CPPNJ - The Center for Psychoanalysis and Psychotherapy of New Jersey

Friday, December 31, 2010

You say you want a resolution

Ah, New Year's. A time of fresh starts and grand resolutions. This is the year you lose weight, look for a new job, learn Swahili, and, in general, get your life in order.

And so you eat plentifully during the holidays, assured that your diet doesn't begin until January 1. You join a gym, and for a few days you actually go, waiting your turn for the elliptical machines with the other easily-winded New Year's resolvers.

Then one morning your alarm goes off, and you hit the snooze button. Once, twice, three times. It's okay, you'll go to the gym after work. But then after work becomes tomorrow morning, which becomes the next week, and there you are, soothing your guilt and shame with a pint of marshmallow chocolate chip ice cream, a spoon, and -- who are we kidding -- no bowl. I say this as a person who was spent plenty of time with my face in front of the freezer vowing just one more scoop and that's it.

This blog post will not offer 10 easy tips for making your resolutions stick. If it were that simple, you would have made the changes years ago, or on any of the other 364 days of the year. What gets people into trouble is the well-meaning naivete with which they make sweeping promises, ignoring their own ambivalence (and their track record).

Each of us has fears and resistances to letting go of bad habits. The devil we know is less frightening than the devil we don't. What if we were to put in the strenuous effort of changing, and we failed? Or if our greatest fears about ourselves proved true? By not really trying, we keep things safe and in our control. There are no unpleasant surprises, even if that means we are unhappy.

For instance, procrastinating on projects and then rushing to do a sloppy job confirms that we are not capable enough for a promotion. That's the unhappy part. But what if we put in our all from the start, and it's still not good enough? That might feel devastating. Better to procrastinate and feel like a failure by our own doing rather than have it irrevocably proven by really trying and missing the mark. All of this happens unconsciously, out of our awareness, which is why it's so confounding. Procrastinating keeps alive the hope that we will still be recognized as unique and talented -- a desire that was not often met as a child -- if we would only stop putting things off.

Which brings us to what psychoanalysts call "secondary gain." Without realizing it, there's something we are getting out of even the most self-destructive traits. I have a friend who is forever sick with ill-defined illnesses and body aches. She bounces from physician, to specialist, to chiropractor, complaining loudly of her misery. Is she happy? No. But, without realizing it, she's getting plenty of attention she feels is lacking in her life. The person who continuously overeats or drinks to excess may be using food or substances to fill an emptiness, or to avoid experiencing other difficult feelings.

Until we look at the unconscious obstacles we put up to dismantling our personality armor, we're likely to continue repeating the same New Year's resolutions -- with the same outcome -- year after year. Still want to make a resolution? Resolve to spend some time truly understanding the complexities of what makes you tick. This is no easy task, but it can be an exciting one. You might want to make an appointment with a psychoanalytic psychotherapist to help in this process.

And then resolve to try to keep that appointment.

Happy new year!
--Eric Sherman, LCSW

Tuesday, December 28, 2010

What's a Lunar eclipse have to do with psychoanalysis anyway?

I keep thinking about the recent full lunar eclipse that occurred at the same time as the winter solstice. This one was especially noteworthy because it was the first time since 1638 that such a confluence of events occurred (that’s 372 years ago!) What I keep thinking about doesn’t have to do with the astronomical factors involved in such an event nor with how beautiful the moon looks cast in an eerie shade of orange. What I keep thinking about is the terror such an event caused in the hearts of our ancestors all those many eons ago. Even more I think about all those poor women who lost their lives as they were offered up for sacrifice in order to appease what was believed to be an angry god. It’s amazing how our ancestors’ lack of knowledge as to what caused this event didn’t keep them from “knowing” how to fix it!

Apparently no one was sitting around at night, seeing this phenomena unfold, saying to themselves and others,

“Hey, look at that! I wonder what’s going on? Everyone ok? Anyone hurt? No? Good, let’s keep an eye on this and see what happens.”

Rather, I imagine what was thought was something like,

“Hey, look at that! I don’t know why that’s happening and worse yet, it seems to be happening outside of my control. That makes me feel small and vulnerable and that makes me anxious! In order to make myself feel better, I’m going to make up a story about why this is happening. Of course, since I’m making this up, it will consist primarily of projections of my own internal world. I know; this will be about having done something to piss off my parents, better known as the ruling gods. (Given that I’m working on getting to the depressive position I will try to make amends but I can’t help but also express my hostility.) I’ve got it; the gods want us to offer them sacrifices of young innocent women, yeah, I’m sure that’s what gods like! “ And so, into the fire those women went giving the gods what they wanted, at least according to the men in charge.

The importance psychoanalysis places on the power of the internal narrative--that’s what keeps occurring to me as I think about the lunar eclipse. How attached, how enamored we become of our story, the one we told ourselves in order to survive what we couldn’t understand or control. How well it serves our anxieties and how poorly it serves our ability to be in the present moment. For the last several days I have found myself listening to my patients struggle with their internal voices, conflicts, and longings. I hear my own drama calling out to me as I move through my day.

When I think of the olden days, I picture tapping those ancients on the shoulder and telling them that it’s safe. They haven’t done anything wrong. They don’t have to “pay” for their misdeeds. The universe doesn’t keep score.

Then I wish I knew the magic words to tell my patients (and myself). I want to tell them that their life is in the present. That yes, we are vulnerable in that present to things we don’t want or control but that we fare so much better when we don’t make up stories or give ourselves things to do that create the illusion that we are protected. I would like them to know that we can be anxious or sad or frustrated and remain thoughtful, curious and still. And that although it is a flawed present, incapable of righting the wrongs done to them, although it is limited in providing them with the antidotes to their early pain, capable of even more disappointments and things that can’t be controlled, it is nowhere as painful, anxiety-producing and limiting as an endless search for what is no longer available.

In the end, I realize that the tap on my patients’ shoulder can’t be so much in what I tell them, as much as in how I am with them. I can invite them into a world that doesn’t shame them for their fears and longings; where there are no forces that need to see pain as proof of one’s devotion We can sit together and observe when it is that their moon disappears, noting, but not necessarily acting on the commands embedded within their ancient story and hoping that in my joining them on their journey we will write a new and more fruitful story, one more firmly rooted in the present. My hope is that we will keep the casualties to a minimum.

By Irwin Badin

Thursday, December 23, 2010

HBO’s IN TREATMENT: Can good drama be good therapy?

Recently, I participated in a terrific discussion group about this season’s HBO series, IN TREATMENT. The group was held in NYC and was led by two analysts from William Alanson White Institute, Claire Basescu and Don Greif. For our final meeting, Claire and Don asked us to respond to questions that addressed whether the show was a good portrayal of therapy. Below are the questions and my responses. Please share your views on these questions.

Did your view of IN TREATMENT as a showcase for therapy change over the season?

I think this season of IN TREATMENT provided great drama and wonderful personal stories. However, a showcase for therapy it was not. My perception about its showcase worth changed over the season. It gradually became less and less so as the personal flaws of both therapists were exposed. While I thought Paul improved somewhat once he was in treatment with Adele, he seemed too restless, angry, and tortured in his own life.

For many prospective patients, I could see this feeding into one potential stereotype about therapy: that the doctor will be crazier than the patient. People considering going into therapy might wonder, “are these my choices: on the one hand, someone who will need me more than I need him and will be working out his own issues with me; or, on the other, a steely, at times robotic, person who adheres so rigidly to her theory, that she misses the unique needs of each patient. And, because of her allegiance to a 1-person view of analysis, does not take ownership of the problems she herself creates?”

What Positive and Negative images of the profession does the show present or reveal?

Negative Images:

  • Therapists will answer my questions with questions
  • The doctor is crazier than the patient (see above)
  • I will be shamed
  • Therapy is a game of “gotcha” if I am avoidant/resistant

Positive Images:

  • I can say anything in a therapist office: swear, rail, talk about sex
  • Therapy may be about connecting to your true, creative, lively self
  • Wow, dreams do mean something and can help me understand myself (Paul’s dream)
  • There is an unconscious: many of my thoughts, feelings, behaviors and relationship choices may be out of my awareness. Now, because of this show, I am curious about finding out more about my unconscious.
  • My confusing behavior and repetitive patterns can be untangled as they are replayed in transference.
  • Therapists are humans too (but with training)
  • I can have some very attractive person focused exclusively on me for 45 minutes!

Are you proud to be identified with the therapists in the show?

No. I was prouder in the last 2 seasons. Not this one though. Several of the treatments might be considered “failures.” Also, the doctor may be crazier than the patient (see above).

What misunderstandings and/or correct understandings about therapy do you think people might glean from the show?

Possible misunderstandings:

Therapists will know better than me about me. They will tell me what I am thinking and feeling and why. Therapy is an exchange between a flawed “me” and an objective other.

Correct understandings:

Therapy can be a very intimate and emotionally charged experience. Therapists really think and feel so much about their patients outside the consulting room. Therapy is only as good as the human being who provides it. Ultimately, no matter what the theory, my problems will be viewed through the subjectivity of the therapist. Finding a “good fit” with someone is important.

Is the show a good vehicle for exploring clinical process & technique?

Yes. I think it is a terrific vehicle. It illuminates so much about: the frame, boundaries, dual relationships, the transference/countertransference matrix, enactment, different meta-theoretical approaches to interpretation, resistance, the classical and contemporary views of neutrality and abstinence, dream interpretation, termination, psychopathology and character disorders.

And, of course, it highlights the importance of a therapist’s own analysis so that the doctor is not perceived as crazier than the patient (see above).

Sally Rudoy, LCSW

Sunday, December 19, 2010

Who's afraid of the big gay wolf?

With a vote that had seemed impossible just a week ago, Congress did the unthinkable yesterday:

The right thing.

Repealing Don't Ask, Don't Know (DADT) should have been a no-brainer. The president, the Pentagon, most lawmakers, the majority of the public, and the Secretary of Defense all supported the repeal. Even 70% of surveyed servicemembers believed it would have no negative impact on their units. But thanks to the voices of fear, it practically didn't happen.

Openly gay soldiers will be a dangerous distraction to the troops, endangering their lives!, warned Sen. John "I never said I was a maverick" McCain and Marine Corps Gen. James F. Amos. Apparently, now that they don't have to be closeted, McCain and Amos expect gay soldiers to hit the trenches in Bob Mackie gowns, making it impossible for our well-trained heterosexual boys to keep their eyes on incoming fire.

Does anyone else find that kind of hysterical homophobia a little, well, queer?

But there it was only a few weeks earlier, in a court hearing involving California's anti-same-sex-marriage law, Proposition 8. In that case, the group ProtectMarriage.com sounded the alarms, warning that allowing gay people to marry would threaten the very foundation of (the apparently fragile) institution of holy matrimony. Ironically, the same argument has been put forth by the likes of McCain, Newt Gingrich and Bill O'Reilly, who have five divorces and numerous affairs between them.

What lies beneath the fear of all things gay? Like all fears and prejudices, what really unnerves people may be deeper than meets the eye.

As a rule, people tend to rail against unpalatable aspects of themselves that they see in others. Someone who is afraid that they may be gay unconsciously tries to eradicate this threat from within by seeing the danger as coming from others. By clamping down on gay people they attempt to eradicate disturbing aspects of themselves. Many of the harshest critics of homosexuality turn out to be gay themselves -- like politician Larry Craig, who was caught in a compromising position in an airport men's room, and "Conversion Therapy" psychologist George Rekers, who believes homosexuality is sinful and was photographed with a male prostitute earlier this year.

Sadly, homosexuality is frequently associated with weakness, and male homosexuality with femininity. For men who feel insecure in their masculinity, gay men pose a particular threat. These heterosexuals try to prove (to themselves) that they are "real men" by beating up on other men.. Explaining why resistance to repealing DADT was particularly prevalent among Marines, Gen. James T. Conway responded, "We recruit a certain type of young American, a pretty macho guy or gal." Someone should tell Gen. Conway that us less-macho guys stopped calling women "gals" decades ago.

Finally, sexuality is a fertile breeding ground for anxiety. Sex represents both the ultimate vulnerability, as well as all that is wild and out of control. Erotic passions attract shame like a (Spanish) fly to a flame. As a society, we talk about sex constantly and often quite crudely (hello "The View"). We spend a fortune on products intended to improve our performance as if our sense of self was as flaccid as our erections. We are obsessed with sex -- we just don't have any. Gay people -- who often seem more sexually uninhibited -- can be a lightning rod for many erotic insecurities.

We all grow up in a heterosexual society that values sameness and conformity. To one degree or another, we are all at least a little homophobic, just as we are all a little racist. Prejudice is particularly insidious where it is most subtle, and therefore easy to hide out of view. Also this month, in the midst of the debates about DADT and same-sex marriage, a study in the journal Pediatrics showed that gay, lesbian and bisexual teenagers in the United States are far more likely to be harshly punished by schools and courts than their straight peers. This was true even though they are less likely to engage in serious misdeeds.

With the surprising repeal of DADT, perhaps homophobia has been dealt a serious blow.

But somehow I doubt it.

-- Eric Sherman, LCSW