Category Archives: The Psyche Patrol

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.  

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.

You and Your Therapist: Part IIa. Therapy Love, Revisited

Sometimes I feel like there’s a wall between me and my therapist.  And sometimes I wish there were some sort of wall between me and my therapist!  It doesn’t make any sense to me.  And I worry:  does it mean she can’t help me?

It’s making me so uncomfortable!  How do I stop falling in love with my therapist?  It’s making me so uncomfortable! How do I keep my therapist from falling in love with me? 

Sometimes I think I don’t even like my therapist.  Do I have to for therapy to work?  I don’t think my therapist even likes me.  Does she have to for therapy to work? 

I hate it when my therapist is mad at me.   Why does it bother me so much? What do I do?  I hate it when I am mad at my therapist.  Why does it bother me so much?  What do I do?

Questions like these just keep rollin’ in to us here at Feeling Up in Down Times.  In the initial installment of Therapy Love, we addressed those good  (sometimes confusingly so) feelings:  loving your therapist – or wondering if your therapist loves you.  But what about all the uncomfortable negative feelings:  worrying if your therapist secretly hates you – or if you secretly hate your therapist?  Worrying if your therapist is angry with you for not acting on what you’ve supposedly been learning in your therapy.  Worrying if you’re too angry with your therapist for therapy to be helpful.

When you come to trust someone as much as you can the therapist you share so much of yourself with, when you come to trust your therapist “gets” you, you’d think you’d feel comfortable, safe, free to be yourself.  And that is usuallythe case.  But in a cruel twist of fate, it can also mean that whatever negative feelings do come up seem particularly meaningful and important.  And that, in turn, makes it both more uncomfortable to share them with your therapist – and more important to do so.

Maybe those negative feelings are so uncomfortable because the relationship comes to matter so much.  Because therapy love just feels so real, almost like the real thing.  Therapy Love is a real thing, it’s just not the realthing.  Therapy love is a state of heightened emotions in a situation where your every emotion is under a microscope:  one you and your therapist share and look through together.  Or – often and –  a microscope you’re uncomfortable having anyone else look through, especially your therapist.  All in an intimate relationship that looks and feels just enough like a real life relationship to make you wonder:  what’s going on here, and what do I do about it?

You take a deep breath.  You bring it up, into the light of day.  You explore the realm of contradictory feelings, the juxtaposition of loving and hating.  Because the one thing you can count on if you do risk sharing those tough feelings with your therapist  is that you’ll learn an awful lot.  About yourself.  About yourself in relationships. It’s rare to have a dedicated person and place to talk about the good, the bad and the ugly – with the very person you’re feeling those things about, when you’re feeling those things.  Unlike the other people you may love, your therapist doesn’t have any vested interest in the outcome.  Your therapist is working for your insight, in your best interest.  It starts in the relationship between you, but it extends beyond that, way beyond that.

Even with any fears or anger or disappointment.  Even better than any fantasies.  And  that just might be the best thing about Therapy Love.

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

Soothe the Stress: A Conscious Breathing Meditation

I was recently asked to put together a conscious breathing meditation for someone who finds reading an easier way to focus than listening to a pre-recorded meditation – and for whom simply returning to a focal point may well be simple, but is not at all easy.  The following meditation is meant to be read, either silently or, if one wanted to, recorded in one’s own voice.  Thought I’d share it here for anyone else who might find it helpful.  Comments – always – appreciated.

Make certain you won’t be disturbed.  Turn off the tv and quiet all electronic devices.  Close the door and quietly yet clearly tell yourself you have decided you will now do a conscious breathing meditation.  Determine if you will give yourself 3-5 minutes, or if you might set aside 15-20 minutes.  Either way, consciously decide you will now do a breathing meditation, and gently tell yourself you will now begin.

Sit comfortably, by which I mean sit with your feet uncrossed and on the floor, and your hands uncrossed in your lap or resting on the arms of the chair.  Let the chair support your weight;  feel the floor under your feet. Or lie down comfortably – supported and uncrossed – on the floor.  If your body wants to shift position as your meditation progresses, that’s fine.  Just start out uncrossed and supported by chair or floor.

Close your eyes and focus your awareness on your breath.  Nothing to do, nothing to worry about, simply notice your breath coming into your body, and moving out of your body.  And again.  And again.  As you focus your awareness on your breath, you may notice your breathing gets deeper – or more shallow.  If it changes, fine.  If it does not change, fine.  Simply focus your awareness on your breath as you inhale and exhale. Notice your breath coming into your body, moving through your body, and moving out of your body.  And again.

Good.

Now allow your awareness of your breath to gently shift, as you focus on HOW you inhale through your nose.  Notice how your breath fills your chest and belly. And then focus on HOW you exhale, also through your nose.  Nothing to do, nothing to change, just focusing your awareness on your breathing however it is in this moment.

You are becoming mindful of your breath, focusing your awareness on your breath, becoming conscious of your breathing.  Nothing to do, nothing to worry about; no correct way, no incorrect way.  Simply focusing your awareness on your breath.  As it moves into your body, as you inhale through your nose.  As it moves through your body, filling your chest and belly with breath.  As it moves out of your body, as you exhale through your nose.  Notice how it is your breath moves into, through, and out of your body.

Good.  As you continue to focus your awareness on your breath, imagine it is as if your breath were breathing you.  As if you were watching a movie called “My breath is breathing me.”  You needn’t do anything; your breath continues with or without your conscious awareness.  You are now choosing to be aware of your breath.

Focus your awareness on your breath as you inhale through your nose.  Focus your awareness on your breath as it fills your chest and belly. Focus your awareness on your breath as you exhale through your nose.

Your mind may wander: remembering something you must do, worrying about a deadline, wondering how you are doing at this meditation.  Minds wander.  It is what minds do.  When your mind wanders, when you become aware of your mind wandering, bring it back to focus on your breath, easily and gently.

Focus your awareness on your breath as you inhale through your nose.  Focus your awareness on your breath as it fills your chest and belly. Focus your awareness on your breath as you exhale through your nose.

Again.  And again.  And again.

Good.

You may find it helpful, as you breathe in, to say to yourself, ‘Breathing in, I know that I am breathing in.’ And as you breathe out, to say ‘Breathing out, I know that I am breathing out.’  Or “Breath in” and “Breath out.”  Or you may find it helpful, as you breathe, to count your breaths.  If you care to try one of these, do try it.  If not, do not.  Either with or without one of the above, you are focusing your awareness on your breath, recognizing your in-breath as an in-breath and your out-breath as an out-breath. And gently bringing your mind back to awareness on your breathing when it wanders.

Focus your awareness on your breath as you inhale through your nose.  Focus your awareness on your breath as it fills your chest and belly. Focus your awareness on your breath as you exhale through your nose.

Again.  And again.  And again.

Good.  And when you have finished, remember you can bring this feeling of focused awareness with you, as you slowly open your eyes and return to the room.

 

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

Dr. P’s Pithy Adages & Epigrams

Bridges:  Tips For Knowing How to Cross Over – and When to Let ’em Burn*

A hypothesis:  What is “obvious” seldom is.   “It’s obvious that she thinks________ ” usually means “I assume – and am now convinced – that she thinks_______.” More often than not, my conviction of the obvious truth is not true at all.  In fact, the stronger my conviction that something you feel or think “obviously” means whatever I am certain it means, the more it’s likely to tell you about me, rather than you. What do you think?  Does this ring true to you?

Here’s the thing:   Inertia isn’t going to get you anywhere you want to go.

The assumption: Everyone thinks the way you do. Or, if they don’t, they should.  Nope.  They don’t.

Nodding your head in agreement as you look someone in the eye, all the while waiting your turn to speak, is not the same thing as listening.  No matter how politely you smile, how patiently you point yourself in his direction.

It’s funny how people rewrite history, isn’t it?  And it’s generally to suit not only what they wish had happened, but who they wish they had been.

Few things in life take more courage than facing the truth about oneself.

If you don’t get your point across the first time, you can say it again, louder. If that doesn’t work, louder still.  Then louder, again.                                                     Or you can try another approach that might actually work…

Who are you when no one is looking?

Before you blow off a problem, make sure it won’t come ‘round and whack you in the back of the head when you least expect or can afford to deal with it.

You might as well forget the first clause of any sentence the second clause of which begins “, but…” 

For the person listening to you, suggesting “it’s just a little ______” doesn’t minimize the attendant issue, it minimizes him.  Not good.

You don’t get to decide someone else’s “no big deal.”

Your partner knows that your “I understand” sometimes really means “I’ve had enough.”

Haste may make waste, but beware of lingering too long at the fair…

It doesn’t cost extra to be kind.  And patience isn’t a waste of time.

Sometimes the only thing you know is what doesn’t work.  It’s a good idea then to try just about anything else…

Anything real and alive is flawed in some way.  Perfect is Disneyland: beautiful surface, but there’s no there there.

There’s power that derives from position.  There’s the power that derives from influence.  There’s power that derives from instilling fear.  There’s power that derives from controlling resources.  There’s power that derives from force.  There’s power that derives from expertise.  There’s power that derives from personality.  There’s power that derives from coalitions.  There’s power that derives from respect.  There’s power that derives from moral authority…

When you push down the bad feelings, lots of the good ones get pushed down, too.

If you have to tell someone “it’s obvious,” it isn’t.

Resolve it, don’t dissolve it.

You can be right or you can be a working team…

~ Copyright © 2011 Marlin S. Potash. All rights reserved.

*~ Paro

 

You and Your Therapist: Part V. Take a Therapy Vacation

Hot time, summer in the city.  Thoughts go to the Cape, the Hamptons, the Jersey Shore…

Well, maybe not specifically, but the imagination does drift to escaping the city’s humidity at the beach, by the pool,  in the country. Oh, the lazy days of summer!  So, should you take a therapy vacation?

Who, you?  Your therapist?  Yup.

You:  You stop working in therapy, really;  you phone it in.  Oh, you show up – most of the time – but your head’s not into it.  You forget to do your homework (you were going to meditate, exercise, daily, remember?).   You’re finding it too hard to resist the long weekend away, the chance to catch the new movie in air-conditioned bliss on a summer Friday…

Your therapist:  Juggling everyone else’s summer vacation schedule and wondering:  take August off, since patients are out of town, or be one of the few therapists in town, available for patients?  Struggles with patient-envy:  patients enjoying being on vacation, therapists worrying if they’ll have a practice come autumn…

Sometimes, a vacation from therapy’s the way to go.  If you’re not going to fully invest your energies in the process (either patient or therapist), don’t waste your/her time and money.  If you’re running on empty, therapy becomes a matter of diminishing returns – something that’s often noticed only after that break.

So go for it.  Time for a break so you can return, refreshed, ready to work, learn, grow, change.  Time for a therapy vacation.

Just remember: you don’t want to lose ground or forget what you’ve learned so far.   A break from therapy – summer vacation – isn’t an excuse to forget everything you’ve learned in therapy.  And it certainly isn’t an excuse to forget to pay attention to what’s good for you – and what’s not.

Copyright © 2011 Marlin S. Potash. All rights reserved.