Wellington Counseling Group

Wellington Counseling Group

Wednesday, 20 November 2019 12:26

Generation Compassion

I am a relatively calm person, not generally prone to panic. However, as a baby boomer, when I was told I would periodically need to post to Facebook, blog, and perform other such unnatural acts, my reaction (and that of many others in my generation) was pure, unadulterated dread. I have adapted to many new things in this fast-paced, exponentially-changing world. Social media has not been one of them. That does not mean that I do not understand the marketing benefit provided by the extensive reach of social-media platforms. But like many of my generation, I prefer individual, personal interaction and to share my life on a more-limited basis.

This is not a criticism of others who are comfortable in the social-media space. However, I personally avoid things that I consider time-eaters, which includes social networks. I admit being slow to pick up on the technology which I find counterintuitive.

As one who manages time as a precious commodity, I want to spend it doing other things. I crave reading books, love doing work as a psychotherapist, advocate for and teach about environmental issues, exercise, visit my children and grandchildren, and travel with my husband.

For reasons described above, I found trying so hard to keep up with all areas of technology robbed me of the time I wanted to spend doing other things about which I care deeply. I often see this tension in patients – of all ages – as well, but I try to be respectful of generational differences.

I am thankful for the neuroplasticity of the brain that has allowed me to engage in technology to the extent I have, but I also recognize and accept my limits. Thus, I have made a very conscious choice not to torture myself by trying to master areas of technology that are counter to the way my brain has understood things for decades when the struggle goes beyond reasonable limits. And I have found that many others in my generation have reached the same conclusion.

New York Times columnist Tom Friedman's new book, Thank You for Being Late (2016), has helped me understand my reaction to the overwhelming flood unleashed by social media. I have always had great regard for Friedman’s thinking and writing. While reading this book, I was riveted by his graphs analyzing the curve extending sharply upwards of technological growth on one axis and human adaptability on the other, no curve but a flat line with only a slight upwards slant.

According to Friedman, this is the first time in history that the exponential rate of change far exceeds people's ability to adapt. In the past, people often had up to a century to adapt to major inventions such as the steam engine and the automobile until the next one came along. Now, looking at all the technological change that has occurred just since 2007, we often have less than a year to adjust to these monumental new life-altering inventions and concepts.

When I saw Friedman's adaptability/technology curves, I felt a huge sense of validation. Despite my ability to adapt to change in the past, there was a reason I finally reached my limit and was screaming "no more” – or at least “not so fast!"

This means I have to choose where to adapt technologically. And, like many others in my generation, social media will not be one of those choices. That’s why the title of this essay – dare I call it a blog? – asks for compassion for my generation. So many boomers face ridicule from their children or co/workers when they are not adept at dealing with new, ever-changing technologies. Clearly, the brains of young people, who are introduced to computers and smartphones practically from birth, are wired differently. Meanwhile, boomers have lived five, six, seven decades without having to engage the world this way. Cut us some slack! Be compassionate – and helpful. We will gladly exchange some of our hard-earned wisdom for your patience with our “fat thumbs.” And please do not discount that wisdom. We boomers may not always be tech-savvy, but we know how to find answers by asking the right questions. Remember that the next time you initiate an online search and come up empty.

I end with a quote from Friedman's book that, much to my delight, lays out the feelings I have tried to express here.

"Finally, philosophically speaking, I have been struck by how many of the best solutions for helping people build resilience and propulsion in this age of accelerations are things you cannot download, but have to upload the old-fashioned way – one human to another human at a time."

Wednesday, 20 November 2019 12:18

Trauma is an Experience, not an Event

Santiago Delboy, LCSW, is a Chicago-based psychotherapist formerly with Wellington Counseling Group. His work has included therapy with individual adults and couples.

It seems like "trauma" has become one of those household terms everyone talks about. I took a look at the number of average monthly Google searches for "trauma" in the U.S., and found that it has grown 22% in only one year. As with other terms that became mainstream (for instance "addiction" or "narcissism"), I suspect the price of increased awareness is a diluted understanding of what they really mean.

After hearing my patients talk about their experiences, reflecting on my own upbringing, and studying some of the literature on trauma, I believe the following can be a useful working definition:

Trauma is an experience that overwhelms our capacity to regulate our emotions and results in fragmentation and dissociation.

While this may not be a comprehensive or final definition, I think it captures a few ideas that are important:

  • Trauma impairs our capacity to regulate our emotions. We feel worried, irritated, anxious, or afraid, consciously or not, and we cannot self-soothe or seek support from others.
  • Trauma creates fragmentation and dissociation. Whether we understand this as an unconscious defense mechanism (e.g., splitting, projection or repression) or as a neurological issue (e.g., thalamus gone offline, hypersensitive amygdala), dissociation is a key trait of trauma.

However, in this post I want to expand on the idea that trauma is not about a past event, but about a present experience.

I think the idea of trauma as a present experience is captured dramatically and beautifully in a 1930 painting by Belgian artist René Magritte.

The Titanic Days

I liked Magritte since I was a little boy, but I saw "The Titanic Days" (Les jours gigantesques) for the first time a couple of years ago, at a special exhibition at the Art Institute of Chicago.

I was stunned by the power and the violence of this piece. What I see is not a rape attempt happening now, but how a past experience is stored in the woman's body and felt in the present moment. I see the terror of her frozen expression, reminiscent of the so-called “thousand-yard stare,” the tension of her entire body and the desperate attempt to push back an attacker from a real or imagined past. I notice the stark contrast of colors in the woman's body and I see the traumatic struggle between life and death, and the need to keep part of her in the shadows. No words are required to convey the drama, and no words could probably do justice to the horror; trauma, in fact, impairs our capacity to develop a cohesive narrative. The experience is overwhelming and occupies most of the space on the canvas, yet the atmosphere feels completely desolate: we know nobody will come to her help. Is the blue background a wall, keeping this woman cornered against the attacker living in her body and in her mind, or does it suggest an abyss, making the woman one step away from oblivion?

We can only imagine the details of what actually happened in this woman's past. Was she sexually abused as an adult by a coworker? Was she touched in uncomfortable ways as a young girl by a family friend? Was she somehow sexualized when she was a toddler by her father? How much of what happened was real and how much a creation of her mind?

These are important questions to consider, but not as important as the terror, the isolation, and the helplessness she is experiencing in the present moment. When I stand in front of this painting, much like when I sit across from my patients in therapy, what I see is this woman's suffering in the here and now. I don't need to know all the actual details of her story, but I am curious about the meaning she assigned to it, about how it feels in her body, her mind and her spirit, and about the ways it might be getting in the way of being her full self.

Trauma is like a splinter

I remembered Magritte's painting some months ago, when I read Bessel van der Kolk, a leading trauma researcher, suggesting the metaphor of trauma as a splinter: it is the body’s response to the foreign object that becomes the problem, more than the object itself.

This idea has been around for some time. Almost twenty years ago Peter Levine, developer of the somatic experiencing approach for trauma treatment, wrote:

"Traumatic symptoms are not caused by the triggering event itself. They stem from the frozen residue of energy that has not been resolved and discharged; this residue remains trapped in the nervous system where it can wreak havoc on our bodies and spirits." - Peter Levine, 1997

It is worth noting that this notion is even older. Not to make the point that everything goes back to Freud, but over a hundred years earlier he and Breuer advanced a similar idea in “Studies on Hysteria”:

"Psychical trauma – or more precisely the memory of the trauma – acts like a foreign body which long after its entry must continue to be regarded as the agent that still is at work." - Sigmund Freud & Josef Breuer, 1895

I think there is value in talking about "traumatic events," but I believe that it is critical to shift our focus toward the ways in which trauma stays with us. Trauma is not remembered, but reenacted. It is not about something that happened in the past, but about its consequences in the present, about the conscious or unconscious meaning we give to our experience, and how that experience defines how it feels to be in our body and in our mind.

From traumatic experience to healing experience

The notion of trauma as an experience is valid for traditional PTSD trauma (e.g., when there is a specific event or situation that triggers the traumatic experience, such as sexual abuse, a war or a natural disaster), and for complex developmental trauma, which is more insidious.

Complex trauma is characterized by an upbringing defined by patterns of inconsistency, neglect or abuse. Emotions are not expressed, not allowed, or even punished. A specific "big" event is not necessary; repeated and chronic interpersonal wounds can overwhelm the child's capacity to regulate emotions, and create fragmentation and dissociation.

Most people I have seen in therapy have experienced some form of developmental trauma. They felt unseen and unheard by physically or emotionally absent parents. They did not feel taken care of, taken seriously, or taken into account. They believed their needs were not important and would ever be met. They had to carry within, in silence, destructive family secrets. They had to be parents to their parents from a very early age. They needed to constantly perform, or pretend to be someone else, in order to feel accepted or loved. They had to learn to soothe themselves. They lived feeling that nothing they did would ever be enough.

All these experiences from the past are reenacted and experienced in the present, keeping them from feeling safe, loved, worthy, and trusting in others or themselves. They get in the way of becoming self-aware, of letting go of control, of developing vulnerable and intimate relationships. They make them feel either in high alert or depleted. These experiences keep them from being fully alive.

The most important thing therapists can do to work through traumatic experiences of this kind is to offer the opportunity for a healing experience.

The essence of that healing experience is not a matter of technique, approach or theory, and goes beyond the promise of providing a safe, calm and reliable environment. I believe the question is about love, authenticity and curiosity.

For me, the question is about being self-aware and curious about my own reactions, about how I think of, feel with, and relate to the person in front of me. It is about being a human being first and a psychotherapist second, which is a difficult task. Often times I get caught up in the need to make sure that I am saying the right words, giving the best feedback, offering the most insightful interpretation, or providing a useful perspective. Instead, I can trust that my presence, my curiosity, my compassion and my humanity, with its flaws and imperfections, is the first thing that matters.

Do my patients feel heard and seen by me? Would they tell me if they didn't? Do they feel there is room for their feelings toward me, whether they come from a place of anger, hurt, sadness, joy, love or desire? Can they express them trusting that our relationship will survive? Can they count on me, and trust that I will provide safe boundaries? Can they feel that every part of themselves is acknowledged, accepted and valued?

I believe these are the types of questions that define a healing therapeutic experience. They matter not only because they allow patients to recognize current dysfunctional relationship patterns in their lives, but mainly because they have the potential to provide an experience that was not available to our patients when they were growing up. We cannot change the past, but we can offer them the opportunity to experience and develop self-awareness, acceptance, and unconditional love.

Wednesday, 20 November 2019 12:15

Men at Midlife—and Beyond

Wellington Group President Dr. David Rakofsky specializes in helping men journey through the challenging years of midlife and beyond. He has a great deal of experience in this area and here he shares his approach.

Do you remember when Michael Jordan left the Bulls? You can imagine how difficult it was for him to define himself after so many years in the spotlight with a singular focus. And you can bet a professional helped Michael Jordan figure out his second act. In my practice, I see successful men who are reaching for something new in their lives.

My job is to help you decide how and when to make a move—professionally or personally. I know that when you’re at the top of your game in your career—or on your way to the top—you don’t want to make a mistake by throwing anything away. You’ve worked hard on your career, your position, your practice, your company, your reputation. But you also know something in you is ready for a change. You may not be burned out—yet but you’re not excited anymore, you’re not as productive as you used to be, and you feel tired. The emotional payback isn’t there. You may know you are open to something new, but not know what that “something new” is.

You might imagine that seeing a therapist would be too touchy-feely, or make you feel flawed or have a mental illness. But that isn’t how I see it, and the men I’ve worked with, men who have stood where you are standing today, agree. I offer you the opportunity to change so you can realize your full potential. It can be difficult to discuss how you are feeling with your colleagues, even your friends and family, because you don’t want to change their perception of you and all that you’ve built. And I know you want to keep your life moving forward while you figure things out.

You may also have personal concerns on your mind: You might be looking for more friends and deeper connections; you and your wife or partner might have grown apart or be in conflict. Maybe one of your children isn’t talking to you. Maybe you’ve never married or never had children. I’ve often found that what seems like a professional crossroads actually involves relationships with other people.

That’s where I come in. Figuring out how to get from here to there—or just where “there” is—is something I specialize in. For men at retirement, it’s about a second act. For men in the thick of their careers, it’s about meaning and fulfillment. I can help you understand and realize you want something that speaks to you more deeply and how to set and achieve new goals.

I work discretely. We’ll have conversations. You’ll be amazed how much we can figure out together in these conversations, and how much you can grow as a result. I’ll help you figure out how you want to approach each area of your life and help you make the changes you are seeking.

Wednesday, 20 November 2019 12:12

Emerging Adults

  • What am I supposed to be doing with my life?
  • Is this the right career choice?
  • When will I find the relationship I’m looking for?
  • Am I making a difference in the world?
  • How can I pay all my bills on this salary?

If you are an adult in your 20s, asking yourself these soul-searching questions, you are in good company! A time full of promise, hope and possibilities, your 20s—and even into your early 30s—are also a uniquely stressful time in life, full of frustration.

While these decades are a wonderful phase of self discovery, offering up a time for exploring the complex issue of who you are in the world, they hold monumental transitions as well. These transitions can be exhilarating. But just think about the myriad choices and decisions that can leave you feeling anxious and confused, for example:

  • Moving out of your parents’ home
  • Beginning college
  • Moving back into your parents’ home
  • Starting a career
  • Finding a life partner
  • Starting a family

Uncertainty about your future and the feeling of living “in-between” can further contribute to you feeling overwhelmed and alone.

But if you are having these feelings, you are definitely not alone. Jeffrey Arnett, a psychology professor at Clark University, coined the term “emerging adulthood” to identify the 20s as a distinct stage of life. “The 20s are a black box, and there is a lot of churning in there,” says Arnett. “One-third of people in their 20s move to a new residence every year. Forty percent move back home with their parents at least once. They go through an average of seven jobs in their 20s, more job changes than in any other stretch.”

The good news is that this can be a time when the decisions you make lay the foundation for a rich and fulfilling life. You are free to explore who you are, with plenty of room to try new things in both your personal and professional life. It’s even a time when failure can positively shape the career or relationship you will come to embrace over time.

But how do you get through this challenging time? If you need support and guidance along this path, I can help. I can work with you to explore a single aspect of your life with a brief series of conversations, or we can delve deeper. Either way, we explore these complex issues in a safe, neutral and confidential environment so you don’t have to do it alone. Ultimately, we can overcome any obstacles to thriving in your adult life.

Page 2 of 2