Remembering Edie Windsor

Ms. Windsor truly helped move the fight for LGBTQ rights forward in very significant ways. Her fight won a Supreme Court decision defeating the Defense of Marriage Act (DOMA), which paved the way for the legalization of gay and lesbian marriages in this country. Many of us never imagined this could happen in our lifetimes.

I’m old enough to remember a time, not really that long ago, actually, when the preferred course of therapy for gay people was “conversion therapy.” This was designed to make homosexual behavior appear to be so repulsive to the client that he or she would want to stop all related sexual behavior as well as the thoughts and feelings they were having toward people of the same sex. In other words, the message was unabashedly “stop being who you are because you’re perverted and society will never accept you!” Fortunately, this horrendous form of treatment is no longer supported by any professional board in the mental health field.

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I was fortunate to be practicing a little later than when the peak of this trend was most prevalent, but it still was widely accepted as my practice was building. Homosexuality was clearly defined as a psychological disorder in the DSM until 1973 and remains stigmatized today, though thanks to activists like Ms. Windsor, we are moving in a more positive direction.

So how does this impact the work we do today and going forward with this community? I think it means to me continuing to look hard and deep at my own learned prejudices and discomfort with that which is different, even when I think that they no longer exist. And then it is about being open to, or reconsidering, new or different viewpoints in a way that fully honors the human sitting in front of me. In order to be able to give therapeutic benefit to anyone else, I must first open my heart and mind to the beauty of individual differences and the common bonds in expressions of love and intimacy.

 

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Believing in our common good

In a recent blog, John Sommers-Flanagan, quoted Adler:

“An incalculable amount of tension and useless effort would be spared in this world if we realized that cooperation and love can never be won by force.” (Adler, 1931, p. 132).

It seems to be obvious on first glance that “force” can never win over the spirit of love or cooperation. Yet, the evidence that entangles our world and everyday lives demonstrates how intensely we as human beings try to hold on to the erroneous belief that we can “make” people love and respect us.

This tends to get us in a lot of trouble. We see this all the time, particularly in the lives of our clients. Couples who have to engage in an argument to its last breath in order to be proven right, adolescents who engage in risky behaviors such as using drugs or running away in order to get parental attention, or the parents who demand respect from their children through intimidation, if not abuse.

The core issue here, as I see it, is that we tend to treat respect as an asymmetrical phenomenon. That is, there is often an  assumption that one person deserves or receives more respect than the other. Therefore, the relationship remains static in its inequality (i.e. a male dominates a sexual relationship or a power struggle is ongoing because there is always competition for who should be the winner for the most respect).

Suzanne Slay - Respect Focused Therapy.pngWhen one steps back to consider this dilemma, the obvious conclusion is that the premise of necessary inequality is false. Parents, teachers, employers, law enforcers, and even therapists can easily fall into the trap of assuming that authority means demanding more respect than one in that position must give to those under such authority.

This way of thinking is toxic, particularly as the concept extends beyond clear lines of established authority or power. The common good of all evaporates when others are belittled, marginalized, or discriminated against.

As therapists, I believe that we have a critical responsibility to demonstrate and advocate for genuine and equitable conveyed expressions of respect in the therapy room and beyond. To do so requires our diligent exercise in practicing for the good of all.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Disasters and Mental Health

I live in Austin, Texas, and we just got our toes dipped in a small part of Hurricane Harvey, but we also watched from the sidelines as our friends and family in Houston and coastal areas were slammed by the terror of the possibility, if not the reality, of losing everything—homes, cars, and belongings, along with memories and a sense of security and safety.

It is this latter concept of losing security and safety which I think is the hardest to cope with psychologically. Having experienced such devastation in such short order is clearly and literally “having the rug pulled out from beneath your feet.” To have this done in such a large scale is further disorientating and catastrophic. Fear and shock dominate the psyche. Knowing where, or having the capacity, to begin to move forward is blocked by the enormity of insecurity.

Will life move on? Of course. But it will not look or feel the same for a very long time. That’s where mental health professionals come in. The trauma endured by so many in these circumstances is much more indelible, beyond the first few weeks or months. PTSD will be prevalent for many for years to come.

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Recovery mentally will be a much slower process than regaining physical and financial losses. Feeling safe again is the struggle. The job for therapists, therefore, is to begin the process of recreating safety and security for our clients who have had such trauma.

It is my belief that we can best do that by honoring them as full human beings who have lost so much, rather than just “refugees.” The differentiation I’m making here at first glance may seem subtle, but categorization and labeling is an easy pitfall. This is even more pronounced when we are working with the poor or indigent. Human nature can often trick us into the trap of stereotyping, albeit unwittingly. But intentional acceptance and focusing on a respectful framework allows us to move in a way that can create safety for everyone we serve.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Multicultural Counseling: Working with People of Color

It is well-documented that working with minority populations can be challenging for therapists, especially for white therapists, largely because of trust and specific cultural issues. Because the current, if not ongoing, issues of racism and bigotry have been brought into the spotlight so starkly once again, I find it to be important and timely to look at these challenges more deeply, so that we, as therapists, can more effectively be part of the solution rather than contribute to the problem.

Williams and Levitt (2007)1 studied the differences between the values of therapists and clients as they relate to multiculturalism. They found substantial evidence supporting the fact that real value differences exist between therapists and clients and, “therapists cannot be value-neutral and that they routinely convey their values with clients.” (p. 256) Therefore, they say, “the potential exists for therapists to consciously or unconsciously influence clients to become more like themselves.” They point out that most therapists are unaware of the potential negative effects of sharing such values with the client, because they do so intending to benefit the client. Within a multicultural context, there is a higher probability of alienation, shame and/or indoctrination for the client in ways that either shut down the treatment or is counter-indicated for real progress to be gained.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity.

According to the research, among the most prominent ethnic minority groups in this country (African-Americans2, Latinos3, Native-Americans4, Asian-Americans5 and Middle Eastern Americans), common themes exist in their overall experiences with therapy. Additionally, there is vast underutilization of mental health services, primarily for the following reasons: a sense of alienation and shame, stereotyping and lack of trust in the therapist (particularly a white therapist).

Because this phenomenon is so embedded in horrific histories as well as ongoing cultural disparities, it often seems insurmountable to rectify. But it is my strong conviction that we in this field can, and must, put every effort into positively intervening in this issue by fully recognizing it and, coming from a place of authenticity, fully focus respectfully on the unique cultural backgrounds and qualities of each human being we encounter.

1Williams, D., & Levitt, H. M. (2008). Clients’ experiences of difference with therapists: Sustaining faith in psychotherapy. Psychotherapy Research18(3), 256-270.

2Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional psychology: Research and practice35(1), 19.

3Comas-Diaz, L. (2006). Latino healing: The integration of ethnic psychology into psychotherapy. Psychotherapy: Theory, Research, Practice, Training43(4), 436.

4Heinrich, R. K., Corbine, J. L., & Thomas, K. R. (1990). Counseling Native Americans. Journal of Counseling & Development69(2), 128-133 and Trujillo, A. (2000). Psychotherapy with Native Americans: A view into the role of religion and spirituality.

5Leong, F. T., & Lau, A. S. (2001). Barriers to providing effective mental health services to Asian Americans. Mental health services research3(4), 201-214.

 

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

 

 

Love Your Enemies

I rarely mix therapy with politics, but we are at a very dangerous precipice in our international history.

Hate has always existed. This has always mystified me. Why? And what are the predicating factors involved in the creation and sustainability of hatred? What is it about, really, and what can be done to diminish its destructive power?

By now we have all heard about the tragic events in Charlottesville. The ugliest head of hatred rose up again toward individuals simply because they were “other’’ and this resulted in violence and death. This incident has been hashed and rehashed in the media and will soon fade away like so many similar horrific incidents in our recent and not so recent past. The ongoing phenomenon remains. Hate and violence don’t seem to go away.

Carol Anderson, professor of African American Studies at Emory College, posed a very interesting theory in an interview I saw recently. She suggests that perhaps hatred is an addiction. At first I was adverse to the idea because it hasn’t been mentioned in addiction literature that I’m aware of. But the more I listened, the more it made sense to me. Just as rage can have addictive qualities, so might hatred share many of the same qualities. Both are based on irrational thinking; they both share adrenaline-related proprieties and appear to be based in victor mentality.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity.

The question remains, though, how does this human emotion-driven behavior get treated? What, if anything can those of us in the mental health field do to effectively respond to or treat this infectious and devastating malady? There is no definitive answer to this and may not ever be. But I believe that the question remains valid and worth our ongoing pursuit. I think we have the best shot as a profession, to provide some answers.

In response to the most recently publicized display of targeted hatred, President Obama shared the popular tweet, “People must learn to hate, and if they can learn to hate, they can be taught to love…”

I believe that therapists have an unique opportunity and skill set to help engage clients in the experiencial understanding of love in its purest form, respect. We can provide the path necessary to begin shifting the paradigm of hatred to genuine caring, kindness and respect toward others.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Tapping into Therapeutic Creativity

Many times, we as therapists can feel “stuck” in the process of doing therapy, either with a particular client or more generally with a certain population. It may be an adolescent not wanting to be in therapy, a very depressed older individual or a couple so entrenched in a non-stop pattern of arguing you feel a need for a megaphone just to interject some redirection.

In most, if not all, of these cases we need some moments of calm and self-clarity to be sure, but it might also be helpful to “think outside of the box” as well. Try introducing creative interventions such as art (music, visual arts, poetry or prose).

We could certainly draw from our own experiences by offering stories, metaphors or pieces of music, but I have found it to be much more profound when tapping into the creativity of the clients themselves. Their own storytelling, poetry, artwork, music, etc. can be much more compelling, meaningful and healing if they are left untouched in a respectful manner. That is, we don’t interpret or judge in any way, but instead encourage growth by allowing clients’ creative outlets to portray whatever meaning and purpose they are attempting to express.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity.

A word of caution: those of us who are not specifically trained or certified in expressive art therapies should use these modalities carefully and only adjunctively to the work we are trained in. However, creativity in all its wonderful forms, used with care, can be transformative in moving the therapeutic process forward.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Preparing for Difficult Clients

Working with clients productively isn’t always an easy road. Clinicians frequently run into clients who are challenging, frustrating, maddening or otherwise pushing our emotional buttons in some fashion.

For example, there are clients who have their own anger issues and come in ready to pick a fight. They simply want to argue with us, and question our knowledge or expertise. There are clients who are passive-aggressive, are in denial of their addictions or simply don’t engage in therapy the way we would like in order to make the progress we wish for them. Then there are clients we just don’t like for some reason; they don’t share our values and don’t respect our time or our boundaries.

Often, the rule of wisdom is to refer such clients out so that they can find a better fit and get better care. But before you do that, I have a few suggestions for preparing yourself for your next session.

To begin with, check yourself. How are you feeling? Tired? Anxious? Hungry? Already dreading this appointment or preoccupied with something you’d rather be doing? What buttons are being pushed inside of you by this client? Spend some time slowing down and acknowledging your feelings. Breathe and try divesting yourself from feeling graded (even pass-fail) on the outcome of this session. This is your client’s session, not yours.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity. copy

Then spend some time thinking about where your client is emotionally and cognitively. As I frequently say to interns, try going behind the curtain of the stage your client occupies to see the stagehands at work. What’s going on behind the behavior or attitudes you’re seeing and experiencing? Behind the anger is there fear or doubt? Behind the bluster is there insecurity or sadness? Is there a traumatized child puppeteer behind the puppet you see?

As you go into your session, attempt to drop all negative pre-conceptions, judgments and expectations into the trash can. Work with the person in front of you who is scared, sad, lonely or vulnerable from a place of authentic respect.

 

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Better Choices, Better World

The whole idea of having choice can be wonderful, but scary at the same time. This is due to the fact that the results of making bad choices can potentially produce unwanted, if not devastating results.

Many, if not all people who seek counseling are somehow caught up in this very dilemma. Choices made in their past or current lives often have had some demoralizing effects— a bad divorce, financial loss, a series of broken relationships, or bad choices made by parents and grandparents before them, being replicated if not complicated in current circumstances.

The affect of one misstep leading to another can create a pattern of mistakes and more distrust as well as anticipation and prophesy of more bad decisions in the future. This cascade of negative events can become overwhelming, eventually defining one’s identity and future without meaningful direction.

Our job as therapists is not about minimizing these realities of our clients’ current situations, but to gently and respectfully suggest that we all have choice about being driven by fear or by courage and hope. Fear alone tends to only make things worse. When afraid, we tend to isolate and not trust, behavior which motivates anger and leads to more stress, depression, and anxiety, often turning into harmful, if not aggressive actions toward self or others.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity..png

Finding and making better choices is frequently a difficult process, because this requires a paradigm shift in restructuring one’s belief system, including the ability to find compassion as well as genuine respect for yourself and then for others.  Choosing to not be the victim of hard times means choosing to “think outside the box,” to be open to more possibilities. To find real and permanent value in yourself—not measured by exterior standards—and then to dare to extend the same to others, is to live more boldly and completely.

Most importantly, I believe in the notion that each human being is in fact an integral part of the larger world. Just as a village affects a family, which in turn affects a child, so does the wellbeing of each person alive affect the sustaining value of the larger systems in which that person exists. As therapists, are more able to introduce as well as help maintain the important role of deep, authentic respect for humanity, we assist to insure a heather world in which we all can live.

RFT Book Cover

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Tackling the Bully Epidemic

“A bully is someone who is regularly overbearing. He or she looks to cause humiliation or discomfort to another, particularly if that other is weaker or smaller. This can be physical bullying, emotional bullying or mental discomfort and humiliation.”
 (Bullying Statistics)

Bullying most often is about imbalance of power, has intention to harm and is repetitive. It is usually culturally based. That is, it comes out of a culture, be it in the family, schoolyard, neighborhood or workplace. Therefore it is frequently systemic rather than isolated. Addressing the larger systemic issues of bullying is a much more daunting task, but usually more significant toward affecting solution-oriented change.

It is this larger, more systemic, more societal form of bullying that is particularly alarming. Yes, unfortunately, bullying behavior has always existed. But given the culture of our current leadership, it seems as though there is greater permission, if not direct role-modeling for mean, hate-based behavior.

We see this play out in families all the time. Someone in authority, usually a parent or a grandparent with specific biases like racism, sexism or faith-ism will model or teach those biases toward others directly or indirectly to their children and grandchildren. Those families within certain neighborhoods, ethnics groups, religions will tend to create bully culture in a more widespread fashion, giving that behavior and hate-driven mentality greater credence and room to grow.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity.

Most of the research literature focuses on school age children and rightly so, in that they are the most vulnerable. School bullies can do the most irrefutable harm, because the psychological impact to a younger brain is potentially so much greater. This is easily evidenced by the sharp rise in teenage suicide in recent years.

School systems have done a very impressive job across this country of designing and implementing anti-bullying programs. Their diligence is paying off, but I’m afraid that we need much more on all levels of our greater society.

The fact remains that bullying exists at every age and social strata, which is ultimately harmful to us all. The current impact and our projected future from what appears to be a growing trend in our society seems to be one of increased anxiety and mistrust among us. Therefore, what effective interventions can we as mental health professionals employ now to help curb this epidemic?

Those of us in the mental health field can certainly make a marked difference. We can help our educators of children interrupt and reverse this paradigm of hatred and harm by introducing, modeling and actively supporting a lifestyle of respect for self and others to each individual, couple and family we serve, thereby creating a healthier environment for us all.

RFT Book Cover

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Meaning and Purpose

Victor Frankl is perhaps one the most famous leaders in the discussion of meaning.  In his signature book, Man’s Search for Meaning, he talks about his many years as a prisoner in Auschwitz where mere survival was the source of meaning, and yet in such a deplorable setting, the search for further meaning became even more important. In this book he says, “Striving to find a meaning in one’s life is the primary motivational force.” (2006, p.99)

To explore our daily sense of meaning and purpose may be a more significant starting point.  For instance, one meaning may be about just getting out of bed every day and going to work or getting the kids off to school for that day. The larger purpose in the daily tasks are obviously about making a living, parenting or getting an education, but those sometimes get lost in the details. Therefore, we can lose sight of this grander perspective and perhaps develop a sense of meaninglessness or lack of purpose.

It is when we “get stuck in the weeds” of life that we are prone to have more existential anxiety about the meaning of our lives; about our identity as human beings. Many times we may not be fully aware of the complete nature of this anxiety, we just know that we feel something’s missing.

Respect needs to come from a place of authenticity and symmetrical balance to have any true validity. copy

This feeling is amplified exponentially, of course, by experiences of trauma or loss. Depending on the severity and timing of such destructive life events, it can be that an individual has not been able to develop such an identity or that identity has been seriously damaged.

Breaking out of this existential angst or repairing an identity to a fuller meaning and purpose is a central part of psychotherapy. There are several ways in which a therapist can be helpful in this process. The primary way is through the qualitative tone in the relationship. If therapists can genuinely provide a comprehensive presence of respect for the client sitting in front of us, we can better foster the opportunity for the growth of internal respect.

We can then foster and support the courage of our client to widen the lens from the mundane existence of daily living. To understand a larger scope of life to include a more solid sense of meaning, such as a spiritual, values or a cause-driven sense of purpose.

Finally, we can assist in the creative process that the client embarks on to build the tools and resources necessary to implement and grow into a restored identity.

RFT Book Cover

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic