addresses an additional six relationships that Jesus has with each of us, but that therapists cannot have with clients since clinicians are flawed human beings. Jesus loves us in such a way that we are not at risk of being used or hurt by him. He is the perfect and ultimate therapist!

Both studies provide a brief historical background and strong biblical bases for each type of relationship. They also include meditation exercises, psychological questions, and musical playlists to encourage you to approach the material in various ways. It is my hope that you will engage worshipfully and dynamically with each chapter. It is also my desire that you will know Jesus on a more intimate basis when you conclude both studies.

You can find paperback copies of these Bible studies at Amazon (Book 1 and Book 2). They also are now available as ebooks on my website. You can buy the books in their entirety or by the chapter. The chapters are available individually because each completely covers its topic and does not depend on previous chapters to develop a context or theme. The Introduction chapter of each ebook study is available for free.

This fall I will begin a new series looking at personality disorders. What are they? How do they affect relationships? If you are in a relationship with someone who is suffering from a personality disorder, how do you manage the interpersonal complexities and difficulties? These articles will begin September, 2011.

Have a great summer!

Mental Health Interview Series: Dr. Bruce Vermeer, Neuropsychological Assessments

2011-05-02T14:55:00.000-07:00

Dr. Bruce H. Vermeer, PsyD is a licensed psychologist with a specialty in neuropsychological assessments. He received his postdoctoral training in this specialty area at Pine Rest Christian Hospital’s psychiatric medical unit located at St. Mary Hospital in Grand Rapids, Michigan. He also worked in Pine Rest’s outpatient department, counseling individuals and couples. Since 2001, Dr. Vermeer has been in private practice where he continues to spend approximately 50 percent of his time completing neuropsychological assessments. His office is located at 2093 Health Drive, Suite 200, Wyoming, Michigan 49519.

Kerry:
Dr Vermeer, thank you for taking time to describe your specialty area. What is a neuropsychological assessment?

Dr. Vermeer:
A neuropsychological evaluation is a paper-based examination which provides a current picture or a “snapshot” of an individual’s cognitive functioning. It is like a road map of a person’s mental functioning level. It shows what is working and not working well. This information can be helpful when someone has undergone a noticeable psychological change, such as experiencing memory loss or displaying impaired judgment. A neuropsychological evaluation can be a useful tool, when combined with a good medical history, to help a primary care physician make an appropriate diagnosis of individual’s cognitive and functional problems.

Kerry:
What should one expect a typical neuropsychological evaluation experience to be like?

Dr. Vermeer:
Each person’s testing is individualized. Depending on the presenting symptoms and the client’s age, testing can varying from two to 12 hours long. The usual duration, however, is about 3 hours and includes several different kinds of tests, all of which evaluate various cognitive functioning. Most clients find the testing experience engaging, and even fun, since it is a bit like a game.

Kerry:
When should someone seek this kind of testing?

Dr. Vermeer:
Clients are most often referred by their primary care physician or their psychiatrist for testing. Usually there has been a change in the individual’s overall level of cognitive (mental) functioning and the physician is looking for a diagnostic understanding of this difficulty.

Kerry:
How are the results helpful to clients and their families?

Dr. Vermeer:
Neuropsychological testing can be helpful in at least two ways.

First, neuropsychological evaluation can help shape a client’s medical assessment and treatment planning process. It can assist physicians in clarifying an individual’s diagnostic picture, and it can help identify additional diagnostic options (if any are needed). It can also provide practical suggestions on how the individual might more adaptively cope with their cognitive deficits. This is accomplished by identifying rehabilitative interventions and/or therapies that might be useful in helping individuals adjust to their current mental deficits. In some cases it is even possible to “train” the brain to overcome compromised functions. Different regions of the brain can be taught to handle previously weak or lost skills. Finally, a neurological assessment can help the physician decide if and when to prescribe cognitive enhancing medication.

Secondly, neuropsychological evaluations are often used in legal situations. For example, evaluation results are sometimes used in the process of determining one’s competency to stand trial. More frequently, however, evaluation results are instrumental in determining whether a person can independently engage in making significant medical, financial, and legal decisions. The results are also used for the purpose of determining whether formal activation of an individual’s power of attorney needs to occur. In the state of Michigan, formal power of attorney is activated by the signature of two physicians, or by one physician and a licensed psychologist.

Kerry:
Is a neuropsychological assessment covered by insurance and Medicare?

Dr. Vermeer:
Yes, it is covered by Medicare and most types of insurance plans. Neuropsychological assessments are considered a medical procedure and are covered under an individual’s medical coverage plan.

Kerry:
Is any special kind of training or experience necessary to be qualified to perform neuropsychological assessments?

Dr. Vermeer:
Presently, you must be a licensed psychologist and have completed two years of specialized postdoctoral training and supervision in neuropsychological evaluations.

Kerry:
If someone would like to seek this kind of assessment and they don’t live in the greater Grand Rapids, Michigan area, how do they go about finding a specialist in their area?

Dr. Vermeer:
I would recommend contacting your insurance carrier for names of providers in this discipline. Primary care doctors also often have contacts of specialists in your area. On-line research can also be helpful.

Kerry:
Thank you, Dr. Vermeer, for this helpful information. If you would like more information about Dr. Vermeer or his practice, you can contact him at 616-742-1960.

Mental Health Specialists Interview Series: Dr. Steven Hamming, PsyD, Performance Anxiety

2011-04-12T17:21:00.000-07:00

I would like to introduce Steven G. Hamming, PsyD, clinical psychologist, who has been in practice for over 20 years and treats performance anxiety. He is a member of the American Psychological Association (APA), the Eye Movement Desensitization Reprocessing International Association (EMDRIA), the American Academy of Experts in Traumatic Stress (AAETS), and the American Group Psychological Association (AGPA). Dr. Hamming is also the founder of OP-Sports, where he specializes in sport-related performance coaching. His practice is located at 5060 Cascade Road, Suite D, Grand Rapids, MI 49546.

Kerry:
Dr. Hamming, briefly tell me about your work with performance anxiety.

Dr. Hamming:
My work focuses on “stage anxiety.” Sometimes the “stage” is literal for singers and actors, while at other times it is metaphorically meaning “the experience of being watched.” This includes athletes, trial lawyers, or anyone who stands in front of others and has to perform.

Kerry:
Is this a common problem?

Dr. Hamming:
Based on one’s own personal history and how one’s first “on stage” experiences were responded to (think ages 2-10) contributes greatly to the level of anxiety one is likely to have in their adult opportunities to be on stage.

Kerry:
Does this problem mainly occur with athletes or do you see it in other professional pursuits?

Dr. Hamming:
I see “performers” from a multitude of stages, but athletes are one of the primary groups that I treat.

Kerry:
How do you know if you or someone you know is experiencing this difficulty?

Dr. Hamming:
The way performance anxiety often shows up athletically is when there is a great disparity between the athlete’s abilities/performances in the practice setting and how his or her performance diminishes under the pressure of “show time.”

Kerry:
What is the best way to seek help?

Dr. Hamming:
It is best to find someone who clinically understands the nature of anxiety and who athletically understands the pressures and nuances of what is necessary to perform. Finding that fit will be the greatest help to understanding and addressing performance anxiety.

Kerry:
What does psychological treatment usually involve?

Dr. Hamming:
Treatment involves an exploration of what is happening during performances. This would include what is going in their mind and what is happening in their body at these stressful moments.

Treatment is not just an intellectual understanding but an integration of the mind with the body and learning to calm both of them down simultaneously. Treatment that only addresses the mind is like putting a band aid on the wound before treating it. It will help some, but not as thoroughly as what would be more useful.

Kerry:
How long does treatment take? And, what is the success rate?

Dr. Hamming:
The length of treatment varies greatly based on the needs of the individual, what his or her personal goals are, and also on how interwoven or complicated the anxiety is in the history of this person. I have seen athletes be greatly helped after one session and others have worked with me for several months before reaching their personal goals.

Kerry:
Have you had any special kind of training or experience to be qualified to perform this kind of counseling?

Dr. Hamming:
My training as a psychologist prepared me for working with anxiety. I have also attended a number of sports psychology conferences, trainings, and workshops to understand the intricacies of working with performers. Finally, I utilize my own competitive experiences, past and present, to help me understand experientially what is happening and what would be helpful ways to intervene.

Kerry:
If someone would like to seek this kind of treatment and they don’t live in the greater Grand Rapids, Michigan area, how do they find a specialist in their area?

Dr. Hamming:
Google! Amazing how many times Google has the right answer!

Kerry:
Thank you, Dr. Hamming!

You can learn more about Dr. Hamming and his work at http://www.op-sports.com/. He also can be contacted by telephone at 616-459-0000 or by email: drhamming@sbcglobal.net.

Mental Health Specialists Interview Series: Dr. Dane Ver Merris, Rehabilitation Psychology

2011-03-18T09:02:00.000-07:00

Dane Ver Merris, Ed.D. is a psychologist with many specializations. Currently he is working for the Traumatic Brain Injury Program of Hope Network Rehabilitation Services as a rehabilitation psychologist. He also is an adjunct facility member at Western Michigan University and Calvin College, teaching graduate and undergraduate courses. He has had years of both inpatient and outpatient clinical experience and currently chairs the State of Michigan Board of Psychology.

Kerry: Dr. Ver Merris, briefly tell me about your specialty.

Dr. Ver Merris:
Rehabilitation psychology is an area of treatment that helps people adapt to the effects of severe—often catastrophic—injury or illness, such as brain injury, stroke, spinal cord injury, or loss of limb. The person’s impairments might be physical, cognitive, emotional, or sensory. Because the impairments are usually permanent, this kind of treatment often involves aiding people to rebuild their lives with these persisting disabilities.

Kerry: When does a person need rehabilitation?

Dr. Ver Merris:
Individuals generally need this kind of clinical intervention after a severe injury or illness. Some injuries, for example, are sustained from a motor vehicle crash, workplace accident, military combat, athletic injury, or assault. Other causes of impairment might include cerebral vascular accident (stroke), anoxia after a heart attack, drowning, or drug overdose, tumors, multiple sclerosis, muscular dystrophy, Parkinson’s disease, or vision or hearing loss. Usually some type of catastrophic event has occurred which has resulted in a person suffering from severe psychological or physical losses.

Kerry: What is involved with this kind of treatment?

Dr. Ver Merris:
After a disabling injury or illness, people sometimes need help in accepting the reality of living with persisting impairments. The treatment focuses on helping each person accept a new definition of himself or herself as an individual with impairment. Rehabilitation psychologists help individuals learn to maximize their functioning and lifestyle despite this drastic loss or change. Psychologists offer testing (for example, of mood or cognitive function after a brain injury), psychotherapy, compensatory strategies, behavior analysis, pain management, education, and support.

Kerry: Are other types of specialists a part of the treatment process?

Dr. Ver Merris:
Yes, a team of specialists are often involved in the injured person’s recovery process. The specialists might include physical therapists, occupational therapists, speech therapists, physiatrists, psychiatrists, social workers, recreational therapists, and vocational rehabilitation specialists.

Kerry: Is this care covered by insurance?

Dr. Ver Merris:
Generally, yes. It may be auto insurance, worker’s compensation insurance, or health insurance, depending on the source of the disability.

Kerry: Do rehabilitation psychologists have any kind of special kind of training or experience to be qualified to provide this type of care?

Dr. Ver Merris:
There are graduate study programs that have a specialization in rehabilitation psychology. There is also additional clinical training, such as conferences that keep clinicians current in the latest treatments. Some psychologists are “board certified” through the American Board of Rehabilitation Psychology.

Kerry: If someone would like to seek this kind of treatment and they don’t live in the greater Grand Rapids, Michigan area, how do they go about finding a specialist in their area?

Dr. Ver Merris:
Most metropolitan areas have rehabilitation psychologists who work in rehabilitation facilities or private practice. APA Division 22, Rehabilitation Psychology would be another source of information.

Thank you, Dr. Ver Merris, for informing us about this important clinical work.

If you would like to contact Dr. Ver Merris, he can be reached at the following address:

Dane Ver Merris, Ed.D.
Hope Network Rehabilitation Services
1490 East Beltline SE
Grand Rapids, MI 49506

Mental Health Specialists Interview Series: Susan DeGroot, MSW, Nutrition and Mental Health

2011-02-28T08:20:00.000-08:00

Susan DeGroot, MSW, is a mental health therapist currently employed at Marquette General Hospital’s Outpatient Behavioral Health Department in Marquette, MI. She has over 35 years of practical experience and has had a long-time interest in the relationship between nutrition and mental health. She recently attended the National Nutrition Conference in Atlanta, Georgia to refine her knowledge in this topic. She also is currently serving on the Nutrition and Medicine Committee at Marquette General Hospital.

Kerry: Thank you, Susan, for taking time to answer a few questions about the effects of nutrition on our mental health. Give some examples of how our diet affects our sense of well-being.

Susan:
Basically, we are what we eat! Many acute nutritional deficiencies have historically been known to cause mental health symptoms. Severe Vitamin C deficiencies, for example, can cause scurvy. This was discovered when individuals deprived of Vitamin C during long ocean voyages became very ill. Iodine deficiencies are known to cause goiters accompanied by psychotic behavior. This problem was very common in the days before salt was iodized. Recently, significant subtle dietary issues have been correlated with depression, bipolar disorder, schizophrenia, and behavioral issues (such as anger and aggression).

Kerry: What are some common problems with an average diet?

Susan:
Two of the most common issues with the western diet or “Standard American Diet” are the excesses of Omega 6 fatty acids and the deficiencies of Omega 3 fatty acids. Prior to about 1900, Americans ate equal ratios of Omega 3 and Omega 6 fatty acids. Current estimates are that the ratio in the American diet is between 10-20 parts Omega 6 to 1 part of Omega 3. The brain is the “fattest” organ in our body and is responsible for all of our emotions. This dietary shift basically has changed the fat composition of the human brain. Excessive amounts of Omega 6’s and insufficient Omega 3’s have been correlated with higher rates of suicide, depression, bipolar disorder, increased frequencies of homicide, and incidents of domestic violence.

Kerry: Which mental health problems have a strong connection to nutritional deficiencies?

Susan:
Basically they all do. While you cannot say that nutritional issues are completely responsible for all of our mental health issues, since there is obviously some genetic basis, it is a major contributor to the level of severity and the timing of the onset of symptoms in almost all mental health disorders.

Kerry: How are these deficiencies diagnosed?

Susan:
There are laboratory tests that can diagnose many of them, but they are expensive and often not covered by insurance. Some tests are available at specialty centers around the country.

The best way to evaluate deficiency is to evaluate the diet. National Health Care Reform, which was passed last year, provides for the services of a registered dietician to be covered at the rate of 100 percent for any person considered “at risk” beginning January 1, 2011. A diet history evaluated by a registered dietician is probably the best diagnostic tool.

Kerry: How are dietary deficiencies typically corrected?

Susan:
There are supplements that can correct many of them, but correcting a deficiency in one nutrient often results in a deficiency developing in another. Nutrition is all about balance. The best solution is to change your diet by including a wider variety of foods, such as vegetables, fruits, fish (Omega 3's), and reducing the amount of processed or pre-prepared foods. While working to change your diet, it is also reasonable for all adults to take a good quality multi-vitamin & mineral supplement, along with extra Vitamin D at a dosage of at least 2000 IU's of Vitamin D3 (This is well within the safe range. Daily dosages of vitamin D3 larger than 3000 IU's from all sources should be monitored by a physician.) and a supplement of Omega 3 fatty acids (Fish Oil) that provides at least a total of 900 mg of “DHA plus EPA” per day (You will find the amounts of DHA and EPA per serving listed on the back of the bottle). It is always wise to check with your doctor before beginning any supplements.

Kerry: Would you recommend any helpful books on this topic?

Susan:
There are many good and reliable books available. I recommend a book by Dr. Andrew Weil, MD, Eating Well for Optimum Health.

Kerry: How does one go about finding a nutritional specialist in their area?

Susan:
All hospitals have dieticians. You may also find them in private practice or affiliated with some weight loss programs.

Kerry: Thank you for this great information.

If you would like to contact Susan DeGroot, please e-mail her at susan.degroot@mghs.org.

Mental Health Interview Specialists Series: Kimberly Gleason, Life Coach

2011-02-14T09:35:00.000-08:00

Let me introduce Kimberly Gleason who is a professional life and executive coach, speaker, author, and owner of the coaching company, Coaching for Life Purpose (soon to be renamed Synergy Coaching Alliance). She graduated with a B.A. in English and a minor in psychology. Thereafter she went through professional coach training through the Institute for Life Coach Training, an International Coach Federation-accredited school. She has been featured in Women’s Lifestyle Magazine as an expert in this field and was recently interviewed for Grand Rapids Magazine.

Kerry: What is life coaching?

Kimberly:
Life coaching is a powerful, synergistic partnership between coach and client that propels the client toward overcoming challenges and achieving his or her goals and dreams, both personally and professionally. Similar to a personal trainer, a coach will encourage, brainstorm, strategize, and motivate clients towards their goals, as well as hold them accountable for achieving them. Basically, a coach helps clients get from where they are in life and career to where they want to be.

Kerry: How does it differ from more traditional forms of counseling?

Kimberly:
Traditionally, counselors are considered the “experts.” Also, counseling often focuses on the past and deals with traumatic issues (such as divorce, death, and other types of disorders). Coaches, on the other hand, help people who are already mentally healthy but simply want more out of life. Coaching is not past-oriented but future and action oriented. They do not consider themselves to be the experts regarding the clients’ lives, but rather partners who align themselves with the clients’ goals. Coaches do not give advice. Instead, they help clients to develop their own goals and strategies based on their values, priorities, experiences, and lifestyle.

Kerry: When should someone seek help from a life coach?

Kimberly:Someone should seek help from a life coach when they feel stuck and unfocused or when they simply want more out of their lives and careers. Coaches are for people who are motivated and driven to be their best selves in all areas of their lives. Because coaches help people to overcome their struggles and reach their goals, coaches generally help people in various aspects of their life and career.

Kerry: What should one expect from coaching?

Kimberly:
One should expect to work with a coach 2-4 times a month for one-hour sessions. Clients always walk away from each session with specific things to do that will help them move forward to where they want to be. Only those who are ready to invest in themselves—their finances, time, energy, and passion—are ready to have a coach. Also, clients can expect that a coach will be someone who believes in them and their capabilities and is entirely committed to their growth and success.

Kerry: Are there typical problems or issues that are addressed?

Kimberly:
Some examples include having better time management, becoming more organized, making a major decision, determining a career choice, keeping focus, strengthening relationships, aligning one's life with one's priorities, accomplishing a particular goal or dream, being more successful, being more productive and efficient, finding one's life purpose, making an impact on the world, decreasing work stress, having more joy, and personal and spiritual growth.

Kerry: How long does the coaching relationship last?

Kimberly:
On average, 4-8 months.

Kerry: What are the most important credentials or personal qualities in an effective life coach?

Kimberly:
When looking for a life coach, make sure that the coach has had professional training through an International Coach Federation-accredited training school.

Kerry: How does one find an effective life coach in their area?

Kimberly:
You can find a coach through the Professional Coaches Association of Michigan.

Thank you, Kimberly, for taking time for this interview!You can find out more about coaching or subscribe to Kimberly Gleason’s free e-newsletter at http://www.coachingforlifepurpose.com/.

Mental Health Interview Specialists Series: Michelle Muezenmeyer, LLP, Eating Disorders Specialist

2011-01-31T09:28:00.000-08:00

Let me introduce Michelle Muezenmeyer, LLP, who started working with eating disorders 8 years ago as an inpatient psychotherapist at Forest View Psychiatric Hospital. She continued this work when she later joined Pine Rest Christian Mental Health Services where she led eating disorder recovery groups and provided specialized individual and family counseling. She currently works as a private practitioner at 5060 Cascade Road, Grand Rapids, Michigan. She can be reached at (616) 454-2911 for appointments or questions.

Kerry: “Michelle, thank you for taking time out to answer a few questions. Tell me, what is an eating disorder?”

Michelle:
“Eating disorders are a group of three serious, potentially life-threatening conditions that affect a person’s emotional and physical health. They are: Bulimia Nervosa; Anorexia Nervosa; and Binge-Eating Disorder. People with these conditions use them to ‘numb’ their emotional experiences and to gain a perceived sense of control over their internal world. Eating disorders have been called ‘a disorder of emotions’ since clients are often unaware of their own feelings, see themselves as unworthy of acceptance and love, and tend to focus on pleasing others. It is common for affected individuals also to struggle with symptoms of depression, anxiety, and substance abuse.”

Kerry: “Briefly describe each type of eating disorders.”

Michelle:
“Bulimia Nervosa is characterized by someone consuming a large amount of calories without gaining weight. He or she is able to do this by vomiting after meals, excessively exercising, and/or overusing laxatives and diuretic medications.

Anorexic clients are individuals who have lost a significant amount of their body weight (usually 15% or more of their original weight) and have a distorted perception of their body shape and size. They usually have a rigid determination to become thinner, often at great risk to their health. Both of these first two conditions are accompanied by low self-esteem and an unrealistic drive to be perfect.

Someone struggling with Binge-Eating Disorder will consume large amounts of food while emotionally ‘zoning out.’ He or she may be unaware of the huge consumption and are often surprised by the behavior. This person usually doesn’t purge and, as a result, is overweight or obese. Health risks are associated with this condition, and it is also often accompanied by depression, anxiety, or other substance abuse problems.”

Kerry: “Who usually recognizes the problem first?”

Michelle:
“In cases that involve a child or adolescent, the primary care doctor often is the first person to recognize the problem. Usually parents will have observed a health issue resulting from the eating disorder and will bring their child to the physician for a health assessment. For example, teenage girls will often have stopped menstruating. Parents also might have seen odd or alarming ritualistic eating behaviors or habits. Adolescent clients, however, are very good at hiding eating disorders. Parents are more likely to have noticed that their child seems depressed, angry, or withdrawn. These changes often cause parents to seek professional advice.

Family members are usually the first to identify a problem in adult clients. Often loved ones will confront a struggling individual. Since most people with an eating disorder don’t want help, they will deny the condition until there are serious health issues that force them to get professional treatment.”

Kerry: “What should one expect from treatment?”

Michelle:
“For the anorexic client, the primary goal is weight restoration, and for the bulimic patient, it is the termination of the binge and purge cycle.

Counseling only begins when clients are medically cleared of any serious health concerns. Once that occurs, struggling individuals need to be motivated to participate in the treatment process. Many eating disorder specialists will involve a nutritionist and a psychiatrist as part of the treatment team. Family counseling and/or group therapy might be included.

Therapy will address clients’ fear of being fat, their obsession with body weight or shape, their low self-esteem, and any difficult interpersonal relationships they are experiencing. They will learn to identify and appropriately express their emotional needs. They also will learn new coping skills to address life’s challenges instead of their previous habit of using food.”

Kerry: “How do you know when individual therapy isn’t enough?”

Michelle:
“Each new client comes into treatment with a different level of motivation. Some individuals are not quite ready to give up their dysfunctional behaviors. In such cases, group therapy can help to provide the impetus and support to help that person take the next step.

Some clients have co-existing psychological conditions. For example, they may have an eating disorder and a substance abuse problem. Other clients might be severely malnourished or medically unstable. In these situations, individual therapy may not be intensive enough. These individuals may need a brief stay in an inpatient psychiatric hospital to help jump-start the treatment process.

Kerry: “What other forms of treatment are there and how does one get admitted to those programs?”

Michelle:
“Other forms of treatment besides inpatient hospitalization and outpatient therapy include: Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior Therapy (DBT), and art therapy. Rarely does someone start these forms of treatment unless he or she has been referred by another specialist, such as a counselor.”

Kerry: “What are the most important credentials or personal qualities in an eating disorder specialist?”

Michelle:
“An effective therapist will have plenty of counseling experience with eating disorders. It may be helpful to ask if the mental health professional has received specialized training and supervision in this area. It is also important that this therapist have good working relationships with other specialists, such as nutritionists, psychiatrists, and primary care physicians, since treatment teams can be very helpful.

Effective therapists will also be patient and knowledgeable. They will come across with personal warmth, compassion, and empathy. They also should be good role models in maintaining open line of communication, setting appropriate limits, and practicing healthy lifestyle habits.”

Kerry: “There is a common perception that eating disorders are difficult to treat, is that true?”

Michelle:
“Therapy requires the client to give up a pattern of behavior that has given this individual a sense of control over painful emotions. This is hard work. There is also a fear that recovery may mean becoming overweight and ugly. Clients have to overcome these fears and concerns in order to learn new behavioral habits.”

Kerry: “What is necessary to make treatment successful?”

Michelle:
“It takes an enormous amount of courage for a struggling individual to face the necessary physical and emotional changes needed for full recovery. Recovering individuals will have confronted their fear of food and possible weight gain, learned to deal with emotions differently, and become able to face the world more assertively.”

Kerry: “How does one find an eating disorder specialist in their area?”

Michelle:
“Some weight loss programs have a referral list of eating disorder providers in their area. One’s primary care doctor and health insurance carrier are also an excellent resource for finding a counselor. Probably the best referral source is by word of mouth. Ask colleagues or co-workers, friends, and family members for a recommendation of a specialist.”

Kerry: “Thank you, Michelle, for taking time today to answer questions about eating disorder treatment!”

If you would like to learn more about Michelle, to ask her any questions, or to make appointment with her, she can be reached at (616) 454-2911.

Mental Health Specialists Interview Series: Melissa Tower, Child and Adolescent Therapist

2011-01-18T16:35:00.000-08:00

This is a start of a Q & A series with mental health specialists. For the first interview, let me introduce Melissa Tower, LLP, who is an excellent child and adolescent therapist. She has been counseling for the past 13 years. She worked for 12 years as an outpatient psychotherapist at Pine Rest Christian Mental Health Services before joining our mental health providers group located at 5060 Cascade Road, Grand Rapids, Michigan. She can be reached at (616) 454-2911 for appointments or questions.

Kerry: “Melissa, thank you for taking time out to answer a few questions about working with children. First off, when should a parent seek help for his or her child?”

Melissa:
“Counseling should always be sought following a traumatic experience or event in a child's life. Otherwise, I would encourage parents to trust their gut instincts regarding when to seek help. If a child is exhibiting a new behavior, including repetitive physical movements, it is good to get a professional's opinion. Sometimes children know they need help and will ask their parents to talk to someone. I urge parents to always take these requests seriously.”

Kerry: “How does a parent know when a new or odd behavior is problematic?”

Melissa:
“When children are in emotional trouble, their daily routines usually change. Parents might notice their child's sleeping pattern or eating habits have become different. Their child might be less interested in connecting with friends or finds his or her hobbies less interesting. School performance may decline. These are all indicators that a child is emotionally struggling.

Sometimes a new behavior appears, such as toileting accidents, repetitive hand-washing, or a facial tic. It is important to observe how often this symptom occurs and the child's reaction to it. Is the child aware of the new behavior, and does it make him or her feel self-conscious? If parents notice these kinds of changes, it is important they seek help for their child.”

Kerry: “How does a parent go about finding a children's therapist?”

Melissa:
“First, ask the child's primary care doctor for a recommendation. Parents might also contact their health insurance company for a list of approved counselors. Sometimes friends and family will have suggestions of a good therapist. The internet and telephone yellow pages can also be a resource.”

Kerry: “What are the most important credentials or personal qualities in a good children's therapist?”

Melissa:
“Parents should look for a counselor who has at least a Master's level of education and identifies himself or herself as a children's therapist. It is important to ask about the therapist's accessibility. Does this individual have voicemail or e-mail? How does he or she deal with after-hour emergencies? Does the counselor return phone calls in a timely manner? It is important the child's therapist is able to maintain open lines of communication throughout the treatment process.

Next parents should pay attention to the therapist's interpersonal qualities. Is this counselor approachable, warm, and honest? Does he or she make the child feel safe and comfortable? Does this individual seem compassionate and empathetic? If there are any misgivings about the counselor, then the parents may need to seek out another mental health professional.”

Kerry: “What should parents expect from treatment?”

Melissa:
“Expect the first session or two to include both the parent(s) and child. These appointments are to gather background information. The therapist should speak to the parent and the child for each of their perspectives of the problem.

After the first session or two are completed, most children's therapists split the 45- 50 minute counseling hour between individual time with the child and meeting with the parent(s). The therapist's counseling technique will usually include some combination of talking, art, and play, depending on the child's age.

Sometimes children need an additional referral for a psychiatric consultation. This is a separate assessment done by a psychiatrist who is a specially-trained medical doctor. This doctor will gather information about the child and determine if medications are necessary to help the child with his or her issues. Parents should be leery of this recommendation if it is made before meeting the child. It needs to be part of the treatment plan and occur after the therapist's assessment of the problem is completed.

Finally, parents should expect regular contact with the therapist about the child's treatment progress. This communication generally includes an overview of issues addressed in counseling. It needs to be communicated carefully so that the child's developing trust in the therapist is not violated. Parents, however, should always expect to be informed when the counselor suspects the child is being harmed in anyway.”

Kerry: “How long does treatment usually take?”

Melissa:
“There are no strict guidelines that govern treatment length, but generally the child's therapist can provide a reasonable estimate at the start of the therapy process. This will be based on the mental health professional's assessment of the child's problem, how long the problem has been occurring, and the severity of the symptoms.”

Kerry: “If the child's problem includes issues at school, does a children's therapist get involved? And if so, in what way?”

Melissa:
“This doesn't happen very often, but if the counselor needs to contact the school for any reason, it is important that the parent provide written permission allowing that contact. The purpose and objective of the contact should also be clearly defined in order to protect the family's confidentiality.”

Kerry: “Thank you, Melissa, for answer questions about therapy with children!”

If you would like to learn more about Melissa, to ask her any questions, or to make appointment with her, she can be reached at (616) 454-2911.

Happy New Year's Day!

2010-12-30T21:55:00.000-08:00

I am excited about the upcoming 2011 articles. Several mental health specialists have agreed to be interviewed about their areas of expertise. The topics will include: 1) what is the purpose of a neuropsychological assessment; 2) what to expect from couple's therapy; 3) when and how to obtain treatment for one's child(ren); 4) what are the symptoms of an eating disorder and what should one expect from treatment; 5) what is life coaching and how does it differ from counseling; and 6) what is the role of nutrition in psychological health. Please feel free to leave comments or suggestions of other topic areas you would like to see discussed.

In the meantime, have a wonderful and safe holiday!

Driving Forces: God's Will

2010-12-16T19:32:00.000-08:00

"Our Father in heaven, hallowed be your name, your kingdom come, your will be done, on earth as it is in heaven. . ."

Matthew 6:9-10

There are four principle driving forces we use to direct our daily lives. They are our emotional needs, our logic and reason, our personal willpower, and God's will. You may have noticed that I started this series with the one most commonly used to govern our lives---our emotional state. Few of us use our analytical reasoning, but even less of us utilize our willpower. The last driving force is the one we least employ: God's will. God's will, however, should be the primary direction for our lives since it provides us with a moral code and clarifies what is important.

So, what is God's will for our lives? That is a huge question. There are many wonderful books written on this topic, but it can be simplified for the purposes of this article. According to Jesus, we are to love God with all our heart, soul, body, and mind, and to love each other (Matthew 22:37, paraphrased). Loving God and loving each other should be the guiding principles to everything we do. We should start each day with those two goals. We need to willfully (using driving force of will) choose these goals and logically (reason) determine how to go about achieving them. We will discover that pursuing God's purposes will lead to lasting personal fulfillment (emotions). We will find that it is only when we deliberately put God's will first, our will second, and our logical reason third, that our emotional needs are met.

Most of us, however, approach life using these driving forces in the opposite order, with emotions directing the show. This approach rarely achieves the personal contentment and satisfaction we seek. Real enjoyment is only possible when we live under God's rule. This may seem illogical to most of us. Why doesn't pursuing pleasure lead to happiness? Despite the reasonable of this idea, it doesn't work.

God desires us to experience real joy, but such emotional state is only possible when we seek his will. This is a hard truth. Most of us resist submitting ourselves to another's plans. Putting God's will first requires us to sacrifice our own pursuits and to trust that God's way is better.

If this is a new concept, I urge you to try it out. Spend some time reading the Bible, find a local church group and get involved, and start to have regular conversations with God. Ask him to help you get to know him better. All of these steps are a great way of making God's will the primary driving force in your life.

Driving Forces: Willpower Gone Awry

2010-12-02T23:05:00.000-08:00

". . .he went up on a mountainside by himself to pray. Later that night, he was there alone. . ."

Matthew 14:23

Over the years I have met a few rare people who live mainly by their willpower. These individuals usually have done amazing things. I was particularly impressed by a 60-year-old man who regularly competed in triathlons. He explained that he daily ran several miles, biked a couple of hours, and regularly swam to prepare for the next race. This man was not prone to using his emotions as a driving force. I suspected he didn't ask himself if he felt like exercising on any given day. Reason also wasn't a driving force. I doubted he allowed distractions to interfere with his training schedule. He probably stayed extremely focused on the necessary preparations for the next race. To an outsider, he may have seemed irrational at times. It was only by his strong determination he was able to be successful.

This man is an example of a person who lives his life by willpower. He sets goals for himself and heads toward them regardless of the personal cost. As a result, he has been a successful athlete. In fact, he has consistently placed in several competitions.

Many very successful people live by their willpower. Top executives of Fortune 500 companies, Olympic medalists, Nobel Prize winning scientists, and some entertainers obtain high achievements because of their driven nature. These individuals are singularly focused. All other needs and agendas are subjugated to their principal goal. I suspect they work at their main objective whether they are hungry, tired, or sick. In other words, they are driven by their will.

This may be admirable, but it is out of balance. Our will should be one of the most important driving forces in our life, but it is not to be the only force. We should use our willpower to set short and long range goals while allowing our logic and emotions to temper those objectives. For example, if we desire to be physically fit, we should regularly exercise, not just when we feel like it. On the other hand, we shouldn't work out when we are ill. Our will needs to let our rational mind and our emotional state determine the reasonableness and wisdom of our goals.

Jesus had strong personal willpower. He knew his powerful message of love would be provocative. Despite the risks, he stayed on message even though it resulted in his death. Jesus, however, did not unreasonably drive himself with this objective. He still took time out to teach his disciples, to spend time with friends, and to be alone with God. Jesus lived a balanced life; one reasonably driven by will.

Driving Force: Our Amazing Willpower

2010-11-22T07:41:00.000-08:00

Thought:

"You, my brothers and sisters, were called to be free. But do not use your freedom to indulge the flesh; rather, serve one another humbly in love."

Galatians 5:13

Anything I have successfully done has been the result of using my willpower. It is amazing what I have accomplished when I set my mind to it. For years, I secretly longed to play violin. I finally decided to do something about it and started taking lessons five years ago. I have stuck with it, despite not being easy. Many days I feel too busy or tired to practice, yet I have been pleasantly surprised at the payoff of my persistence. Thirty minutes of practice five to seven times a week has allowed me to now play concertos by Vivaldi and Handel.

God gave us a fantastic gift when he empowered us with willpower. Our will not only enables us to be self-determined, but it also gives our life purposefulness. It gives shape to each day. We can decide to clean the house or to leave it a mess. We can decide to eat the extra serving of food or to go for a jog. The quality of our life is up to us, and our willpower determines the course by governing our reason and emotions.

Unfortunately, most of us have weak willpower. We let our emotional needs and desires set our life's direction. It is easy to let our level of interest be the determining factor rather than our agenda. We are more likely to participate in activities or relationships that meet an emotional need, instead of those that move us closer to a long-range goal . But, this is a dangerous practice. Most long-range goals and accomplishments require a regular, incremental routine. For example, we cannot become a successful NFL football player without years of tedious exercise and practice. It is when we consistently discipline ourselves we become successful.

Our will is an incredible gift. It does take self-control to consistently use willpower, but it will enable us to achieve some incredible accomplishments. Through the use of our will, we are able to learn a new skill, become more physically fit, grow spiritually closer to God, or even take better care of ourselves and our community. As we begin to look toward the new year, let's plan to use our willpower more often.

Driving Forces: A Life of Reason

2010-11-05T10:48:00.000-07:00

Thought:

"Come now, let us reason together, says the Lord."

Isaiah 1:18a

I recently watched a trailer advertising a reality television show. It showed a woman pleading with an airline ticket agent to get on an overbooked airplane. She demanded she be allowed on the plane since it was the last flight of the day. She said she hadn't seen her 6-year-old son for the past several months and had to get home immediately. Over and over again, she screamed and pounded her fists on the ticket countertop to be allowed on the overbooked flight. As the story unfolded, she confessed she had been in drug rehab for the past six months. She claimed she needed to be with her young son since he couldn't understand the reason for his mother's absence. Her tirade became so severe that eventually security officers were called to contain her. Then the video clip ended.

At first I felt sorry for the woman. I imagined she was inadvertently separated from her young boy. Then, as more of the story was revealed, I felt disgusted. Her addiction, not the overbook flight, caused the separation. Why was it critical she get home that day since she hadn't seen her son in over six months? And, why didn't she care enough about her 6-year-old son to avoid using drugs in the first place? Finally, why was she acting aggressively? I believe this woman's behavior is an example of a life driven without the support of reason.

Reason is an important driving force in our life. It is our intellectual ability to analyze life situations. We use it to make logical decisions about our daily priorities. Reason puts highly-charged situations into perspective. It also enables us to develop strategies and helps us to problem-solve difficult situations.

We need a balance of both driving forces. A person who lives life only from emotions appears hysterical, whereas an individual who is driven by reason seems inhuman. Both make for fun television, but neither are easy to live with. Reason without emotions is cold. This individual appears computer-like and uncaring. Sheldon, on The Big Bang Theory, is a great example of a person who is driven primarily by reason. To be a whole person both driving forces, emotions and reason, are necessary. However, they must work together, with reason governing emotions.

As I pointed out before, Jesus was an emotional person, but he also used his intellect to determine his actions. He appropriately used reason. Logic governed his emotions. He often made interesting observations or asked questions about the situations he encountered before emotionally reacting. He was educated and used his knowledge to inform his daily decisions. We should strive to be like Jesus; to appropriately use reasoning in our day-to-day life.

Life with Emotions

2010-10-18T11:10:00.000-07:00

Thought:

A fool gives full vent to his anger, but a wise man keeps himself under control.

Proverbs 29:11

Emotions play an important role. We already know they are not to dictate the direction of our day-to-day decisions, but feelings remind us we are alive. They add color and texture. Our reactions let us know how life impacts us. Some situations make us sad; others excited. Life without emotions would be flat and joyless.

Some emotional reactions are also a warning. Anger, jealousy, guilt, and embarrassment tell us that we need to pay attention. These feelings inform us something is wrong. They urge us to consider making some kind of change. We should not ignore these feelings. They are like a STOP sign along the roadside. If we pay attention to the underlying cause(s), we will be able to make appropriate adjustments which should reduce our internal tension.

Negative emotions are misunderstood. Many people believe all feelings should be acted on. If we feel anger, then we have permission to act angry. We have no choice but to be angry. This is a false assumption. Our rational mind is able to stay in control of our behavior. Maintaining such control does take practice. And, some of us may not exercised that kind of "muscle" much. We, however, are never at the whim of emotions, unless we choose to be.

During my first graduate internship, I encountered a difficult situation. My supervisor was an odd woman. She seemed suspicious of others and began to isolate me. I remember feeling frightened and trapped. Instead of reacting, I used my emotions as a guide and contacted the school official overseeing my work experience. The school coordinator acted on my behalf and asked the mental health agency for a change in supervisors. I was very relieved. The rest of year went great. I contacted the previous year's student who had had the same experience. Instead of using her sense of alarm to seek help, she fled the situation and dropped out of the graduate program.

Emotions are wonderful. I love laughing at a funny movie. Emotions are also helpful. They inform us when something is wrong and needs addressing. They, however, do not dictate our actions. Feeling angry does not mean we have to act aggressively. If we act out of anger it is because we have made a decision to behave that way, not because we simply felt an emotion.

Jesus experienced emotions. He wept at the news of a friend's death. In anger he overturned money-changers' tables when he saw the system's injustice, and he sweated blood as he faced his upcoming death. His example gives us permission to be emotional people, as along as emotions are not the driving force in our life.

Driving Forces: The Danger of Operating From Feelings Only

2010-10-04T16:19:00.000-07:00

Thought:

So I say, live by the Spirit, and you will not gratify the desires of the sinful nature. For the sinful nature desires what is contrary to the Spirit, and the Spirit what is contrary to the sinful nature. They are in conflict with each other, so that you do not do what you want.

Galatians 5:16-17

Did you try the experiment I recommended in the last article? How did it go? Which driving force played the largest role in your decision-making process? I wonder if you discovered the same thing that I did: my emotional state controlled too much of my day-to-day life.

This isn't surprising since we consistently hear from cultural influences that we should satisfy our emotional needs. Nike's slogan encourages us to "just do it." McDonald's tells us that we "deserve a break today." Most marketing jingles suggest we might be happier people if we regularly attended to our emotional and physical needs.

Are those messages accurate? A better question might be, how successful have you been in your efforts to feel happy?

I have never taken a cruise vacation, although it sounds fun. I have known a few people who have and they tell me the food is amazing. It sounds like there are 24 hours a day buffet meals available of the most deliciously-prepared dishes. I imagine it would be easy to tell myself (if I were to go on such a vacation) that a few days of unrestrained eating wouldn't hurt me. Most cruise ship vacationers tell me, however, that they return home at least 5 pounds heavier.

Dallas Willard, in Renovation of the Heart, points out that most of us make our emotional state the driving force in our lives. However, he goes on to say that this drive should not have the first priority, rather the last. Living based on how we feel will result in impulsive decisions, expensive splurges, and regular overindulgences resulting in us feeling out of control, overwhelmed, disappointed, and ultimately ashamed. Operating out of our feeling state doesn't work.

Maybe you are still an unbeliever. If so, then deliberately take one small area of your life and live only from your emotions. Act only if you feel like it. Don't go to the gym to work out unless you are in the mood. Only go to work when you feel inspired or motivated. Then let me know if you still believe this method works.

What should be the main driving force in our lives? Feelings are the last thing that should be considered when making a decision. However, they are important and God-given. So, in the next article I will discuss what role emotions are supposed to play in our lives.

Driving Forces: How Do You Make Daily Decisions?

2010-09-19T12:34:00.000-07:00

Thought:

For everything in the world—the cravings of sinful man, the lust of his eyes and the boasting of what he has and does—comes not from the Father but from the world. The world and its desires pass away, but the man who does the will of God lives forever.

1 John 2:16-17

How do you determine how you will spend your day? What is the deciding factors or driving forces? Is it how you feel? Or have you set an agenda or daily goals? Every day you are faced with a myriad of decisions. How do you make your priorities and proceed? How successful is your method or does your day get regularly sidetracked? Let's look closer at this issue and identify what forces or factors decide or affect the way your life is lived.

Dallas Willard, an author and theologian, in his book Renovation of the Heart identifies four driving forces that determine how you prioritize your life. These forces are (1) feelings, (2) rational thought or the "mind,"(3) your will or "heart," and (4) God's will. Let's briefly define each. Feelings are your emotional and physical states, such as sadness, hunger, anger, or pain (both physical and emotional). The mind is your thought life---it is how you analyze the world and make sense of it. Your will or heart is your determination and how you set short- and long-term goals for yourself. Finally, God's will can be understood as God's law or moral code for your life.

Over the next few weeks, I will take a closer look at each driving force, define them further, address their strengths and weaknesses , and discuss the balance or relationship they should have with each other. But, between now and the next article, notice which of these needs or forces determine the pace of your day. Do you have an agenda or a set of goals for each day? If so, how successful do you tend to be with your priorities? Or, do you wing it and spontaneously approach every day? How do changes occur to your schedule? And, how do you feel when those changes happens? I will look forward to entering this introspective journey with you as we close out the summer and start our busy fall schedules.

Gender Differences: A Few Practical Suggestions on How to Avoid Conflict

2010-08-15T11:41:00.000-07:00

Thought:

My dear brothers, take note of this: Everyone should be quick to listen, slow to speak and slow to become angry, for man's anger does not bring about the righteous life that God desires.

James 1:19-20

If each gender has a radically different view of the world and communicates from this perspective, how do you deal with the inevitable conflicts that will occur? Here are some simple techniques and suggestions to get you through these rough spots.

First, expect misunderstandings to occur. If you expect occasional communication errors, then you won't be surprised, and your attitude will more likely be supportive, open, and cooperative, making it easier to resolve any conflicts that arise. It is easy to believe that you consistently and accurately share your thoughts, opinions, and views. This perspective, however, will lead you to assume that when miscommunications occur they are the listener's fault. This, in fact, may be correct, but your stance will make negotiation and resolution difficult since it often causes the listener to feel defensive.

Second, in tricky or touchy situations, clarify your intentions before you start to discuss the issue. In this instance, you tell the listener what you hope is accomplished before you embark on the effort. Imagine a father and daughter having an argument. They disagree on the teenager's curfew. If the father explains his desire to keep his daughter safe from harm (the intention), the daughter will have an easier time understanding his conservative stance on the curfew (the issue).

Third, when you receive controversial or objectionable information, pause and clarify the main gist of the message by repeating the message back to the speaker, before giving a verbal reaction. Message are often lost in translation between what the speaker intended to say and what the listener believes he heard the speaker say. Just play a children's game of "Operator" or "Telephone" to see how easily this happens. Clarifying the main points of the communication will enable the speaker to hear what message was transmitted and to adjust it if there were errors in the initial proclamation. This process also gives you time during the pause to process your reaction to the information. This may help you avoid hasty or impulsive reactions. This technique may also divert silly arguments that were only miscommunicated messages.

Finally, error in the direction of being kind over being right. In most disagreements there comes a moment when you can choose to move in the direction of preserving the relationship or choose to pursue your need to be right. You may achieve your desire to come out on top in the disagreement, but at great costs to the long-term health of the relationship. Consistently choosing to win arguments can result in lost relationships.

God made each gender unique. Each sex brings a necessary perspective: men's awareness of standing helps to give structure to our society whereas women's focus on relationships provides the social connections to that structure. Your challenge is to use your particular gender viewpoint to live a righteous life.

Communication between the Genders: Relational vs. Hierarchical Viewpoints

2010-07-15T17:10:00.000-07:00

Thought:

"However, each one of you also must love his wife as he loves himself, and the wife must respect her husband."

Ephesians 5:33

In order to understand how common miscommunications occur between men and women, it is important to appreciate how each gender views the world. It is natural for each of us to believe that our perspective is universal, but one's gender tremendously impacts thinking style.

Researcher/author Deborah Tannen has done interesting work examining sociolinguistic differences between the sexes. In her book, You Just Don't Understand, she explains that the male worldview is hierarchical whereas the female's is relational. These perspectives are radically different from each other.

Men's communication tends to establish and manage their standing with those around them. In other words, they see the world in terms of who has greater prestige or respect than themselves and who does not. In this perspective there are winners and losers, and each man works to win. It is not surprising that most male establishments or businesses have a management style that reflect this worldview. Many of these organizations have a hierarchical system that is comprised of a president, then, department heads, and finally, co-workers.

The male hierarchical social perspective tends to make men sensitive to feeling blame since protecting their standing with others is very important. They dislike apologizing, as this would be taking a "one-down" position, and their communication style usually is very literal and direct. Men generally don't tend to each other's feelings, but rather talk about numbers, tangible details, and day-to-day activities.

Women, on the other hand, see the world in terms of social connections. They are aware of who they have relationships with and who they don't. Because of this style, women are concerned with maintaining affiliation with others. They are careful not to hurt another's feelings. Their communication habits reflect this value and, therefore, are often indirect, abstract, and qualitative. Women tend to talk about relationships, such as, who is dating whom, the latest neighborhood gossip, or working through social difficulties. They often monitor each other's reactions to stay in good graces with each other and apologize easily in order to maintain social connections.

Due to these stark differences, it is easy to see how communication mishaps occur. Women hint at issues and then wonder why their boyfriends or spouses don't catch on. They long to have their male loved one understand their gentle indirect reminders and feel hurt when he isn't a mind-reader. Apologies are difficult for men leaving the women in their lives feeling that their emotional pain is devalued. God had it right when he gave instructions for a good marriage (Ephesians 5:33). In Paul's letter, wives are encouraged to respect their husbands (i.e. understand and support the husband's standing), and men are instructed to love their wives (or tend to the relationship). If both parties could become aware of the way that the opposite gender sees and communicates about life, then fewer misunderstandings are likely to occur.

Communication Between the Genders: "That's Not What I Meant!"

2010-06-15T20:27:00.000-07:00

Thought:

"So God created man in his own image, in the image of God he created him; male and female he created them."

Genesis 1:27

Have you ever found yourself in an argument with the opposite sex and wondered why he or she just isn't getting your point of view? Or you start to explain something only to have your partner suddenly take offense and become upset? What happened?

A frequent topic in therapy is communication breakdowns between men and women. After many firsthand observations and hearing common stories of communication problems in my practice, I am surprised that the most basic communication efforts are successful between the genders. Yes, men and women are that different. The way in which each gender uses language and views the world is unique and sometimes opposite of each other.

So, how do you effectively share ideas, opinions, and viewpoints to a member of the opposite sex? How can you successfully work through issues and conflicts without having the discussion turn into a yelling match or having someone storm off in a huff?

I thought I would tackle this subject over the summer. In the first article, I will discuss the radically different viewpoints of each gender. Then, I will cover how men and women's world perspectives affect language and communication styles. And finally, I will end the series with some practical suggestions on how to help reduce common misunderstandings.

Finding a Good Therapist: Treatment Gone Wrong

2010-05-21T20:27:00.000-07:00

Thought:

". . . be wary and wise as serpents, and be innocent (harmless, guileless, and without falsity) as doves."

Matthew 10:16b Amplified Bible

Before graduate school education is complete, every mental health clinician is required to understand and is tested on the ethical guidelines of treatment. Yet, despite such training, too often you hear on the news about therapists who have abused their power. What went wrong?

The relationship between therapist and client is an unusual one in that the counselor is seen as the expert. This leads to a relationship where most of the interpersonal power is on the therapist's side. As a result, there are opportunities for the misguided, dysfunctional, or damaged clinician to hurt clients. Being aware of and alert to signs of treatment relationships gone wrong will enable you to protect yourself better should such a situation occur.

Due to the unique type of relationship between therapist and client there are some basic guidelines that should be maintained throughout treatment. A therapist who shares personal information needs to be very careful. This is a therapeutic relationship that was created for the sole purpose of healing the client. It is not to be meeting the needs of the counselor. All personal information shared should be done for the purpose of advancing the clinical relationship. It is not unusual for clients to ask about the therapist’s demographical information, such as does the counselor have children or is he or she married. Knowing such answers may help strengthen the treatment relationship, but it also could accidently create barriers. For example, if your therapist doesn’t have children and you are seeking help on handling your difficult child, you may feel your counselor isn’t qualified despite his or her expertise with children. Counselors should share personal information carefully and thoughtfully, and always in the best interest of the treatment relationship.

Your counselor cannot be your friend. He or she should not be going out to lunch with you or contacting you at home to chat. Treatment sessions should maintain the focus on you and your issues, not on the counselor's hobbies or interests. I remember one new client telling me that his last therapist spent a significant portion of each session talking about the counselor’s recent golf games instead of allowing the client to discuss his issues. If there is a sense that the sessions are primarily about meeting the social needs of the clinician, then treatment is being compromised.

Physical contact should be minimal. Many schools of thought recommend that there is no physical contact between therapist and client. Therapists have different guidelines regarding this boundary. I generally don't touch unless it is an initial handshake with a new client, or a quick hug that is initiated by the same-sex patient at the close of a session. Substituting physical forms of comfort instead of words can dilute or change the treatment process. Clients seek treatment to understand and work through their emotional pain. This best occurs through the use of words, not touch.

There are some strict guidelines that should never be crossed: 1.) there should be no contact between therapist and client that is flirty or sexual in nature; 2.) counselors should not be marketing or selling you product(s) that they are representing; and finally, 3.) confidentiality of your identity as a client and the content of your sessions should be strictly maintained.

What should you do if treatment is going wrong? If you see problem signs, you should first discuss your concerns and observations with your counselor. There may have been a misunderstanding. Working it through could improve communication and strengthen the treatment relationship. But if this does not work or if the situation continues, you should get advice or a second opinion from another counselor. Terminating the treatment relationship is another option. If you chose to do this, I would strongly encourage you to find another therapist in order to process your previous negative therapy experiences. In extreme situations, such as sexual abuse, you should contact the disciplinary committee of your state to file a complaint. Again, get help from a reputable therapist to help you through such an emotional process of filing or reporting a complaint.

It is unfortunate when treatment goes wrong, but therapists are human. Your best defense against such abuses is to be your own advocate. If something isn’t feeling right about your therapy experience, trust your instincts and get another opinion.

The summer months are almost here and I will be posting articles less frequently until Labor Day. I welcome any topical suggestions for future blogs or comments about past articles.

Finding a Good Therapist: After the First Session

2010-05-14T16:26:00.000-07:00

Thought:

"let the wise listen and add to their learning, and let the discerning get guidance-"

Proverbs 1:5

You have found a good therapist and finished your initial appointment. You felt that your presenting issues were defined; treatment goals were established. Now what? Moving from the initial interview into the actual treatment phase is often an awkward stage of therapy. Your counselor should help you with this transition by telling you what is expected.

My counseling style is insight-oriented therapy. In the first session, I inform my new clients that in future sessions they will have the freedom to talk about whatever comes to their mind or is a concern to them. I have found that no matter the topic, whether upbeat and positive or discouraging, it reveals how clients feel about themselves and the world around them. As a result, I don't lead sessions into a particular direction. I usually start each session with an open-ended question, such as "how are you doing?" or "what would you like to talk about today?"

Not all clinicians work this way since there are several other therapy styles. Some treatment models have a problem-solving focus, and others focus on specific topics. Good therapists, however, will let you know what they expect and will guide you into that direction.

Once you start treatment, don't be surprised if you begin to see the world around you differently. Since you are taking time to focus on how you respond to events, situations, and people, you may find yourself observing yourself throughout each day. This is very normal. I once heard it said that while you are in therapy, all of life becomes about therapy. You may feel like you are examining yourself and your surrounding social environment under a microscope. This experience or sensation is useful since your increased awareness helps you make new observations and conclusions about what works and doesn't work in your life, but it will fade once treatment ends.

How will you know when treatment is finished? Once you begin to feel better and your main issue seems improved or resolved, it may be time to bring up the topic to your counselor. The therapist may also bring it up to you. Sometimes this is an opportunity to re-assess treatment gains and to define new goals. Other times, a termination plan is formed. But the direction---continuing treatment in a new direction or ending----should be a collaborative decision between you and your counselor.

Endings can happen in several ways. Sometimes there is a last appointment and treatment finishes in that session. Other times sessions are scheduled further and further apart until you feel comfortable stopping. Or finally, you can have a "last appointment" as a trial and leave it with the understanding that you can make another appointment sometime in the future, if you need to. It all depends upon the circumstances that brought you into treatment and on your therapist's counseling style. There is no right or wrong way to finish therapy, as long as you feel supported and the termination plan seems appropriate.

It is normal to feel a little nervous about ending treatment and not seeing your therapist again, especially if your therapy has been going on for awhile. This is called "termination anxiety." Your counselor will be able to help process your fears and concerns about termination, and the feelings will go away once therapy has successfully ended.

For the last article in this series, "Finding a Good Therapist," we will look at how to spot when treatment has gone wrong.

Finding a Good Therapist: The First Session with Children or Adolescents

2010-05-07T21:16:00.000-07:00

Thought:

“Then little children were brought to Jesus for him to place his hands on them and pray for them.”

Matthew 19:13a

The initial session with a minor is different from an adult's session in a couple of ways. First, one or both parents need to accompany the minor to the appointment since in most states children under the age of 13 cannot legally consent to treatment. During this first appointment, the parent(s) will also be the main source of the child's history considering that there are many details that children don't know, such as, the parent's marital history, any unusual issues during the pregnancy, labor and delivery of this child, and the child's early developmental history.

Obtaining consent and gathering history may occur in the child's presence or during a separate appointment. Either interviewing style is appropriate and varies among clinicians. Treatment circumstances will also determine the interviewing process. There are some instances when taking a history in front of the minor is painful or uncomfortable. If treatment is being sought because of a sensitive issue or a traumatic event, then this information is best obtained privately with a parent. In such circumstances, it is helpful to speak to the counselor by telephone ahead of the appointment to make sure that the clinician is aware of the special condition.

Secondly, few teenagers or children ask for counseling. Usually an adult notices a change in behavior that suggests that the child is emotionally or psychologically struggling and then initiates treatment. As a result of this dynamic, minors may be ambivalent and reluctant to engage in counseling. They may be unsure of the role the counselor is to play in their life and uncertain as to how to use therapy. Clinicians who specialize in the treatment of children are aware of this issue and will know how to draw children or teenagers into the use of therapy. But these issues affect treatment and results may be subtler and slower when compared to an adult's treatment experience.

Not all minors will voluntarily engage in counseling and some under aged clients will resist treatment. There are therapists who will patiently counsel such clients whereas others will not. In such circumstances, a change in treatment focus can be helpful. It may be beneficial to help parents learn new ways to deal with the child's issue, or to engage the whole family in treatment. A good child therapist will have suggestions as to how to best address any particular child's needs and issues. These methods may vary from play therapy, traditional talk therapy with the under aged client, therapy with parents only, or some form of family therapy.

For more information about obtaining counseling for children, please also visit:

"Children and Counseling: What to Expect"
"Can Your Child Benefit From Counseling?"

Next week we will address what happens in counseling after the first session.

Finding a Good Therapist: What to Expect from the First Appointment

2010-04-30T09:01:00.000-07:00

Thought:

"Otherwise they might see with their eyes, hear with their ears, understand with their hearts, and turn and be healed."

Isaiah 6:10b

Your first appointment time has arrived. What is reasonable to expect from this interview? That is what the first appointment is: an interview. During the first 45 to 50 minutes the counselor will listen to why you are seeking help, the history of the issue(s), and your hopes and expectations of treatment. This information will determine the course and method of therapy.

The style of first appointments varies from clinician to clinician. Some therapists have a specific set of questions that they ask every first-time client. Others will start with an open-ended question and let you lead the direction of the appointment. The purpose of either method is to understand your emotional or psychological difficulties and to establish some treatment goals and objectives. By the end of the session you should have a sense that the therapist has an initial understanding of the problems and that there is a direction or a set of goals that will guide the course of treatment. How this looks again varies among therapists. I usually tell the client the initial diagnosis and together we identify the treatment goals. Not all clinical styles are this direct.

You should also have an understanding of the rules of therapy. Confidentiality, expectations about how to make and cancel appointments, the cost of each session, any financial arrangements to cover treatment, and how to contact the counselor if an emergency occurs are all terms that should be covered. Some of these points may be outlined in the initial paperwork you will have received and other terms may be discussed directly. These are very important issues. If you need further clarification or don't feel fully informed, please discuss it with your therapist. These rules help to create a sense of predictability and safety. They enable good treatment to occur.

You may feel a need to have someone accompany you to the first appointment. Can this individual join you for the first session? Again, this varies among clinicians. Unless you are seeking family or relationship treatment, you will eventually need to attend the appointments alone. Sometimes a new client is feeling so ill that an accompanying friend or family member is helpful to physically aid the client to the therapy room, and also to provide the necessary history of the problem. I often allow a close friend, a family member, or a spouse to attend the first session with the understanding that in subsequent sessions only the client will attend.

I frequently have clients who ask a family member or a friend to drive them to appointments. That is perfectly acceptable.

By the end of the first session, you should feel comfortable and safe enough to explore personal topics with this clinician. Also, the rules and terms of treatment should be very clear and understandable. If these objectives are achieved, then you have a good foundation for the beginning of therapy.

How does the first appointment look when a child or a teenager is the client? Next week, I will provide an overview of a first session with a minor.

Finding a Good Therapist: Making the First Contact

2010-04-23T08:37:00.000-07:00

Thought:

"Reckless words piece like a sword, but the tongue of the wise brings healing."

Proverbs 12:18

At this point in the process of finding a good therapist, you have obtained the names of several clinicians from reputable sources. Many of them have credentials you haven't seen before, such M.D., D.O., Ph.D., Psy.D., Ed.D., LCSW, LLP, and MFCC. What do these degrees mean?

Mental health specialists fall into one of four categories:

Psychiatrists (M.D. or D.O.): These individuals are medical doctors who have specialized in the diagnosis and treatment of mental health disorders instead of another specialty, such as cardiology or dermatology. They have medical training and are licensed to prescribe medication. They assess individuals from a biological angle and provide medical treatment.

Psychologists (Ph.D., Psy.D., Ed.D., or LLP): These therapists have intensive training in psychology. They have studied human behavior and personality development. They provide counseling to help individuals improve their overall emotional functioning. They also can conduct psychological testing.

Social Workers: (MSW or LCSW): These counselors have been trained to understand a person's psychological and social functioning. Like psychologists, they provide counseling to help individuals improve their coping skills and solve personal and family problems.

Licensed Professional Counselors (MFCC): These are counselors who have met state licensure laws to provide therapy. They have at least a Master's Degree in a related field and have completed their state-mandated post-Master's clinical experience. Each state varies on which professional counseling licenses are allowed to practice in that given state. Michigan, for example, does not grant such licenses.

At this point, you know that the recommended therapists have the appropriate credentials or licenses to provide treatment, what do you do next?

Now, it is about finding a good fit between you and your chosen counselor. Each therapist will have a slightly different style and manner. It is important that the counselor you meet with makes you feel valued. You want someone who is objective, yet also is warm, trustworthy, and creates a sense of security and safety. The best way to find this fit is to meet each person for one time. You might find in the first session with the first therapist that you already feel comfortable and won't need to meet the other individuals on your list. Or you might find that none of the recommended clinicians are quite what you are looking for. Nonetheless, you are looking for someone you can trust so that you can talk about the issues that matter the most to you.

Making the first contact is quite easy. It is usually done by telephone. Most therapists are listed in the business pages of the local phone book. You may reach the therapist directly, speak to his or her secretary, or be asked to leave a voice mail message. If you leave a message or speak to the support staff, you should only leave your name, basic contact information, and a request for a first appointment. Some offices ask for a one sentence reason for the visit, but providing such information is not necessary. If it feels uncomfortable explaining the reason for your call, error in the direction of privacy. By the end of the first contact you should have an appointment time for your first session.

Sometimes new clients want to know a few things about the therapist before the first appointment. It is acceptable to ask to speak to the therapist by phone before the first appointment. Please be considerate and keep this phone call brief (5 minutes or less). I have been asked about my treatment style, how long I have been practicing, and my experience with a particular issue or problem. Most clinicians will be comfortable answering such questions. More personal questions, such as age and religious beliefs, however, may receive some hesitation and are less likely to be answered. Therapists will vary in their degree of openness about personal questions. Some clinicians believe that such questions distract or are irrelevant to treatment, whereas others don't mind answering, if it increases the client's comfortableness with treatment. Again, please remember to keep this contact succinct and short.

You have your first appointment! Next week I will discuss what to expect during the first session.

How to Find a Good Therapist

2010-04-15T16:10:00.000-07:00

Thought:
"let the wise listen and add to their learning,
and let the discerning get guidance-"

Proverbs 1:5

It happened again last week. A new client came into my office for her first appointment. She had been referred by her primary care doctor's office, but was hoping to start medical treatment. She didn't know I only provided "talk therapy" and not medication. I worried that she may have wasted an hour of her time only to have the end result be another referral to a different specialist. Fortunately, this error only occurs a couple times a year, but even one time is too many. How could this have been avoided? I would like to use this article to help you be more informed as you seek psychological help.

Identify your primary reason for seeking treatment. Has there been a change (or changes) in your overall psychological and physical functioning? What symptoms you are experiencing? When did these symptoms start? Are you looking for counseling ("talk therapy") only, medication only, or a combination of both? Are you experiencing difficulties in your social connections, family relationships, or occupational life? You may know you want to feel better or less stressed, but spending some time clarifying what's wrong and what you want changed will provide helpful information as you seek a mental health specialist.

How will you be paying for services? Are you planning to use your insurance coverage or pay out-of-pocket? Many insurance plans have a listing of approved providers in your area. If you plan to use your benefit, this network is a good starting point. I have been aware of many first-time clients who have wasted precious time contacting therapists only to find out these individuals were not in their provider network.

Are there specific therapist skills or qualities that are important? Are you looking for a male or female counselor? Do you have special needs (such as, needing to go to an office that is handicap-accessible or seeking a specialist who fluently speaks a language other than English)? Does the office setting matter? Some clinicians will be practicing in a hospital setting, others in a clinic, and some will be in a private practice. Are you looking for unusual office hours? Many therapists have specific hours they are available. Make sure their schedule fits your schedule. Are you seeking marital, individual, or group therapy? Again, each counselor offers different types of treatment styles.

You may not know the answer to all of these questions, but having some idea of what you are looking for will provide direction. Now, you are ready to solicit recommendations. The best referral source for therapist recommendations is a trusted individual; such as, your primary care doctor, nurse, healthcare specialist, teacher, pastor, or friend. It is best to obtain several names since not each counselor will take your insurance or be accepting new clients.

The internet is another excellent source of information for referral names. Several regional and national associations have listings of providers by area. You might try:

American Psychological Association
National Association of Social Workers
National Register of Health Service Providers

There are other internet sources available as well. The monthly magazine, Psychology Today, has a nice website of providers who have paid for a brief description of themselves and the type of therapy they provide. There are also specialty websites (such as, National Association for the Mentally Ill and Robyn's Nest-The Parenting Network), that might include treatment recommendations and suggestions.

I would not recommend using the Yellow Pages as a referral source. It will help you identify someone who is providing services nearby, but it gives little other important information.

Once you have the names of 3 to 5 mental health specialists, you are ready for the next step; to make contact and to set up the first appointment. In next week's article I will cover how to initiate that contact, as well as briefly discuss the various types of credentials (Ph.D., MSW, LLP, M.D., D.O.) you might encounter.

Introduction: Finding a Good Therapist

2010-04-08T15:08:00.000-07:00

Thought:

"Plans fail for lack of counsel, but with many advisers they succeed.
A man finds joy in giving an apt reply--- and how good is a timely word!"

Proverbs 15: 22-23

Probably the most common question I'm asked is for a name of a good therapist. My friends and family figure I must have contacts since I work in the field of psychology. I consider this a very important question and am glad to give recommendations.

In the 1960 and 70's there was an explosion of new counseling models. Each specialty group thought it had found a better way to treat emotional problems. Was this assumption true? Whose treatment techniques were the most effective? Research studies began with the belief that one clinical model would rise to the top as the most effective treatment style. The results were surprising. No treatment modality was better than another. Instead, the studies found that the personality characteristics of therapists influenced treatment outcomes. Counselors who were genuine and transparent, empathetic, and valued their clients were more helpful.

Since the personal qualities of a clinician are essential to the development of a strong therapist-client relationship, it makes the request for a counselor's name very important. And considering the fact I am already working in the counseling field, it makes sense that I would have a decent knowledge of my local associates. Asking me for names of other therapists is a good idea. I can be a resource to those who live near me and know me, but what about those who don't know me or live in my community? How do those individuals find a good therapist?

I would like to spend several weeks exploring the ABC's of finding a good therapist and starting counseling. I plan to cover how to obtain recommendations for a counselor, what to ask during the initial contact (most likely a phone call) with potential therapists, and what to expect from the first appointment. I welcome any comments or questions you might have as we explore this area together.

Interview with Shirley Pieters Vogel

2010-03-26T08:47:00.000-07:00

My next blog will be posted on April 9th when I start a series on how to find a good therapist and what to expect during the initial counseling sessions.

This week I am going to shift gears and introduce you to Shirley Vogel, an inspirational author and speaker. I met her at a recent writer's conference where she encouraged me in my writing endeavors. Shirley's book, wHispers: when He is so precious even rocks sing, was awarded second place in the Spiritual Division of New England Book Festival 2009. She graciously agreed to an interview about her work and this book.

If you would like to purchase an autographed copy of wHispers or to engage Shirley for a speaking event, please contact her at her website. You also can order her book directly from Amazon.

.....
Kerry:
What led you to write about your experiences with God?
Shirley:
During my troubled marriage, and the counseling and divorce that followed, I began journaling. I didn’t consider writing a book until after God brought Stefan into my life in such a marvelous way that he calls it God’s Soap Opera! When we began sharing that unique story with others, their reaction was almost always, “You must write a book!” So I began writing, joined a local writing group, and attended annual Christian Writers’ Publishing Workshops. After five years the editor/directors said my book was ready for publication, and so I sent Prayers by a Picket Fence (now part one of my book, wHispers) to six major Christian houses and received six rejections! Still, I was encouraged because there were only two form letters. The remaining four were personal letters saying my story was well written and one that needed to be out there - just not their genre’. They encouraged me to continue looking for a publisher, but full time volunteer ministry permitted little time. However, in the process of serving God, and also facing severe medical challenges I came to know God better and love Him more. That gave me impetus to complete my book, and 20 years later, in a remarkable and humorous way, God helped me to do just that. The story of how this happened is on pages 221-223 of my book.

Kerry:
Your story has low points and high points, yet your intimacy with Christ seemed to consistently increase, despite your circumstances. How do you explain this?
Shirley:
It’s quite simple, really. The high point of each painful challenge put me on my knees where I could hear God better, and there I learned to love and trust Him more deeply. It has been said that man’s extremities are God’s opportunities and I’m a living example of that. Each time I reach the end of myself, I long for a closer walk with the Lord and He’s always waiting to take my hand. A favorite example of this occurred at Breakwater Beach - pages 143-144.

Kerry:
What do you say to individuals who have had their spouse leave them without a reason why? How do these individuals go on without good closure or a decent understanding of what went wrong in the previous marriage?
Shirley:
Perhaps I can best respond by sharing how I dealt with this. I was stunned when my husband said he was no longer happy, but despite 22 months of counseling, he could never say what was bothering him, or why he was leaving our 27 year marriage. I vowed never to say anything negative to my children about their father because I didn’t want to add to their sadness. And knowing harbored resentment could make me bitter, I held tight to God’s promise never to leave me, and others such as Nehemiah 8:10, “The joy of the Lord is your strength.” I remember sitting on the floor in front of our stereo - making myself sing choruses of praise to God with a squeaky voice as tears ran down my face - even though I didn’t have a clue what my future held. God not only heard me, but provided for me in surprising ways that gave me peace and helped me to let go of myself and trust Him more.
I found it impossible to ignore the past, but God helped me develop supportive new relationships; friends who helped me look to the future. And I claimed the promise in Jeremiah 29:11, “’For I know the plans I have for (Shirley),’ says the Lord; ‘plans for a future filled with hope; plans for good and not for evil.’” Isn’t it wonderful that we can each insert our name there! How much God loves us to always have us on His mind!

Kerry:
You share in wHispers about your unexpected divorce and significant health problems. Have you been asked why you think good people suffer? If so, what’s your answer?
Shirley:
I have not been asked that question, but understand why this is such a puzzler - some situations are very difficult to understand/accept! However, I would make two points: first, to define the word, good, which according to Webster means better or best. But, everyone - even those who seem most righteous in their love and service for the Lord - fall short of God’s will for their lives because no one mirrors Jesus all of the time. Second and more important, in the Sermon on the Mount, Jesus said that our Heavenly Father does not discriminate, “…that you may be sons of your Father in heaven; for He makes His sun rise on the evil and on the good, and sends rain on the just and on the unjust.” (Matthew 5:45 NKJV) So, my answer to your question is only God knows the answer, and because He alone is sovereign, we do our best to trust Him - even when we don't understand.

Kerry:
What is your current favorite Bible verse and why?
Shirley:
I have many favorites, but I’ve come to greatly appreciate Job 42:12 (NIV), “The Lord blessed the latter part of Job’s life more than the first.” My Heavenly Father has permitted severe challenges in my later years, but I consider them blessings because He’s using them to draw me closer to Himself! I’ve learned in a deeper way that God never leaves me and He’s faithful! When I experience residual symptoms (unsteadiness or forgetfulness) from my stroke and brain hemorrhages, I’m able to center on God rather than my weaknesses because I know He has a plan for my life. Either He continues to use me to encourage and give hope to the hurting as I share His unconditional love and faithfulness, or He takes me home to Himself – either way I can’t lose! Walking with God is a win-win situation!

Kerry:
Where is God taking you now?
Shirley:
God continually provides new ways to serve Him; both speaking for women’s events and retreats as well as sharing my faith one-on-one at church, the gym, etc. Opportunities to disciple also come as I respond to emails, phone calls and letters; many from readers of wHispers. God’s amazing love and faithfulness make me laugh – I laugh a lot!

Kerry:
Will you write more?
Shirley:
For the past year, I’ve been stuffing hastily written notes for a possible second book into what is now a bulging file with all kinds of paper scraps. I had hoped to begin writing in January, but I’ve been so busy with unexpected personal and family stuff I’ve had little time. I started once, but was definitely running ahead of God! I didn’t know what to write or how to express myself. When I‘m in God‘s will, ideas flow easily, and so I frequently ask the Holy Spirit to overflow me – Your thoughts on my mind and Your words on my lips - and when I’m writing - my paper ! So yes, when God lets me know it’s time, I‘ll begin another book - I’m eager to start.

. . . . . . . . .
Thank you, Shirley, for this wonderful opportunity to interview you and for such thoughtful, honest answers. God bless you as he uses you in all and every opportunity!

"Is There an Afterlife?" Ontological Question #5

2010-03-19T16:14:00.000-07:00

Thought:

"Do not let your hearts be troubled. Trust in God; trust also in me. In my Father's house are many rooms; if it were not so, I would have told you. I am going there to prepare a place for you. And if I go and prepare a place for you, I will come back and take you to be with me that you also may be where I am.

John 14: 1-3

The final ontological question is "where do I go when I die?" This question seems to get our attention when we have experienced a close loss (such as a death of a family member) or are facing serious health issues. Otherwise, we ignore this question since we generally feel uncomfortable thinking about our mortality. Facing the unknown is scary and we feel tension or anxiety considering this question. Yet, our answer can either fill us with hope, or fear and discouragement.

Years ago I heard Dr. Dobson on his daily Focus on the Family radio show interview a mother. She shared a story of how one of her children died in a terrible accident. While her three young children were playing outside, they wandered over to a nearby pond. Two of the children fell in while the youngest child went for help. The mom was able to rescue one child who was barely alive, but had to leave the other drowned child behind in order to save the child she had found. This was a horrible loss and would be gut-wrenching for any parent. But what I remember most profoundly was her next comment in this interview. She said that most of us like to live denying this horrible reality: everyone dies and someone in any given family will die first. I felt punched by her final comments. Her words had an uncomfortable ring of truth.

The reality of death brings us back to this ontological question. What do we believe about the afterlife? Is there even an afterlife? Is there a heaven? Who is it for? Will I be recognizable to my loved ones? How we answer such questions shape how we conduct our lives. If there is no heaven, then we better live it up each day since there is nothing beyond our lifespan. If there is afterlife, and especially a heaven, then we need to understand how we are to conduct our lives to obtain this wonderful reward. This belief in an afterlife encourages us to live with hope since we know that our lives do not end with our death. It is simply a transition from one stage of life to the next.

In the above passage (John 14:1-3), Jesus knew his time was short. He was aware that many were plotting his death. He was preparing his disciples for this upcoming loss. He told them he would be leaving them (going to die), but would be readying a place (heaven) for their eventual reunion. This promise is still true today. Paul wrote, "Listen, I tell you a mystery: We will not all sleep ( or die), but we will all be changed---in a flash, in the twinkling of an eye. . .for the perishable must clothe itself with the imperishable, and the mortal with immortality" (1 Corinthians 15:51-52a, 54a). He affirmed Jesus' words and reminded Christians that Jesus would one day come again to take his followers (both alive and dead) to heaven where we will live forever with God. This gives us hope: for ourselves and for our loved ones. We do not need to avoid, ignore, or fear death. Instead of seeing it as an ending, we can see it is a start of a whole new chapter in heaven with God.

What is Man's Basic Nature? Ontological Question #4

2010-03-11T21:21:00.000-08:00

Thought:

This righteousness from God comes through faith in Jesus Christ to all who believe. There is no difference, for all have sinned and fall short of the glory of God, and are justified freely by his grace through the redemption that came by Christ Jesus.

Romans 3:22-24

The fourth ontological question is "What is man's basic nature?" I remember my professor introducing this question and wondering how it could give us problems. What does it matter what we believe about our basic makeup? Yet, I have noticed that we, as a country, spend enormous amounts of money addressing this issue. I see our school systems using educational models trying to fix this problem. The way in which we answer this question affects how we make sense of mankind and its struggle. Our belief shapes the solutions we propose to fix social issues. This is a very important ontological question.

Here are some assessment questions to help each of us determine what we believe about man's basic nature. Are some people by nature good and others bad? What makes a man good or bad, genetics? Parenting? Or societal pressures? Is man redeemable? If so, how? Is man by design different than animals and plants ? Or, is all life equally sacred?

Since the twentieth century Western culture has adopted a humanistic view of man's fundamental makeup. We generally accept that each individual is basically good and needs a healthy, supportive environment to achieve his or her personal potential. We see criminal behavior as an outcome of poverty, racism, or a dysfunctional family structure. As a result of this assumption, we try to re-habilitate criminals, hoping that earlier developmental failures can be overcome and new learning can occur. We have developed governmental and educational programs to address weaknesses in our current social support systems, such as daycare programs for teenage mothers trying to finish high school, school breakfasts and lunches for impoverished inner city children, and halfway houses for parolees. Many of these programs assume that if each recipient is encouraged, championed, and loved enough that they will leave the system a stronger individual, capable of better choices.

These programs are wonderful and I have been involved with several over the course of my career, but as a Christian, I believe the underlying ontological assumption is wrong. The Old Testament records that while we were created in the image of God (Genesis 1:26) we all are like sheep who have gone astray, each of us turning to our own ways (paraphrase of Isaiah 53:7). Paul's instruction to the church in Rome tells us that our only hope for a righteous life is found in our faith and belief in Jesus. Answering this ontological question biblically helps us to make sense of the world's injustices (humanity is sinful and in need of God)and directs us to look to Jesus as the solution to our problems. As a result of this belief, we are not surprised when others disappoint us and do not put our hopes in any government agenda or social program to solve our problems. We understand that every institutional solution has one major flaw, humanity. There is a answer to our dilemma and it is Christ's redemption, freely offered to every person.

Next week is the last ontological question, Where do we go when we die?

Who is in Control of my Life?---Ontological Question #3

2010-03-05T08:09:00.000-08:00

Thought:

"Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. . .
your heavenly Father knows that you need them. But seek first his kingdom and his righteousness, and all these things will be given to you as well.

Matthew 6:28a, 33b

The third ontological question is "Who is in control of life?" Most of us at one time or another have wondered about this mystery. Is there a Master Creator who set in motion and continues to sustain the cosmos, or is life simply a random event? If there is a God, does He think about us and care about the mundane details of our lives, or are we completely on our own? This ontological question is rooted in how we explain and make sense of life's purposefulness.

I have met some individuals who say that they haven't given this question much thought, as if the question doesn't impact their daily lives. I don't believe this is true. The way we answer this question affects how we make sense of life's tragedies and victories. A belief that life occurred as part of a random evolutionary process causes us to see things as accidental and without purpose, whereas a belief rooted in God or a Higher Power causes us to see life as intentional and with design.

Many of us do believe in God. We may have had a personal experience with this Spiritual Being. We may also see an artistry in nature around us and accredit this beauty as evidence of a Higher Power. It is important we integrate our faith into our daily life. Failure to do so can get us into trouble. We might have a strong certainty of an involved God, yet find ourselves often feeling anxious and out of control. In such cases, we haven't connected our faith life with our daily life. If we believe there is a personal God who is in control, then we should be living as if He is participating in every facet of our lives.

Integration problems cause us to go into over-drive. We try to manage daily details that we really have no control over. For instance, parents might go to great efforts to supervise their children every second of every day out of fear that once their children are out of sight they might come to harm. This is an impossible task. None of us can be with another person constantly, nor can we control all aspects of another's life to protect this individual's security. The concern and love are completely understandable, but such control is not achievable. These are the places where our answer to this ontological question becomes visible. Do we really believe there is an involved God who is in control of our lives, or is all of life accidental and every man is watching out for himself?

Obviously, by my inclusion of a biblical context, I believe in a higher power, God. I also believe that He is a part of every aspect of my life and is intentionally directing all of life. Jesus also believed this. He said in John 5:17 that God is always at his work. I am a part of this work. Jesus also said that I bring his kingdom into the world around me by my obedience to his will (Luke 17:20-21). This is encouraging. I feel a part of something bigger than myself and know that my actions have potentially lasting consequences.

Answering this question is an important part of psychological health and has far-reaching ramifications. How do you answer the question, Who is in control of your life?

What is the Meaning of my Life?---Ontological Question #2

2010-02-26T08:37:00.000-08:00

Thought:

Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God

Hebrews 12:2

The second ontological question is "What is the meaning of my life?" This question seems to give people trouble. Inadequate answers tend to be a cause of chronic apathy and boredom. Why bother to get up every day if our life has no point? All of us need to have purpose to our existence. Without direction, our life could feel insignificant.

To address this issue, each of us should consider developing a personal mission statement. This might feel like a huge undertaking, yet it is actually quite simple. We need to listen to ourselves carefully and to hear what goals and activities excite us. Do we love working with people? Does our heart break when we see mistreated animals? Do we prefer helping out behind the scenes? Are we more of a leader? Do we enjoy organizing events and activities? Do we like putting things together? By paying attention to what motivates us, we can begin to see an outline of what gives our life passion and intention. Using this information, we are able to construct our own mission statement.

I used to think that a personal mission statement should be dramatic and rock the world, like discovering cold fusion. This isn't so. Some of history's most defining moments have come from individuals focusing on one small act. I think of Mother Teresa caring for the starving in the streets of Calcutta. She didn't set out to change the world, just to help one person. Yet her dedication and focus had a powerful ripple effect. When defining our life's purpose, no mission is too insignificant. It just needs to matter personally to us.

Even a well-defined answer to this ontological question can run into difficulty. Sometimes meaningful work feels boring. There can be periods that are repetitious and take on a sense of flatness. A woman who has purposefully defined her mission as raising orphaned children can get tired of cleaning up spilt milk and changing dirty diapers. Is life's flatness due to an undefined purpose? Or do we need a vacation? It is helpful to stop and make sure that our passion is directing us. We may need to re-direct our efforts by redefining our goals. We might just need to take a much needed break. We also might want to ask God for strength to endure the hard places of our life's work.

So, have you stopped to ask yourself what gives your life meaning?

Jesus' purpose was clear. God was on a mission to save the world. He sent his son to come and pay for humanity's debt of sin. Jesus lived his life with the goal of the cross. He let nothing or no one deter him from his purpose. We, too, can live a life with such clarity and direction. It probably won't be saving the whole world, but we could be lighting the corner of our neighborhood. And when it comes down to it, those we encourage will feel as if their world has been saved. So, maybe it is the same thing.

"Who am I?" Ontological Question #1

2010-02-19T11:50:00.000-08:00

Thought:

When Jesus spoke again to the people, he said, "I am the light of the world. Whoever follows me will never walk in darkness, but will have the light of life."

"I tell you the truth," Jesus answered, "before Abraham was born, I am!" At this, they picked up stones to stone him, but Jesus hid himself, slipping away from the temple grounds.

John 8:12, 58-59

One of my favorite classes in graduate school was an elective course called "Philosophy and Psychology." It wasn't popular since the reading list was long, but I found the topic interesting and decided to risk it. The professor was a practicing psychiatrist. He started the course explaining the importance of five ontological questions (for a definition of ontology, please see post dated February 13, 2010). He said that as psychologists we would be working with an ill population who would be searching for answers. He warned us that if we have not spent some time clarifying or defining these questions for ourselves we would be at risk of becoming infected by our clients' distress and confusion. That comment made me pause and consider my own belief system. Could it be true? How many therapists have burned out or lost their way? How many therapists have abused their power and hurt clients? Those were frightening questions and motivated me to take this seriously.

So, what are the ontological questions? They are:

Who am I?

What is the purpose or meaning of my life?

Who is in control of my life?

What is man's basic nature?

Where do I go when I die?

Let's start with the first question, "Who am I?"

How have defined yourself? Does your appearance match with your internal world? Do you have a consistent way in which you approach those around you? Do you like yourself? Would you chose yourself as a friend? Are you a friend to yourself? Do you take care of yourself well? The answers to these questions will help you see how well and congruently you have defined yourself. Are there any inconsistencies? If so, those are areas where you will find tension or distress. What can you do to make those areas more consistent or congruent?

Our identity is defined by our needs and likes and dislikes. Many of us do not spend much time on this area. We let our self-definition happen almost unconsciously and without much thought. We say we like the color red and hate the color green, but we rarely ask ourselves why. We aren't very deliberate in how we take care of ourselves. For example, I have discovered that many women clients cook food they don't like in order to please their hungry family. I wonder how this practice affects their body weight. What happens to our overall enjoyment of life when our needs are consistently denied? I am afraid that it puts us at risk of living an unbalanced life.

I saw this happen in my own life. After having children, my life got out of balance. I am an individual who needs a great deal of sleep to function. I also require a good dose of solitude. Those two demands didn't go well with taking care of my young children. I found myself frustrated and exhausted as I stayed up later and later at night in order to be alone. This caused me not to get enough sleep since my children were early risers. Once I realized the conundrum, I was able to make a few adjustments to fix the problem. I made sure that my children had a couple hours of "quiet time" every afternoon to give me the much needed solitude. I was disciplined about this. I carefully made sure appointments and other demands didn't conflict with this time. Once my need for solitude was met better, I was able to go back to my normal bedtime.

Jesus had a clear mental picture of himself and presented it in an unambiguous way to the world around him. This wasn't always popular to those in power. Some thought he was crazy. Others dismissed him. Many followed him. Jesus wasn't wishy-washy about who he was. He was confident and bold in his actions and proclamations . Besides ministering to the needy, he made sure to eat, rest, spend time alone in prayer, and enjoy the presence of his disciples. His actions were completely defined by his identity and purpose. He lived a balanced life. We should strive to live with the same kind of ontological clarity and confidence as Jesus did.

So, let me repeat the first question: Who are you?

State of Double-Mindedness: Ontological Conflicts

2010-02-13T17:35:00.000-08:00

Thought:

If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him. But when he asks, he must believe and not doubt, because he who doubts is like a wave of the sea, blown and tossed by the wind. . . he is a double-minded man, unstable in all he does.

James 1:5-6

As I evaluate new clients, I mentally place their emotional distress or psychological problems on a continuum. On the far right end of this continuum are those whose lives have been going pretty well. They are surprised by the development of a psychological condition. They haven't made any recent changes, they like their job, their children are doing well, and the marriage is strong. As I listen to their list of new symptoms, I see a biological illness. This is the right end of the continuum; the presenting issue is primarily a physical condition.

At the far left end of the continuum are individuals whose lives are undergoing significant change. These clients' life stress scores are very high(for more information about this, please see below). They have been undergoing difficulties for awhile and now feel exhausted, overwhelmed, and helpless. I can sense their desperation and frustration. Their reported symptoms do not match well with a condition of a mental disorder, instead their psychological problems seem to be based on a situational predicament.

It is this left end of the continuum I would like to focus on for the next few weeks.

There is a common theme to situational problems. It is this: clients' problems often are rooted in ontological confusion. Let me explain. Ontology is the philosophical study of the state of being or existence. In other words, each of us have unconsciously or deliberately defined the nature of ourselves and the basic fabric of our lives. This definition either isn't working well or is conflicted. For example, a PETA volunteer who works in at a butcher shop probably isn't very happy. This individual's work life is in conflict with his core belief that that all life, even an animal's, is sacred. Many people have similar ontological conflicts, but either don't recognize the psychological discord or don't know what to do about the clash of beliefs.

Today's verses address this double-minded state. This Scripture calls us to live a life that is in agreement with itself. Over the next few weeks I would like to explore five ontological issues to help us untangle our internal conflicts.

Note:

Drs. Holmes and Rahe, psychiatrists at University of Washington Medical School, have devised a list of stressful events. An individual who scores over a 150 is at risk of experiencing an illness. For more information or to take the Life Stress Scale, please visit the following link: http://www.martinvcohen.com/stressscale.html

Triangulation: Staying out of the Middle

2010-02-05T08:03:00.000-08:00

Thought:

As Jesus and his disciples were on their way, he came to a village where a woman named Martha opened her home to him. She had a sister called Mary, who sat at the Lord's feet listening to what he said. But Martha was distracted by all the preparations that had to be made. She came to him and asked, "Lord, don't you care that my sister has left me to do the work by myself? Tell her to help me!"
"Martha, Martha," the Lord answered, "you are worried and upset about many things, but only one thing is needed. Mary has chosen what is better, and it will not be taken away from her."

Luke 10:38-42

Today's blog is the final article in the interpersonal boundaries series. We are going to focus on "triangulation." This is a psychological concept introduced in the early 1970's, although it is an interpersonal maneuver as old as man. Basically, triangulation is drawing a third person into an unstable two-person relationship. For example, this happens frequently in homes with toddlers. Two children, Tommy and Sally, are playing relatively peacefully with their toys. Suddenly, a disagreement erupts. Tommy picks up a block that Sally decides she wants. Sally begins tattling to her mother, asking her to "make Tommy give it back." Sally believes that by enlisting her mother's help she will solve her problems with Tommy. This is triangulation in a nutshell. We involve an outside person to help us deal with our difficult relationships hoping that it will improve our interpersonal position.

Triangulation is rarely a healthy move. It usually signals that this relationship has communication and conflict resolution problems. There are a few appropriate situations of triangulation. Marital or family counseling is a great example of this. A therapist is enlisted to help troubled relationships. A pastor or priest is another healthy situation of triangulation. We are also using this strategy when we hire an attorney or utilize a medical/legal case manager. But outside these few examples, triangulation isn't functional. In fact, it usually complicates the situation and in some instances, backfires.

The two main impetuses for triangulation are 1. to shore up a weak interpersonal position, and 2. to indirectly communicate to another. The scenario with Sally and Tommy is an illustration of the first reason. Sally believes she doesn't have the resources to convince Tommy to give her the desired toy. She recognizes that her mother has power, so she enlists her mother‘s help. She hopes her mother will make Tommy comply, but this rarely works. Usually the enlisted individual resents being pulled into the conflict and retaliates against both parties. The mother may end up punishing both children before the conflict is finally resolved.

Triangulation also is used as a method of communication. It is an indirect way to share information. You often see this used at high schools. Sue likes Bill, but is afraid to tell him directly. Instead, she tells a mutual girl friend of both parties about her feelings, in hopes that this information gets back to Bill. This technique is not only used to convey risky positive information, but also as a way to resolve conflict. For example, after dating Bill for awhile, Sue and Bill have a falling out. She is angry that Bill can't drive them both to the prom. After getting no where with Bill about the issue, she tells a friend about her frustrations. She hopes Bill will hear about this from his friends and be influenced to go along with her wishes. She is using additional pressure from outsiders to get her way.

Triangulation is often a roundabout, manipulative way to get one's needs met. It runs the risk of hurting others and failing in its objectives. But, we love to use it. Pay attention to your social network. Where do you find triangulation? It is often between parents and children, in-laws and adult couples, and co-workers and supervisors. If you find examples of this dysfunctional style in your life, identify whether or not you are the one enlisting the outside help (i.e. Sue and Sally), the one who is being influenced by the outside involvement (i.e. Tommy and Bill) or the one being enlisted (i.e. the mother or outside friends). Finally, if you find yourself in one of the first two positions, deal with the other person directly about the issue. If you are the one being enlisted as an outsider, politely decline and recommend that the two parties talk to one another.

Jesus was often enlisted in this way to help others, but he rarely got involved. Two examples come to mind. James and John's mother wanted the best heavenly seats for her sons and asked Jesus for those spots. It is interesting that the story mentioned James and John were present. I wonder if they were too embarrassed to ask Jesus directly. Jesus told them that those heavenly seats were not his to give (see story found in Matthew 20:20-24.), then dealt with larger issue of jealousy among the disciples by urging them to model his example of humility. We see another situation of triangulation in the story of Mary and Martha. The women had a house full of guests. Martha was busy preparing a meal while Mary listened to Jesus' teachings. Instead of dealing with Mary directly, Martha tattled to Jesus and asked him to make Mary help. Jesus chastised Martha instead (Luke 10:38-42). Despite its popularity, triangulation is an unpredictable interpersonal strategy, one to be avoided, if possible.

Assessing Your Levels of Interpersonal Intimacy

2010-01-28T17:56:00.000-08:00

Thought:

Once when Jesus was praying in private and his disciples were with him, he asked them, "Who do the crowds say I am?"
They replied, "Some say John the Baptist; others say Elijah; and still others, that one of the prophets of long ago has come back to life."
"But what about you?" he asked. "Who do you say I am?"
Peter answered, "The Christ of God."
Jesus strictly warned them not to tell this to anyone.

Luke 9:18-21

Intimacy is another facet of interpersonal boundaries. Who are we close to? How much do we share about ourselves and with whom? These are important questions. Mismanaged intimacy leads to feelings of betrayal or abandonment. So, let's take a closer look at this issue.

I like to think of varying stages of intimacy like visiting different floors in a tall skyscraper. Just as most large city buildings have lobbies, so does our first level of intimacy. Our first floor is open to the public, like most building lobbies are. It is what we present to strangers and neighbors alike. This includes our physical appearance, our style of clothes, and the car we drive. Most of these things we know everyone will see so we consciously shape this public persona to reveal what we choose about our inner self.

The next several low levels of intimacy are what we share about ourselves with acquaintances and distant friends. It tends to comprise of details of our life that we consider low risk. This information may include which Super Bowl team we are routing for or what movies we've recently seen. It is what we typically share on our Facebook profile. Generally, we are not very invested in protecting these pieces of information.

Mid-level floors of intimacy are things we share with friends. We let this group know our thoughts, opinions, and some likes and dislikes. These are relationships that have some safety. We know these individuals and have found them trustworthy. We share more of ourselves which increases our risk.

Finally each of us have our upper most floors of intimacy. Here we share our emotional reactions, private opinions and thoughts, and deeply held personal likes and dislikes. Risk at this level is very high because we are sharing the core of who we are. Few people should be allowed to enter this level. They might include a friend or two, our spouse, and God.

There are a couple of intimacy related problems. First, some people have problems developing increasing levels of intimacy with others. Of course, not all relationships should become close and personal, but a few should. There is a complication if no relationships grow beyond casual levels of intimacy.

People also get in trouble when interpersonal intimacy is not mutual and reciprocal. Casual friendships should not be sharing deeply personal details or having sexual contact. Likewise, we will be very hurt if we discover our spouse or best friend have kept inappropriate secrets and hidden important parts of themselves from the relationship. If this mismatch occurs, feelings of betrayal are likely since the levels of intimacy aren't mutual.

This leads us to back to the original question. How well are you doing with your management of intimacy? Do you have varying levels of friendships? Are you on the same "intimacy floors " with your acquaintances, friends, and loved ones?

Jesus' relationship intimacy levels varied. He shared one level of intimacy with the Pharisees, then another with the crowd, a different level with the disciples, and finally a high level with his three closest friends, Peter, James, and John. Those three knew him so well that Peter correctly guessed that Jesus was the son of God.

This strategy won't protect us from all interpersonal pain. Even in the best situations, we will still have others disappoint or hurt us, but it will reduce our exposure. Even Jesus was emotionally wounded by his disciples. Peter denied him, Thomas doubted him, and Judas sold him out. But this technique will protect us from some interpersonal risk.

Interpersonal Boundaries: Change and the Holy Spirit

2010-01-20T08:49:00.000-08:00

Thought:

Jesus said to them, "My Father is always at his work to this very day, and I, too, am working."

John 5:17

I consider my last two blog articles to be uncomfortable topics. It's frustrating to know that I don’t have the right or the power to change those around me. This is particularly discouraging news considering my job as a therapist. What am I doing, if I am not changing people? Is there any hope if I don't have the power to change others? I think there is.

God loves the whole world. It is his desire that not one of us is lost to sin (1 Timothy 2:3-4). He knows we need help. As Jesus was preparing to be crucified, he told his disciplines that he was sending the Comforter or Counselor to be with his people for forever (John 14:16). The word Counselor is Greek for "parakletos" which literally means "called to one's side." It is used to describe an advocate or an intercessor. Jesus further explained that it will be the work of the Counselor or Holy Spirit to convict the lost of their guilt (John 16:7-11), to encourage and exhort the believers (John 14:16), and to reveal the truth of Jesus (John 16:13).

This battle isn't ours, it's God's. We may be powerless to change others, but God is at work.

What is our job? Timothy tells us to pray. That is our task. "I urge, then, first of all, that requests, prayers, intercession and thanksgiving be made for everyone. . . This is good, and pleases God our Savior, who wants all men to be saved and to come to a knowledge of the truth (1 Timothy 2:1, 3-4)." Good advice. James takes it a step farther. He tells us that our prayers are powerful and effective (James 5:17). Even if we feel helpless, we really are not. Much is being done with our prayers. We are joining the work that God already is doing through his Holy Spirit. We need to remember that God's investment is much greater than our own. He loves this world so much that he did not even withhold his only son in order to save us.

My current favorite Bible verse is today's thought, John 5:17. I have seen this truth in my office. God is always at work to set every person free from all kinds of sins. My job is to release my loved ones to God's care and to pray on their behalf. I know this is difficult. It can feel discouraging, useless, and even hopeless. But when I start to feel powerless, I remember that God has much more invested in this situation than I do. It is then I find hope and encouragement.

Interpersonal Boundaries: How do People Change?

2010-01-14T17:56:00.000-08:00

Thought:

"Then they came to Jericho. As Jesus and his disciples, together with a large crowd, were leaving the city, a blind man, Bartimaeus (that is, the Son of Timaeus), was sitting by the roadside begging. When he heard that it was Jesus of Nazareth, he began to shout, "Jesus, Son of David, have mercy on me!"

Many rebuked him and told him to be quiet, but he shouted all the more, "Son of David, have mercy on me!"

Jesus stopped and said, "Call him." So they called to the blind man, "Cheer up! On your feet! He's calling you." Throwing his cloak aside, he jumped to his feet and came to Jesus.

"What do you want me to do for you?" Jesus asked him.

The blind man said, "Rabbi, I want to see."

"Go," said Jesus, "your faith has healed you." Immediately he received his sight and followed Jesus along the road."

Mark 10:46-52

How do people change? This is the billion dollar question. Imagine the money to be made if this mystery was solved. Advertisements would always work. Psychological techniques and suggestions would be foolproof. Psychology and business research have spent a considerable amount of money trying to solve this problem.

It may be a blessing in disguise that we only know the sketchy outlines of the answer to this question since this power would negate free will. Think about it, if someone could change us at any time to fit their whims or needs, would our personal control continue to exist? No, it wouldn't.

This struggle is important to understand when we deal with interpersonal boundaries. We need to accept that no one has the ability or right to change another, no matter the circumstances. This is a very hard truth. Our power over others is very limited and for good reasons. Even God, the Master and Creator of the Universe, does not walk around commanding us to change.

We see this kind of respect in the type of questions Jesus asked those he helped. He would meet a blind or paralyzed man and asked what he could do for him. Wasn't it obvious? Heal him! But, Jesus never presumed to know the answer, despite knowing the man's heart. Instead, Jesus waited for the answer as an invitation to act.

What if we learned this same kind of respect? How would it alter our relationships if we grasped our real limitations to change others? We tend to take risks with others under the premise that we can change them later to suit our needs. Jesus never called Zacheaus a thief (Luke 19:1-9). He didn't insist that Matthew, the tax collector, stop cheating (Matthew 9:9-12). These men's lives were transformed by Jesus' acceptance and love, not because of any demands Jesus might have made.

That's how change really happens. It sometimes occurs. It occasionally happens under one of three conditions : 1. in the form of a miraculous answer to prayer (rare), 2. precipitated by an extreme crisis which results in a decision to live differently, or 3. a conscious choice one repeats over and over again (common). We cannot command someone to change his or her life. And not everyone who tries to alter habits and behaviors will be successful. It takes tremendous self-discipline, and frankly, most of us don't want change that badly. It’s a dismal picture, isn't it. It makes God's love and patience even more amazing.

Don't get discouraged, we haven't explored the role of the Holy Spirit in regards to change. I will pick up that topic next week.

Interpersonal Boundaries: A Therapist's Secret

2010-01-06T13:18:00.000-08:00

Thought:

"For I have come down from heaven not to do my will but to do the will of him who sent me."

John 6:3

I am going to let you in on a therapist's secret. It's this: you can't change another person, no matter how much you ask, beg or plead. They just won't do it. If you don't believe me, ask a spouse or a parent of a heroin addict. They'll tell you. They will have tried crying, screaming, threatening, and even manipulating their drug addicted loved one to no avail. People don't change because you ask them too; they only change when and if they want to.

Jesus knew this. You never saw him asking someone to change. He didn't try to stop Judas from selling him out (John 13:26-30). He didn't throw Peter out of the group of disciples despite Peter's immaturity (Matthew 16:22-24). He didn't even tell Martha to leave her sister, Mary, alone (Luke 10:38-41). He understood this principle and followed it. You would think that if anyone could get people to live a better life and to be nicer to those around them, it would be Jesus. After all he was "God in flesh." All the angels were at his command (Luke 4:10). He had complete control over the wind and the waves (Matthew 8:27) , why not control those around him? But he didn't. He did tell the woman caught naked and having an affair to leave her life of sin, but I don't believe that he was saying that she must change her life. Jesus showed mercy and made a recommendation. She could have taken the advice or disregarded it. Jesus didn't visit her later to see if she was being obedient. He respected her free will and left the decision to sin or not to sin up to her (John 8:1-11).

If this secret is true, then how are you suppose to manage all the hurtful and irritating people in your life?

You may not have the power to change others, but you can limit how much contact they have with you and reduce the amount of influence they have in your life. I can already hear the questions that come from this statement. How are you supposed to limit another's intrusiveness when he or she is a regular part of your life? You already have asked this person not to make comments on your life style decisions, without success. So, what are you suppose to do?

There are two ways to prevent other people from hurting you. The first method is limit your physical contact with them. This works well with individuals who are peripheral to your life. In graduate school there were professors who were known for their expertise but also for their brutal treatment of students. I consciously chose not to take their classes, despite the fact that I may have missed out on some excellent teaching. When it is possible, this is the simplest way to control difficult people.

This method doesn't work well, however, when the hurtful people are close family members or co-workers. You can decide to avoid these people, but this isn't always possible or necessarily the best course of action to take. A second and sometimes better method to manage others' intrusiveness and hurtfulness is to limit the power you give them to affect you. I have to admit this is hard to do. It means developing thicker emotional skin (see December 10th blog for more info on this topic).

Jesus was great at this. He was not bothered by the Pharisees' hatred of him. He never needed his disciples' approval before he made a decision. He didn't need the crowds to love and adore him. He didn't derive his sense of confidence and direction from the opinions or approval of those around him. He only cared about pleasing and obeying his Father, God. If we all learned to base our needs for affirmation on God, like Jesus, then we would not be hurt and insulted by those around us, even those closest to us.

This is real emotional freedom.

So, how do people change? I will talk more about that in my next blog.

Christmas

2009-12-23T13:26:00.001-08:00

Merry Christmas!

I am so grateful for the gift of Jesus. He loves us so much that he doesn't come in with power and glory, but as a tiny, frail baby. He doesn't appear in a glorious fiery entrance, but instead by birth in a humble, cold, dark stable. It's because of his humility that we are able to approach him. How amazing and fantastic that he comes to show us God.

After the new year starts, I will continue the series on interpersonal boundaries. I hope each of you has a wonderful holiday season. It is my prayer that in 2010 the wonder of Jesus' love fills you in new and surprising ways.

Interpersonal Boundaries: Practicing Tough Love

2009-12-18T20:08:00.000-08:00

Thought:

"As Jesus started on his way, a man ran up to him and fell on his knees before him. "Good teacher," he asked, "what must I do to inherit eternal life?"

Jesus looked at him and loved him. "One thing you lack," he said. "'Go sell everything you have and give it to the poor, and you will have treasure in heaven. Then come, follow me."

At this the man's face fell. He went away sad, because he had great wealth."

Mark 10:17, 21-22

One of my boys has a large school project. He has procrastinated and now has almost no time left to finish the project. I seriously doubt that it will be done well. He is in high school and hopes to be accepted at a highly competitive college. As a result, his grade point average is very important. This project has the potential to hurt him. I want the best for him. I want him to achieve his goals, so my investment is high too. What should I do? Do I leave it be and let his lack of motivation and laziness affect the end result? Or, do I step in and take charge. Maybe even give some practical help, like write part of it?

Fortunately, I made up this scenario, but this situation is familiar to many of us. Someone we love is in a tough situation and isn't making wise decisions. What do we do?

This situation is another interpersonal boundary issue. And, it is a tough one. If we intervene in such predicaments too much than we are invading and overpowering another's personal space, but if we do too little, it might feel like mild emotional abandonment. So, how do we navigate such complicated interpersonal seas?

I find Jesus' reaction to the rich, young man interesting. Jesus came to save the entire world. This rich, young man was one of the individuals he came to save. This young man asked how to inherit eternal life, but didn't like the answer. This must have hurt Jesus deeply. Jesus desperately wanted him to make the right decision. After all, this man was the bride of Christ. Yet, shockingly, Jesus let the man walk away. How did he do that? I would have ran after him, yelling a more agreeable answer to his question. But, Jesus didn't do that.

If we want our life simpler and with less pain, then this is the kind of boundaries we need to maintain. We need to let those we love make bad decisions and then suffer the consequences. We need to stop rescuing them from the outcomes of their choices, even if it hurts us and makes no sense. Believe it or not, this is the most respectful thing you can do. When you do that, you are saying to the other person, "I believe in you," "this is your life," and "I respect you." When we rescue, we are accidently saying, "you can't do it right," "you are weak," and "I don't respect you" by our actions, even though we act out of love. Jesus respects the rich, young man enough to let him make a terrible decision. Can we love those in our lives to the same degree?

Interpersonal Boundaries: Castle Wall or Open Perimeters?

2009-12-10T14:28:00.000-08:00

Thought:

"My food," said Jesus, "is to do the will of him who sent me and to finish his work." John 4:34

When the Lord saw her, his heart went out to her and he said, "Don't cry." Luke 7:13

So far we have defined interpersonal boundaries as the psychological place that makes up you, called the Self. It is the location where you start and another person ends. I like to visualize it as an actual wall, just like you might find around a castle. However, this wall or boundary can have varying levels of thickness and flexibility. It can be rigidly formed like a brick and mortar wall, or it can be open and undefined, more like my property line. It all depends on you.

The next challenge is becoming aware of your type of personal boundary: rigid, fixed and clearly defined vs. open, permeable, and flexible or fluid. This is something you may or may not know about yourself. So let me ask you some questions to help clarify your type of interpersonal boundaries.

Answer these questions on a scale of 1 to 5 with 1 = none of the time and 5 = all of the time.

__My plans are open and easily changeable.

__I like to try new things, like new activities and new foods.

__I don't like a set schedule since I often play it by ear.

__I am a person who goes along with the crowd.

__I am not a leader.

__I don't have strong opinions.

__Angry people make me uncomfortable and I avoid conflict, if I can.

__I make friends very easily and quickly.

Add up your scores. Totals under 24 are individuals who have firmer, more defined, and maybe even rigid boundaries. Totals above 24 are individuals who have open, fluid, and more undefined boundaries.

Which one is the right kind to have? Both are fine and both present problems. Boundaries that are too open and flexible can result in someone who doesn't have clear goals or direction. These individuals might even be spontaneous to the point of impulsive. Their sense of Self might be very susceptible to outside influence. They are liked by others since they are easy to get along with and tend to be followers. They dislike conflict and might even go out of their way to avoid disagreements.

Those with firmer boundaries tend to have a well-defined view of themselves. This includes interests, likes and dislikes, and viewpoints. They are less open to changing those areas since their Self is less open to outside influence. Conflict doesn't bother them; they might even welcome it. They tend to be leaders or loners. These individuals might be more scheduled or structured in their daily life routines. They like some type of rules (it might not be conventional rules though) and tend to play by them.

As you can see, each end of the continuum of interpersonal boundaries has its pros and cons. It is okay to have either type of interpersonal boundary as long as you are aware of the inherent weaknesses of your type and shore up those areas. For example, if you really dislike conflict, that can be a serious problem, since avoiding all problems, as a rule, generally doesn't work. But, if you know this about yourself, and learn to deal with some conflict, then you are less vulnerable and in a more empowered position.

I chose two Bible verses today as examples of Jesus' interpersonal boundaries. As I wrote before, Jesus' purpose was already clearly defined and well-formed. In this way, he had firm, set interpersonal boundaries. Yet, we also see Jesus impacted by others. It didn't mean he shifted from his original goals or purposes, but he could be touched and affected by the needs and pain of those around him. As a result he was emotionally available. This is the kind of balance we need to find within ourselves: to be defined, yet interpersonally open.

Interpersonal Boundaries What are They?

2009-12-04T07:43:00.000-08:00

Thought:

. . While his parents were returning home, the boy Jesus stayed behind in Jerusalem, but they were unaware of it.

When his parents saw him, they were astonished. His mother said to him, "Son, why have you treated us like this? Your father and I have been anxiously searching for you?
"Why were you searching for me?" he asked. "Didn't you know I had to be in my Father's house?"

Luke 2:43, 48-49

Lately I have been thinking about interpersonal boundaries. In counseling it comes up frequently as an issue. How much control do we have over the daily decisions of our lives? Who makes the decisions and why? Who suffers the consequences? How much do I share of myself and my opinions with those around me? How comfortable am I with conflict and how do I go about dealing with unresolved disagreements between myself and others? All of these questions have to do with interpersonal boundaries. I thought I would spend a few weeks focusing on these types of questions from a psychological and biblical perspective.

Why biblical? I think Jesus is the best example of how to maintain appropriate boundaries. He grew up in a large family and later lived and worked with twelve quirky guys. He frequently dealt with demanding people. People either loved or hated him. Wherever he went he drew crowds. Jesus had experience with maintaining healthy interpersonal boundaries.

Let's first define interpersonal boundaries. It is really a fancy way of defining where I begin and you end. The most obvious interpersonal boundary is our skin. I physically begin where I have skin. My external body defines my physical space. But I also have a psychological boundary. Just as my skin shapes and defines my physical space, my psychological boundary shapes and defines my interior world or my "Self" (who I am and who I am not).

Most of us don't spend much time observing and knowing our psychological "Self," whereas, it is a national preoccupation to spend energy on our physical selves. Just watch how many television commercials during primetime hours are about clothing, dieting, teeth, and hair. Despite this obsession with exterior attractiveness, many of us don't really know ourselves. How much sleep do you actually need? What is your favorite color? What foods do you really like to eat? What emotionally rejuvenates you? Too many of us don't know the answers to these simple questions. Yet these answers help to make up what defines and shapes us.

Jesus at the age of 12 already knew himself perfectly. He didn't stay behind in Jerusalem out of disobedience, it was goal-directed behavior. He knew his purpose and wasn't afraid to pursue it, despite the possibility of upsetting his parents. He let his purpose direct and define him. I find Jesus' question to his parents interesting. "Didn't you know I had to be in my Father's house?" Both parents knew that Jesus was God's son and that he came for a special purpose, yet they forgot and were surprised by his behavior. Jesus didn't let this parental oversight change his direction. He wasn't intimidated or emotionally manipulated by others. Jesus' interpersonal boundaries were well formed.

How can you and I improve our interpersonal boundaries? Begin to pay attention. What bores you? Fatigues you? Excites you? What do you like and dislike? Why? When? What do you spend most of your time thinking about? Why? If you became as invested and interested in your interior self as you are with your physical self, you will begin to know yourself. Why is knowing your "Self" important? Why spend all this effort and time? You can only begin to have better boundaries when you know what and who you are protecting. Just as our skin acts as a barrier, we need psychological barriers too. But you can't resist or invite something through your interpersonal boundary unless you know what belongs to you or is a part of you. If you want healthier boundaries, then this is the place to start. Have fun with it!

Thankful for God's Amazing Love

2009-11-19T19:26:00.000-08:00

Thought:

“But while he was still a long way off, his father saw him and was filled with compassion for him; he ran to his son, threw his arms around him and kissed him.”

Luke 15: 20 (For whole story, please see Luke 15: 11-31)

Thanksgiving Day is almost here and I have been thinking about what I am thankful for. I heard a great sermon recently that helped me in this endeavor. Though the story is familiar, the pastor presented a new slant that sheds light on God's amazing love. I found myself very thankful to God once again.

Sermons usually focus on the prodigal son and his outrageous, selfish behavior. However, the pastor shared that the father in the story is the main character, not the prodigal son. Maybe instead of focusing on the son's rebelliousness, we should concentrate on the father's equally outrageous loving behavior. The pastor reminded us of the Old Testament Jewish law regarding disobedient sons. Deuteronomy 21: 18-21 tells us that rebellious sons are to be brought before the elders at the city gate so that they can be stoned to death. Gulp. This father doesn't do this. Instead he abstains from carrying out the punishment; rather he divvies up his estate--- giving the young man his share. This stupid son parties it up, runs through the money quickly, and ends up broke, starving, and in a horrible situation. The son decides to go home where even the hired help has it better, only to be met in the road by his father who lavishes him with love and throws a party in celebration.

Jesus tells us this picture of the loving father is a picture of God. We are born into sin from the moment we take our first breath of life. We continually choose ourselves and our plans instead of God's will. We deserve absolutely nothing, yet daily we wake up to the sun shining, fresh air to breathe and food to eat. We deserve the punishment of eternal separation from God. Instead he sends us Jesus who willingly pays our punishment by his own death so that we can know God once again.

What amazing, ridiculous love. As Thanksgiving approaches, I am grateful that I have such a Father God who loves me to such extreme lengths so I can have a relationship with him for all of eternity.

Happy Thanksgiving!

Tip #4: A Common Mistake to Avoid When Supporting Others

2009-11-13T11:12:00.000-08:00

Thought:

"…there is a friend who sticks closer than a brother."

Proverbs 18:24b

In previous blogs I have covered what I consider to be the most important aspects of compassionate support. They are:

1. Be patient. Everyone experiences pain differently. Each of us will have our own expressions of suffering and our own healing time.

2. Be Accepting. Not everyone shows pain the same way or grieves alike.

3. Express support by using reflective listening. Be slow to offer advice. Instead show sympathy or empathy by actively listening to the one in pain.

4. Offer tangible support by using one of Gary Chapman's five love languages. Be sure you know which language particularly encourages and ministers to the one you are supporting.

Now I would like to encourage you not to make a common mistake. In the counseling office, I have listened to many stories of loss and trauma. There is an error people make when they try to comfort the suffering. Usually it comes from that awkwardness I mentioned in previous blogs. You see the pain in your loved one and recognize your sense of helplessness. Now what. How do you help? So, in this frustration you respond out of this awkwardness. What often happens is the suffering person is given encouragement or an effort is made to "talk them out" of their feelings. These comments often come off as shallow or crass. They end up creating more pain and may permanently damage your relationship. Let me give some examples of such comments:

"God must have needed your baby as another angel."
"You can always have more children."
"I 've had this happen to me and it will be over before you know it."
"Keep your chin up!"
"You should try Coral Calcium, it did wonders for me."
"Don't lose hope."
"Remember God never gives us more than we can bear." ---this is a misquote that has to do with temptation.

All of these comments come from an effort to care for another, but they have more to do with comforting the speaker than empathizing with the listener. If you feel paralyzed by the intensity of your loved one's pain, you are better off saying nothing then to say the wrong thing. I think the greatest comfort I have received in times of difficulty is someone simply standing beside me and offering me a hug or to hold my hand. It is your presence that is the help, not your words.

Tip #3: Acts of Love

2009-11-06T13:36:00.000-08:00

Thought:

They went to a place called Gethsemane, and Jesus said to his disciples, "Sit here while I pray." He took Peter, James and John along with him, and he began to be deeply distressed and troubled. "My soul is overwhelmed with sorrow to the point of death," he said to them. "Stay here and keep watch."

Mark 14:32-34

Up to now I have been focusing on being emotionally present to those in need. My son who has been a reader of my blog found tip #1 and #2 frustrating. He said he feels like he isn't doing much to help. It is true the first part of caring for another by maintaining a loving, accepting presence might feel like nothing. However, this supportive presence encourages the suffering to freely express their pain and gives them a sense of safety. I think this is the hardest work there is. A few years ago I spent a couple of weeks with someone who was dying. She couldn't be alone so I kept her company. Every day I spent with her was exhausting, despite it just being a few hours of sitting. I think most of us struggle feeling awkward around suffering people. Learning how to get comfortable with the awkwardness is key to being a caring, supportive person.

I want to switch gears with this article and talk about how to minister practically to those in pain. It feels empowering to do something tangible. But how do you know what will be meaningful? Gary Chapman has a great series of books. One of his books particularly speaks to this issue. It is The Five Love Languages. He defines them for you here.

Dr. Chapman teaches you your particular love language, but I am using the love languages in a different way. Instead of figuring out your own particular style of receiving love, focus on the person you want to minister to. How do they receive and accept love? I have figured out at trick to answer this question. As I have spent time counseling couples, I've discovered that we usually use our particular style of receiving love to show love to others. For example, Steve and Mary are having marital difficulties. Mary wishes Steve would take her on a date and spend "quality time" with her. She keeps trying to set dates up, but they don’t go as she expects and feels disappointed. Steve, on the other hand, doesn't feel loved or supported by this love language. He appreciates words of affirmation. He is frustrated that Mary is unhappy. He tells her daily how much he appreciates her and how much she means to him. Both are lovingly reaching out, but their efforts are missed. Why? Because they are using their own preferred love language to minister to each other instead of learning and using their partner's love language.

How does the person we are reaching out to show support and affection to others? Do they affirm others? Spend lots of time hanging out? Or do they give gifts? By asking this question you can reasonably figure out their love language. Now you know how to support them. Use the knowledge of their preferred love language to help them. If your close friend is having surgery and you know she is someone you can count on to help you out with acts of service, then you know she will appreciate a similar type of support from you.

I find Mark's account of Jesus in the Garden of Gethsemane interesting, but sad. Jesus specifically requested the gift of quality time while he spiritually wrestled with the upcoming events. Peter, James, and John completely missed it. Jesus was being straightforward about what would be helpful. It didn't require guesswork on the part of his friends. But in their distress, they overlooked and ignored his needs. He ended up agonizing and praying alone (see Mark 14:40).

Let's hope we can do a better job listening and observing what our friends and family members need when they are deeply troubled; then we truly will be a comfort.

Tip #2: Empathy--- The Art of Reflective Listening

2009-10-30T11:41:00.000-07:00

Thought:

"Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres."

1 Corinthians 13:4-7

My father-in-law was diagnosed with terminal cancer several years ago. We got the news in mid-March. After doing some internet research, we knew that his time would be short. We also discovered that most treatments were palliative, not curative. There was no remission or cure for this type of cancer. I was shocked. My grief started when I realized what this diagnosis meant. My father-in-law died four short months later.

I shared his condition with various communities: my colleagues at work, my own family, and my church community. Some people were appropriately supportive. With them I found I could be honest about my feelings and reactions. Others were not so supportive, though I am sure they thought they were being helpful. I found myself avoiding this group. When I was around them I stopped talking about the situation. It left me tired and often avoiding large groups.

What were some individuals doing wrong? I think my grief and despair overwhelmed them. They didn't want to hear my pain since they didn't know how to change my circumstances. When I shared my reaction about my father-in-law's prognosis, they tried to offer suggestions of cures or urged me to pray for his recovery. Although sweet, their suggestions failed to register what I needed. I was looking for a listening ear or a hug, not more problem-solving. They wanted me to hope, when I needed to grieve.

It is easy to fail at being supportive. It takes hard work and a willingness to tolerate another's pain. Think back to the last time you were with someone who was emotionally or physically suffering. Didn't you feel awkward?

Being supportive means being ok with not having any answers. Most suffering people don't want more solutions. Usually we are pretty good at problem-solving. Instead those suffering are looking for understanding and empathy. I needed my friends to hear my pain about my father-in-law dying and sympathize with me.

So how do you help? One psychological technique students learn in graduate school is "reflective listening." It is actually pretty basic and something anyone can do with a high degree of success. Reflective listening is simply hearing what the other person is saying and repeating the emotional content of their message back to them.

For example, Jane is sharing with Judy her thoughts about a recent test. She says, "I don't think I did very well. Questions 10 and 12 were really tough."
Judy replies, "You sound worried."
Jane sighs and say, "Yeah, I am."

That is reflective listening. Believe it or not, it is very powerful. The speaker feels empathetically connected when his or her feelings are correctly heard and accurately reflected back. It leads the conversation into more meaningful levels. It validates the speaker's emotional experience. It develops trust and rapport.

When using reflective listening, you will need to practice restraint. You may feel like you are not doing enough by just listening and reflecting back what you hear. Don't jump in by giving some quick solutions or telling the person in pain not to be discouraged. Be patient. If you think they do want some practical help, ask before giving it. What you are doing by listening is important work: it is loving another person.

Tip #1: The Art of Compassionate Support

2009-10-19T19:09:00.000-07:00

Thought:

"When Mary reached the place where Jesus was and saw him, she fell at his feet and said, "Lord, if you had been here, my brother would not have died."

When Jesus saw her weeping, and the Jews who had come along with her also weeping, he was deeply moved in spirit and troubled. "Where have you laid him?" he asked.
"Come and see, Lord," they replied.

Jesus wept."

John 11:32-35

I met M. in graduate school. I liked her quiet presence. She had a way of just being with you without saying much. I could tell she was going to be an outstanding therapist. Her insights were amazing when we studied clinical cases. After spending some time together I realized she was quietly suffering. She had chronic depression. You could see it on her face. She looked in pain or troubled by something. She didn't have much energy. M. didn't hang out with the other graduate students after hours. At times her mood dragged me down too. I sometimes was relieved that our time together came to an end.

I wasn't M.'s only friend. She had connections at school, but they were sparse. She told me that one friend called her up to talk. When the friend learned that M. was having a rough day, she replied she would call back later when M. was feeling better. This crushed her. It was embarrassing and rejecting. However, I understood where this person was coming from. You call someone up and can't wait to tell them your latest news only to find out that they are emotionally unavailable. It's awkward and feels socially clumsy. But this wasn't being the kind of friend that M. needed.

There are all kinds of emotional pain. Some emotional pain seems to have no explanation, like depression or anxiety. Some pain comes in the form of shock, like a car accident. Then there is the type of pain that comes with bad news--like losing a job. Emotional pain also can come from physical pain---acute or chronic. I think the worst emotional pain is grief.

I love the story of Jesus meeting Mary and Martha in the streets after their brother had died. Mary was hopping mad. She knew Jesus could heal her brother and had asked him to come earlier, but he didn't show up in time. She met him in the street and let him have it. "Lord, if you had been here, my brother would not have died." Wow, right straight to the point. Jesus didn't get defensive though. He didn't give her a theological discussion on healing. He didn't get personally hurt or angry. Instead he listened to her emotional response, allowed himself to feel her pain, and was moved. So moved that he wept. He didn't just shed a tear, he wept.

How can you or I help someone who is in pain? The biggest gift you can give is your silent emotional support. M. didn't need me to tease her out of her depression. She didn't want to be told that the glass was really half-full, not half-empty. She just wanted me to accept her as she was: pain and all. Being present and listening is a way to do that. Our non-judgmental support of someone hurting communicates empathy and compassion. I know this sounds like nothing. But it is the most powerful thing you can do.

You want to be a friend to someone in pain? Be with them. Listen to them. Finally, be moved by them. Then you are being like Jesus, our truest friend.

Compassion: How to Support the Ones We Love

2009-10-17T13:29:00.000-07:00

Thought:

"Friends come and friends go, but a true friend sticks by you like family."

Proverbs 18:24 translation: The Message

Yesterday I sat at the doctor's office waiting for my turn. I have had a sinus infection the past few days and wasn't feeling well. The poor soundproofing enabled me to hear the doctor's conversations with the patient next door. The woman sounded awful. Her cough was loud and loose. It was the kind of cough that makes your ribcage ache. I could tell she was very ill. I heard the doctor inform her that she had the flu. He proceeded to tell her what she probably already knew by listing all the over-the-counter medications she could use. She asked how long the symptoms would last. He explained. She followed up by reminding him she had to return to work soon. I heard the sound of frustration in her voice. I suspected this appointment hadn't really helped. She left the building in the same condition she entered it: still running a fever, coughing, and in pain. My heart went out to her.

How many times are we in this situation with someone we know? They are in pain and we want to help them. The woman at the doctor's office was hoping for a cure. Instead she learned that there wasn't a quick fix nor was she comforted by the doctor's efforts. I often hear painful stories at my workplace. Being a psychologist means people tell me things even though they don't want to be reminded of. It's hard. I wish I could make the pain go away by changing their circumstances, but know I can't. Through the years I have learned some tips that do help. We may not be able to change an individual's situation or condition, but we can bring comfort. I have heard over and over again how one can tell who their true friends are during difficult times. Too many of us pull away and avoid people in pain. A real friend sticks around.

Over the next few days, I would like to pass on a few tips on how to be a compassionate friend. It is my hope that next time you are around someone who is suffering you will feel less awkward and better equipped.

Video of Leeland and Brandon Heath "Follow You"
example of compassionate love

Jesus, Our Firm Foundation

2009-10-12T12:23:00.000-07:00

Thought:

"Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock. The rain came down, the streams rose, and the winds blew and beat against that house; yet it did not fall, because it had its foundation on the rock."

Matthew 7:24-25

Wind storms blew through my hometown last week tearing down power lines and damaging trees. I saw the utility company crew out cleaning up the damage and repairing downed power lines. As I walked, I noticed a beautiful old maple tree. It looked worn hard, yet once again it had withstood adverse conditions and thrived. What was different about this tree and the others that were damaged?

It reminds me of Jesus' parable found in Matthew 7:21-27. Jesus teaches the crowd around him about the man who built his house on the rock. The rain came, streams rose, and wind blew and beat against it, yet it withstood these stresses and didn't collapse. It is interesting that Jesus didn't promise a life without adversity. I find that many believers think that God's love means a stress-free life. That just isn't so. I don't see Jesus making that promise. If fact, he tells us to expect trouble. All kinds of trouble. But when we build our lives on Jesus and his truths we can withstand the challenges that life brings. We will be like this old maple tree which has seen thousands of storms yet continues to persevere and grow. It roots itself in very solid ground. It has a firm foundation. Jesus wants to provide this kind of foundation for you and me.

Facing Life and Trusting our Father

2009-10-11T17:57:00.000-07:00

Thought:

"There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love."

1 John 4:18

Heard a lot of bad news lately. A friend and a family member both were told that they have cancer. Neither know the scope of the disease or what treatment will look like. Right now they are facing the unknown with the large word DEATH floating around. This is a horrible place. It doesn't seem to matter where we are in our spiritual journey, it stills seems to bring up the basic, yet profound questions. Like: where is God in this matter? Does my life and my desire matter much to God? What happens when I die? Who does God heal and will I be among those that He touches that way? Does He see me and care?

I used to go there. But as a psychologist I have listened to too many painful stories. I've learned just how capable we are of hurting each other and how many times life disappoints us. I've also learned that I don't have any easy answers. If I believe that God is sovereign and completely determines all things, then I don't like him very much because I don't understand why He lets us suffer. If I believe that He is respecting our free will and is somewhat less involved out of that respect, then I feel He should step in because we are making a pretty big mess of things. I know that both ends of the spectrum are true: God is absolutely sovereign, yet He respects our free will. I don't know how to reconcile these two diametrically opposed ends, except to believe.

In crises, I now focus on my faith. Who is God to me? Who does He say He is to me? How can I grow to trust Him more? Perfect love casts out fear. I have watched a father toss his little girl up in the air while she enjoys every second of the attention. If her father was physically weak or terribly cruel, he could hurt her by letting her fall. Instead she knows him so well that this moment isn't scary, it's fun. Her love and trust of her father leaves no room for fear.

God urges us to know Him similarly. Instead I find myself with my teeth clenched and my fingernails bit short. What more do I need to know of my Heavenly Father that make me more like the little girl and her father? I know that life isn't quite the same as the game I just described. Most of our "tosses" are gut-wrenching and painful. But I need to focus on God and not on the air around me. I need to know that no matter what happens, God still has me. My eternal life is secure in him. I am loved, known, and valued by God. Even when it doesn't seem like it, He has got me in his arms.

Dear Father,

Teach me to trust you with my life and current circumstances. Show me where I lack faith and help me to grow there. I want to trust you like the little girl and her father. I know your love for me is so great and I long for it to diminish my fears and anxieties.

ArtPrize Winner: Modern Example of Running the Race

2009-10-09T14:30:00.000-07:00

Thought

". . .let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us."

Hebrews 12:1

Last night in Grand Rapids, MI a Brooklyn-based artist, Ran Ortner won grand prize in the first annual ArtPrize competition. He is characterized as "a struggling artist." He spent over 30 years pursuing his passion and lived in obscurity until these past few weeks. Mr. Ortner learned of ArtPrize several months ago and painted Open Water no. 24. He entered the largest art competition in the world where he competed against 1262 other art displays. After over 300,000 votes were cast by Grand Rapids visitors, Mr. Ortner won the top prize of $250,000. He shared in an interview how financially challenging it has been pursuing art. He said that for the first time he would have "the resources to work without having to worry about making ends meet." His winnings will go first to pay an overdue phone bill.

Hebrews speaks of such perseverance. We are encouraged to "throw off everything that hinders" (Hebrews 12:1). Mr. Ortner did not let discouragement, the lack of notoriety, and even financial difficulties obscure his goals. His love of nature and his passion to express that love in painting focused him. Each of us have a race to run. And each of us will face challenges as we complete our course. There are many things that distract us from our race, but we are urged with the help of Jesus to stay focused and to finish that race. What is the race God has marked out for you? What are the challenges you face? Mr. Ortner's life is changed by his endurance and perseverance, will yours be?