Integrity and Self-Forgiveness

Integrity is that part of ourselves which holds us accountable to our core beliefs and is at the heart of respecting who we really can be. This accountability includes a standard in human behavioral values, but should not be so rigid as to make that standard humanly unachievable. No one is above making mistakes or bad choices. Our sense of well-established integrity, therefore, necessarily includes compassion, forgiveness and grace.

The pathway to achieving such a balance of moral integrity, and the ability to genuinely forgive one’s perceived shortcomings, is frequently interrupted or broken by trauma and the resulting life experiences, such as PTSD, addiction, depression or other mental impairments. Integrity may seem as if it is unattainable or out of one’s reach even if it is already there. Shame often becomes a dominant source of blockage around the trauma(s), and the resulting experiences or behaviors by the traumatized or impaired, because it frequently becomes the way we interpret those negative events in our lives. We tend to internalize those events and cast blame on ourselves.

Therefore, self-forgiveness becomes key to repairing the psychological damage done by shame. This process of self-forgiveness, then, is not about making excuses for one’s behavior, but truly acknowledging wrongdoings with grace, letting go self-imposed penalties, self regret, hatred or other forms of disregard. It is also about being able and willing to make amends and correcting hurtful behavior where and when possible in context of relating to others.

 

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.

Dealing with sexual trauma in therapy

We have reminded in the news once more that sexual harassment and abuse are very prominent issues in today’s society. The latest controversy around a famous movie producer for decades of sexual harassment and assault only adds to a long list of known cases of people using their positions of power to abuse others.

Of course, what we also know is this horrific phenomenon is not restricted to the rich and famous. Many therapists see the results of sexual trauma play out in our practices on a fairly regular basis. The range in behavior is vast, but the overreaching message of disrespect for another human being is resoundingly the same. In a therapeutic context, the victims of sexual misconduct are wounded deeply, mainly because of the serious lack of regard for their innermost sanctity and personhood.

This goes far beyond the physical acts themselves. It is the robbery of emotional and spiritual safety. It is the denigration of personal value. The damage done is ultimately repairable, but not before the pain is fully recognized and experienced.

Therapy is about this very process. It is the full recognition of what has been taken away without self blame or shame. Most often, the healing process involves self-forgiveness for being broken by the event, even though there is really nothing internally to forgive. A violation occurred externally, but struck so privately and personally that it frequently feels like a stain on one’s soul or psyche. With this understanding, it then makes perfect sense that coming forward by the victims may be indeterminately delayed, for fear of being seen with such a stain and/or having to endure more disgrace and humiliation because of it.

Cleansing and healing the wound made by someone else’s invasive or attacking behavior is the task that therapists are asked to assist with. Respect-Focused Therapy suggests that the best, most effective way we can do that is by concentrating our full energy and focus on truly respecting a person’s pain as well as the whole person completely. With the experience of receiving such depth of genuine respect, it is hoped that these individuals will have the platform on which to begin building, once again, their own self-respect as well as respect for others around them.

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.

Exploring Beneath Addiction

In the last several years it has become more and more clear in the media as well as within the mental health profession that addiction has become an out-of-control epidemic, especially addictions to meth, opioids, and heroin.

I supervise post-grad interns who work with this population (addicts of all substances), many of whom are homeless and/or ex-incarcerated. Most of these clients have years, if not decades, of addictive patterns of behavior well established, such as lying, cheating, and portraying some level of aggression or passive-aggressive behavior. Many are dually diagnosed with other mental illnesses and have suffered various traumas during the course of their lives.

These entrenched behaviors often become like masks or shields for the people living inside of them, seemingly impenetrable to those working with them. So many layers of harm from others, self harm, and harm done to others are woven into the horrific disease of addiction, that it seems extremely difficult to unravel and find the human being strangling inside.

Exploring beneath this quagmire of addiction requires the willingness to suspend judgment and presumptions about the limitations of hope placed on or by this person. Societal norms and personal records of misconduct have put boxes of low expectations on addicts. To find the real people hiding in these boxes is the primary challenge of therapy, as I see it. As we go about the careful process of doing so, we need to help that person exposed learn to not be afraid of who he or she really is, but to have the courage to heal and embrace the broken goodness within.

 

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.

Intersecting Therapy and Religion

Research on the interrelatedness of psychotherapy and religion or spirituality has been relatively sparse historically, but in the last decade or so, it has received greater interest, particularly as it relates to multiculturalism. In a study conducted by Post & Wade (2009), several interesting findings about the differences between therapists and their clients were found. First, most therapists overall were found to have significantly less personal identification with being religious or spiritual than their clients and had very little training in counseling around spiritual issues, yet for the most part, they saw their clients’ religious beliefs or practices as a positive addition to their mental health. However, the belief systems outside of the more traditional western religions, i.e. the Judeo-Christian tradition, were more often seen as being tied to some pathology. Eastern religions, Islam and Native American faiths would be typical examples of such misunderstandings.

As this study continues to point out, the pluralistic approach, that is, the broader willingness to be open to and accepting of all faiths, even those unknown to us, is perhaps the most effective and ethical stance we can have with clients. The key danger in not taking such a position is to fall into the trap of trying, consciously or subconsciously, to make clients become more like ourselves. It is not wise, particularly in therapy, to impose our beliefs on someone else, especially to those who are more vulnerable.

There are those counselors who identify themselves as Christian counselors (or other faiths), who use such spiritual tools as scripture readings and prayers within the context of doing therapy. If this is understood and agreed to by the client prior to implementing these practices, it can be a powerful tool, which may reach into the deeper spiritual needs of the client. If handled with care and respect for the client’s perspective, without judgment, this can truly be an enriching process.

 

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.

Working with People with Disabilities

Disabilities primarily fall into three main categories—physical, intellectual, and the ones we in the mental health profession are most acquainted with, mental or emotional disorders. This is not to say that these disabilities don’t overlap. They frequently do, however, it’s important to clearly understand the differences and the unique qualities and psychosocial impact of each category. It’s imperative to point out here that any and all disabilities bring with them stigma and prejudgment, not unlike racial and ethnic stereotyping. Some common responses to people with disabilities include talking down to them, avoiding them, bullying, and other abusive behavior.

Disabilities come in all shapes and sizes. Many are quite visible, like people in wheelchairs who use walkers and people who are blind. And there are others without visible disabilities, like deaf people or those with heart or respiratory issues. Some disabilities are developmental, meaning that they are existent from birth or early childhood, like cerebral palsy or spinal-bifida, but others are traumatic, with later onset, such as spinal cord injuries, traumatic brain injuries, or amputees. People with physical disabilities are often misunderstood to have other intellectual or mental disabilities and are often judged unfairly to be incapable of being functioning social, adults.

Intellectual disabilities, or as it used to be called, mental retardation, can be related to a number of different causes, i.e. Down’s Syndrome, cerebral palsy or brain injury. People with these related disabilities have the most stereotypes put upon them in terms of being social outcasts, weirdos, or freaks.

Mental illness clearly carries with it plenty of stereotypic biases as well. People with bipolar disorder, schizophrenia, or personality or identity disorders, have tremendous social alienation issues to deal with as well. But those of us in the mental health field have greater familiarity with this particular population, and are, hopefully more accustomed and comfortable interacting respectfully with them than perhaps with those with other disabilities. This is largely due to the level of exposure to and education about these various disabilities.

I have been a psychotherapist for forty years, and I have had cerebral palsy all my life and have used a wheelchair for most of it. My life experiences have brought with them the dichotomy of being the stereotyped disabled person, with all the biases and social prejudice that comes with it—and as an educated, professional healer. The combined awareness brings me the opportunity to deepen my senses around human variation and my desire to broaden my respect for all.

 

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.

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.

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.

 

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).

When 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.

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.

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.

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.

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 Research, 18(3), 256-270.

²Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional psychology: Research and practice, 35(1), 19.

³Comas-Diaz, L. (2006). Latino healing: The integration of ethnic psychology into psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 43(4), 436.

⁴Heinrich, R. K., Corbine, J. L., & Thomas, K. R. (1990). Counseling Native Americans. Journal of Counseling & Development, 69(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 research, 3(4), 201-214.

 

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.

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.

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.