Quiet Amidst the Chaos

Rupert Park

There are times when you need a moment of peace and quiet.  It can be difficult in the city to find that quiet place.  But finding the quiet place inside, that’s the real trick.  And that, that you can find anywhere.  How?  Ah, that’s what we’re all working on, isn’t it?

Copyright © 2014  Marlin S. Potash, Ed.D.  All rights reserved.  

ADHD, MDHD*: Attention, Mindfulness and the Zeitgeist of Disorder

IMG00054-20100925-1729Four articles in three sections of today’s The New York Times on how we do (and don’t) focus our minds – and how we can (and might) do so for the better.  They’re onto something.

In his review of Daniel Goleman’s new book, “Focus:  The Hidden Driver of Excellence,” Nicholas Carr describes how Stephen Dedalus “monitors his thoughts without reining them in” as an example of open awareness, one of many types of awareness Goleman details (http://www.nytimes.com/2013/11/03/books/review/focus-by-daniel-goleman.html?smid=pl-share).  In “Jumper Cables for the Mind,” Dan Hurley reports on tDCS at Harvard’s Laboratory of Neuromodulation, and research that shows low voltage electrical brain stimulation seems to enhance any number of cognitive functions(http://www.nytimes.com/2013/11/03/magazine/jumper-cables-for-the-mind.html?smid=pl-share). David Hochman, in “Mindfulness at Every Turn,” details the increasing reach of mindfulness: the Marine Corps, Silicon Valley, The Huffington Post (http://www.nytimes.com/2013/11/03/fashion/mindfulness-and-meditation-are-capturing-attention.html?smid=pl-share).  And Clive Thompson’s “Brain Game,” the subject of Walter Isaacson’s review, proposes an increasing reliance on “intelligence amplification,” human cognition harnessed to the power of computers (http://www.nytimes.com/2013/11/03/books/review/smarter-than-you-think-by-clive-thompson.html?smid=pl-share). 

As a psychologist and psychotherapist who has been involved in mindfulness education since the late ’60′s (when it was called meditation), and integrative medicine before it had a name, this explosion of interest in expanding awareness and increasing attention – improving the powers of the mind – thrills me.  I’m all for anything that increases compassionate awareness and improves attention:  for my clients, my patients, our children, and certainly myself.

The idea of “more, better” is as American as it gets, and I’m all for more and better when it comes to the mind.  But I’ve got some reservations about the how of all this.  The selling of mindfulness seems somehow antithetical to the very acceptance mindfulness cultivation strives for.  And it may seem a strange thing for a psychologist whose focus is on problem solving to say, but life is not simply a problem to be solved.

Hegel supposed that all art is a reflection of the time in which it is created; the same is no doubt true of the psychological arts.  Ours is a time when excellence is valued.  Not necessarily the pursuit of excellence, however.  We like our accomplishments big and easy and fast.  And the improvement of mental functioning, while often shockingly quick when we begin proper training, is indeed a lifelong practice.  In it for the long haul, not simply for today’s trend.

Training takes practice.  So why bother?

When we correlate attention solely with achievement, we limit what the mind can do even as we improve our chances for success.  Just as an efficient laser requires vast numbers of atoms in an excited state, our human laser-like focus, so crucial for excellence in completing many tasks, requires a ramping up of very specific kinds of attention.  As we learn more about the brain’s neuroplasticity – and apply ever more sophisticated technology – exciting real life applications will allow us to improve attention.  An eye surgeon focuses his attention as well as his laser beam, and a good thing that is.  But while a  laser can attain and sustain this heightened excitation and focus, we, on the other hand, experience stress in response to the demand for constant laser-like focus.  We can focus our attention sharply and well – but only for so long.

We also require rest.

But what is the nature of the rest we require?  Not the sort of lack of attention we often choose: multi-tasking, zoning out, mindlessly watching tv, texting while talking and walking.  Divided attention does not refresh, it simply provides a break from the intensity of single focus attention.

What is the awareness that refreshes?

Open awareness, mindfulness, the meditative state.  The form really doesn’t matter.  Pick and choose,  try a form that suits, or try one and switch to another.  What matters is the ongoing practice of focusing awareness, even while accepting all the gyrations of mind that accompany the attempt to do so.  We can quiet the “monkey mind” with practice, but not by ignoring or drugging away our thoughts and feelings.

Focused attention AND open awareness.  We need both for success in accomplishing our goals, and success in living a fulfilled life.  Both.  And both can be improved – greatly – through practice.   It may seem an oxymoron, but research has shown what generations (and other cultures) know: the work of improving attention and awareness mean less stress, increased productivity, and happier lives.

* Mindfulness Disorder, with and without hyperactivity

Copyright © 2013  Marlin S. Potash, Ed.D.  All rights reserved.  

A meditation…

THE 8 PSYCHOLOGICAL ISSUES THAT CAN SPELL SUCCESSION PLANNING DISASTER

LOGOWPMCAfter years of advising entrepreneurial partnerships and family businesses – often working collaboratively with their financial and legal advisors – it continues to be puzzling:  why don’t they plan adequately for succession when it makes no rational sense not to?

Well, the short answer is: because it makes a-rational (and sometimes irrational) sense not to.  But only by addressing the psychological and emotional issues everyone would rather avoid can rational decision making rule the day.  What are these issues that – unresolved – spell DISASTER?  With thanks to the research and in-the-field expertise of my colleagues, present and past,  I offer my own take on the founder and family issues to consider.  A  primer:

D eath –

  • The Founder:  “I’m gonna live forever” attitude – or s/he simply doesn’t want to face her/his own demise.
  • The Family:   Taboo to talk about mom/dad’s death, not to mention life afterward?

I dentity –

  • The Founder:  “Who am I without the business?”  S/he fears loss of identity, which is bound up with the company s/he created.
  • The Family:    They worry about the Founder without the business – and the business without the Founder.

S upremacy –

  • The Founder:  “I’ve still got what it takes, they won’t know how to run this company without me.”  S/he doesn’t want to relinquish power and control.
  • The Family:    How to wrestle with the head of the family about a different vision for the firm’s future, when s/he is still the one in control.

A mbivalence –

  • The Founder:  “Of course I want my kids to take over.”  But s/he somehow undermines that process…
  • The Family:     The next generation want to take over, but feel guilty about pushing mom/dad out.  And the spouse may both want and fear retirement.

S olo  act –

  • The Founder:  “I’ll figure it out.  I’ve done fine this far, with no one helping me.” Getting professional help is seen as a sign of weakness – or a waste of money.  Or time, for someone who’s more of a doer than a planner.
  • The Family:    Having always relied on, leaned on the Founder, they don’t want to face the realization that s/he cannot just ‘take care’ of this, too.

T ime –

  • The Founder:  “Not now.  They’re not ready yet.”  It’s never a good time.  And then there’s the heart attack, or buyout offer…
  • The Family:     The next gen are dealing with the stresses related to adjusting to adulthood: becoming independent, having their own children, marriage (divorce); the spouse has his/her own concerns.

E motions –

  • The Founder:   “I can’t deal with all that emotional stuff.”  Jealousy, rivalry, quarrelling, choosing among the children: all things better (easier) ignored.
  • The Family:      Jealousy, rivalry, quarrelling, choosing sides:  all the old, unresolved issues flare up – and new ones show themselves.

R oles –

  • The Founder:  “So what would I do if I’m not running the business? Play golf all day?”  S/he does not see a future that works once s/he steps down.
  • The Family:     Change affects everyone in the family, and in different ways.   And everyone in the family copes with change differently.

What to do ?  What helps?  To be continued …

 

Copyright © 2013  Marlin S. Potash, Ed.D.  All rights reserved.  

Handling the Erotic Transference: Male Patient, Female Therapist

Seem to be getting lots of queries about erotic transference, otherwise known as falling for your shrink.  Since I specialize in treating men, thought I’d take a crack at the subject from the particular angle of male patient/female therapist.

Male patients – all patients – bring to therapy the gender role expectations, attitudes and behaviors they experience in their other male-female relationships. But because the doctor/patient  relationship  in psychotherapy is a unique – and often new – experience, male patients often do not know quite how to proceed.  And this can make for discomfort difficult to tolerate.  For both the patient and his therapist.

In part this is so because there are so few models for an intimate professional relationship.   In fact, it’s often rare for a man to have a relationship that is intellectually and emotionally intimate but with no physical/sexual intimacy.  They tend to go together for many, if not most, men.   And for countless men, intimacy is physical intimacy.  Women are likely to share private thoughts and feelings with a variety of platonic co-workers, neighbors, friends and family.  For many men, particularly men of a certain age,  vulnerability, attunement, expression of deep feelings most often occur in the context of a sexually intimate encounter – and seldom elsewhere.  The notion of  intimacy without a sexual component simply does not compute.  “Intimacy” is code for “sexual intimacy.”

In these instances, it’s crucial that the woman therapist establish and maintain strict behavioral boundaries – at the same time as she encourages verbal exploration of uncomfortable thoughts, feelings, and yes, even sexual fantasies.  Talking, not doing.  This requires constant vigilance.  Therapists can get uncomfortable and awkward.  Patients can attempt to catch the therapist off-guard and deprofessionalize the relationship, particularly when they fear becoming too vulnerable or losing control.  The male patient whose glance lingers a bit too long shifts the discomfort from himself to his therapist.  Not that his therapist isn’t uncomfortable herself…

Discussing all this can prove amazingly beneficial.  By delving into all this rather than avoiding, by talking but not doing, the therapist provides reassurance of the safety of the therapeutic alliance, necessary for the trust effective psychotherapy requires.  (And make no mistake:  it is the therapist’s job to make sure “nothing happens.”   Always.)  The shared, in vivo context provides common ground for exploring sexual and emotional intimacy issues, often the very issues that prompted therapy.

And talking about sex, sexual feelings, without doing?  Well, that’s apt to be a rather novel experience.  How often do men and women talk honestly, openly, about sex – without engaging in sex?  Lots to learn, lots to learn…

Copyright © 2013 Marlin S. Potash. All rights reserved.

The Nice and Not-So-Nice Therapist: Who is Really Nicer?

NICE ?

How nice should a therapist be?

Nice. Someone pleasant, agreeable.  “He’s such a nice guy,” we say, imagining someone good natured, kind-hearted.  Or  exacting, evidencing great skill:  “Nicely done!”  Or scrupulous, exacting, hard to please:  “Give me a nice piece of corned beef” – which really means “give me your best cut, extra lean!  Nice can mean trivial, easily dismissed: “that’s nice, but”  or treading carefully, behaving delicately: “be nice to your cousin!”  And then there’s making nice, acting as if one were feeling all those good things, somewhat hypocritally.  Oh, and the ironic nice, a nice that means not nice at all:that’s a nice way to say thank you!”

How can one word mean such different – even antithetical – things?  Its origin provides hints.  Originally Middle English, it meant stupid or foolish, deriving from the Latin nescius ignorant, by way of French.  It meant coy, reserved, and by the 16th century fastidious, later still  fine, subtle (considered by some the ‘correct’ sense, and on to the current pleasant, agreeable.

What happens when conflict and confrontation-avoidance masquerade as being nice?  When does acting nice not only not equal being or feeling nice, but actually serve as a cover for feelings that are anything but nice?  When is being nice a cop-out for not dealing with the difficult and messy – but important – stuff?

Which brings us to the question of the day:  Exactly how nice should your therapist be? How nice is therapeutic?

Therapy’s not about appearance, but substance.  And when it comes to the therapy experience,  there’s often a difference between nice and helpful.

If the therapist’s prime motivation is to be liked, well, then, she’s got to act nice to be seen as, thought of, as nice.  When being nice is crucial, gratifying the patient is crucial,  first and foremost, pretty much always.  Even if it means avoiding the tough stuff; especially if it means avoiding the tough stuff that doesn’t feel so, well, nice

But if the therapist’s prime motivation is to promote learning – to provide tools for a better life, to help her patient become all s/he can be, to heal – real trumps nice every day of the week.  It may not always feel nice.   But if your therapist  goes beyond skin-deep nice, if together you do more than scratch the surface – explore and understand and accept what’s real – you’ve got a shot at goodReal good.  Which has a whole lot more healing power than some ironic nice.

Copyright © 2012 Marlin S. Potash. All rights reserved.

Reasons to Leave your Therapist, Part III: Therapy Love? How about Therapy I’m starting to Hate?

September is back to school, back from summer vacation, and for many the beginning of a new year and a new beginning.  In our lives, some things are always beginning, and some ending, but it often takes contemplation to know which should be which…

How in the world do you know when to end therapy?  There are a number of scenarios, depending on you, your therapist, and your course of treatment. Leaving the good experience can be tough; ending a not-so-good, or a downright bad, therapy can be even more difficult.

Ending before you begin:  What’s a fair amount of time to decide if this is the (right) therapist for you?  What if you get a funny feeling early on?  What if you’ve been given a referral by someone you trust, and you have a terrific initial conversation, only to find something comes up early on that really bothers you?  Should you start with a therapist when you’re not so sure she’s the right one for you?

Yup.

Here’s a shortcut to what I think is the right balance:  you should feel comfortable enough to speak openly and honestly, but not so comfortable you feel as if you’re having coffee with a friend.  Go with your feelings.  If it feels right, dive in, if not, keep looking.

Ending in the middle:  You’ve hit a speed bump.  Maybe your therapist did something you didn’t like, or has turned out to have shortcomings you hadn’t seen before (I have certainly been guilty of both, and no doubt will again).  Maybe your therapy’s veered in a direction that doesn’t quite feel on the mark.  Maybe there’s something you just can’t bring up, maybe even bring yourself to face – about the problem that brought you in to therapy in the first place, about your feelings toward your therapist, about your thoughts or conclusions. 

Bring it up.  No matter what it is, whether you are “right” or “wrong” think you “should” feel this way or not, might “hurt feelings” or “make her angry.”  Bring it up.  Because that accomplishes two things:  you get it out and realize you’re still alive (hopefully with a tour guide who’s calm and compassionate), AND you get to see how your therapist reacts.  Does she minimize what you say, make you feel small or silly or just plain wrong or bad?  Or does she listen, take you seriously, consider her part in your discomfort and work with you to get over (not around) the bump?  Because that will tell you all you need to know.  Can’t avoid the bumps, I’m afraid; can avoid feeling afraid to talk about the bumps with the therapist who’s meant to help you do so.

Ending when it feels as if you’ve been going forever.  If therapy’s been uncomfortable and unproductive for a long time, if you find yourself leaving each session wondering why you bother,  if you keep trying to communicate something but your therapist really doesn’t seem to get it/you,  if you feel increasingly frustrated (maybe even angry), it’s time to reassess.

If, after months, maybe even years in therapy, you are feeling that you’ve hit a wall, chances are you have.  If, after months, maybe even years in therapy,  you are feeling unheard, you’ve got to wonder:  what will it take for this therapist to get me?  Actually, maybe you’ve got to stop wondering, and just start saying your goodbyes.  Because if you’ve invested months and years in treatment and your therapist still doesn’t get it, or you’ve stopped learning anything significant about yourself long ago, or if you’ve gotten stuck in the land of diminishing therapeutic returns: it is time to go.  Maybe time to end therapy, maybe just time to end therapy with this therapist.  Doesn’t mean it hasn’t been real, useful, important; just means it hasn’t been for a while.  A dry spell is one thing – every therapy relationship (geez, every relationship) goes through those – but a dry spell that lasts for weeks and months is more than a dry spell.  It’s a dessicated therapy experience.  And that is none too therapeutic.

Copyright © 2012 Marlin S. Potash. All rights reserved.